title: Hypothalamic tumors impact gray and white matter volumes in fronto-limbic brain areas.
abstract: Patients with hypothalamic involvement of a sellar/parasellar tumor often suffer from cognitive and social-emotional deficits that a lesion in the hypothalamus cannot fully explain. It is conceivable that these deficits are partly due to distal changes in hypothalamic networks, evolving secondary to a focal lesion. Focusing on childhood-onset craniopharyngioma patients, we aimed at investigating the impact of hypothalamic lesions on gray and white matter areas densely connected to the hypothalamus, and to relate structural changes to neuropsychological deficits frequently observed in patients. We performed a voxel-based morphometric analysis based on data of 11 childhood-onset craniopharyngioma patients with hypothalamic tumor involvement, and 18 healthy controls (median age: 17.2 and 17.4 yrs.). Whole-brain analyses were used to test for volumetric differences between the groups (T-tests) and subsequent regression analyses were used to correlate neuropsychological performance with gray and white matter volumes within the patient group. Patients compared to controls had significantly reduced gray matter volumes in areas of the anterior and posterior limbic subsystems which are densely connected with the hypothalamus. In addition, a reduction in white matter volumes was observed in tracts connecting the hypothalamus to other limbic areas. Worse long-term memory retrieval was correlated with smaller gray matter volumes in the posterior cingulate cortex. Our data provide the first evidence that hypothalamic tumor involvement impacts gray and white matter volumes in limbic areas, outside the area of tumor growth. Notably, the functional range of the two limbic subsystems affected, strikingly parallels the two major domains of psychological complaints in patients i.e., deficits in episodic memory and in socio-emotional functioning. We suggest that focal hypothalamic lesions may trigger distal changes in connected brain areas, which then contribute to the impairments in cognitive, social and emotional performance often observable in patients, and not explicable by a hypothalamic lesion alone.
authors.affiliation: Biological Psychology Lab, Department of Psychology, Faculty of Medicine and Health Sciences, Carl von Ossietzky Universität Oldenburg, Oldenburg, Germany. Electronic address: jale.oezyurt@uni-oldenburg.de.
authors.forename: Jale
authors.initials: J
authors.lastname: Özyurt
authors.affiliation: Department of Pediatrics and Pediatric Hematology and Oncology, Klinikum Oldenburg, Medical Campus University Oldenburg, Oldenburg, Germany.
authors.forename: Hermann L
authors.initials: HL
authors.lastname: Müller
authors.affiliation: Department of Neuroradiology, University Hospital Würzburg, Würzburg, Germany.
authors.forename: Monika
authors.initials: M
authors.lastname: Warmuth-Metz
authors.affiliation: Biological Psychology Lab, Department of Psychology, Faculty of Medicine and Health Sciences, Carl von Ossietzky Universität Oldenburg, Oldenburg, Germany; Research Center Neurosensory Science and Cluster of Excellence "Hearing4all", Carl von Ossietzky Universität Oldenburg, Oldenburg, Germany.
authors.forename: Christiane M
authors.initials: CM
authors.lastname: Thiel
mesh_terms: D000293:Adolescent; D000328:Adult; D002648:Child; D003397:Craniopharyngioma / Q000000981:diagnostic imaging* / Q000473:pathology; D005260:Female; D005625:Frontal Lobe / Q000000981:diagnostic imaging* / Q000473:pathology; D066128:Gray Matter / Q000000981:diagnostic imaging* / Q000473:pathology; D006801:Humans; D007029:Hypothalamic Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology; D008032:Limbic System / Q000000981:diagnostic imaging* / Q000473:pathology; D008297:Male; D009929:Organ Size; D066127:White Matter / Q000000981:diagnostic imaging* / Q000473:pathology; D055815:Young Adult
keywords: Brain tumors; Cognitive; Craniopharyngioma; Hypothalamus; Social-emotional