{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,23]],"date-time":"2026-10-23T20:27:59Z","timestamp":1792787279883,"version":"4.5.0"},"reference-count":30,"publisher":"BMJ","issue":"3","license":[{"start":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T00:00:00Z","timestamp":1790640000000},"content-version":"unspecified","delay-in-days":28,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"name":"Department of Science and Technology of Jiangxi province","award":["20202BBGL73040"],"award-info":[{"award-number":["20202BBGL73040"]}]},{"name":"Department of Science and Technology of Jiangxi province","award":["20212BAG70012"],"award-info":[{"award-number":["20212BAG70012"]}]},{"DOI":"10.13039\/501100010857","name":"Jiangxi Provincial Department of Science and Technology","doi-asserted-by":"publisher","award":["20202BBEL53005"],"award-info":[{"award-number":["20202BBEL53005"]}],"id":[{"id":"10.13039\/501100010857","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100010857","name":"Jiangxi Provincial Department of Science and Technology","doi-asserted-by":"publisher","award":["20202BBGL73040"],"award-info":[{"award-number":["20202BBGL73040"]}],"id":[{"id":"10.13039\/501100010857","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100010857","name":"Jiangxi Provincial Department of Science and Technology","doi-asserted-by":"publisher","award":["20212BAG70012"],"award-info":[{"award-number":["20212BAG70012"]}],"id":[{"id":"10.13039\/501100010857","id-type":"DOI","asserted-by":"publisher"}]},{"name":"National Clinical Research Center for Geriatrics","award":["2021ZDG02001"],"award-info":[{"award-number":["2021ZDG02001"]}],"id":[{"id":"https:\/\/ror.org\/03ddkvp86","id-type":"ROR","asserted-by":"crossref"}]},{"name":"Key R&D Program of jiangxi Provincial Department of Science and Technology","award":["No. 20202BBGL73040 and 20202BBEL53005"],"award-info":[{"award-number":["No. 20202BBGL73040 and 20202BBEL53005"]}],"id":[{"id":"https:\/\/ror.org\/00t30yz20","id-type":"ROR","asserted-by":"crossref"}]},{"name":"Ministry of Science and Technology of the People\u2019s Republic of China","award":["2020YFC2005800"],"award-info":[{"award-number":["2020YFC2005800"]}],"id":[{"id":"https:\/\/ror.org\/027s68j25","id-type":"ROR","asserted-by":"crossref"}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["bmjph"],"accepted":{"date-parts":[[2026,7,7]]},"published-print":{"date-parts":[[2026,9]]},"abstract":"<jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Moyamoya disease (MMD) has been reported to be continuously increasing in China, with Jiangxi Province having the highest incidence nationwide. However, limited by data sources, national survey results have difficulty accurately reflecting the true incidence of MMD, indicating that detailed epidemiological data for this highest incidence province remain unavailable.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We extracted medical records of MMD patients from 210 secondary and tertiary hospitals in Jiangxi Province from 2015 to July 2022. Spatiotemporal analysis was adopted to explore the spatial and temporal patterns and hospital burden of MMD in different counties and municipalities of Jiangxi Province.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      A total of 18\u2009693 hospitalisation records were included in this study, of which 11\u2009140 were new-onset patients. The average annual incidence during 2015\u20132022 was 3.36 per 100\u2009000 residents, with an average annual prevalence of 5.65 per 100\u2009000 residents. The incidence exhibited a clustered regional distribution pattern (\n                      <jats:italic>Moran\u2019s I=0.51, Z-score=8.14, p&lt;0.001<\/jats:italic>\n                      ). The peak incidence and prevalence occurred in adults aged 51\u201355 years. Common comorbidities included hypertension (36.4%), diabetes (11.1%) and hyperlipidaemia (6.2%). The mean annual hospitalisation cost was approximately CNY 29,409, with basic medical insurance covering about 67% of payment methods.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>This study is the first to comprehensively characterise the epidemiological characteristics and hospital burden of MMD in the highest incidence province of China. Our findings contribute to the development of effective public health policies, may provide novel insights into the aetiology of MMD and reduce the burden of MMD.