Choi Young-Ah
Department of Rehabilitation Medicine, Incheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea.
Cerebrovasc Dis. 2025;54(3):379-388. doi: 10.1159/000539694. Epub 2024 Jun 12.
Many patients with moyamoya disease (MMD) exhibit cognitive decline; however, the link between cognitive reserve (CR) and cognitive function in those who have not undergone revascularization remains unexplored. We aimed to evaluate preoperative cognitive impairment in such patients and to explore the relationship between CR, measured using the Cognitive Reserve Index questionnaire (CRIq), and cognitive abilities across different domains, determined using neuropsychological tests.
Demographic, clinical, CRIq, and neuropsychological assessment data were gathered from patients with MMD who underwent preoperative cognitive functional assessments at our center during 2021-2023. These patients were categorized according to their Montreal Cognitive Assessment score. Multivariable linear regression was performed to analyze the association between CRIq score and cognitive performance, both globally and in specific domains.
In the MMD cohort of 53 patients, 49% (n = 26) of the patients exhibited a decrease in overall cognitive performance. Individuals with cognitive dysfunction had significantly lower composite CRIq scores than those with intact cognition. Although no association between overall cognitive ability and CR was observed, independent associations emerged between CR and specific cognitive functions - language (β = 0.56, p = 0.002), verbal memory (β = 0.45, p = 0.001), and executive function (β = 0.35, p = 0.03).
This preliminary study revealed that expressive language, verbal memory, and executive function are linked to CR in presurgical patients with MMD, highlighting the role of CR in predicting cognitive outcomes. Further research is warranted to elucidate the combined effects of CR and other risk factors on the cognitive function of patients with MMD.
许多烟雾病（MMD）患者存在认知功能下降；然而，未接受血运重建治疗的患者中认知储备（CR）与认知功能之间的联系尚未得到探索。我们旨在评估此类患者术前的认知障碍，并探讨使用认知储备指数问卷（CRIq）测量的CR与通过神经心理学测试确定的不同领域认知能力之间的关系。
收集了2021年至2023年期间在我们中心接受术前认知功能评估的MMD患者的人口统计学、临床、CRIq和神经心理学评估数据。这些患者根据蒙特利尔认知评估得分进行分类。进行多变量线性回归分析，以分析CRIq得分与整体及特定领域认知表现之间的关联。
在53例MMD患者队列中，49%（n = 26）的患者整体认知表现下降。认知功能障碍患者的CRIq综合得分显著低于认知功能正常者。虽然未观察到整体认知能力与CR之间的关联，但CR与特定认知功能之间出现了独立关联——语言（β = 0.56，p = 0.002）、言语记忆（β = 0.45，p = 0.001）和执行功能（β = 0.35，p = 0.03）。
这项初步研究表明，术前MMD患者的表达性语言、言语记忆和执行功能与CR相关，突出了CR在预测认知结果中的作用。有必要进一步研究以阐明CR与其他风险因素对MMD患者认知功能的综合影响。
