SYSTEMATIC REVIEW article
Front. Neurol.
Sec. Endovascular and Interventional Neurology
Volume 16 - 2025 | doi: 10.3389/fneur.2025.1626817
This article is part of the Research TopicEmerging Trends in Moyamoya Disease: Diagnostic and Therapeutic InnovationsView all 4 articles
Clinical and radiological course of asymptomatic and hemodynamically stable moyamoya disease: A systematic review and meta-analysis
Provisionally accepted
Yang Chen1
Zixuan Zhou1
Bingyang Qin1
Yan Liang2Peize Li1
Ziao Li1
Yu Chen3
Ren Li2
Biao Yang1Xiaogang Wang1Yongqiang Wu1Xiaolong Guo1Huidong Zhang4
GENG GUO1*- 1First Hospital of Shanxi Medical University, Taiyuan, China
- 2shanxi medical university, Taiyuan, China
- 3Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
- 4The Eighth Affiliated Hospital of Sun Yat-sen University, Shenzhen, China
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Background: Moyamoya disease (MMD) is an idiopathic chronic intracranial vascular stenosis and occlusion disease However, there is currently a lack of comprehensive analysis on clinical and radiological course of asymptomatic MMD (AMMD) and hemodynamically stable MMD (HSMMD).Data source: We conducted retrieval base on online bibliographic indexing database Embase, Medline, Pubmed, Web of science, and Cochrane library.Methods: The systematic review was composed based on the PRISMA statement. Study quality was accessed by the methodological index for nonrandomized study (MINORS). Effect sizes were pooled with random effects model. Heterogeneity between studies was estimated via the I test. Publication bias was detected by the Egger’s test. The registration code is CRD42023444432.Result: A total of 7 AMMD studies were included in meta-analysis, involved 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%), 15.6% (95% CI 10.2%-22.1%), respectively. The pooled rate for stroke, TIA and radiological progress of 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.Conclusion: AMMD and HSMMD presents a concerning risk of clinical and radiological progression over a follow-up period of more than two years. Further high-quality studies are needed to optimize treatment strategies.
Keywords: Moyamoya Disease, asymptomatic, Hemodynamically stable, Clinical course, radiological course
Received: 11 May 2025; Accepted: 28 May 2025.
Copyright: © 2025 Chen, Zhou, Qin, Liang, Li, Li, Chen, Li, Yang, Wang, Wu, Guo, Zhang and GUO. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: GENG GUO, First Hospital of Shanxi Medical University, Taiyuan, China
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