Chinese Journal of Contemporary Neurology and Neurosurgery ›› 2022, Vol. 22 ›› Issue (9): 805-809. doi: 10.3969/j.issn.1672-6731.2022.09.010

• Clinical Study • Previous Articles     Next Articles

Impact of superficial temporal artery-middle cerebral artery bypass combined with encephalo-myo-synangiosis on cognitive function in patients with moyamoya disease

SONG Yun-fei, ZHAO Yan, JIA Xiao-dan, SUN Chao, YANG Shu-yuan, YANG Xin-yu   

  1. Department of Neurosurgery, Tianjin Medical University General Hospital, Tianjin 300052, Chin
  • Received:2022-09-14 Online:2022-09-25 Published:2022-10-10
  • Supported by:
    This study was supported by Science and Technology Plan Project of Tianjin (No. 20JCZDJC00300), and Tianjin Medical University Clinical Research Program (No. 2018kylc008).

颞浅动脉-大脑中动脉搭桥术联合脑-颞肌贴敷术对烟雾病患者认知功能的影响

宋云飞, 赵岩, 贾晓丹, 孙超, 杨树源, 杨新宇   

  1. 300052 天津医科大学总医院神经外科
  • 通讯作者: 杨新宇,Email:yangxinyu@tmu.edu.cn
  • 基金资助:
    天津市科技计划项目(项目编号:20JCZDJC00300);天津医科大学临床课题(项目编号:2018kylc008)

Abstract: Objective To evaluate the improvement of superficial temporal artery-middle cerebral artery (STA-MCA) bypass combined with encephalo-myo-synangiosis (EMS) on cognitive function in patients with moyamoya disease (MMD). Methods Total 37 patients with MMD treated with STA-MCA + EMS in Tianjin Medical University General Hospital from July 2017 to June 2020 were reviewed. Mini-Mental State Examination (MMSE), Auditory Verbal Learning Test (AVLT), Trail Making Test-A (TMT-A), Trail Making Test-B (TMT-B), Verbal Fluency Test (VFT) and Rey-Osterrieth Complex Figure Test (ROCFT) were used to evaluate overall cognitive function, memory, attention, executive function, language function and visuospatial function in all patients one week before surgery and 6 months after surgery. Results Compared with one week before surgery, the MMSE score[24 (23, 26) score vs. 25.00 (23.50, 27.00) score; Z=-4.201, P=0.000] and ROCFT score[28 (23, 30) score vs. 31.00 (28.50, 32.00) score; Z=-3.968, P=0.004] increased, while the TMT-A test[69.00 (56.00, 87.50) s vs. 42 (37, 48) s; Z=-5.144, P=0.002] and TMT-B test[177 (168, 190) s vs. 138 (133, 144) s; Z=-5.309, P=0.001] decreased at 6 months after surgery. There was no statistic difference of AVLT-1R (Z=-1.595, P=0.113), AVLT-5R (Z=-1.573, P=0.121) and VFT (Z=-1.616, P=0.124) before and after surgery. Conclusions STA-MCA + EMS can improve the overall cognitive function, attention, executive function and visuospatial ability of patients with MMD, but has no significant effect on short-term memory, long-term memory and language function, and can improve cognitive function and the quality of life.

Key words: Moyamoya disease, Cerebral revascularization, Cognition disorders, Neuropsychological tests

摘要: 目的 探讨颞浅动脉-大脑中动脉(STA-MCA)搭桥术联合脑-颞肌贴敷术(EMS)对烟雾病患者认知功能的改善作用。方法 纳入2017年7月至2020年6月在天津医科大学总医院行STA-MCA搭桥术+EMS的37例烟雾病患者,分别于术前1周和术后6个月采用简易智能状态检查量表(MMSE)评估整体认知功能、听觉词汇学习测验(AVLT)评估记忆力、连线测试A (TMT-A)评估注意力、连线测试B (TMT-B)评估执行功能、词语流畅性测验(VFT)评估语言功能、Rey-Osterrieth复杂图形测验(ROCFT)评估视空间能力。结果 与术前1周相比,术后6个月时MMSE[24(23,26)分对25.00(23.50,27.00)分;Z=-4.201,P=0.000]和ROCFT[28(23,30)分对31.00(28.50,32.00)分;Z=-3.968,P=0.004]评分增加,TMT-A[69.00(56.00,87.50) s对42(37,48) s;Z=-5.144,P=0.002]和TMT-B[177(168,190) s对138(133,144) s;Z=-5.309,P=0.001]完成时间缩短;手术前后AVLT-1R (Z=-1.595,P=0.113)、AVLT-5R (Z=-1.573,P=0.121)和VFT (Z=-1.616,P=0.124)评分差异无统计学意义。结论 STA-MCA搭桥术+EMS可以改善烟雾病患者整体认知功能、注意力、执行功能和视空间能力,而对短时记忆、长时记忆和语言功能无明显作用,可以一定程度改善认知功能,提高生活质量。

关键词: 脑底异常血管网病, 脑血管重建术, 认知障碍, 神经心理学测验