成人もやもや病の高次脳機能障害

Cognitive Impairment in Adult Patients with Moyamoya Disease

Point

・成人もやもや病患者の4人に1人は高次脳機能障害を伴う．

・高次脳機能障害は¹²³I-IMZ-SPECTでの前頭葉内側や帯状回の神経細胞脱落所見と関連している．MRIでは，3D-T1での詳細な解剖学的評価や拡散テンソル画像での評価によって，帯状回や前頭葉皮質の萎縮，脳梁の白質変化などの形態的変化がみられる．

・高次脳機能障害に対するバイパス手術の治療効果については証明されていない．

　Moyamoya disease is characterized by stenosis of the terminal region of the internal carotid artery and the development of collateral blood vessels with a smoke-like appearance. It causes cerebral infarction and hemorrhage. However, the occurrence of cognitive impairment in patients with moyamoya disease has been insufficiently addressed. Many patients with moyamoya disease experience difficulties in social life, such as schooling and employment, due to cognitive impairment.

　This article describes the current cognitive impairment status in patients with moyamoya disease, focusing on the COSMO-Japan Study, a multicenter study on patients with moyamoya disease.