Clinical and radiological course of asymptomatic and hemodynamically stable moyamoya disease: a systematic review and meta-analysis
BackgroundMoyamoya disease (MMD) is an idiopathic, chronic intracranial vascular stenosis and occlusion disease. However, there is currently a lack of comprehensive analysis on the clinical and radiological course of asymptomatic MMD (AMMD) and hemodynamically stable MMD (HSMMD).Data sourceWe conduc...
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Frontiers Media S.A.
2025-07-01
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| author | Yang Chen Yang Chen Yang Chen Yang Chen Zixuan Zhou Zixuan Zhou Zixuan Zhou Zixuan Zhou Bingyang Qin Bingyang Qin Bingyang Qin Bingyang Qin Yan Liang Peize Li Peize Li Peize Li Peize Li Ziao Li Ziao Li Ziao Li Ziao Li Yu Chen Yu Chen Ren Li Ren Li Ren Li Ren Li Biao Yang Biao Yang Biao Yang Biao Yang Xiaogang Wang Xiaogang Wang Xiaogang Wang Xiaogang Wang Yongqiang Wu Yongqiang Wu Yongqiang Wu Yongqiang Wu Xiaolong Guo Xiaolong Guo Xiaolong Guo Xiaolong Guo Huidong Zhang Geng Guo Geng Guo Geng Guo Geng Guo |
| author_facet | Yang Chen Yang Chen Yang Chen Yang Chen Zixuan Zhou Zixuan Zhou Zixuan Zhou Zixuan Zhou Bingyang Qin Bingyang Qin Bingyang Qin Bingyang Qin Yan Liang Peize Li Peize Li Peize Li Peize Li Ziao Li Ziao Li Ziao Li Ziao Li Yu Chen Yu Chen Ren Li Ren Li Ren Li Ren Li Biao Yang Biao Yang Biao Yang Biao Yang Xiaogang Wang Xiaogang Wang Xiaogang Wang Xiaogang Wang Yongqiang Wu Yongqiang Wu Yongqiang Wu Yongqiang Wu Xiaolong Guo Xiaolong Guo Xiaolong Guo Xiaolong Guo Huidong Zhang Geng Guo Geng Guo Geng Guo Geng Guo |
| author_sort | Yang Chen |
| collection | DOAJ |
| description | BackgroundMoyamoya disease (MMD) is an idiopathic, chronic intracranial vascular stenosis and occlusion disease. However, there is currently a lack of comprehensive analysis on the clinical and radiological course of asymptomatic MMD (AMMD) and hemodynamically stable MMD (HSMMD).Data sourceWe conducted a comprehensive literature search using major bibliographic indexing databases, including Embase, Medline, PubMed, Web of Science, and Cochrane Library.MethodsThis systematic review was conducted based on the PRISMA guidelines. The quality of the included studies was accessed using the Methodological Index for Non-Randomized Studies (MINORS). Effect sizes were pooled with a random-effects model. Heterogeneity between studies was estimated via the I2 test. Publication bias was assessed with Egger’s test. The registration code is CRD42023444432.ResultA total of seven AMMD studies were included in a meta-analysis, involving 393 patients and 649 hemispheres. Three HSMMD studies were all from the same institution. The pooled rate for clinical progression, hemorrhagic stroke, ischemic stroke, transient ischemic attack (TIA), and radiological progress of conservative group was 10% (95% CI 4.9–15.1%), 3.8% (95% CI 0.4–7.2%), 0.7% (95% CI 0–2.3%), 3.6% (95% CI 0.6–6.6%), and 15.6% (95% CI 10.2–22.1%), respectively. The pooled rate for stroke, TIA, and radiological progress of the surgical group was 3.7% (95% CI 0–10.8%), 0.2% (95% CI 0–3.0%), and 4.8% (95% CI 0–10.5%), respectively. Revascularization did not show a protective effect on TIA and radiological progression for AMMD.ConclusionAMMD and HSMMD present a concerning risk of clinical and radiological progression over a follow-up period of more than 2 years. Further high-quality studies are needed to optimize treatment strategies.Systematic review registrationhttps://www.crd.york.ac.uk/prospero/display_record.php?RecordID=444432, CRD42023444432. |
| format | Article |
| id | doaj-art-e9500f26db0147e282df036d66b54e3b |
| institution | OA Journals |
| issn | 1664-2295 |
| language | English |
| publishDate | 2025-07-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Neurology |
