Pediatric Moyamoya Biomarkers: Narrowing the Knowledge Gap

doi:10.1016/j.spen.2022.101002

Review

. 2022 Oct:43:101002.

doi: 10.1016/j.spen.2022.101002. Epub 2022 Sep 15.

Pediatric Moyamoya Biomarkers: Narrowing the Knowledge Gap

Affiliations

¹ Department of Neurology, Boston Children's Hospital, Boston, MA; Harvard Medical School, Boston, MA. Electronic address: Laura.Lehman@Childrens.Harvard.edu.
² Department of Neurology, CHU Sainte-Justine, Montreal, Quebec, Canada; Université de Montréal, Montreal, Quebec, Canada.
³ Harvard Medical School, Boston, MA; Newborn Medicine, Boston Children's Hospital, Boston, MA.
⁴ Harvard Medical School, Boston, MA; Department of Neurosurgery, Boston Children's Hospital, Boston, MA; Department of Radiology, Boston Children's Hospital, Boston, MA.
⁵ Department of Pediatrics, Division of Neurology, Nationwide Children's Hospital, Columbus, OH.
⁶ Division of Pediatric Neurology, Division of Cerebrovascular Neurology, Department of Neurology, Johns Hopkins School of Medicine, Baltimore, MD.
⁷ Department of Pediatrics, Faculty of Medicine, Ain Shams University, Cairo, Egypt.
⁸ Department of Paediatric Intensive Care, Queensland Children's Hospital; Centre for Child Health Research, The University of Queensland, Brisbane, Australia.
⁹ Department of Radiology, Children's Hospital of Philadelphia, University of Philadelphia, Philadelphia, Pennsylvania.
¹⁰ Harvard Medical School, Boston, MA; Department of Neurosurgery, Boston Children's Hospital, Boston, MA.
¹¹ Division of Neurology, Department of Paediatrics, The Hospital for Sick Children, Toronto, Canada; Faculty of Medicine, University of Toronto, Canada.

PMID: 36344019
DOI: 10.1016/j.spen.2022.101002

Review

Pediatric Moyamoya Biomarkers: Narrowing the Knowledge Gap

Laura L Lehman et al. Semin Pediatr Neurol. 2022 Oct.

. 2022 Oct:43:101002.

doi: 10.1016/j.spen.2022.101002. Epub 2022 Sep 15.

Authors

Affiliations

¹ Department of Neurology, Boston Children's Hospital, Boston, MA; Harvard Medical School, Boston, MA. Electronic address: Laura.Lehman@Childrens.Harvard.edu.
² Department of Neurology, CHU Sainte-Justine, Montreal, Quebec, Canada; Université de Montréal, Montreal, Quebec, Canada.
³ Harvard Medical School, Boston, MA; Newborn Medicine, Boston Children's Hospital, Boston, MA.
⁴ Harvard Medical School, Boston, MA; Department of Neurosurgery, Boston Children's Hospital, Boston, MA; Department of Radiology, Boston Children's Hospital, Boston, MA.
⁵ Department of Pediatrics, Division of Neurology, Nationwide Children's Hospital, Columbus, OH.
⁶ Division of Pediatric Neurology, Division of Cerebrovascular Neurology, Department of Neurology, Johns Hopkins School of Medicine, Baltimore, MD.
⁷ Department of Pediatrics, Faculty of Medicine, Ain Shams University, Cairo, Egypt.
⁸ Department of Paediatric Intensive Care, Queensland Children's Hospital; Centre for Child Health Research, The University of Queensland, Brisbane, Australia.
⁹ Department of Radiology, Children's Hospital of Philadelphia, University of Philadelphia, Philadelphia, Pennsylvania.
¹⁰ Harvard Medical School, Boston, MA; Department of Neurosurgery, Boston Children's Hospital, Boston, MA.
¹¹ Division of Neurology, Department of Paediatrics, The Hospital for Sick Children, Toronto, Canada; Faculty of Medicine, University of Toronto, Canada.

PMID: 36344019
DOI: 10.1016/j.spen.2022.101002

Abstract

Moyamoya is a progressive cerebrovascular disorder that leads to stenosis of the arteries in the distal internal carotid, proximal middle cerebral and proximal anterior cerebral arteries of the circle of Willis. Typically a network of collaterals form to bypass the stenosis and maintain cerebral blood flow. As moyamoya progresses it affects the anterior circulation more commonly than posterior circulation, and cerebral blood flow becomes increasingly reliant on external carotid supply. Children with moyamoya are at increased risk for ischemic symptoms including stroke and transient ischemic attacks (TIA). In addition, cognitive decline may occur over time, even in the absence of clinical stroke. Standard of care for stroke prevention in children with symptomatic moyamoya is revascularization surgery. Treatment of children with asymptomatic moyamoya with revascularization surgery however remains more controversial. Therefore, biomarkers are needed to assist with not only diagnosis but also with determining ischemic risk and identifying best surgical candidates. In this review we will discuss the current knowledge as well as gaps in research in relation to pediatric moyamoya biomarkers including neurologic presentation, cognitive, neuroimaging, genetic and biologic biomarkers of disease severity and ischemic risk.

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Pediatric Moyamoya Biomarkers: Narrowing the Knowledge Gap

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Pediatric Moyamoya Biomarkers: Narrowing the Knowledge Gap

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