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Cited by 31Pituitary Gland Disorders and TreatmentsAdvanced Neuroimaging Techniques and ApplicationsNeuroendocrine regulation and behavior

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

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Fjalldal, S, Follin, C, Svärd, D, Rylander, L, Gabery, S, Petersén, Å, van Westen, D, Sundgren, P C +5 more·2018·European Journal of Endocrinology
DOI 10.1530/eje-18-0081PMC PMC5937918
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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.

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  • Individuals with craniopharyngioma have impaired episodic memory and slowed processing speeds that are associated with changes in hippocampal volumes and white matter alterations on brain imaging.

    “Individuals with craniopharyngioma have impaired episodic memory and slowed processing speeds that are associated with changes in hippocampal volumes and white matter alterations on brain imaging (87).”

    From Approach to the patient with acquired hypothalamic syndrome (2026) · cites this paper as [87]

    The Discussion links hippocampal volume and white-matter alterations to poorer episodic visual memory and links cingulum alterations to processing speed. However, the Results report no significant cognitive-test differences between the whole craniopharyngioma group and controls; the reported memory and processing-speed differences were in the subgroup with hypothalamic lesions. The claim overgeneralizes those impairments to all individuals with craniopharyngioma. (LLM, conf=0.88)

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Authors
Fjalldal, S., Follin, C., Svärd, D., Rylander, L., Gabery, S., Petersén, Å., van Westen, D., Sundgren, P. C., Björkman-Burtscher, I. M., Lätt, J., Ekman, B., Johanson, A., & Erfurth, E. M.
Affiliations
  • Skåne University Hospital (SE)
  • 2Department of Diagnostic Radiology, Clinical Sciences
  • Lund University (SE)
  • Linköping University (SE)
Corresponding author
Erfurth, E M
ORCID
Venue
European Journal of Endocrinology
Publisher
Oxford University Press (OUP)
Published
2018-06
Volume
178
Issue
6
Pages
577-587
ISSN
  • 0804-4643 (ISSN-L)
  • 1479-683X
DOI
10.1530/eje-18-0081
PMC
PMC5937918
OpenAlex
W2794933342
Cited by
31
References
3
Citations by year
2026: 4 · 2025: 2 · 2024: 2 · 2023: 4 · 2022: 1 · 2021: 7 · 2020: 6 · 2019: 5
FWCI
3.58
Type
journal article
Language
en
Open access
Licence
Locations
  • European Journal of Endocrinology (publishedVersion, cc-by)
  • Europe PMC (PubMed Central) (publishedVersion, cc-by)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
  • DiVA (Linkoping University) (submittedVersion, other-oa)
  • Lund University Publications (Lund University) (submittedVersion)
Topics
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Pituitary Gland Disorders and Treatments
  • Health Sciences › Medicine › Radiology, Nuclear Medicine and Imaging › Advanced Neuroimaging Techniques and Applications
  • Social Sciences › Psychology › Social Psychology › Neuroendocrine regulation and behavior
Keywords
craniopharyngioma, childhood-onset craniopharyngioma, hypothalamic lesions, white matter microstructure, hippocampal volume, cognitive impairment, uncinate fasciculus, cingulum, fornix, visual episodic memory, executive function, visuospatial ability, general knowledge, diffusion tensor imaging
MeSH terms
Adolescent, Adult, Craniopharyngioma, Cross-Sectional Studies, Female, Follow-Up Studies, Hippocampus, Humans, Male, Middle Aged, Organ Size, Pituitary Neoplasms, Random Allocation, Young Adult, Diffusion Tensor Imaging, Cognitive Dysfunction, White Matter

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