| spelling | doaj-art-e9500f26db0147e282df036d66b54e3b2025-08-20T02:36:12ZengFrontiers Media S.A.Frontiers in Neurology1664-22952025-07-011610.3389/fneur.2025.16268171626817Clinical and radiological course of asymptomatic and hemodynamically stable moyamoya disease: a systematic review and meta-analysisYang Chen0Yang Chen1Yang Chen2Yang Chen3Zixuan Zhou4Zixuan Zhou5Zixuan Zhou6Zixuan Zhou7Bingyang Qin8Bingyang Qin9Bingyang Qin10Bingyang Qin11Yan Liang12Peize Li13Peize Li14Peize Li15Peize Li16Ziao Li17Ziao Li18Ziao Li19Ziao Li20Yu Chen21Yu Chen22Ren Li23Ren Li24Ren Li25Ren Li26Biao Yang27Biao Yang28Biao Yang29Biao Yang30Xiaogang Wang31Xiaogang Wang32Xiaogang Wang33Xiaogang Wang34Yongqiang Wu35Yongqiang Wu36Yongqiang Wu37Yongqiang Wu38Xiaolong Guo39Xiaolong Guo40Xiaolong Guo41Xiaolong Guo42Huidong Zhang43Geng Guo44Geng Guo45Geng Guo46Geng Guo47Department of Neurosurgery, First Hospital of Shanxi Medical University, Taiyuan, ChinaCerebrovascular Disease Center, First Hospital of Shanxi Medical University, Taiyuan, ChinaCenter for Cerebrovascular Diseases Research, Shanxi Medical University, Taiyuan, ChinaMOE Key Laboratory of Coal Environmental Pathogenicity and Prevention, Shanxi Medical University, Taiyuan, ChinaCerebrovascular Disease Center, First Hospital of Shanxi Medical University, Taiyuan, ChinaCenter for Cerebrovascular Diseases Research, Shanxi Medical University, Taiyuan, ChinaMOE Key Laboratory of Coal Environmental Pathogenicity and Prevention, Shanxi Medical University, Taiyuan, ChinaDepartment of Emergency, First Hospital of Shanxi Medical University, Taiyuan, ChinaDepartment of Neurosurgery, First Hospital of Shanxi Medical University, Taiyuan, ChinaCerebrovascular Disease Center, First Hospital of Shanxi Medical University, Taiyuan, ChinaCenter for Cerebrovascular Diseases Research, Shanxi Medical University, Taiyuan, ChinaMOE Key Laboratory of Coal Environmental Pathogenicity and Prevention, Shanxi Medical University, Taiyuan, ChinaSchool of Basic Medicine, Shanxi Medical University, Taiyuan, ChinaDepartment of Neurosurgery, First Hospital of Shanxi Medical University, Taiyuan, ChinaCerebrovascular Disease Center, First Hospital of Shanxi Medical University, Taiyuan, ChinaCenter for Cerebrovascular Diseases Research, Shanxi Medical University, Taiyuan, ChinaMOE Key Laboratory of Coal Environmental Pathogenicity and Prevention, Shanxi Medical University, Taiyuan, ChinaDepartment of Neurosurgery, First Hospital of Shanxi Medical University, Taiyuan, ChinaCerebrovascular Disease Center, First Hospital of Shanxi Medical University, Taiyuan, ChinaCenter for Cerebrovascular Diseases Research, Shanxi Medical University, Taiyuan, ChinaMOE Key Laboratory of Coal Environmental Pathogenicity and Prevention, Shanxi Medical University, Taiyuan, ChinaDepartment of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, ChinaNational Clinical Research Center for Neurological Diseases, Beijing, ChinaCerebrovascular Disease Center, First Hospital of Shanxi Medical University, Taiyuan, ChinaCenter for Cerebrovascular Diseases Research, Shanxi Medical University, Taiyuan, ChinaMOE Key Laboratory of Coal Environmental Pathogenicity and Prevention, Shanxi Medical University, Taiyuan, ChinaDepartment of Environmental Health, School of Public Health, Shanxi Medical University, Taiyuan, ChinaDepartment of Neurosurgery, First Hospital of Shanxi Medical University, Taiyuan, ChinaCerebrovascular Disease Center, First Hospital of Shanxi Medical University, Taiyuan, ChinaCenter for Cerebrovascular Diseases Research, Shanxi Medical University, Taiyuan, ChinaMOE Key Laboratory of Coal Environmental Pathogenicity and Prevention, Shanxi Medical University, Taiyuan, ChinaDepartment of Neurosurgery, First Hospital of Shanxi Medical University, Taiyuan, ChinaCerebrovascular Disease Center, First Hospital of Shanxi Medical University, Taiyuan, ChinaCenter for Cerebrovascular Diseases Research, Shanxi Medical University, Taiyuan, ChinaMOE Key Laboratory of Coal Environmental Pathogenicity and Prevention, Shanxi Medical University, Taiyuan, ChinaCerebrovascular Disease Center, First Hospital of Shanxi Medical University, Taiyuan, ChinaCenter for Cerebrovascular Diseases Research, Shanxi Medical University, Taiyuan, ChinaMOE Key Laboratory of Coal Environmental Pathogenicity and Prevention, Shanxi Medical University, Taiyuan, ChinaDepartment of Emergency, First Hospital of Shanxi Medical University, Taiyuan, ChinaDepartment of Neurosurgery, First Hospital of Shanxi Medical University, Taiyuan, ChinaCerebrovascular Disease Center, First Hospital of Shanxi Medical University, Taiyuan, ChinaCenter for Cerebrovascular Diseases Research, Shanxi Medical University, Taiyuan, ChinaMOE Key Laboratory of Coal Environmental Pathogenicity and Prevention, Shanxi Medical University, Taiyuan, China0Key Laboratory of Environment and Female Reproductive Health, The Eighth Affiliated Hospital, Sun Yat-sen