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

Fjalldal, S. LU ; Follin, C. LU ; Svärd, D. LU ; Rylander, L. LU ; Gabery, S. LU ; Petersén, LU ; van Westen, D. LU ; Sundgren, P. C. LU ; Björkman-Burtscher, I. M. LU and Lätt, J. LU , et al. (2018) In European journal of endocrinology 178(6). p.577-587
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... (More)

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.

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European journal of endocrinology
volume
178
issue
6
pages
11 pages
publisher
Society of the European Journal of Endocrinology
external identifiers
  • scopus:85046571341
ISSN
1479-683X
DOI
10.1530/EJE-18-0081
language
English
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yes
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862c939e-4752-436b-a216-eeb96c5075c8
date added to LUP
2018-05-21 15:01:19
date last changed
2019-03-19 03:54:50
@article{862c939e-4752-436b-a216-eeb96c5075c8,
  abstract     = {<p>CONTEXT: Patients with craniopharyngioma (CP) and hypothalamic lesions (HL) have cognitive deficits. Which neural pathways are affected is unknown.</p><p>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.</p><p>DESIGN: A cross-sectional study with a median follow-up time of 22 (6-49) years after operation.</p><p>SETTING: The South Medical Region of Sweden (2.5 million inhabitants).</p><p>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.</p><p>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.</p><p>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.</p><p>CONCLUSIONS: A structure to function relationship is suggested between microstructural WM alterations in cingulum and in hippocampus with cognitive deficits in CP.</p>},
  author       = {Fjalldal, S. and Follin, C. and Svärd, D. and Rylander, L. and Gabery, S. and Petersén,  and van Westen, D. and Sundgren, P. C. and Björkman-Burtscher, I. M. and Lätt, J. and Ekman, B. and Johanson, A. and Erfurth, E. M.},
  issn         = {1479-683X},
  language     = {eng},
  month        = {06},
  number       = {6},
  pages        = {577--587},
  publisher    = {Society of the European Journal of Endocrinology},
  series       = {European journal of endocrinology},
  title        = {Microstructural white matter alterations and hippocampal volumes are associated with cognitive deficits in craniopharyngioma},
  url          = {http://dx.doi.org/10.1530/EJE-18-0081},
  volume       = {178},
  year         = {2018},
}