Brain perfusion, cognition, and plasma Alzheimer's biomarkers in moyamoya disease

Abstract INTRODUCTION Because growing interest has been focusing on cerebral blood flow (CBF) to predict, prevent, and treat Alzheimer's disease (AD), it is important to clarify the role of CBF in AD pathology and cognitive decline. METHODS In a moyamoya disease (MMD) cohort, we examined CBF, specific cognitive domains, and plasma AD biomarkers, as well as correlations among these variables. RESULTS CBF was significantly reduced in newly diagnosed MMD patients, while plasma phosphorylated tau181 was elevated and positively correlated with hypoperfusion accumulation. MMD patients scored significantly lower than controls in multiple cognitive tests. Revascularization increased CBF to the recipient brain territories as well as cognitive performance but produced no significant change in AD biomarker levels. DISCUSSION These data suggest a link between accumulated reductions in CBF and cognitive decline, as well as a possible role of AD‐like pathological burden. Further studies in MMD will provide opportunities to explore new treatment strategies.