Microstructural white matter alterations and hippocampal volumes are associated with cognitive deficits in craniopharyngioma

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title = "Microstructural white matter alterations and hippocampal volumes are associated with cognitive deficits in craniopharyngioma",
abstract = "CONTEXT: Patients with craniopharyngioma (CP) and hypothalamic lesions (HL) have cognitive deficits. Which neural pathways are affected is unknown.OBJECTIVE: To determine whether there is a relationship between microstructural white matter (WM) alterations detected with diffusion tensor imaging (DTI) and cognition in adults with childhood-onset CP.DESIGN: A cross-sectional study with a median follow-up time of 22 (6-49) years after operation.SETTING: The South Medical Region of Sweden (2.5 million inhabitants).PARTICIPANTS: Included were 41 patients (24 women, ≥17 years) surgically treated for childhood-onset CP between 1958-2010 and 32 controls with similar age and gender distributions. HL was found in 23 patients.MAIN OUTCOME MEASURES: Subjects performed cognitive tests and magnetic resonance imaging, and images were analyzed using DTI of uncinate fasciculus, fornix, cingulum, hippocampus and hypothalamus as well as hippocampal volumetry.RESULTS: Right uncinate fasciculus was significantly altered (P ≤ 0.01). Microstructural WM alterations in left ventral cingulum were significantly associated with worse performance in visual episodic memory, explaining approximately 50{\%} of the variation. Alterations in dorsal cingulum were associated with worse performance in immediate, delayed recall and recognition, explaining 26-38{\%} of the variation, and with visuospatial ability and executive function, explaining 19-29{\%}. Patients who had smaller hippocampal volume had worse general knowledge (P = 0.028), and microstructural WM alterations in hippocampus were associated with a decline in general knowledge and episodic visual memory.CONCLUSIONS: A structure to function relationship is suggested between microstructural WM alterations in cingulum and in hippocampus with cognitive deficits in CP.",
author = "S. Fjalldal and C. Follin and D. Sv{\"a}rd and L. Rylander and S. Gabery and Peters{\'e}n and {van Westen}, D. and Sundgren, {P. C.} and Bj{\"o}rkman-Burtscher, {I. M.} and J. L{\"a}tt and B. Ekman and A. Johanson and Erfurth, {E. M.}",
year = "2018",
month = "6",
day = "1",
doi = "10.1530/EJE-18-0081",
language = "English",
volume = "178",
pages = "577--587",
journal = "European Journal of Endocrinology",
issn = "1479-683X",
publisher = "Society of the European Journal of Endocrinology",
number = "6",