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

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T1 - Microstructural white matter alterations and hippocampal volumes are associated with cognitive deficits in craniopharyngioma

AU - Fjalldal, S.

AU - Follin, C.

AU - Svärd, D.

AU - Rylander, L.

AU - Gabery, S.

AU - Petersén,

AU - van Westen, D.

AU - Sundgren, P. C.

AU - Björkman-Burtscher, I. M.

AU - Lätt, J.

AU - Ekman, B.

AU - Johanson, A.

AU - Erfurth, E. M.

PY - 2018/6/1

Y1 - 2018/6/1

N2 - 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.

AB - 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.

UR - http://www.scopus.com/inward/record.url?scp=85046571341&partnerID=8YFLogxK

U2 - 10.1530/EJE-18-0081

DO - 10.1530/EJE-18-0081

M3 - Article

VL - 178

SP - 577

EP - 587

JO - European Journal of Endocrinology

T2 - European Journal of Endocrinology

JF - European Journal of Endocrinology

SN - 1479-683X

IS - 6

ER -