Neuromodulatory Role of Revascularization Surgery in Moyamoya Disease

作者：Noshiro Shouhei; Mikami Takeshi; Komatsu Katsuya; Kanno Aya; Enatsu Rei; Yazawa Shogo; Nagamine Takashi; Matsuhashi Masao; Mikuni Nobuhiro^*

来源：World Neurosurgery, 2016, 91: 473-482.

DOI：10.1016/j.wneu.2016.04.087

• Electrocorticography
• Ischemia
• Moyamoya disease

BACKGROUND: To evaluate the effectiveness of bypass surgery for moyamoya disease, electrocorticography was first evaluated.
METHODS: A total of 13 hemispheres in 9 patients with moyamoya disease were included in this study. To record the spectral power of electrocorticography continuously during the bypass procedure, a 4 x 5 subdural electrode grid was placed on the middle frontal gyrus. The changes in spectral power before and after bypass surgery were evaluated and compared with those in a control group. The correlation between changes in spectral power and regional cerebral blood flow was analyzed.
RESULTS: The average spectral power ratio of the beta band per total band in moyamoya disease before bypass surgery was lower than that of controls (P = 0.027), and the significance disappeared after bypass surgery (P = 0.800). The spectral power levels of the beta band and gamma band were increased in moyamoya disease after bypass surgery (P < 0.001). Changes in spectral power of the beta band correlated with changes in regional cerebral blood flow (P = 0.002).
CONCLUSIONS: The spectral power of the beta band on electrocorticography was focally suppressed in patients with moyamoya disease, and the suppression was reversible by revascularization surgery. Steno-occlusive ischemic changes in moyamoya disease might cause suppression of neurophysiologic activity, and the present results provide insight into the potential neuromodulatory role of revascularization surgery.

• 出版日期2016-7