University, Guangzhou, Shenzhen, ChinaCerebrovascular Disease Center, First Hospital of Shanxi Medical University, Taiyuan, ChinaCenter for Cerebrovascular Diseases Research, Shanxi Medical University, Taiyuan, ChinaMOE Key Laboratory of Coal Environmental Pathogenicity and Prevention, Shanxi Medical University, Taiyuan, ChinaDepartment of Emergency, First Hospital of Shanxi Medical University, Taiyuan, ChinaBackgroundMoyamoya disease (MMD) is an idiopathic, chronic intracranial vascular stenosis and occlusion disease. However, there is currently a lack of comprehensive analysis on the clinical and radiological course of asymptomatic MMD (AMMD) and hemodynamically stable MMD (HSMMD).Data sourceWe conducted a comprehensive literature search using major bibliographic indexing databases, including Embase, Medline, PubMed, Web of Science, and Cochrane Library.MethodsThis systematic review was conducted based on the PRISMA guidelines. The quality of the included studies was accessed using the Methodological Index for Non-Randomized Studies (MINORS). Effect sizes were pooled with a random-effects model. Heterogeneity between studies was estimated via the I2 test. Publication bias was assessed with Egger’s test. The registration code is CRD42023444432.ResultA total of seven AMMD studies were included in a meta-analysis, involving 393 patients and 649 hemispheres. Three HSMMD studies were all from the same institution. The pooled rate for clinical progression, hemorrhagic stroke, ischemic stroke, transient ischemic attack (TIA), and radiological progress of conservative group was 10% (95% CI 4.9–15.1%), 3.8% (95% CI 0.4–7.2%), 0.7% (95% CI 0–2.3%), 3.6% (95% CI 0.6–6.6%), and 15.6% (95% CI 10.2–22.1%), respectively. The pooled rate for stroke, TIA, and radiological progress of the surgical group was 3.7% (95% CI 0–10.8%), 0.2% (95% CI 0–3.0%), and 4.8% (95% CI 0–10.5%), respectively. Revascularization did not show a protective effect on TIA and radiological progression for AMMD.ConclusionAMMD and HSMMD present a concerning risk of clinical and radiological progression over a follow-up period of more than 2 years. Further high-quality studies are needed to optimize treatment strategies.Systematic review registrationhttps://www.crd.york.ac.uk/prospero/display_record.php?RecordID=444432, CRD42023444432.https://www.frontiersin.org/articles/10.3389/fneur.2025.1626817/fullmoyamoya diseaseasymptomatichemodynamically stableclinical courseradiological course |
| spellingShingle | Yang Chen Yang Chen Yang Chen Yang Chen Zixuan Zhou Zixuan Zhou Zixuan Zhou Zixuan Zhou Bingyang Qin Bingyang Qin Bingyang Qin Bingyang Qin Yan Liang Peize Li Peize Li Peize Li Peize Li Ziao Li Ziao Li Ziao Li Ziao Li Yu Chen Yu Chen Ren Li Ren Li Ren Li Ren Li Biao Yang Biao Yang Biao Yang Biao Yang Xiaogang Wang Xiaogang Wang Xiaogang Wang Xiaogang Wang Yongqiang Wu Yongqiang Wu Yongqiang Wu Yongqiang Wu Xiaolong Guo Xiaolong Guo Xiaolong Guo Xiaolong Guo Huidong Zhang Geng Guo Geng Guo Geng Guo Geng Guo Clinical and radiological course of asymptomatic and hemodynamically stable moyamoya disease: a systematic review and meta-analysis Frontiers in Neurology moyamoya disease asymptomatic hemodynamically stable clinical course radiological course |
| title | Clinical and radiological course of asymptomatic and hemodynamically stable moyamoya disease: a systematic review and meta-analysis |
| title_full | Clinical and radiological course of asymptomatic and hemodynamically stable moyamoya disease: a systematic review and meta-analysis |
| title_fullStr | Clinical and radiological course of asymptomatic and hemodynamically stable moyamoya disease: a systematic review and meta-analysis |
| title_full_unstemmed | Clinical and radiological course of asymptomatic and hemodynamically stable moyamoya disease: a systematic review and meta-analysis |
| title_short | Clinical and radiological course of asymptomatic and hemodynamically stable moyamoya disease: a systematic review and meta-analysis |
| title_sort | clinical and radiological course of asymptomatic and hemodynamically stable moyamoya disease a systematic review and meta analysis |
| topic | moyamoya disease asymptomatic hemodynamically stable clinical course radiological course |
| url | https://www.frontiersin.org/articles/10.3389/fneur.2025.1626817/full |
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