title: Hypothalamic involvement predicts cognitive performance and psychosocial health in long-term survivors of childhood craniopharyngioma.
abstract: BACKGROUND
  Hypothalamic damage caused by craniopharyngioma (CP) is associated with poor functional outcome.
  
  
  OBJECTIVE
  To assess cognitive function and quality of life in childhood-onset CP on hormonal replacement, including GH treatment.
  
  
  METHODS
  A cross-sectional study with a median follow-up time of 20 years (1-40).
  
  
  METHODS
  Patients were recruited from the South Medical Region of Sweden.
  
  
  METHODS
  The study included 42 patients (20 women) surgically treated for a childhood-onset CP between 1958 and 2000. Patients were aged ≥17 years. Equally many controls, matched for age, sex, residence, and smoking habits, were included. Tumor growth into the third ventricle was found in 25 patients.
  
  
  METHODS
  All subjects were examined with a battery of cognitive tests and the following questionnaires: Symptom Checklist-90, the Interview Schedule for Social Interaction, and the Social Network concept.
  
  
  RESULTS
  The CP patients had lower cognitive performance, reaching statistical significance in 12 of 20 test variables, including executive function and memory. Comparison of patients with tumor growth into the third ventricle to controls revealed a significant lower mean total score (P = .006). A significant negative correlation was recorded between mean z-score of cognitive performance and years since operation (r = -0.407; P = .014). No statistically significant group differences were observed across any of the 9 Symptom Checklist-90 subscales.
  
  
  CONCLUSIONS
  Adults with childhood-onset CP, on hormone replacement, including GH treatment, have memory defects, disturbed attention, and impaired processing speed. Patients with hypothalamic involvement are more affected. Patients rated their quality of life as good as their matched controls.
authors.affiliation: Department of Endocrinology, Skåne University Hospital, SE-221 85 Lund, Sweden.
authors.forename: Sigridur
authors.initials: S
authors.lastname: Fjalldal
authors.forename: Helene
authors.initials: H
authors.lastname: Holmer
authors.forename: Lars
authors.initials: L
authors.lastname: Rylander
authors.forename: Maria
authors.initials: M
authors.lastname: Elfving
authors.forename: Bertil
authors.initials: B
authors.lastname: Ekman
authors.forename: Kai
authors.initials: K
authors.lastname: Osterberg
authors.forename: Eva Marie
authors.initials: EM
authors.lastname: Erfurth
mesh_terms: D000293:Adolescent; D000328:Adult; D001288:Attention; D002648:Child; D003071:Cognition; D003397:Craniopharyngioma / Q000401:mortality / Q000473:pathology / Q000523:psychology* / Q000601:surgery; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D007031:Hypothalamus / Q000473:pathology*; D008297:Male; D008568:Memory; D008603:Mental Health; D008875:Middle Aged; D010911:Pituitary Neoplasms / Q000401:mortality / Q000523:psychology* / Q000601:surgery; D011788:Quality of Life; D017741:Survivors