Glucose metabolic pattern in adult moyamoya disease with or without cognitive disorder: A 18F-FDG PET study

Abstract Cognitive disorder (CD) is a critical issue in moyamoya disease (MMD). This study aimed to identify the metabolic signature of cognitive disorder in MMD using 18F-2-fluoro-2-deoxy-D-glucose PET (18F-FDG PET). One hundred fifty-four MMD patients who underwent brain 18F-FDG PET scans before surgery were enrolled and classified into a cognitively intact (CI, n = 54) group and a cognitive disorder (CD, n = 100) group according to neuropsychological testing. Using 18F-FDG PET, we found that the CD group showed hypometabolism mainly in the left basal ganglia compared to the CI group. In addition, CD patients exhibited extensive hypometabolism in the bilateral frontal and cingulate regions and hypermetabolism in the bilateral cerebellum, while CI patients showed hypermetabolism only in the cerebellum and slight hypometabolism in the frontal and temporal regions compared to HCs. The SR-based classifier algorithm distinguished between CD and CI patients with an accuracy of 82.4%. This study demonstrated a characteristic metabolic pattern progressing from CI to CD in a large cohort of patients with MMD. Since 18F-FDG PET provides us with an available method to estimate cerebral metabolic patterns, it might be helpful in the early diagnosis of possible cognitive disorder in MMD patients.