Impact of superficial temporal artery⁃middle cerebral artery bypass combined with encephalo⁃myo⁃synangiosis on cognitive function in patients with moyamoya disease

Objective To evaluate the improvement of superficial temporal artery⁃middle cerebral artery (STA⁃MCA) bypass combined with encephalo⁃myo⁃synangiosis (EMS) on cognitive function in patients with moyamoya disease (MMD). Methods Total 37 patients with MMD treated with STA⁃MCA+EMS in Tianjin Medical University General Hospital from July 2017 to June 2020 were reviewed. Mini⁃Mental State Examination (MMSE), Auditory Verbal Learning Test (AVLT), Trail Making Test⁃A (TMT⁃A), Trail Making Test⁃B (TMT⁃B), Verbal Fluency Test (VFT) and Rey⁃Osterrieth Complex Figure Test (ROCFT) were used to evaluate overall cognitive function, memory, attention, executive function, language function and visuospatial function in all patients one week before surgery and 6 months after surgery. Results Compared with one week before surgery, the MMSE score [24 (23, 26) score vs. 25.00 (23.50, 27.00) score; Z=⁃4.201, P=0.000] and ROCFT score [28 (23, 30) score vs. 31.00 (28.50, 32.00) score; Z=⁃3.968, P=0.004] increased, while the TMT⁃A test [69.00 (56.00, 87.50) s vs. 42 (37, 48) s; Z=⁃5.144, P=0.002] and TMT⁃B test [177 (168, 190) s vs. 138 (133, 144) s; Z=⁃5.309, P=0.001] decreased at 6 months after surgery. There was no statistic difference of AVLT⁃1R (Z=⁃1.595, P=0.113), AVLT⁃5R (Z=⁃1.573, P=0.121) and VFT (Z=⁃1.616, P=0.124) before and after surgery. Conclusions STA⁃MCA+EMS can improve the overall cognitive function, attention, executive function and visuospatial ability of patients with MMD, but has no significant effect on short⁃term memory, long⁃term memory and language function, and can improve cognitive function and the quality of life.