The goal of this work is to apply time-regression analysis to hypercapnic reactivity data in an interventional trial to identify pre-surgical indicators of treatment response in moyamoya vasculopathy patients. We hypothesized that pre-surgical posterior flow-territory reactivity, including greater cerebrovascular reactivity and reduced vascular delay time, portend collateralization success. In 41 participants evaluated pre and 1-year post-operatively, pre-surgical posterior flow-territory maximum reactivity was higher (p=0.02) in patients with good vs. poor angiographic outcomes. This highlights that topographical features of preserved cerebral auto-regulation may contribute to neoangiogenic potential, and importantly, that reactivity mapping may provide a diagnostic tool for informing surgical candicacy.
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