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Saccaro LF, Mallet C, Wullschleger A, Sabé M. Psychiatric manifestations in moyamoya disease: more than a puff of smoke? a systematic review and a case-reports meta-analysis. Front Psychiatry 2024; 15:1371763. [PMID: 38585478 PMCID: PMC10995700 DOI: 10.3389/fpsyt.2024.1371763] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/16/2024] [Accepted: 03/11/2024] [Indexed: 04/09/2024] Open
Abstract
Introduction Moyamoya disease (MMD) is a life-threatening condition characterized by stenosis of intracranial arteries. Despite the frequency and the impact of psychiatric symptoms on the long-term prognosis and quality of life of MMD patients, no systematic review on this topic exists. Methods This systematic review and meta-analysis included 41 studies (29 being case reports), from PubMed, Scopus, Embase until 27/3/2023, on MMD patients exhibiting psychiatric symptoms. Results Despite a fair average quality of the articles, quantitative synthesis through logistic regression was possible only for case reports, due to heterogeneity between the other studies. Psychosis, the most frequent psychiatric symptom reported in case reports, was more frequent in MMD patients with left hemisphere involvement. Neurological symptoms occurrence increased the odds of MMD diagnosis preceding psychiatric symptoms. Psychiatric symptoms are highly prevalent in MMD patients and are relatively often the only presenting symptoms. Discussion We discuss the diagnostic, therapeutic, and prognostic implications of recognizing and characterizing specific psychiatric symptoms in MMD, outlining preliminary guidelines for targeted pharmacological and psychotherapeutic interventions. Lastly, we outline future research and clinical perspectives, striving to enhance the oft-overlooked psychiatric care for MMD patients and to ameliorate their long-term outcome. Systematic Review Registration https://www.crd.york.ac.uk/PROSPERO/, identifier CRD42023406303.
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Affiliation(s)
- Luigi F. Saccaro
- Psychiatry Department, Geneva University Hospital, Geneva, Switzerland
- Psychiatry Department, Faculty of Medicine, University of Geneva, Geneva, Switzerland
| | - Clément Mallet
- Psychiatry Department, Geneva University Hospital, Geneva, Switzerland
| | - Alexandre Wullschleger
- Psychiatry Department, Geneva University Hospital, Geneva, Switzerland
- Psychiatry Department, Faculty of Medicine, University of Geneva, Geneva, Switzerland
| | - Michel Sabé
- Psychiatry Department, Geneva University Hospital, Geneva, Switzerland
- Psychiatry Department, Faculty of Medicine, University of Geneva, Geneva, Switzerland
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Zuo Z, Li G, Chen Y, Qiao P, Zhu J, Wang P, Wu F, Yu H, Jiang Y, Yang J, Li G, Jiang R, Du F. Atrophy in subcortical gray matter in adult patients with moyamoya disease. Neurol Sci 2023; 44:1709-1717. [PMID: 36622475 PMCID: PMC10102099 DOI: 10.1007/s10072-022-06583-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2022] [Accepted: 12/21/2022] [Indexed: 01/10/2023]
Abstract
BACKGROUND Acute cerebrovascular accidents, long-term hypoperfusion, and/or remote neuronal degeneration may lead to structural alterations in patients with moyamoya disease (MMD). This study sought to comprehensively investigate the distribution characteristics of subcortical gray matter volume and their correlations with angiographic changes in the intracranial artery in patients with MMD. METHOD One hundred forty-two patients with MMD and 142 age- and sex-matched healthy controls underwent 3-dimensional high-resolution structural magnetic resonance imaging. Volumes of subcortical gray matter and subregions of the hippocampus and amygdala were calculated, and the degree of stenosis/occlusion of intracranial arteries in patients with MMD was evaluated on MR angiography. RESULTS Volume reductions in the thalamus, caudate, putamen, hippocampus, amygdala, pallidum, and nucleus accumbens were found in patients with MMD. Hippocampal subfields and amygdala subnuclei in patients with MMD showed distinct vulnerability, and morphological alterations in specific subregions were more obvious than in the whole hippocampus/amygdala. Volume loss in several subcortical areas was related to disease duration and intracranial arterial changes. CONCLUSIONS Our findings revealed structural alteration patterns of subcortical gray matter in MMD. The specific atrophy in subregions of the hippocampus and the amygdala suggested potential cognitive and affective impairments in MMD, which warrants further investigation. Chronic cerebral hemodynamic alterations in MMD may play a pivotal role in morphological changes in subcortical areas.
