Chinese moyamoya disease study:cohort profile

Background The etiology and natural course of moyamoya disease (MMD) remain unknown. This study evaluated the natural course and etiology of MMD using data from the Chinese MMD (C-MMD) cohort study. Methods The C-MMD cohort consisted of 6,167 patients with MMD treated at our center over the past 20 years. We analyzed the medical history and laboratory and imaging examination results of the patients at different stages of the disease to identify common features of MMD. Results The median age for symptom onset was 32 years. The age distribution was bimodal; the highest peak was between ages 35 and 45 years, with a smaller peak between ages 3 and 9 years. The female-to-male ratio was 1:1. The disease occurred mainly in the Han people and was rarely observed in minority nationalities. In our cohort, a transient ischemic attack was the most common initial clinical manifestation (46.3%); others included infarction (25.0%), hemorrhage (15.1%), and headache (7.9%). Conclusions The C-MMD cohort is currently one of the largest single-center MMD cohorts in the world. This study provides baseline data for future research on the etiology and natural course of MMD. Clinical Trial Registration This study has been registered in the Chinese Clinical trial registry (registration number: ChiCTR2200064160). ### Competing Interest Statement The authors have declared no competing interest. ### Clinical Trial This study has been registered in the Chinese Clinical trial registry (registration number: ChiCTR2200064160). ### Funding Statement This research was supported by the National Natural Science Foundation of China (Grant no: 82171280). ### Author Declarations I confirm all relevant ethical guidelines have been followed, and any necessary IRB and/or ethics committee approvals have been obtained. Yes The details of the IRB/oversight body that provided approval or exemption for the research described are given below: The Ethics Committee of the General Hospital of the Chinese People's Liberation Army approved this study (No. KY-2022-9-69-1). This study has been registered in the Chinese Clinical trial registry (registration number: ChiCTR2200064160). I confirm that all necessary patient/participant consent has been obtained and the appropriate institutional forms have been archived, and that any patient/participant/sample identifiers included were not known to anyone (e.g., hospital staff, patients or participants themselves) outside the research group so cannot be used to identify individuals. Yes I understand that all clinical trials and any other prospective interventional studies must be registered with an ICMJE-approved registry, such as [ClinicalTrials.gov][1]. I confirm that any such study reported in the manuscript has been registered and the trial registration ID is provided (note: if posting a prospective study registered retrospectively, please provide a statement in the trial ID field explaining why the study was not registered in advance). Yes I have followed all appropriate research reporting guidelines, such as any relevant EQUATOR Network research reporting checklist(s) and other pertinent material, if applicable. Yes C-MMD cohort members welcome and encourage collaboration to maximize the use of data and samples. The data is currently not freely available in the public domain owing to sensitive information in the study database. However, specific proposals for possible collaborations are welcome. Researchers interested in collaboration and further information are invited to contact the corresponding author by email at: duanlian307{at}sina.com (Duan lian). * C-MMD : Chinese moyamoya disease DSA : Digital subtraction angiography MRA : Magnetic resonance angiography MMD : Moyamoya disease TIA : Transient ischemic attack [1]: http://ClinicalTrials.gov