烟雾病患者的脑白质损伤及认知功能减退的研究进展

Research progress on white matter damage and cognitive impairment in patients with moyamoya disease

烟雾病(MMD)的特征是颈内动脉的颅内段部分及其近端分支的进行性狭窄或闭塞,导致缺血性或出血性卒中,致残率、病死率高。已有很多研究发现,MMD患者普遍存在脑白质的高信号,并有不同程度的脑白质损伤。同时MMD患者认知功能也被发现存在普遍减退的现象,在手术治疗后白质损伤及认知功能也都会得到一定的改善,说明MMD患者脑白质损伤及认知功能下降存在一致性。本文综述了MMD白质损伤的研究进展及较为全面的评估方法,并对血运重建术后MMD患者白质损伤及认知功能改善情况进行了总结。

The characteristic of moyamoya disease(MMD) is progressive narrowing or occlusion of the intracranial segment and its proximal branches of the internal carotid artery,leading to ischemic or hemorrhagic stroke with high disability and mortality rates.Many studies show that patients with MMD generally have high signal intensity in the white matter of the brain and varying degrees of white matter damage.At the same time,it has been found that there is a general decline in cognitive function in patients with MMD.After surgical treatment,white matter damage and cognitive function will also be improved to a certain extent,indicating consistency between white matter damage and cognitive function decline in MMD patients.This article reviews the research progress and comprehensive evaluation methods of white matter damage in patients with MMD,and summarizes the improvement of white matter damage and cognitive function in patients with smoke disease after revascularization surgery.