Network centrality alterations in patients with moyamoya disease after combined revascularization surgery: a resting-state fMRI study

Objective This study aimed to explore alterations in brain network characteristics among patients with moyamoya disease (MMD) before and after combined revascularization surgery (CRS). Methods This investigation enrolled 20 MMD patients alongside 20 age- and sex-matched healthy controls (HCs). All participants underwent MRI scans. Additionally, MMD patients were subjected to comprehensive clinical assessments. Degree centrality (DC) analysis was utilized to assess the connectivity features of the entire brain network. The study also examined correlations between DC values in MMD patients before- (pre-CRS) and after-CRS (post-CRS) and various clinical indicators. Results Compared with HCs, pre-CRS MMD patients showed abnormal DC values in multiple brain regions, mainly including the cerebellum, frontal lobe, temporal lobe, and cingulate gyrus. One year after CRS treatment, the DC values of the bilateral cerebellum posterior lobe showed a reverse increase. In addition, the DC value of the right cerebellum posterior lobe in pre-CRS MMD patients was positively correlated with the Montreal cognitive assessment scores. Conclusions CRS treatment can effectively improve the functional network damage of the bilateral cerebellum posterior lobes caused by MMD, and it is expected to provide a new neuroimaging marker for the evaluation of CRS treatment efficacy.