So Dr. Lei is winning the International Abstract Award for his presentation entitled Brain Functional Reconfiguration and Cognitive Impairment in Adult Moyamoya Disease, a Resting State fMRI Study. And we have a little plaque here for you. So thank you very much. And then we're looking forward to your presentation. OK. My name is Lei Yu, and I'm from Huashan Hospital. And thank you for giving me the chance to introduce our work of the cognitive impairment in adult Moyamoya disease. And I want to introduce our work in the following order, the background, the measures, the results, and the conclusion and expectations. As we all know, the vascular cognitive impairment has been achieved by the study of brain function and cognitive impairment has been a chief complaint of Moyamoya disease in our all patients. And a lot of issues have not been tackled, such as the difference of VCI between the pediatric and adult patients, between the ischemic and hemorrhagic types, and also issues related to the mild and dementia, and also different types of VCI. Recent developments in the graph theory has offered us a chance to understand the denser interregional interactions of brain. And cognitive neuroscience has offered us a new angle to explore the underlying mechanism of VCI in adult Moyamoya disease. After years of struggling, we have tried to understand the structural, aesthetic, and local characteristics of Moyamoya disease through the resting state, the EEG, and the ECG. And now we should step on to understand the functional, dynamic, and natural characteristics of Moyamoya disease. Since the topological and temporal functional interactions of Moyamoya disease has not been well studied, the aim of the present study is to acquire the accurate and detailed knowledge of its complex connectivity patterns and heterogeneous spatial-temporal organizations over time. I want to skip the criteria of inclusion to save some time. And the neuropsychological evaluation, we use the MMSE to differentiate the VCI and non-VCI. And we use the scores standards based on the 2011 HA-ASC statement. We have involved 51 adult Moyamoya disease patients, including 27 with VCI and 24 without VCI. And we also involved 26 healthy subjects as normal controls. I want to separate the methods and the results into two parts, the static property and the dynamic property. Firstly is the static network properties. We can see that adult Moyamoya disease, both with and without VCI, exhibited small-world network topologies. And we also can note here that a pattern of topological properties deviating from healthy subjects as disease progressed in all the three aspects of static network, the integration, the segregation, and small-worldness. Then related to the dynamic functional connectivity analysis, we use the sliding window analysis approach. And we adopted a new measurement of connectivity number entropy. And entropy is an expression of disorder or randomness of a system. And it has been used to describe the regional flexibility. And the regional flexibility means the frequency of connection of one region with other regions in your network. And regions with high entropy values are termed as flexible regions. And regions with low entropy values are termed as specialized regions. So from the whole brain levels from the graph A, we can see that the whole brain entropy decreased as disease progressed, implying that the VCI of adult Moyamoya disease is associated with a comprehensive deterioration of functional flexibility. Then from the regional levels from the graph B, C, and D, we noted that most regions with significant entropy differences among the three groups have been implicated in key aspects of information precision. Then from the network levels, we found it's interesting because that all three networks, we have studied that related to the VCI of Moyamoya disease showed reconfigured as disease progressed. And we noted that both the default mode network and the exciter control network may assume the main responsibility of VCI in adult Moyamoya disease. Then I listed the entropy values of all brain regions of a brain. And we noted that the regions labeled as two stars are regions with flexible regions. And these regions are all with high order quality demands. And we see that the regions labeled with one star are regions of specialized regions. And these regions are with special tasks such as emotion regulation and sensory relaying. And we found that all the flexible regions and the specialized regions are reconfigured as disease progressed. And this is a conclusion. This study not only says that both the static and dynamic organizational principles behind network changes in adult Moyamoya disease for the first time, but also provides a new methodological viewpoint to acquire the knowledge of its pathology and treatment direction. This study also has some limitations. Firstly, this is a cross-sectional study. And so the longitudinal cognitive related brain functional reconfiguration was not detected. Secondly, this is a study of small sample size. So the surgical power will be weakened if the patient group was further subdivided according to the radiological classification. This is a map of Moyamoya disease in the world and China. And the VCI has been known as the main cause of disability and the financial burden. So we should try our best to prevent and treat the VCI of Moyamoya disease. Then I will use several seconds to introduce our department of Huashan Hospital. And this is our department from the northern, eastern, western, and central division. Leaded by Professor Liang Fuqiu and Ying Mao, we have 800 hospital beds and 12,000 neurosurgeons a year. And welcome to Shanghai. Welcome to our hospital. Thank you for listening. Thank you. Okay, are there any questions for Dr. Lei? So this is a great study. I wanted to ask you how easy is this to do everywhere in China? How well can you do this everywhere in China? So it's really difficult. We have patients from all over the country and we have to do surveys such as Monday in the Central Division and Tuesday in the Northern Division, such like this. Thank you.

Dr. Lei Yu

Huashan Hospital

Cognitive Impairment

Moyamoya Disease

Brain Networks