Abnormalities in hippocampal volume of glioma patients prior to radiotherapy

Abstract

Background: Radiation-induced cognitive impairment may be mediated by hippocampal damage, but the structural integrity of this region in tumor patients at baseline is unclear. Hippocampal volumes of 31 glioma patients prior to receiving radiotherapy were compared to a group of 34 healthy controls.Materials and methods: Left and right hippocampi on T1-weighted pre-contrast magnetic resonance images were automatically segmented using Freesurfer, and visually inspected for segmentation errors. Normalized hippocampal volume for each subject was calculated as the sum of left and right hippocampal volumes divided by the estimated total intracranial volume. The normalized amygdala volume was similarly analyzed as a reference structure.Results: A Wilcoxon rank-sum test showed a significant difference in normalized hippocampal volumes between patients and controls (mean value 0.499 vs. 0.524, p = .01). No statistically significant difference was found for the amygdala. A post-hoc analysis revealed a significant difference in normalized hippocampal volumes between patients who had experienced seizures (mean value: 0.480, p < .05) and controls. No difference was noted between patients without seizures (mean value: 0.513) and controls.Conclusions: Hippocampi of glioma patients prior to radiotherapy were significantly smaller than those of age-matched controls. Group differences were larger in patients with tumor-associated seizures. This may be secondary to other processes such as tumor biology and inflammation.