{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T19:05:52Z","timestamp":1790708752953,"version":"4.1.0"},"reference-count":30,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T00:00:00Z","timestamp":1790640000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T00:00:00Z","timestamp":1790640000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/100000050","name":"National Heart, Lung, and Blood Institute","doi-asserted-by":"publisher","award":["K23HL155898"],"award-info":[{"award-number":["K23HL155898"]}],"id":[{"id":"10.13039\/100000050","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Develop Med Child Neuro"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Aim<\/jats:title>\n                    <jats:p>To evaluate the feasibility of a stepwise, non\u2010invasive screening framework integrating blood pressure measurement with transcranial Doppler ultrasonography.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Method<\/jats:title>\n                    <jats:p>In this prospective single\u2010site cohort study, 793 individuals with Down syndrome aged 8 to 26\u2009years underwent standardized blood pressure assessment. Comparisons with National Health and Nutrition Examination Survey 2017\u20132018 were restricted to participants aged 8\u2009years to younger than 18\u2009years and performed using survey\u2010weighted regression. A smaller cohort of 111 participants underwent repeat blood pressure assessment, awake transcranial Doppler ultrasonography, and confirmatory magnetic resonance imaging\/angiography.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Among 988 screened participants, 793 were enrolled (mean age 16\u2009years 7\u2009months [SD 4\u2009years 6\u2009months]; 414 females, 378 males, and one participant of unknown sex). Mean systolic blood pressure centile was 44.7 in Down syndrome and 42.6 in the comparison cohort (difference 2.07 points, 95% confidence interval [CI] \u22121.12 to 5.26;\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0=\u00a00.200). Diastolic blood pressure centile was higher in Down syndrome (difference 12.21 points, 95% CI 8.88\u201315.53;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001). Of the 111 participants who completed transcranial Doppler ultrasonography, 10 required repeat acquisition. Higher blood pressure was associated with higher mean middle cerebral artery velocity (75.5 vs 65.7\u2009cm\/s;\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0=\u00a00.006). Imaging identified asymptomatic moyamoya syndrome in four participants.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Interpretation<\/jats:title>\n                    <jats:p>A stepwise approach incorporating blood pressure and transcranial Doppler ultrasonography is feasible for cerebrovascular surveillance in Down syndrome. These findings support development of scalable screening strategies and warrant multicenter validation.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/dmcn.70552","type":"journal-article","created":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T18:19:26Z","timestamp":1790705966000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Blood pressure and transcranial ultrasound predict moyamoya vasculopathy in Down syndrome"],"prefix":"10.1111","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8350-8234","authenticated-orcid":false,"given":"Jonathan D.","family":"Santoro","sequence":"first","affiliation":[{"name":"Division of Neurology, Department of Pediatrics Children's Hospital Los Angeles  Los Angeles CA USA"},{"name":"Department of Neurology Keck School of Medicine of the University of Southern California  Los Angeles CA 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