{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,8]],"date-time":"2026-10-08T00:42:28Z","timestamp":1791420148736,"version":"4.3.3"},"reference-count":71,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2024,3,21]],"date-time":"2024-03-21T00:00:00Z","timestamp":1710979200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Psychiatry"],"abstract":"<jats:sec><jats:title>Introduction<\/jats:title><jats:p>Moyamoya disease (MMD) is a life-threatening condition characterized by stenosis of intracranial arteries. Despite the frequency and the impact of psychiatric symptoms on the long-term prognosis and quality of life of MMD patients, no systematic review on this topic exists.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This systematic review and meta-analysis included 41 studies (29 being case reports), from PubMed, Scopus, Embase until 27\/3\/2023, on MMD patients exhibiting psychiatric symptoms.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Despite a fair average quality of the articles, quantitative synthesis through logistic regression was possible only for case reports, due to heterogeneity between the other studies. Psychosis, the most frequent psychiatric symptom reported in case reports, was more frequent in MMD patients with left hemisphere involvement. Neurological symptoms occurrence increased the odds of MMD diagnosis preceding psychiatric symptoms. Psychiatric symptoms are highly prevalent in MMD patients and are relatively often the only presenting symptoms.<\/jats:p><\/jats:sec><jats:sec><jats:title>Discussion<\/jats:title><jats:p>We discuss the diagnostic, therapeutic, and prognostic implications of recognizing and characterizing specific psychiatric symptoms in MMD, outlining preliminary guidelines for targeted pharmacological and psychotherapeutic interventions. Lastly, we outline future research and clinical perspectives, striving to enhance the oft-overlooked psychiatric care for MMD patients and to ameliorate their long-term outcome.<\/jats:p><\/jats:sec><jats:sec><jats:title>Systematic Review Registration<\/jats:title><jats:p><jats:uri>https:\/\/www.crd.york.ac.uk\/PROSPERO\/<\/jats:uri>, identifier CRD42023406303.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fpsyt.2024.1371763","type":"journal-article","created":{"date-parts":[[2024,3,22]],"date-time":"2024-03-22T08:42:13Z","timestamp":1711096933000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":6,"title":["Psychiatric manifestations in moyamoya disease: more than a puff of smoke? a systematic review and a case-reports meta-analysis"],"prefix":"10.3389","volume":"15","author":[{"given":"Luigi F.","family":"Saccaro","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cl\u00e9ment","family":"Mallet","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexandre","family":"Wullschleger","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michel","family":"Sab\u00e9","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2024,3,21]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","DOI":"10.2147\/TACG","article-title":"Moyamoya disease and syndromes: from genetics to clinical management","volume":"49","author":"Kossorotoff","year":"2015","journal-title":"TACG"},{"key":"B2","doi-asserted-by":"publisher","DOI":"10.1093\/neuros\/nyaa284","article-title":"Clinical course of unilateral moyamoya disease","volume":"87","author":"Church","year":"2020","journal-title":"Neurosurgery"},{"key":"B3","doi-asserted-by":"publisher","DOI":"10.1016\/S0090-3019(96)00358-8","article-title":"CURRENT STATE OF STUDY ON MOYAMOYA DISEASE IN JAPAN","volume":"47","author":"Fukui","year":"1997","journal-title":"Surg Neural"},{"key":"B4","doi-asserted-by":"publisher","first-page":"1","DOI":"10.2176\/nmc.47.1","article-title":"Histological features of middle cerebral arteries from patients treated for Moyamoya disease","volume":"47","author":"Takagi","year":"2007","journal-title":"Neurol Med Chir (Tokyo)"},{"key":"B5","article-title":"Moyamoya disease and Down syndrome: case report and review of the literature","volume":"102","author":"de Borchgrave","year":"2002","journal-title":"Acta Neurol Belg"},{"key":"B6","doi-asserted-by":"publisher","DOI":"10.3892\/etm","article-title":"Epidemiology, diagnosis and treatment of moyamoya disease","volume":"17","author":"Zhang","year":"2019","journal-title":"Exp Ther Med"},{"key":"B7","doi-asserted-by":"publisher","DOI":"10.7759\/cureus.10994","article-title":"Moyamoya: an update and review","volume":"12","author":"Berry","year":"2020","journal-title":"Cureus"},{"key":"B8","article-title":"Something hazy drifting in the air","volume-title":"Archives of disease in childhood - 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