Moyamoya Disease Clinical Trial
— NRAAMUSOfficial title:
Neurocognitive and Radiological Assessments in Adult Patients With Moyamoya Disease Undergoing Surgical Revascularization
Adult patients with moyamoya disease (MMD) are reported to suffer from considerable
impairment of executive function/attention. Although reduced cerebrovascular reserve (CVR) in
frontal areas has been detected by perfusion MRI and then confirmed to be associated with
executive dysfunction in adult MMD, the structural and functional changes is still unclear
with progression of executive dysfunction. Furthermore, it is very important to study the
association between the neurocognitive and radiological improvement after surgical
revascularization, so as to help detecting cerebral regions which are involved in executive
deterioration or improvement after surgery. Then the investigators can determine whether
these regions can be used as indicators to decide rational therapeutic schedule and timing of
adult MMD with executive dysfunction.
Thus the aim of this study is to primarily find out the neuropsychological and radiological
correlates in adult MMD, and then to quantitatively evaluate the effectiveness of surgical
revascularization in prevention of executive dysfunction in adult MMD.
Status | Recruiting |
Enrollment | 80 |
Est. completion date | May 2018 |
Est. primary completion date | April 2018 |
Accepts healthy volunteers | Accepts Healthy Volunteers |
Gender | All |
Age group | 18 Years to 80 Years |
Eligibility |
Inclusion Criteria: - Right-handed Chinese people aged over 18 years - No evidence of recent or remote infarct in the cerebral cortical, basal ganglia, brainstem or cerebellum - No evidence of recent or remote intracerebral hemorrhage - Diagnosis confirmed by digital subtraction angiography (DSA) according to Suzuki scale - No surgical intervention before recruitment - Physically capable of cognitive testing - Geographically accessible and reliable for follow-up. Exclusion Criteria: - Significant neurological diseases or psychiatric disorders that could affect cognition - Other cerebrovascular diseases (such as atherosclerosis or vasculitides) likely to cause focal cerebral ischemia - Concomitant cerebrovascular diseases (such as aneurysms or arteriovenous malformation) that need surgical intervention - Severe systemic diseases - Pregnant or perinatal stage women - Any diseases likely to death within 2 yeas - Taking drugs such as benzodiazepine clonazepam - Any contraindications or allergy to aspirin - Allergy to iodine or radiographic contrast media - Past history of surgical revascularization - Concurrent participation in any other experimental treatment trial - Any condition that in the surgeon's judgment suggests the patient an unsuitable surgical candidate. |
Country | Name | City | State |
---|---|---|---|
China | Department of Neurosurgery, Huashan Hospital | Shanghai | Shanghai |
Lead Sponsor | Collaborator |
---|---|
Huashan Hospital |
China,
Type | Measure | Description | Time frame | Safety issue |
---|---|---|---|---|
Primary | Neurocognitive outcomes at 3/6/12/24-month follow-up after surgical revascularization or conservative treatment. | Measure neurocognitive outcomes with a battery of neuropsychological tests covering global cognition, executive, memory, language, and visuospatial functions. It involves the Mini-mental state examination (MMSE), the Memory and Executive Screening test (MES), the Trail Making Test (TMT), the Auditory Verbal Learning Test (AVLT), the verbal fluency test (VFT), the Rey-Osterrieth complex figure test (CFT), etc. | 2 years | |
Secondary | The number of participants who suffer from all stroke or death during 30 days to 24 months | 24 months | ||
Secondary | The number of participants who suffer from all kinds of adverse events related to surgery. | 30 days | ||
Secondary | Postoperative neurocognitive outcomes before discharge. | Measure neurocognitive outcomes about 1 week after surgery according to participants' physical condition, using the tests mentioned in the primary outcome measurement. | average of 1 week after surgery | |
Secondary | Postoperative radiological outcomes before discharge. | Measure cerebral perfusion simultaneously with neurocognitive testing, using the single photon emission computed tomography (SPECT). | average of 1 week after surgery | |
Secondary | The changes from baseline in modified Rankin scale (mRS) and national institutes of health stroke scale (NIHSS). | at 7 days, 30 days, 3/6/12/24 months | ||
Secondary | The changes from baseline in single photon emission computed tomography (SPECT). | 2 years | ||
Secondary | The changes from baseline in blood oxygen level-dependent functional magnetic resonance imaging (BOLD fMRI) during rest. | Data analysis techniques include amplitude of frequency fluctuation (ALFF), regional homogeneity (ReHo), independent component analysis (ICA), voxel-based morphometry analysis (VBM), etc. | 2 years |
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