To investigate myelin structural damage caused by chronic ischemia, we applied myelin imaging using magnetization transfer saturation (MTsat) method to 15 patients with moyamoya disease (36.6±11.6-year-old) and 10 normal volunteers (28.4±5.2-year-old). Although many patients received bypass surgery in the past and currently had good hemodynamic status, we found myelin volume fraction (MVF) was significantly lower and g-ratio was significantly higher in the patient group compared to normal controls. Moreover, regional MVF values showed some correlation with neurocognitive tests. This finding suggests myelin damage occurs in moyamoya disease, is associated with neurocognitive dysfunction, and is perhaps irreversible.
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