成人烟雾病脑血管重建术后的神经认知表现
Neurocognitive Performance After Cerebral Revascularization in Adult Moyamoya Disease.
作者信息
Zeifert Penelope D, Karzmark Peter, Bell-Stephens Teresa E, Steinberg Gary K, Dorfman Leslie J
机构信息
From the Department of Neurology and Neurological Sciences (P.D.Z., P.K., G.K.S., L.J.D.), Department of Neurosurgery (P.D.Z., T.E.B.-S., G.K.S.), and Neuropsychology Service (P.D.Z., P.K.), Stanford Stroke Center, Stanford University Medical Center, CA.
出版信息
Stroke. 2017 Jun;48(6):1514-1517. doi: 10.1161/STROKEAHA.116.016028. Epub 2017 May 9.
BACKGROUND AND PURPOSE
Cerebral revascularization using EC-IC bypass is widely used to treat moyamoya disease, but the effects of surgery on cognition are unknown. We compared performance on formal neurocognitive testing in adults with moyamoya disease before and after undergoing direct EC-IC bypass.
METHODS
We performed a structured battery of 13 neurocognitive tests on 84 adults with moyamoya disease before and 6 months after EC-IC bypass. The results were analyzed using reliable change indices for each test, to minimize test-retest variability and practice effects.
RESULTS
Twelve patients (14%) showed significant decline postoperatively, 9 patients (11%) improved, and 63 patients (75%) were unchanged. Similar results were obtained when the analysis was confined to those who underwent unilateral (33) or bilateral (51) revascularization.
CONCLUSIONS
The majority of patients showed neither significant decline nor improvement in neurocognitive performance after EC-IC bypass surgery. Uncomplicated EC-IC bypass seems not to be a risk factor for cognitive decline in this patient population.
背景与目的
采用颅外-颅内血管搭桥术进行脑血运重建广泛应用于烟雾病的治疗，但手术对认知功能的影响尚不清楚。我们比较了烟雾病成人患者在接受直接颅外-颅内血管搭桥术前后进行正规神经认知测试的表现。
方法
我们对84例烟雾病成人患者在颅外-颅内血管搭桥术前和术后6个月进行了一组包含13项神经认知测试的结构化测试。使用每项测试的可靠变化指数对结果进行分析，以尽量减少重测变异性和练习效应。
结果
12例患者（14%）术后表现出显著下降，9例患者（11%）有所改善，63例患者（75%）无变化。当分析仅限于接受单侧（33例）或双侧（51例）血运重建的患者时，得到了类似的结果。
结论
大多数患者在颅外-颅内血管搭桥术后神经认知表现既无显著下降也无改善。在该患者群体中，单纯的颅外-颅内血管搭桥术似乎不是认知功能下降的危险因素。
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