Cognitive interference processing in adults with childhood craniopharyngioma using functional magnetic resonance imaging

Daniel SväRd,Peter Mannfolk,Robin Hellerstedt,Sigridur Fjalldal,Johan MåRtensson,Cecilia Follin,Pia Sundgren,Eva Marie Erfurth

doi:10.1007/s12020-021-02824-9

Daniel SväRd, Peter Mannfolk + Show 6 more

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https://doi.org/10.1007/s12020-021-02824-9

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Abstract

PurposeTo assess cognitive interference processing in adults with childhood craniopharyngioma (CP), with and without hypothalamic injury, respectively, in terms of behavioral performance and functional magnetic resonance imaging (fMRI) activity, using the multi-source interference task (MSIT).MethodsTwenty-eight CP patients (median age 34.5 [29.0–39.5] years) were investigated at median 20.5 (16.3–28.8) years after treatment with surgical resection and in some cases additional radiotherapy (n = 10) and compared to 29 matched controls (median age 37.0 [32.5–42.0] years). The subjects performed the MSIT during fMRI acquisition and behavioral performance in terms of response times (ms) and accuracy performance (%) were recorded.ResultsThe MSIT activated the cingulo-fronto-parietal (CFP) attention network in both CP patients and controls. No differences were found in behavioral performance nor fMRI activity between CP patients (interference effect 333.9 [287.3–367.1] ms and 3.1 [1.6–5.6]%, respectively) and controls (309.1 [276.4–361.0] ms and 2.6 [1.6–4.9]%). No differences were found in behavioral performance nor fMRI activity between the two subgroups with (332.0 [283.6–353.4] ms and 4.2 [2.3–5.7]%, respectively) and without hypothalamic injury (355.7 [293.7–388.7] ms and 2.1 [1.0–5.2]%, respectively), respectively, and controls.ConclusionAdults with childhood CP performed cognitive interference processing equally well as controls and demonstrated no compensatory fMRI activity in the CFP attention network compared to controls. This was also true for the two subgroups with and without hypothalamic injury. The results can be useful to better characterize this condition, and to optimize treatment and support for these individuals.

Highlights

Craniopharyngioma (CP) is a rare, benign, embryonic pituitary tumor with an aggressive growth pattern and high recurrence rate, associated with increased mortality and morbidity in cardiovascular disease [1,2,3,4,5,6]
The difference in functional magnetic resonance imaging (fMRI) activity required to perform the more cognitively demanding interference tasks compared to the control tasks, demonstrated fMRI activity in the CFP attention network, in both the CP patients, the two subgroups of CP patients with and without hypothalamic injury, respectively, and in the control group
Comparisons between CP patients and controls, CP patients with hypothalamic injury and controls, and CP patients without hypothalamic injury and controls showed no significant differences in fMRI activity between any of the groups

Summary

Introduction

Craniopharyngioma (CP) is a rare, benign, embryonic pituitary tumor with an aggressive growth pattern and high recurrence rate, associated with increased mortality and morbidity in cardiovascular disease [1,2,3,4,5,6]. A previous study using magnetic resonance imaging (MRI) voxel-based morphometry have demonstrated reduced gray and white matter volumes in the limbic areas connected to the hypothalamus and an association between impaired long-term memory and reduced gray matter volumes in the posterior cingulate cortex in adolescents with childhood CP [10]. Another previous study using diffusion tensor imaging (DTI), reported an association between microstructural white matter alterations in the dorsal cingulum and a decline in episodic visual memory, visuospatial abilities, executive function, attention, and processing speed in adults with childhood CP [11]. This study reported an association between alterations in the ventral cingulum and a decline in episodic visual memory, and an association between alterations in the uncinate fasciculus and a decline in semantic memory [11]

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