• Sara Yasuda, Yasukazu Katakura, Yoshitaka Kubo, Kazumasa Dobashi, Kazuto Kimura, Shunrou Fujiwara, Kohei Chida, Yosuke Akamatsu, Masakazu Kobayashi, Kenji Yoshida, Kazunori Terasaki, and Kuniaki Ogasawara.
• Department of Neurosurgery, Iwate Medical University School of Medicine, Yahaba, Japan.
• World Neurosurg. 2022 Aug 1; 164: e1135-e1142.

ObjectiveBrain 123I-iomazenil single-photon emission computed tomography (SPECT) can assess the distribution of the binding potential of central benzodiazepine receptors in the cerebral cortex. This binding potential may reflect neuronal function in viable tissues. The present prospective study using brain 123I-iomazenil SPECT aimed to determine whether improvements in cognitive function after indirect revascularization surgery alone are associated with postoperative recovery in neurotransmitter receptor function in the affected cerebral hemisphere among adult patients with moyamoya disease accompanied by ischemic presentation due to misery perfusion.MethodsTwenty-two patients who underwent indirect revascularization surgery alone also underwent brain SPECT scanning at 180 minutes after 123I-iomazenil administration and neuropsychological testing before and at 6 months after surgery. The affected-to-contralateral cerebral hemispheric asymmetry of tracer uptake before and after surgery was then calculated.ResultsThe asymmetry of tracer uptake was significantly increased after surgery (P < 0.0001). A significant difference between the preoperative and postoperative asymmetry of tracer uptake was seen in patients with improved cognition compared with those with unchanged cognition (P = 0.0001). The area under the receiver operating characteristic curve was 0.99 for the difference between the preoperative and postoperative asymmetry of tracer uptake to assess the ability to discriminate patients with improved cognition from those with unchanged cognition.ConclusionsImprovements in cognitive function after indirect revascularization surgery alone are associated with postoperative recovery in the binding potential of central benzodiazepine receptors in the affected cerebral hemisphere in adult patients with moyamoya disease accompanied by ischemic presentation due to misery perfusion.Copyright © 2022 Elsevier Inc. All rights reserved.

27 keywords...

hide…