title: Remote effects of hypothalamic lesions in the prefrontal cortex of craniopharygioma patients.
abstract: Albeit histologically low grade (WHO I(o)) brain tumors, craniopharyngiomas and/or their surgical removal frequently affect the hypothalamus, amongst other brain regions at risk. Due to rich hypothalamic connections with prefrontal and limbic regions, hypothalamic injury may adversely affect neural substrates of emotion processing and higher cognitive control, including memory and executive functions. The current study is the first to investigate the consequences of hypothalamic involvement on neural substrates of emotional and cognitive functioning. Ten patients with childhood craniopharyngioma and known hypothalamic involvement and fifteen age- and intelligence matched control subjects (median age: 17.8 and 17.3 yrs.) were studied with functional magnetic resonance imaging and an emotional face recognition task. During encoding, participants were asked to classify neutral and emotional faces. In a subsequent recognition phase, participants had to recognize these old faces within a set of new faces. Behavioral performance was comparable between patients and controls. Neural activity revealed, however, differential recruitment of fronto-limbic brain regions during recognition. Patients exhibited an abnormal pattern of task-induced activation and deactivation in the anterior and posterior rostral medial prefrontal cortex and a higher functional coupling between anterior rostral medial prefrontal cortex and the thalamus. Additionally, we found a higher reactivity in the patients' amygdala to emotional relative to neutral faces when compared to healthy controls. Our data provide first evidence that hypothalamic damage impacts neural correlates of memory retrieval in medial prefrontal cortex, indicating a less efficient use of an area involved in executive control processes. We propose that the deactivation failure in the patients' anterior rostral medial prefrontal cortex is related to an increased coupling with the thalamus and reflects a reduced efficiency to flexibly adapt to task demands.
authors.affiliation: Biological Psychology Lab, Department of Psychology, European Medical School, Carl von Ossietzky Universität, 26111 Oldenburg, Germany. Electronic address: jale.oezyurt@uni-oldenburg.de.
authors.forename: Jale
authors.initials: J
authors.lastname: Ozyurt
authors.affiliation: Biological Psychology Lab, Department of Psychology, European Medical School, Carl von Ossietzky Universität, 26111 Oldenburg, Germany.
authors.forename: Anna
authors.initials: A
authors.lastname: Lorenzen
authors.affiliation: Department of Pediatrics and Pediatric Hematology and Oncology, Zentrum für Kinder- und Jugendmedizin, Klinikum Oldenburg gGmbH, 26131 Oldenburg, Germany.
authors.forename: Ursel
authors.initials: U
authors.lastname: Gebhardt
authors.affiliation: Department of Neuroradiology, University Hospital Würzburg, 97080 Würzburg, Germany.
authors.forename: Monika
authors.initials: M
authors.lastname: Warmuth-Metz
authors.affiliation: Department of Pediatrics and Pediatric Hematology and Oncology, Zentrum für Kinder- und Jugendmedizin, Klinikum Oldenburg gGmbH, 26131 Oldenburg, Germany.
authors.forename: Hermann L
authors.initials: HL
authors.lastname: Müller
authors.affiliation: Biological Psychology Lab, Department of Psychology, European Medical School, Carl von Ossietzky Universität, 26111 Oldenburg, Germany; Research Center Neurosensory Science, Carl von Ossietzky Universität, 26111 Oldenburg, Germany.
authors.forename: Christiane M
authors.initials: CM
authors.lastname: Thiel
mesh_terms: D000293:Adolescent; D000328:Adult; D001931:Brain Mapping; D003397:Craniopharyngioma / Q000503:physiopathology*; D004644:Emotions / Q000502:physiology*; D005149:Facial Expression; D005260:Female; D006801:Humans; D007031:Hypothalamus / Q000473:pathology*; D008279:Magnetic Resonance Imaging; D008297:Male; D009415:Nerve Net / Q000503:physiopathology; D010911:Pituitary Neoplasms / Q000503:physiopathology*; D017397:Prefrontal Cortex / Q000503:physiopathology*; D021641:Recognition, Psychology / Q000502:physiology; D055815:Young Adult
keywords: Craniopharyngioma; Executive functions; Hypothalamus; Memory; Neuroimaging; Prefrontal