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

Autor: Pia C. Sundgren, Sanaz Gabery, Aki Johanson, D. van Westen, Bertil Ekman, Lars Rylander, Sigridur Fjalldal, Åsa Petersén, Daniel Svärd, Jimmy Lätt, Isabella M. Björkman-Burtscher, Eva Marie Erfurth, Cecilia Follin
Jazyk: angličtina
Rok vydání: 2018
Předmět:
Adult
Male
medicine.medical_specialty
Adolescent
Endocrinology
Diabetes and Metabolism
Uncinate fasciculus
Hippocampus
030209 endocrinology & metabolism
Context (language use)
Hippocampal formation
Audiology
behavioral disciplines and activities
White matter
03 medical and health sciences
Craniopharyngioma
Random Allocation
Young Adult
0302 clinical medicine
Endocrinology
Internal medicine
medicine
Cingulum (brain)
Humans
Gerontologi
medicinsk/hälsovetenskaplig inriktning
Cognitive Dysfunction
Pituitary Neoplasms
Gerontology
specialising in Medical and Health Sciences
Episodic memory
business.industry
Fornix
General Medicine
Organ Size
Middle Aged
White Matter
medicine.anatomical_structure
Cross-Sectional Studies
Diffusion Tensor Imaging
Clinical Study
Female
business
030217 neurology & neurosurgery
Follow-Up Studies
Zdroj: European Journal of Endocrinology
ISSN: 1479-683X
0804-4643
Popis: 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.
Databáze: OpenAIRE
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