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

作者：Fjalldal S; Follin C; Svard D; Rylander L; Gabery S; Petersen A; van Westen D; Sundgren P C; Bjorkman Burtscher I M; Latt J; Ekman B; Johanson A; Erfurth E M^*

来源：European Journal of Endocrinology, 2018, 178(6): 577-587.

DOI：10.1530/EJE-18-0081

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. HI 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.

• 出版日期2018-6