title: White matter changes linked to visual recovery after nerve decompression.
abstract: The relationship between the integrity of white matter tracts and cortical function in the human brain remains poorly understood. We investigate reversible white matter injury, in this case patients with compression of the optic chiasm by pituitary gland tumors, to study the structural and functional changes that attend spontaneous recovery of cortical function and visual abilities after surgical removal of the tumor and subsequent decompression of the nerves. We show that compression of the optic chiasm led to demyelination of the optic tracts, which reversed as quickly as 4 weeks after nerve decompression. Furthermore, variability across patients in the severity of demyelination in the optic tracts predicted visual ability and functional activity in early cortical visual areas. Preoperative measurements of myelination in the optic tracts predicted the magnitude of visual recovery after surgery. These data indicate that rapid regeneration of myelin in the human brain is a component of the normalization of cortical activity, and ultimately the recovery of sensory and cognitive function, after nerve decompression. More generally, our findings demonstrate the use of diffusion tensor imaging as an in vivo measure of myelination in the human brain.
authors.affiliation: Department of Brain and Cognitive Sciences, University of Rochester, Rochester, NY 14642, USA. Department of Neurobiology and Anatomy, University of Rochester School of Medicine, Rochester, NY 14642, USA.
authors.forename: David A
authors.initials: DA
authors.lastname: Paul
authors.affiliation: Department of Brain and Cognitive Sciences, University of Rochester, Rochester, NY 14642, USA.
authors.forename: Elon
authors.initials: E
authors.lastname: Gaffin-Cahn
authors.affiliation: Department of Brain and Cognitive Sciences, University of Rochester, Rochester, NY 14642, USA. Department of Neurosurgery, University of Rochester School of Medicine, Rochester, NY 14642, USA.
authors.forename: Eric B
authors.initials: EB
authors.lastname: Hintz
authors.affiliation: Department of Neuroscience, University of Rochester, Rochester, NY 14642, USA.
authors.forename: Giscard J
authors.initials: GJ
authors.lastname: Adeclat
authors.affiliation: Department of Radiation Oncology, University of Michigan Medical Center, Ann Arbor, MI 48109, USA.
authors.forename: Tong
authors.initials: T
authors.lastname: Zhu
authors.affiliation: Department of Ophthalmology, University of Rochester School of Medicine, Rochester, NY 14642, USA.
authors.forename: Zoë R
authors.initials: ZR
authors.lastname: Williams
authors.affiliation: Department of Neurosurgery, University of Rochester School of Medicine, Rochester, NY 14642, USA.
authors.forename: G Edward
authors.initials: GE
authors.lastname: Vates
authors.affiliation: Department of Brain and Cognitive Sciences, University of Rochester, Rochester, NY 14642, USA. Department of Neurosurgery, University of Rochester School of Medicine, Rochester, NY 14642, USA. Center for Visual Science, University of Rochester, Rochester, NY 14642, USA. mahon@rcbi.rochester.edu.
authors.forename: Bradford Z
authors.initials: BZ
authors.lastname: Mahon
mesh_terms: D000236:Adenoma / Q000378:metabolism / Q000601:surgery*; D000328:Adult; D000465:Algorithms; D016477:Artifacts; D001499:Bayes Theorem; D001921:Brain / Q000473:pathology; D001931:Brain Mapping / Q000379:methods; D019299:Decompression, Surgical; D056324:Diffusion Tensor Imaging; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009038:Motion; D009186:Myelin Sheath / Q000737:chemistry; D009473:Neuronal Plasticity; D009474:Neurons / Q000473:pathology; D065866:Optic Tract; D010911:Pituitary Neoplasms / Q000378:metabolism / Q000601:surgery*; D011601:Psychophysics / Q000379:methods; D014785:Vision, Ocular; D066127:White Matter / Q000473:pathology*