title: Affective Symptoms and White Matter Changes in Brain Tumor Patients.
abstract: BACKGROUND
  Affective symptoms are frequent in patients with brain tumors. The origin of such symptoms is unknown; either focal brain injury or reactive emotional distress may be responsible. This cross-sectional pilot study linked depressive symptoms and anxiety to white matter integrity. The objective was to test the hypothesis of a relationship between tissue damage and brain function in patients with brain tumors and to provide a basis for further studies in this field.
  
  
  METHODS
  Diffusion tensor imaging was performed in 39 patients with newly diagnosed supratentorial primary brain tumor. Patients completed the Beck Depression Inventory, and examiners rated them on the Hamilton Depression Rating Scale (HDRS). State and trait anxiety were measured using the State-Trait Anxiety Inventory. Correlations between fractional anisotropy (FA) and psychological measures were assessed on the basis of regions of interest; the defined regions of interest corresponded to clearly specified white matter tracts.
  
  
  RESULTS
  Statistical analysis revealed correlations between FA in the left internal capsule and scores on the HDRS, Beck Depression Inventory, and State-Trait Anxiety Inventory (P < 0.05). HDRS scores were also correlated with FA in the right medial uncinate fasciculus, and state anxiety scores were significantly correlated with FA in the left lateral and medial uncinate fasciculus (P < 0.05).
  
  
  CONCLUSIONS
  Our results suggest that neurobiologic mechanisms related to the integrity of tissue in specific white matter tracts may influence affective symptoms in patients with brain tumors, and these mechanisms can be investigated with diffusion tensor imaging. However, prospective observational studies are needed to investigate further the links between brain structures and the severity of affective symptoms in this patient population.
authors.affiliation: Department of Psychiatry, University Hospital of Zurich, University of Zurich, Zürich, Switzerland. Electronic address: andre.richter@uzh.ch.
authors.forename: Andre
authors.initials: A
authors.lastname: Richter
authors.affiliation: Department of Neurosurgery, University Hospital of Zurich, University of Zurich, Zürich, Switzerland.
authors.forename: Cristoph M
authors.initials: CM
authors.lastname: Woernle
authors.affiliation: Department of Neurosurgery, University Hospital of Zurich, University of Zurich, Zürich, Switzerland.
authors.forename: Niklaus
authors.initials: N
authors.lastname: Krayenbühl
authors.affiliation: Department of Neuroradiology, University Hospital of Zurich, University of Zurich, Zürich, Switzerland.
authors.forename: Spyridon
authors.initials: S
authors.lastname: Kollias
authors.affiliation: Department of Neurosurgery, University Hospital of Zurich, University of Zurich, Zürich, Switzerland.
authors.forename: David
authors.initials: D
authors.lastname: Bellut
mesh_terms: D000328:Adult; D000342:Affective Symptoms / Q000209:etiology* / Q000523:psychology*; D000368:Aged; D001007:Anxiety / Q000209:etiology / Q000523:psychology; D001932:Brain Neoplasms / Q000150:complications* / Q000473:pathology / Q000523:psychology*; D003430:Cross-Sectional Studies; D003863:Depression / Q000209:etiology / Q000523:psychology; D056324:Diffusion Tensor Imaging; D005260:Female; D006801:Humans; D020772:Internal Capsule / Q000473:pathology; D008297:Male; D008875:Middle Aged; D010865:Pilot Projects; D011446:Prospective Studies; D011569:Psychiatric Status Rating Scales; D012959:Socioeconomic Factors; D066127:White Matter / Q000473:pathology*
keywords: Anxiety; Depression; Diffusion tensor imaging; Internal capsule; Primary brain tumor; Uncinate fasciculus