{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,17]],"date-time":"2026-06-17T14:36:39Z","timestamp":1781706999232,"version":"3.54.5"},"reference-count":9,"publisher":"S. Karger AG","issue":"6","license":[{"start":{"date-parts":[[2022,1,1]],"date-time":"2022-01-01T00:00:00Z","timestamp":1640995200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/www.karger.com\/Services\/SiteLicenses"},{"start":{"date-parts":[[2022,1,1]],"date-time":"2022-01-01T00:00:00Z","timestamp":1640995200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.karger.com\/Services\/SiteLicenses"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Cerebrovasc Dis"],"published-print":{"date-parts":[[2022]]},"abstract":"<b><i>Introduction:<\/i><\/b> Certain studies have observed that patients with moyamoya disease (MMD) have cognitive decline after revascularization. Thus, this study analyzed the relationship between cognitive decline and altered cerebral perfusion after revascularization. <b><i>Methods:<\/i><\/b> Here, 313 adult patients with MMD underwent single unilateral revascularization. First, cognitive function was scored using a Mini-Mental Scale (MMSE) and Montreal cognitive function scale (MoCA) before and 3 months after the operation (superficial temporal artery-middle cerebral artery anastomosis with encephalo-myo-synangiosis). Then, computed tomography perfusion was performed before and 1 week after the operation to assess the cerebral perfusion. <b><i>Results:<\/i><\/b> Our data showed that cognitive function decreased in 55 cases (17.6%) after revascularization. Furthermore, the incidence of cerebral hyperperfusion (CHP) was significantly higher in the cognitive decline group (49\/55) than in the cognitive nondecline group (89.1% vs. 5.4%, <i>p<\/i> &#x3c; 0.001). Results also showed that although all 55 patients had postoperative cognitive decline, 47 experienced relative cerebral blood flow (CBF) decrease at a relatively distant area of the anastomosis compared with that before the operation, which was significantly higher than in patients without cognitive decline (85.5% vs. 1.94%, <i>p<\/i> &#x3c; 0.001). In addition, 41 patients had a simultaneous occurrence of local CHP and paradoxical CBF decrease at a relatively distant anastomosis area, which indicated the incident of watershed shift (WS). As observed, WS occurred in 74.5% of patients with cognitive decline, significantly higher than in patients without cognitive decline (74.5% vs. 0%, <i>p<\/i> &#x3c; 0.0001). Through multiple logistic regression analysis, WS was also observed to be a strong independent risk factor for predicting postoperative cognitive decline 3 months after revascularization (odds ratio 17.780, 95% confidence interval 1.668\u201318.564; <i>p<\/i> = 0.017). <b><i>Conclusion:<\/i><\/b> Therefore, cognitive decline in patients with MMD after revascularization is related to WS, leading to an uneven distribution of CBF. <\/jats:p>","DOI":"10.1159\/000524240","type":"journal-article","created":{"date-parts":[[2022,4,27]],"date-time":"2022-04-27T21:00:36Z","timestamp":1651093236000},"page":"764-773","source":"Crossref","is-referenced-by-count":6,"title":["Association between Cognitive Decline and Altered Cerebral Perfusion in Adults with Moyamoya Disease after Revascularization"],"prefix":"10.1159","volume":"51","author":[{"given":"Yiwen","family":"Bao","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fei","family":"Yu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Liang","family":"Wei","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wenxia","family":"Zhu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lufeng","family":"Wang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hao","family":"Ding","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jie","family":"Yang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dongya","family":"Huang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"127","published-online":{"date-parts":[[2022,4,27]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","DOI":"10.1001\/archneur.1969.00480090076012"},{"key":"ref2","doi-asserted-by":"publisher","DOI":"10.3171\/2016.11.JNS161688"},{"key":"ref3","doi-asserted-by":"publisher","DOI":"10.1161\/STROKEAHA.116.016028"},{"key":"ref4","doi-asserted-by":"publisher","DOI":"10.1159\/000336765"},{"key":"ref5","doi-asserted-by":"publisher","DOI":"10.1620\/tjem.236.45"},{"key":"ref6","doi-asserted-by":"publisher","DOI":"10.1037\/\/0022-006x.67.4.594"},{"key":"ref7","doi-asserted-by":"publisher","DOI":"10.1002\/gps.4539"},{"key":"ref8","doi-asserted-by":"publisher","DOI":"10.1038\/srep32328"},{"key":"ref9","doi-asserted-by":"publisher","DOI":"10.1227\/00006123-198408000-00006"}],"container-title":["Cerebrovascular Diseases"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.karger.com\/Article\/Pdf\/524240","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.karger.com\/Article\/Pdf\/524240","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,4,23]],"date-time":"2025-04-23T15:59:54Z","timestamp":1745423994000},"score":1,"resource":{"primary":{"URL":"https:\/\/karger.com\/article\/doi\/10.1159\/000524240"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022]]},"references-count":9,"journal-issue":{"issue":"6","published-online":{"date-parts":[[2022,12,22]]},"published-print":{"date-parts":[[2023,1,17]]}},"URL":"https:\/\/doi.org\/10.1159\/000524240","archive":["Portico"],"relation":{},"ISSN":["1015-9770","1421-9786"],"issn-type":[{"value":"1015-9770","type":"print"},{"value":"1421-9786","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022]]}}}