Thalamic structure and anastomosis in different hemispheres of moyamoya disease

Junwen Hu; Yongjie Wang; Yun Tong; Gaojun Lin; Yin Li; Jingyin Chen; Duo Xu; Lin Wang; Ruiliang Bai

doi:10.3389/fnins.2022.1058137

Thalamic structure and anastomosis in different hemispheres of moyamoya disease

Front Neurosci. 2023 Jan 9:16:1058137. doi: 10.3389/fnins.2022.1058137. eCollection 2022.

Authors

Junwen Hu^{1

2}, Yongjie Wang^{1

2}, Yun Tong³, Gaojun Lin⁴, Yin Li^{1

2}, Jingyin Chen^{1

2}, Duo Xu⁵, Lin Wang^{1

2}, Ruiliang Bai^{6

7

8}

Affiliations

¹ Department of Neurosurgery, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China.
² Clinical Research Center for Neurological Diseases of Zhejiang, Hangzhou, China.
³ Affiliated Cixi Hospital of Wenzhou Medical University, Ningbo, China.
⁴ Zhejiang University School of Medicine, Hangzhou, China.
⁵ Department of Radiology, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China.
⁶ Key Laboratory of Biomedical Engineering of Ministry of Education, College of Biomedical Engineering and Instrument Science, Zhejiang University, Hangzhou, China.
⁷ Department of Physical Medicine and Rehabilitation of the Affiliated Sir Run Run Shaw Hospital and Interdisciplinary Institute of Neuroscience and Technology, Zhejiang University School of Medicine, Hangzhou, China.
⁸ MOE Frontier Science Center for Brain Science and Brain-Machine Integration, School of Brain Science and Brain Medicine, Zhejiang University, Hangzhou, China.

Abstract

Objective: The progression of the asymptomatic hemisphere of moyamoya disease (MMD) is largely unknown. In this study, we investigated the differences in subcortical gray matter structure and angiographic features between asymptomatic and symptomatic hemispheres in patients with MMD.

Methods: We retrospectively reviewed patients with MMD in consecutive cases in our center. We compared subcortical gray matter volume and three types of collaterals (lenticulostriate anastomosis, thalamic anastomosis, and choroidal anastomosis) between symptomatic and asymptomatic hemispheres. Symptomatic hemispheres were classified as ischemic hemisphere (i-hemisphere) and hemorrhagic hemisphere (h-hemisphere). Asymptomatic hemispheres were classified as contralateral asymptomatic hemisphere of i-hemisphere (ai-hemisphere), contralateral asymptomatic hemisphere of h-hemisphere (ah-hemisphere), bilateral asymptomatic hemispheres in asymptomatic group (aa-hemisphere).

Results: A total of 117 MMD patients were reviewed, and 49 of them met the inclusion criteria, with 98 hemispheres being analyzed. The thalamic volume was found to differ significantly between the i- and ai-hemispheres (P = 0.010), between the i- and ah-hemispheres (P = 0.004), as well as between the h- and ai-hemispheres (P = 0.002), between the h- and ah-hemispheres (P < 0.001). There was a higher incidence of thalamic anastomosis in the ai-hemispheres than i-hemispheres (31.3% vs. 6.3%, P = 0.070), and in the ah-hemispheres than h-hemispheres (29.6% vs. 11.1%, P = 0.088). Additionally, the hemispheres with thalamic anastomosis had a significantly greater volume than those without thalamic anastomosis (P = 0.024). Univariate and multivariate logistic regression analysis showed that thalamic volume was closely associated with thalamic anastomosis.

Conclusion: The thalamic volume and the incidence of thalamic anastomosis increase in asymptomatic hemispheres and decrease in symptomatic hemispheres. Combining these two characteristics may be helpful in assessing the risk of stroke in the asymptomatic hemispheres of MMD as well as understanding the pathological evolution of the disease.

Keywords: anastomosis; brain structure; cerebral angiography; moyamoya disease; thalamus.

Grants and funding

The National Natural Science Foundation of China provided the funding for this work (grant number 81870910), as well as the Key R&D Program of Zhejiang (No. 2022C03133).