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. 2023 Mar 2:14:1128338.
doi: 10.3389/fneur.2023.1128338. eCollection 2023.

Potential predictors for progression of moyamoya disease: A systematic review and meta-analysis

Jun Cao  1   2 , Zixuan Xing  3 , Ling Dai  4 , Tao Wang  1 , Yuhai Zhang  2 , Yao Feng  1 , Yanfei Chen  1
Affiliations

Potential predictors for progression of moyamoya disease: A systematic review and meta-analysis

Jun Cao et al. Front Neurol. .

Abstract

Background: The progress of Moyamoya disease (MMD) is often accompanied by the occurrence of new ischemia or hemorrhagic events, which was difficult to predict. This systematic review and meta-analysis aimed to identify predictors for progression in MMD patients.

Methods: We searched PubMed, Web of Science, Cochrane Library, and Embase databases up to December 10th, 2022 for randomized controlled trials, case-control studies, or cohort studies reporting predictors of disease progression in MMD patients. The results of each predictor were pooled by meta-analysis and further analyzed by subgroup analysis for predictors of unilateral to bilateral progression of MMD.

Results: A total of 842 patients from 12 studies were included. The estimated pooled means indicated lower age (standard mean difference [SMD]: -0.29, 95% confidence interval [CI]: -0.55 to -0.03; P = 0.03), family history (odds ratio [OR] 3.97, 95% CI: 1.96 to 8.03; P < 0.001) and contralateral abnormality (OR 3.95, 95% CI: 1.10 to 14.20; P = 0.04) were associated with progression in MMD patients. Subgroup analyses indicated that the same three factors were associated with the progression of unilateral to bilateral MMD.

Conclusions: This meta-analysis revealed that lower age, family history and contralateral abnormality were associated with progression in MMD patients. The same three factors are associated with the progression of unilateral to bilateral MMD. Further studies are needed to validate our results.

Keywords: meta-analysis; moyamoya disease; potential predictors; progression; systematic review.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest. The reviewer SH declared a shared affiliation with the authors JC, TW, YF, and YC to the handling editor at the time of review.

Figures

Figure 1
Figure 1
Flow chart of the study selection.
Figure 2
Figure 2
Positive predictor for progression in MMD patients. MMD, moyamoya disease; SD, standard deviation; IV, Inverse variance; M-H, Mantel-Haenszel; df, degrees of freedom; CI, Confidence Interval; Std. Mean Difference, standardized mean difference.
Figure 3
Figure 3
Potential predictors which were not significantly associated with the progression in this meta-analysis. MMD, moyamoya disease; M-H, Mantel-Haenszel; df, degrees of freedom; CI, Confidence Interval.
Figure 4
Figure 4
Positive predictor for progression in unilateral MMD patients. MMD, moyamoya disease; SD, standard deviation; IV, Inverse variance; M-H, Mantel-Haenszel; df, degrees of freedom; CI, Confidence Interval; Std. Mean Difference, standardized mean difference.
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