• Akira Nakamizo, Yuichiro Kikkawa, Akio Hiwatashi, Toshio Matsushima, and Tomio Sasaki.
• Department of Neurosurgery, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan. Electronic address: nakamizo@ns.med.kyushu-u.ac.jp.
• J Stroke Cerebrovasc Dis. 2014 Mar 1;23(3):457-61.

BackgroundCognitive impairment is a frequent complication of moyamoya disease (MMD) in adults. Chronic hypoperfusion in frontal lobes can lead to subtle brain injury, resulting in cognitive dysfunctions. Apparent diffusion coefficient (ADC) in normal-appearing white matter on conventional magnetic resonance imaging correlates with cerebral hemodynamics in the frontal lobe.ObjectiveThe purpose of this study was to examine the relationship of ADC with executive function in patients with MMD.MethodsThirty-one patients (25 women and 6 men; mean age, 32.6 ± 10.4 years) were included in this study. Executive function was evaluated by the Frontal Assessment Battery (FAB) at 21.5 ± 7.5 years after disease onset. ADC was measured in the normal-appearing frontal white matter.ResultsADC was statistically related to the occurrence of executive dysfunction in multivariate analysis (P = .0179). Total FAB score and ADC were negatively correlated (r(2) = .22; P = .0072; Spearman correlation coefficient, -.41; P = .024). Elevated ADC predicted executive dysfunction (area under the receiver operating characteristic curve, .73; 95% confidence interval, .55-.91; P = .029).ConclusionsThe association of ADC with executive function might suggest that ADC is useful in screening for executive dysfunction during follow-up in the outpatient setting.Copyright © 2014 National Stroke Association. Published by Elsevier Inc. All rights reserved.

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