TY - JOUR
T1 - Disease progression, transient ischemic attack, and de novo parenchymal lesions in asymptomatic moyamoya disease
T2 - Results of a 5-year interim analysis of the AMORE study
AU - on behalf of the AMORE Study Group
AU - Kuroda, Satoshi
AU - Yamamoto, Shusuke
AU - Funaki, Takeshi
AU - Fujimura, Miki
AU - Kataoka, Hiroharu
AU - Hishikawa, Tomohito
AU - Takahashi, Jun C.
AU - Endo, Hidenori
AU - Nariai, Tadashi
AU - Osato, Toshiaki
AU - Saito, Nobuhito
AU - Sato, Norihiro
AU - Hori, Emiko
AU - Kashiwazaki, Daina
AU - Ito, Yoichi M.
AU - Miyamoto, Susumu
AU - Inaji, Motoki
AU - Morita, Kenichi
AU - Maruyama, Daisuke
AU - Nakagawara, Jyoji
AU - Hashimura, Naoki
AU - Hamano, Eika
AU - Iihara, Koji
AU - Hashimoto, Nobuo
AU - Honjo, Kaori
AU - Nakamura, Hirohiko
AU - Imai, Hideaki
AU - Miyawaki, Satoru
AU - Hongo, Hiroki
AU - Yoshida, Kazumichi
AU - Kikuchi, Takayuki
AU - Mineharu, Yohei
AU - Isozaki, Makoto
AU - Kikuta, Kenichiro
AU - Araki, Yoshio
AU - Kanamori, Fumiaki
AU - Date, Isao
AU - Ono, Junichi
AU - Machida, Toshio
AU - Mase, Mitsuhito
AU - Katano, Hiroyuki
AU - Yamaguchi, Koji
AU - Kawamata, Takakazu
AU - Tominaga, Teiji
AU - Uchino, Haruto
AU - Tokairin, Kikutaro
AU - Ito, Masaki
AU - Houkin, Kiyohiro
AU - Chida, Kohei
AU - Ogasawara, Kuniaki
N1 - Publisher Copyright:
© AANS 2025.
PY - 2025/3
Y1 - 2025/3
N2 - OBJECTIVE Recently, the authors have reported the 5-year risk of stroke in patients with asymptomatic moyamoya disease (MMD). In this report, the aim was to clarify patients' 5-year risk of disease progression, transient ischemic attack (TIA), and de novo parenchymal lesions and to identify their predictors. METHODS This multicenter, prospective cohort study (Asymptomatic Moyamoya Registry [AMORE]) in Japan is still ongoing. Participants were enrolled if they were 20-70 years of age, had bilateral or unilateral MMD, experienced no episodes suggestive of TIA and stroke, were functionally independent (modified Rankin Scale score of 0 or 1), and had been followed up for 10 years. Clinical and radiological data were obtained at enrollment and annually thereafter for 5 years. In this 5-year interim analysis, the authors defined disease progression, TIA, and de novo parenchymal lesions as the secondary endpoints. The predictors for these events were identified, using a stratification analysis method. RESULTS A total of 103 patients were enrolled and prospectively followed up for 5 years. On annual MRA examinations, disease progression occurred in 39 hemispheres in 26 patients. The incidence of disease progression was 5.9% per patient-year, and the predictors included younger age (OR 5.72, 95% CI 1.28-25.56; p = 0.0223) and hypercholesterolemia (OR 5.41, 95% CI 1.37-21.28; p = 0.0158). TIA occurred in 12 hemispheres in 10 patients, for an incidence of 2.3% per patient-year. The disease progression prior to TIA was a significant predictor for TIA (OR 5.00, 95% CI 1.31-19.0; p = 0.0184). De novo microbleeds were found in 11 hemispheres in 10 patients (2.3% per patient-year). The presence of microbleeds at enrollment was a significant predictor for de novo microbleeds (OR 5.53, 95% CI 1.17-26.13; p = 0.0309). CONCLUSIONS Patients with asymptomatic MMD may carry a significant risk of disease progression, TIA, and de novo microbleeds during the first 5 years after initial diagnosis. Practitioners should very carefully follow up with them to improve their outcome, using MRI and MRA at regular intervals.
AB - OBJECTIVE Recently, the authors have reported the 5-year risk of stroke in patients with asymptomatic moyamoya disease (MMD). In this report, the aim was to clarify patients' 5-year risk of disease progression, transient ischemic attack (TIA), and de novo parenchymal lesions and to identify their predictors. METHODS This multicenter, prospective cohort study (Asymptomatic Moyamoya Registry [AMORE]) in Japan is still ongoing. Participants were enrolled if they were 20-70 years of age, had bilateral or unilateral MMD, experienced no episodes suggestive of TIA and stroke, were functionally independent (modified Rankin Scale score of 0 or 1), and had been followed up for 10 years. Clinical and radiological data were obtained at enrollment and annually thereafter for 5 years. In this 5-year interim analysis, the authors defined disease progression, TIA, and de novo parenchymal lesions as the secondary endpoints. The predictors for these events were identified, using a stratification analysis method. RESULTS A total of 103 patients were enrolled and prospectively followed up for 5 years. On annual MRA examinations, disease progression occurred in 39 hemispheres in 26 patients. The incidence of disease progression was 5.9% per patient-year, and the predictors included younger age (OR 5.72, 95% CI 1.28-25.56; p = 0.0223) and hypercholesterolemia (OR 5.41, 95% CI 1.37-21.28; p = 0.0158). TIA occurred in 12 hemispheres in 10 patients, for an incidence of 2.3% per patient-year. The disease progression prior to TIA was a significant predictor for TIA (OR 5.00, 95% CI 1.31-19.0; p = 0.0184). De novo microbleeds were found in 11 hemispheres in 10 patients (2.3% per patient-year). The presence of microbleeds at enrollment was a significant predictor for de novo microbleeds (OR 5.53, 95% CI 1.17-26.13; p = 0.0309). CONCLUSIONS Patients with asymptomatic MMD may carry a significant risk of disease progression, TIA, and de novo microbleeds during the first 5 years after initial diagnosis. Practitioners should very carefully follow up with them to improve their outcome, using MRI and MRA at regular intervals.
KW - TIA
KW - asymptomatic moyamoya disease
KW - disease progression
KW - natural course
KW - outcome
KW - transient ischemic attack
KW - vascular disorders
UR - http://www.scopus.com/inward/record.url?scp=86000311162&partnerID=8YFLogxK
U2 - 10.3171/2024.6.JNS24736
DO - 10.3171/2024.6.JNS24736
M3 - 学術論文
AN - SCOPUS:86000311162
SN - 0022-3085
VL - 142
SP - 658
EP - 666
JO - Journal of Neurosurgery
JF - Journal of Neurosurgery
IS - 3
ER -