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjph-2024-002339","type":"journal-article","created":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T17:20:42Z","timestamp":1790702442000},"page":"e002339","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Spatiotemporal distribution and clinical manifestations of moyamoya disease in Jiangxi Province, China: a retrospective hospital-based study"],"prefix":"10.1136","volume":"4","author":[{"given":"Xinlei","family":"Yang","sequence":"first","affiliation":[{"name":"Department of Biobank Center, The Second Affiliated Hospital, Jiangxi Medical College, Nanchang University, Nanchang, Jiangxi, China"},{"name":"School of Basic Medical Sciences, Jiangxi Medical College, Nanchang University, Nanchang, Jiangxi, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhou","family":"Xu","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine, The Second Affiliated Hospital, Jiangxi Medical College, Nanchang University, Nanchang, Jiangxi, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuan","family":"Xu","sequence":"additional","affiliation":[{"name":"Department of Medical Big Data Center, The Second Affiliated Hospital, Jiangxi Medical College, Nanchang University, Nanchang, Jiangxi, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Huan","family":"Wan","sequence":"additional","affiliation":[{"name":"The Second Clinical Medical College, Jiangxi Medical College, Nanchang University, Nanchang, Jiangxi, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ping","family":"Hu","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, The Second Affiliated Hospital, Jiangxi Medical College, Nanchang University, Nanchang, Jiangxi, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuan","family":"Jiang","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine, The Second Affiliated Hospital, Jiangxi Medical College, Nanchang University, Nanchang, Jiangxi, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tengfeng","family":"Yan","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, The Second Affiliated Hospital, Jiangxi Medical College, Nanchang University, Nanchang, Jiangxi, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Long","family":"Jiang","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine, The Second Affiliated Hospital, Jiangxi Medical College, Nanchang University, Nanchang, Jiangxi, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6767-9570","authenticated-orcid":false,"given":"Xingen","family":"Zhu","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, The Second Affiliated Hospital, Jiangxi Medical College, Nanchang University, Nanchang, Jiangxi, China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2026,9,29]]},"reference":[{"key":"2026092910202915000_4.3.e002339.1","doi-asserted-by":"publisher","DOI":"10.1016\/S1474-4422(22)00165-X"},{"key":"2026092910202915000_4.3.e002339.2","doi-asserted-by":"crossref","first-page":"292","DOI":"10.2174\/1570159X19666210716114016","article-title":"Progression in Moyamoya Disease: Clinical Features","volume":"20","author":"Zhang","year":"2022","journal-title":"Neuroimaging Evaluation, and Treatment Current Neuropharmacology"},{"key":"2026092910202915000_4.3.e002339.3","doi-asserted-by":"crossref","first-page":"S1","DOI":"10.1016\/S0303-8467(97)00031-0","article-title":"Epidemiological features of moyamoya disease in Japan: findings from a nationwide survey","volume":"99 Suppl 2","author":"Wakai","year":"1997","journal-title":"Clin Neurol Neurosurg"},{"key":"2026092910202915000_4.3.e002339.4","doi-asserted-by":"publisher","DOI":"10.1161\/STROKEAHA.107.490714"},{"key":"2026092910202915000_4.3.e002339.5","doi-asserted-by":"publisher","DOI":"10.1016\/j.clineuro.2009.11.009"},{"key":"2026092910202915000_4.3.e002339.6","doi-asserted-by":"crossref","first-page":"e917","DOI":"10.1016\/j.wneu.2018.10.175","article-title":"Epidemiology of Moyamoya Disease in China: Single-Center, Population-Based Study","volume":"122","author":"Bao","year":"2019","journal-title":"World Neurosurg"},{"key":"2026092910202915000_4.3.e002339.7","article-title":"Epidemiology of Moyamoya disease in China: A nationwide hospital-based study","volume":"18","author":"Zhang","year":"2022","journal-title":"Lancet Reg Health West Pac"},{"key":"2026092910202915000_4.3.e002339.8","doi-asserted-by":"publisher","DOI":"10.1136\/svn-2021-000909"},{"key":"2026092910202915000_4.3.e002339.9","doi-asserted-by":"publisher","DOI":"10.1053\/j.gastro.2021.09.043"},{"key":"2026092910202915000_4.3.e002339.10","doi-asserted-by":"crossref","DOI":"10.1002\/rmv.2382","article-title":"Norovirus outbreaks in China, 2000-2018: A systematic review","volume":"32","author":"Yu","year":"2022","journal-title":"Rev Med Virol"},{"key":"2026092910202915000_4.3.e002339.11","doi-asserted-by":"crossref","DOI":"10.3389\/fnut.2022.827093","article-title":"A County-Level Spatial Study of Serum Selenoprotein P and Keshan Disease","volume":"9","author":"Jia","year":"2022","journal-title":"Front Nutr"},{"key":"2026092910202915000_4.3.e002339.12","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pntd.0009996","article-title":"Prevalence and spatial distribution characteristics of human echinococcosis in China","volume":"15","author":"Wang","year":"2021","journal-title":"PLoS Negl Trop Dis"},{"key":"2026092910202915000_4.3.e002339.13","doi-asserted-by":"crossref","DOI":"10.3390\/ijerph14040416","article-title":"Spatio-Temporal Pattern and Risk Factor Analysis of Hand, Foot and Mouth Disease Associated with Under-Five Morbidity in the Beijing-Tianjin-Hebei Region of China","volume":"14","author":"Xu","year":"2017","journal-title":"Int J Environ Res Public