Psychological outcomes and health-related quality of life changes in Chinese patients with moyamoya disease after revascularization

TL;DR

This study found that revascularization surgery improves both psychological health and quality of life in Chinese patients with moyamoya disease, especially those with pre-surgery impairments.

Contribution

The study provides new evidence that revascularization surgery can improve psychological outcomes and health-related quality of life in moyamoya disease patients.

Findings

Patients with preoperative impairments showed significant improvements in HRQOL domains like physical functioning and vitality.

Psychological improvements included reduced anxiety, aggressiveness, and depression in many patients.

Executive function tests improved significantly in the impaired group but not in those without preoperative impairments.

Abstract

This study aimed to evaluate the psychological outcomes and changes in health-related quality of life (HRQOL) in Chinese patients with Moyamoya disease (MMD) following revascularization procedures.

A total of 68 patients diagnosed with MMD and who underwent revascularization at Nanjing Drum Tower Hospital between January 2023 and January 2024 were retrospectively analyzed. Neuropsychological assessments, including the Trail Making Test, Chapuis Maze, Digit D2, Symptom Checklist-90 (SCL-90), Beck Depression Inventory-II (BDI-II), and the 36-item Short Form Health Survey (SF-36), were administered preoperatively and postoperatively at 3 months and 1 year. Statistical analysis was performed using SPSS version 29.0, with appropriate parametric or non-parametric tests applied based on data distribution.

Baseline characteristics revealed no significant differences between the Unremarkable and Impaired groups, confirming comparability. Postoperative improvements were observed in HRQOL across multiple domains, particularly in patients with preoperative impairments. Significant improvements were seen in physical functioning, general health, physical pain, emotional role function, and vitality (P < 0.05). Psychological outcomes also showed significant improvements, with reductions in aggressiveness, anxiety, and somatization (P < 0.001). Depression scores significantly decreased in 29.4% of patients (P < 0.001), and executive function, as measured by TMTA, TMTB, and Digit D2, also showed significant improvements in the impaired group (P < 0.001). However, patients without preoperative impairments exhibited no significant changes in any of the assessed domains.

Revascularization significantly improves both psychological outcomes and HRQOL in Chinese patients with MMD, particularly in those with preoperative impairments. These findings highlight the importance of surgical intervention in enhancing both cognitive and psychological functioning in this patient population. Further prospective studies are warranted to confirm these results and explore long-term benefits.