Effect of new combined revascularization surgery on cognitive function of adult patients with moyamoya disease
Bibliographic record
Abstract
Objective To explore the effect of new combined revascularization surgery on cognitive function in adult patients with moyamoya disease (MMD). Methods From May 2021 to April 2022, a total of 23 adult with MMD underwent superficial temporal artery (STA)⁃middle cerebral artery (MCA) bypass surgery and encephalo⁃duro⁃myo⁃arterio⁃periosto⁃synangosis (EDMAPS) at Aviation General Hospital were enrolled. They underwent head MRI, DSA and CT perfusion (CTP) examinations before and 6 months after surgery, and were graded for collateral compensation by the Matsushima grading system. Cognitive function was evaluated by Montreal Cognitive Assessment (MoCA) Beijing version. Results Total 23 patients had an increase in the MoCA total score (t=4.132, P=0.000), as well as the scores of visual space/executive ability (t=2.612, P=0.016), memory (t=5.144, P=0.000), attention (t=2.655, P=0.014) and directional ability (t=2.105, P=0.047). Based on the Matsushima grading system after surgery, there were 12 patients with grade A (>2/3 of MCA blood supply area), 8 with grade B (1/3-2/3 of MCA blood supply area), and 3 with grade C (<1/3 of MCA blood supply area). There was a statistically significant difference in the MoCA total score before and after surgery in patients with different Matsushima grading system (F=4.096, P=0.032). Further pairwise comparison showed that patients with Matsushima grade C had lower MoCA total score than that with grade B (t=2.715, P=0.018). There were 13 cases (56.52%) with postoperative cognitive function improvement (MoCA total score improvement rate≥12%), including 10 cases with Matsushima grade A, 2 with grade B, and one with grade C. The difference in cognitive function improvement rate among cases with different Matsushima grade was statistically significant (χ2=7.079, P=0.029), and only cognitive function improvement rate in Matsushima grade A was higher than that in grade B (Z=⁃2.543, P=0.011). Conclusions New combined revascularization surgery can effectively improve the cognitive function of adult patients with MMD, especially their visual space/executive ability, memory, attention and directional ability. The improvement of overall cognitive function is related to the range of collateral compensation after surgery.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.001 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".