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Affiliation(s)
- Zhiwei Zuo
- Department of Radiology, The General Hospital of Western Theater Command, 270# Tianhui Road, Rongdu Avenue, Chengdu, 610000, People's Republic of China
| | - Guo Li
- Department of Radiology, The General Hospital of Western Theater Command, 270# Tianhui Road, Rongdu Avenue, Chengdu, 610000, People's Republic of China
| | - Ya Chen
- Department of Radiology, The General Hospital of Western Theater Command, 270# Tianhui Road, Rongdu Avenue, Chengdu, 610000, People's Republic of China
| | - Penggang Qiao
- Department of Radiology, Beijing Friendship Hospital, Capital Medical University, Beijing, People's Republic of China
| | - Jing Zhu
- Department of Radiology, The General Hospital of Western Theater Command, 270# Tianhui Road, Rongdu Avenue, Chengdu, 610000, People's Republic of China
| | - Peng Wang
- Department of Radiology, The General Hospital of Western Theater Command, 270# Tianhui Road, Rongdu Avenue, Chengdu, 610000, People's Republic of China
| | - Fa Wu
- Department of Radiology, The General Hospital of Western Theater Command, 270# Tianhui Road, Rongdu Avenue, Chengdu, 610000, People's Republic of China
| | - Hongmei Yu
- Department of Radiology, The General Hospital of Western Theater Command, 270# Tianhui Road, Rongdu Avenue, Chengdu, 610000, People's Republic of China
| | - Yalan Jiang
- Department of Radiology, The General Hospital of Western Theater Command, 270# Tianhui Road, Rongdu Avenue, Chengdu, 610000, People's Republic of China
| | - Jindou Yang
- Department of Radiology, The General Hospital of Western Theater Command, 270# Tianhui Road, Rongdu Avenue, Chengdu, 610000, People's Republic of China
| | - Gongjie Li
- Department of Radiology, Affiliated Hospital of Academy of Military Medical Sciences, Beijing, People's Republic of China
| | - Rui Jiang
- Department of Radiology, The General Hospital of Western Theater Command, 270# Tianhui Road, Rongdu Avenue, Chengdu, 610000, People's Republic of China
| | - Feizhou Du
- Department of Radiology, The General Hospital of Western Theater Command, 270# Tianhui Road, Rongdu Avenue, Chengdu, 610000, People's Republic of China.
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Yang YS, Ryu GW, Delespaul PAEG, Choi M. Psychometric Properties of the Korean Version of the PsyMate Scale Using a Smartphone App: Ecological Momentary Assessment Study. JMIR Mhealth Uhealth 2020; 8:e17926. [PMID: 32706707 PMCID: PMC7404014 DOI: 10.2196/17926] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2020] [Revised: 05/21/2020] [Accepted: 05/27/2020] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Ecological momentary assessment (EMA) is a method for capturing the changes in the variables in daily life with increased accuracy and decreased recall bias. The PsyMate scale assesses momentary moods in daily life and can be used in various settings. OBJECTIVE The aim of this study was to develop a Korean version of the PsyMate (K-PsyMate) scale and evaluate its psychometric properties by using the EMA method in patients with moyamoya disease (MMD) in South Korea. METHODS Patients with MMD aged over 18 years were recruited from July 2018 to January 2019 at the inpatient and outpatient departments of a university hospital in South Korea. The K-PsyMate scale comprising 13 items was developed following a translation/back translation approach of the English version and loaded onto a mobile app. Participants were instructed to enter their moods 4 times a day for 7 consecutive days. Content validity index, factor analysis, and Pearson's correlation were performed for validity analysis. For reliability, intraclass correlation coefficients between the first and last measurements were estimated by mean rating, absolute agreement, and a 2-way mixed-effects model. Usability was analyzed through a descriptive analysis, 2-tailed t test, and analysis of variance, and the results were confirmed by Mann-Whitney U test and the Kruskal-Wallis test, as the dependent variable was not normally distributed. RESULTS In total, 1929 assessments from 93 patients were analyzed. The mean age of the participants was 40.59 (SD 10.06) years, and 66 (71%) of the 93 participants were women. Content validity was excellent as content validity index was 0.99, and 2 factors, negative affect and positive affect, were derived by an exploratory factor analysis. The correlations between the subdomains of the K-PsyMate scale and Hospital Anxiety and Depression Scale were significant (P<.001). The agreement between the first and last measurements was poor to moderate according to the obtained intraclass correlation coefficient values. Usability was evaluated by 67 (72%) out of the 93 participants. The participants rated the accuracy of assessing their momentary moods on the app at 4.13 (SD 0.97), easiness in understanding questions, operating, and inputting answers at 4.12 (SD 0.88), and interruption by the survey alarms at 2.48 (SD 1.02) out of 5. CONCLUSIONS The K-PsyMate scale has good validity but poor to moderate agreement, which reflects the characteristics of the EMA data collected in real and natural living environments without control. The findings of our study show that the K-PsyMate scale uploaded in a mobile app can be a valid and reliable tool for evaluating the momentary mood of patients with MMD because using a mobile app is convenient and patients are familiar with their own smartphones, which they use in their daily lives.
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Affiliation(s)
- Yong Sook Yang
- Mo-Im Kim Nursing Research Institute, Yonsei University College of Nursing, Seoul, Republic of Korea
| | - Gi Wook Ryu
- Mo-Im Kim Nursing Research Institute, Yonsei University College of Nursing, Seoul, Republic of Korea
| | - Philippe A E G Delespaul
- Department of Psychiatry and Neuropsychology, Faculty of Health Medicine and Lifesciences, Maastricht University, Maastricht, Netherlands
| | - Mona Choi
- Mo-Im Kim Nursing Research Institute, Yonsei University College of Nursing, Seoul, Republic of Korea
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