Moyamoya Disease Biomarkers in Patients With Intracranial Atherosclerotic Stroke

Moyamoya Disease Biomarkers in Patients With Intracranial Atherosclerotic Stroke

The aim of this study is to investigate the proportion of patients with moyamoya disease among the patients who were diagnosed as having intracranial atherosclerotic stroke. To do this, biomarkers (gene and imaging) for moyamoya disease are tested and follow up angiography are performed during follow up (in selected patients).

1. Purpose Both moyamoya disease (MMD) and intracranial atherosclerotic stenosis (ICAS) are more prevalent in Asians than in Westerners, although the reason for the race-ethnic differences is unsettled. It is possible that patients with adult-onset MMD were misclassified as having ICAS, which may in part explain the high prevalence of intracranial atherosclerosis in Asians. It is important to differentiation between these two diseases because MMD and ICAS have differential therapeutic strategies (surgical revascularization in MMD vs. the use of antithrombotics/statins and stenting in ICAS). The ring finger 213 (RNF213) was recently identified as a susceptibility gene for MMD in East Asians. Characteristic high-resolution (HR) MRI findings of MMD and ICAS have recently been reported. The aim of this study is to investigate the proportion of patients with moyamoya disease among the patients who were diagnosed as having intracranial atherosclerotic stroke. To do this, biomarkers (gene and imaging) for moyamoya disease are tested and follow up angiography are performed during follow up (in selected patients).
2. Conditions: Stroke, intracranial occlusive lesion
3. Intervention: None
4. Study period: Jan 22, 2014 ~ Dec 31, 2016
5. Study design: Observational model Time perspective: Retrospective-Prospective

Inclusion Criteria:

1. Intracranial atherosclerotic stroke

   • Patients with age over 20 years
   • Patients with focal neurological deficits presented within 7 days of symptom onset
   • Patients with acute ischemic lesions on diffusion-weighted image (DWI)
   • Patients with stenosis on the relevant intracranial vessels (distal ICA and/ or M1)

2. Moyamoya disease

   • Patients with age over 20 years
   • Patients who performed conventional angiography
   • Patients who are diagnosed as having either definite or probable Moyamoya disease

3. Healthy subjects

   • Subjects with age over 20 years
   • Subjects with no history of cerebrovascular disease

Exclusion Criteria:

• Patients with extracranial stenosis more than 50%
• Patients with potential sources of cardio-aortic embolism
• Patients with moderate to severe renal disease
• Pregnancy or lactation
• Patients with short life expectancy