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Research ArticleAdult Brain
Open Access

Hemodynamic Impairment Measured by Positron-Emission Tomography Is Regionally Associated with Decreased Cortical Thickness in Moyamoya Phenomenon

J.J. Lee, J.S. Shimony, H. Jafri, A.R. Zazulia, R.G. Dacey, G.R. Zipfel and C.P. Derdeyn
American Journal of Neuroradiology November 2018, 39 (11) 2037-2044; DOI: https://doi.org/10.3174/ajnr.A5812
J.J. Lee
aFrom the Mallinckrodt Institute of Radiology (J.J.L., J.S.S., H.J., A.R.Z.)
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J.S. Shimony
aFrom the Mallinckrodt Institute of Radiology (J.J.L., J.S.S., H.J., A.R.Z.)
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H. Jafri
aFrom the Mallinckrodt Institute of Radiology (J.J.L., J.S.S., H.J., A.R.Z.)
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A.R. Zazulia
aFrom the Mallinckrodt Institute of Radiology (J.J.L., J.S.S., H.J., A.R.Z.)
bDepartments of Neurology (A.R.Z., G.R.Z.)
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R.G. Dacey Jr.
cNeurosurgery (R.G.D., G.R.Z.), Washington University, St Louis, Missouri
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G.R. Zipfel
bDepartments of Neurology (A.R.Z., G.R.Z.)
cNeurosurgery (R.G.D., G.R.Z.), Washington University, St Louis, Missouri
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C.P. Derdeyn
dDepartment of Radiology (C.P.D.), University of Iowa, Iowa City, Iowa.
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    Fig 1.

    Representative views of OEFRs averaged over Destrieux parcellations, T1-anatomy, and cortical thickness on inflated surface maps. A–D, Four patients without infarction or hemorrhage were selected randomly from the patient cohort for visualization. E, This patient exemplifies the rationale for excluding infarcted hemispheres. Extensive encephalomalacia distorts cortical parcellations and confounds calculations on cortical and pial anatomy by FreeSurfer (arrows). F, This patient demonstrates paradoxically decreased OEFR around a region of infarction (arrows). The validity and significance of such decreases near infarcted areas are unknown. Consequently, all hemispheres ipsilateral to infarctions or hemorrhages were excluded. Modal color maps are identical for all subfigures and views.

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    Fig 2.

    A, Histogram of OEFR from Destrieux FreeSurfer regions within MCA vascular territories from 15 historically obtained healthy control subjects. Superimposed is the histogram of OEFR from anatomically corresponding regions from 35 patients with Moyamoya phenomenon. Following applying exclusion criteria, there are 900 regions from controls and 3420 regions from patients. B, Histogram of cortical thickness from the same 3420 MCA regions in patients with Moyamoya phenomenon.

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    Fig 3.

    Plots of data arranged by granularity of measurements (FreeSurfer regions, hemispheres, patients) in columns and mappings of predictors (OEFR, age, sex, and time from symptom onset to scanning) of cortical thickness in rows. For sex, male = 0 and female = 1. The color map indicates patient identities. Lines of regression between model parameters and cortical thickness correspond to significant predictors. ρ denotes the partial correlation coefficient between the plotted parameter and cortical thickness. The top-left panel excludes a data point with OEFR = 0.479 and 4 data points with an OEFR of >2 to clarify the distribution of regional data with respect to OEFR and thickness. All plots exclude regions and hemispheres ipsilateral to infarctions or hemorrhages as detailed in the Materials and Methods.

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American Journal of Neuroradiology: 39 (11)
American Journal of Neuroradiology
Vol. 39, Issue 11
1 Nov 2018
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Cite this article
J.J. Lee, J.S. Shimony, H. Jafri, A.R. Zazulia, R.G. Dacey, G.R. Zipfel, C.P. Derdeyn
Hemodynamic Impairment Measured by Positron-Emission Tomography Is Regionally Associated with Decreased Cortical Thickness in Moyamoya Phenomenon
American Journal of Neuroradiology Nov 2018, 39 (11) 2037-2044; DOI: 10.3174/ajnr.A5812

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Hemodynamic Impairment Measured by Positron-Emission Tomography Is Regionally Associated with Decreased Cortical Thickness in Moyamoya Phenomenon
J.J. Lee, J.S. Shimony, H. Jafri, A.R. Zazulia, R.G. Dacey, G.R. Zipfel, C.P. Derdeyn
American Journal of Neuroradiology Nov 2018, 39 (11) 2037-2044; DOI: 10.3174/ajnr.A5812
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