Hemodynamic Impairment Measured by Positron-Emission Tomography Is Regionally Associated with Decreased Cortical Thickness in Moyamoya Phenomenon

J J Lee; J S Shimony; H Jafri; A R Zazulia; R G Dacey Jr; G R Zipfel; C P Derdeyn

doi:10.3174/ajnr.A5812

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Hemodynamic Impairment Measured by Positron-Emission Tomography Is Regionally Associated with Decreased Cortical Thickness in Moyamoya Phenomenon

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Hemodynamic Impairment Measured by Positron-Emission Tomography Is Regionally Associated with Decreased Cortical Thickness in Moyamoya Phenomenon

J J Lee, J S Shimony, H Jafri, A R Zazulia, R G Dacey Jr, G R Zipfel and C P Derdeyn

American journal of neuroradiology : AJNR, Vol.39(11), pp.2037-2044

11/2018

DOI: 10.3174/ajnr.A5812

PMCID: PMC7655355

PMID: 30361434

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Abstract

Impaired cerebrovascular reactivity has been associated with decreased cortical thickness in patients with arterial occlusive diseases. This study tests the hypothesis that severe hemodynamic impairment, indicated by increased oxygen extraction fraction ratios on positron-emission tomography with O tracers, is associated with decreased cortical thickness in patients with Moyamoya phenomenon. Patients with unilateral or bilateral idiopathic Moyamoya phenomenon were recruited. Oxygen extraction fraction ratio maps were generated from cerebral images of O[ O] counts divided by H [ O] counts with normalization by corresponding cerebellar counts. The normal range of the oxygen extraction fraction ratio was estimated from historically available healthy control subjects. Cortical thickness was estimated from T1-weighted MR imaging and FreeSurfer. Regional samples of oxygen extraction fraction ratios and cortical thicknesses were drawn using FreeSurfer parcellations, retaining only parcellations from the vascular territory of the middle cerebral artery. Complete MR imaging and PET datasets were available in 35 subjects, including 23 women; the mean age at scanning was 44 years. Patients with Moyamoya phenomenon had a significantly increased regional oxygen extraction fraction ratio compared with 15 healthy control subjects ( < .001). Regional oxygen extraction fraction ratio and age were significant predictors of cortical thickness ( < .001 for each) in a generalized linear mixed-effects model. Using hemisphere averages and patient averages, we found that only age was a significant predictor of cortical thickness ( < .001). Chronic hemodynamic impairment, as indicated by a higher regional oxygen extraction fraction ratio, was significantly predictive of reduced cortical thickness in mixed-effects analysis of FreeSurfer regions. This phenomenon may be related to reversible metabolic down-regulation.

Cerebral Cortex - blood supply

Cerebrovascular Circulation - physiology

Humans

Middle Aged

Cerebral Cortex - pathology

Magnetic Resonance Imaging - methods

Male

Moyamoya Disease - pathology

Positron-Emission Tomography - methods

Hemodynamics - physiology

Cerebral Cortex - diagnostic imaging

Adult

Female

Moyamoya Disease - physiopathology

Moyamoya Disease - diagnostic imaging

Details

Title: Subtitle: Hemodynamic Impairment Measured by Positron-Emission Tomography Is Regionally Associated with Decreased Cortical Thickness in Moyamoya Phenomenon
Creators: J J Lee - From the Mallinckrodt Institute of Radiology (J.J.L., J.S.S., H.J., A.R.Z.) jjlee@wustl.edu
J S Shimony - From the Mallinckrodt Institute of Radiology (J.J.L., J.S.S., H.J., A.R.Z.)
H Jafri - From the Mallinckrodt Institute of Radiology (J.J.L., J.S.S., H.J., A.R.Z.)
A R Zazulia - Departments of Neurology (A.R.Z., G.R.Z.)
R G Dacey Jr - Neurosurgery (R.G.D., G.R.Z.), Washington University, St Louis, Missouri
G R Zipfel - Neurosurgery (R.G.D., G.R.Z.), Washington University, St Louis, Missouri
C P Derdeyn - Department of Radiology (C.P.D.), University of Iowa, Iowa City, Iowa
Resource Type: Journal article
Publication Details: American journal of neuroradiology : AJNR, Vol.39(11), pp.2037-2044
DOI: 10.3174/ajnr.A5812
PMID: 30361434
PMCID: PMC7655355
NLM abbreviation: AJNR Am J Neuroradiol
ISSN: 0195-6108
eISSN: 1936-959X
Publisher: United States
Grant note: TL1 RR024995 / NCRR NIH HHS U54 HD087011 / NICHD NIH HHS KL2 RR024994 / NCRR NIH HHS UL1 RR024992 / NCRR NIH HHS UL1 TR002345 / NCATS NIH HHS P30 NS048056 / NINDS NIH HHS R01 NS051631 / NINDS NIH HHS
Language: English
Date published: 11/2018
Academic Unit: Neurology; Radiology; Iowa Neuroscience Institute; Neurosurgery
Record Identifier: 9984020636502771

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