Abstract

Objective

This study aims to identify the clinical characteristics of Moyamoya disease (MMD) combined with psychiatric disorders and explore the potential pathogenesis.

Material and Methods

Psychiatric disorders between 88 MMD patients and 72 health controls were investigated using psychological testing scales. We subsequently analyzed the clinical features of 72 MMD patients with psychiatric comorbidities retrospectively. Finally, neurotransmitters analysis was conducted to further explore the pathogenesis.

Results

Results of self-testing scales revealed a significantly higher susceptibility of psychiatric disorders in MMD patients. Compared with MMD group, clinical features of combined group demonstrated significant differences in age (51.3±9.6 vs. 40.9±10.4, p=0.000), gender of female (68.1% vs. 51.3%, p=0.018), duration time (33.3±44.6mon vs. 8.1±15.3mon, p=0.000), cerebral infarction (55.2% vs. 70.8%, p=0.025), initial type, Suzuki stage and mRS scores (p<0.05). The perfusion results revealed significantly decreased time to peak in frontal parietal lobe (1854.14±238.62 vs. 1242.79±115.99, p=0.025), temporal occipital lobe (1721.55±245.15 vs. 1165.71±111.55, p=0.040), lateral ventricle (1840.03±256.88 vs. 1221.95±115.53, p=0.028), and the cerebral blood volume of temporal occipital lobe was found significantly decreased (300.36±34.93 vs. 403.23±19.70, p=0.026), and remarkable lower incidence of hyperperfusion syndrome and subdural effusion were demonstrated. Differential neurotransmitters of decreased 3-htdroxybutyric acid expression and increased sarcosine, tyrosine, betaine aldehyde chloride, kynurenic acid, glycine, succinic acid and lysine were identified in combined group.

Conclusions

Patients of MMD combined with psychiatric disorders presented unique clinical characteristics. Neurotransmitters disorder may be involved in the pathogenesis. These results provided novel clinical management evidence and new insights in pathologic mechanism of MMD combined with psychiatric disorders.

Key words:

Moyamoya disease; Psychiatric disorders; Clinical characteristic; Neurotransmitter