Correlation Analysis of Middle Cerebral Artery Stenosis and Enlarged Perivascular Space in Patients with Moyamoya Disease
Guangsong Han1, Yuehui Hong2, Dingding Zhang2, Xiaoyuan Fan2, Ming Yao2, Jun Ni2
1Medical Research Center, State Key laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, 2Peking Union Medical College Hospital
Objective:

To explore the correlation between the MCA stenosis and the CSO-EPVS in patients with MMD and whether brain atrophy plays a mediating role.

Background:

Moyamoya disease (MMD) is a nonatherosclerotic cerebrovascular structural abnormality. Previous studies have found that central semiovale Enlarged enlarged perivascular spaces (CSO-EPVS) are associated with decreased regional cerebral blood flow in MMD patients, but the specific mechanism remains unclear.

Design/Methods:

177 patients from 2017 to 2022 were consecutively enrolled in this single-center Moyamoya disease cohort. All 354 MCAs were divided into three groups according to the severity of MCA on the MRA: no stenosis, mild or moderate stenosis, and severe stenosis or occlusion. The correlation between cerebral hemisphere volume, MCA stenosis and CSO-EPVS was analyzed, and the confounding factors including age, gender and hypertension were adjusted.

Results:

MCA stenosis was significantly associated with CSO-EPVS (no stenosis vs mild or moderate stenosis: 95%CI [0.954, 4.473], P=0.000; no stenosis vs severe stenosis or occlusion: 95%CI [4.419, 9.586], P=0.000). Cerebral hemisphere volume was correlated with CSO-EPVS (no stenosis vs mild or moderate stenosis: 95%CI [-0.824, 0.414], P=0.047; no stenosis vs severe stenosis or occlusion: 95%CI [-1.051, 4.431], P=0.018), but there was no significant correlation between MCA stenosis and the hemisphere volume (no stenosis vs mild or moderate stenosis: 95%CI [-0.097, 0.123], P=0.434; no stenosis vs. severe stenosis or occlusion: 95%CI [-1.012, 1.210], P=0.403). Mediating variable analysis showed that hemisphere volume had no mediating effect in the correlation between the MCA stenosis and CSO-EPVS (no stenosis vs mild or moderate stenosis: 95%CI [-0.039, 0.329], P=0.910; no stenosis vs severe stenosis or occlusion: 95%CI [-0.118, 0.106], P=0.350).

Conclusions:

Our study shows the association between the MCA stenosis and CSO-EPVS without brain atrophy as a mediator, highlighting the potential correlation between large artery stenosis and small cerebral vessel.

10.1212/WNL.0000000000204129