Artikel
Loss of microstructural integrity of the callosal body is associated with cognitive decline in patients with glioblastoma multiforme
Eine verminderte Integrität der Mikrostruktur des Corpus Callosum ist mit einer kognitiven Beeinträchtigung bei Patienten mit Glioblastoma multiforme assoziiert
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Autoren
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Xenia Hautmann
- Universitätsklinikum Würzburg, Department of Neurosurgery, Würzburg, Deutschland
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Carolin Weiß Lucas
- Uniklinik Köln, Abteilung für Neurochirurgie, Köln, Deutschland
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Roland Goldbrunner
- Uniklinik Köln, Abteilung für Neurochirurgie, Köln, Deutschland
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Mario Löhr
- Universitätsklinikum Würzburg, Department of Neurosurgery, Würzburg, Deutschland
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Ralf-Ingo Ernestus
- Universitätsklinikum Würzburg, Department of Neurosurgery, Würzburg, Deutschland
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Stefan Rückriegel
- Universitätsklinikum Würzburg, Department of Neurosurgery, Würzburg, Deutschland
| Veröffentlicht: | 8. Mai 2019 |
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Gliederung
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Objective: In this study, we aimed at a specific characterization of the association between cognitive decline and damage to white matter fiber bundles in patients with a glioblastoma multiforme (GBM) before treatment. Since the callosal body (CB) is an important anatomical substrate for cognitive function, we hypothesised that loss of fractional anisotropy (FA) in three parts of the CB correlates significantly with impairment of specific neuropsychological parameters.
Methods: Thirteen patients with a radiologically suspected, supratentorial and monolocular GBM underwent preoperatively a neuropsychological test battery as a part of the multicenter study NOA-19. MRI including diffusion tensor imaging was carried out before surgery to identify a loss of integrity of the CB. We created FA maps and merged them with MPRAGE images using the software FSL, Oxford (fMRI Software Library). We defined three parts of the CB (anterior, middle and posterior CB; respectively genu, body and splenium) and determined the average FA in each of them. Finally, the neuropsychological parameters were correlated with the mean FA of these three regions (Spearman correlation, two-tailed), using the statistical software SPSS. P-values below 0.01 were regarded as significant due to multiple comparisons.
Results: Five parameters of different cognitive domains correlated significantly with the FA of different parts of the CB (p<0.01), predominantly in the anterior CB and middle CB. Detailed cognitive functions, significance levels and correlation coefficients are displayed in Table 1 [Tab. 1]. In all significant correlations, a higher FA value went along with a better cognitive function.
Conclusion: In the present study, we verified significant correlations between the integrity of the microstructure of the CB and different cognitive functions. These functions include graphomotor and visual motor abilities, fluency of speech and memory. Consequently, changes of FA in the CB seem to be a good indicator for cognitive function. The investigation of the postoperative course of this association is warranted in order to examine the impact of resection and adjuvant treatment.