Health"},{"key":"2026092910202915000_4.3.e002339.14","doi-asserted-by":"crossref","first-page":"873754","DOI":"10.3389\/fpubh.2022.873754","article-title":"Spatio\u2013temporal variation on syphilis from 2005 to 2018 in Zhejiang Province, China","volume":"10","author":"Zhu","year":"2022","journal-title":"Front Public Health"},{"key":"2026092910202915000_4.3.e002339.15","doi-asserted-by":"publisher","DOI":"10.1161\/STROKEAHA.113.004273"},{"key":"2026092910202915000_4.3.e002339.16","doi-asserted-by":"crossref","first-page":"1973","DOI":"10.1161\/STROKEAHA.119.024689","article-title":"Characteristics of Moyamoya Disease Based on National Registry Data in Japan","volume":"50","author":"Sato","year":"2019","journal-title":"Stroke"},{"key":"2026092910202915000_4.3.e002339.17","doi-asserted-by":"crossref","first-page":"105719","DOI":"10.1016\/j.clineuro.2020.105719","article-title":"Socioeconomic and demographic disparities of moyamoya disease in the United States","volume":"192","author":"Ghaffari-Rafi","year":"2020","journal-title":"Clin Neurol Neurosurg"},{"key":"2026092910202915000_4.3.e002339.18","doi-asserted-by":"crossref","first-page":"2446","DOI":"10.1111\/ene.14439","article-title":"Moyamoya disease in a European setting: a Danish population-based study","volume":"27","author":"Birkeland","year":"2020","journal-title":"Eur J Neurol"},{"key":"2026092910202915000_4.3.e002339.19","doi-asserted-by":"publisher","DOI":"10.1161\/STROKEAHA.113.004160"},{"key":"2026092910202915000_4.3.e002339.20","doi-asserted-by":"crossref","first-page":"371","DOI":"10.1007\/s10143-018-0994-5","article-title":"Progress in moyamoya disease","volume":"43","author":"Shang","year":"2020","journal-title":"Neurosurg Rev"},{"key":"2026092910202915000_4.3.e002339.21","doi-asserted-by":"publisher","DOI":"10.1136\/jnnp.2007.130666"},{"key":"2026092910202915000_4.3.e002339.22","doi-asserted-by":"crossref","DOI":"10.1186\/s40249-020-00764-6","article-title":"Spatial and spatio-temporal analysis of malaria cases in Zimbabwe","volume":"9","author":"Gwitira","year":"2020","journal-title":"Infect Dis Poverty"},{"key":"2026092910202915000_4.3.e002339.23","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pone.0083605","article-title":"Space-Time Clustering Characteristics of Tuberculosis in China, 2005-2011","volume":"8","author":"Zhao","year":"2013","journal-title":"PLoS ONE"},{"key":"2026092910202915000_4.3.e002339.24","doi-asserted-by":"crossref","DOI":"10.1186\/1476-072X-6-42","article-title":"Using geographic information systems and spatial and space-time scan statistics for a population-based risk analysis of the 2002 equine West Nile epidemic in six contiguous regions of Texas","volume":"6","author":"Lian","year":"2007","journal-title":"Int J Health Geogr"},{"key":"2026092910202915000_4.3.e002339.25","doi-asserted-by":"crossref","first-page":"1254","DOI":"10.1161\/STROKEAHA.123.044693","article-title":"Incidence and Outcomes of Posterior Circulation Involvement in Moyamoya Disease","volume":"55","author":"Tigchelaar","year":"2024","journal-title":"Stroke"},{"key":"2026092910202915000_4.3.e002339.26","doi-asserted-by":"crossref","DOI":"10.1161\/SVIN.123.001176","article-title":"Prevalence of Systemic Hypertension and the Effects of Cerebral Revascularization in Patients With Moyamoya Disease","volume":"4","author":"Lee","year":"2024","journal-title":"SVIN"},{"key":"2026092910202915000_4.3.e002339.27","doi-asserted-by":"crossref","first-page":"2472","DOI":"10.1161\/STROKEAHA.120.030027","article-title":"Modifiable Risk Factors Associated With Moyamoya Disease: A Case-Control Study","volume":"51","author":"Ge","year":"2020","journal-title":"Stroke"},{"key":"2026092910202915000_4.3.e002339.28","doi-asserted-by":"crossref","unstructured":"Wang Y , Zhang Z , Wang X , et al . Validation and Extension Study Exploring the Role of RNF213. J Stroke Cerebrovasc Dis 2021;30. doi:10.1016\/j.jstrokecerebrovasdis.2021.106071","DOI":"10.1016\/j.jstrokecerebrovasdis.2021.106071"},{"key":"2026092910202915000_4.3.e002339.29","first-page":"722","article-title":"Moyamoya Disease: Pathophysiology, Diagnosis, and Treatment","volume":"122","author":"Mertens","year":"2025","journal-title":"Dtsch Arztebl Int"},{"key":"2026092910202915000_4.3.e002339.30","doi-asserted-by":"publisher","DOI":"10.1016\/j.wneu.2021.11.026"}],"container-title":["BMJ Public Health"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bmjph-2024-002339","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T17:20:47Z","timestamp":1790702447000},"score":1,"resource":{"primary":{"URL":"https:\/\/bmjpublichealth.bmj.com\/lookup\/doi\/10.1136\/bmjph-2024-002339"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,9]]},"references-count":30,"journal-issue":{"issue":"3","published-online":{"date-parts":[[2026,9,29]]},"published-print":{"date-parts":[[2026,9]]}},"alternative-id":["10.1136\/bmjph-2024-002339"],"URL":"https:\/\/doi.org\/10.1136\/bmjph-2024-002339","relation":{},"ISSN":["2753-4294"],"issn-type":[{"value":"2753-4294","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,9]]}}}