ECE2015 Guided Posters Pituitary–Basic and IGF-1 (9 abstracts)
A small hypothalamic volume correlates with impaired cognitive outcome in childhood onset craniopharyngioma on long-term follow up
Sigridur Fjalldal 1 , Cecilia Follin 1 , Sanaz Gabery 2 , Æsa Petersén 2 , Lars Rylander 3 , Bertil Ekman 4 , Aki Johansson 5 , Kai Österberg 3 , Magdalena Jansson 5 , Andrea Rovira 5 & Eva-Marie Erfurth 1
1Department of Endocrinology, Skåne University Hospital, Lund, Sweden; 2Translational Neuroendocrine Research Unit, Department of Experimental Medical Science, Lund University, Lund, Sweden; 3Division of Occupational and Environmental Medicine, Lund University, Lund, Sweden; 4Department of Medical and Health Sciences, Linköping University, Linköping, Sweden; 5Institution of Psychology, Lund University, Lund, Sweden.
Background: Hypothalamic damage caused by craniopharyngioma (CP) is related to memory deficits, disturbed attention, and impaired processing speed. This is the first study that aims to establish a structure to function relationship by assessing cognitive function in adult patients with childhood-onset (CO) CP along with volumetric analysis of the hypothalamus.
Method: Forty-one (24 women) surgically treated CO-CP patients (median age at diagnosis; 11 years) from the South Medical Region of Sweden were included in the study. Eighteen patients had received cranial radiotherapy. Twenty-eight patients had panhypopituitarism, 35 were treated with ADH and 32 with GH. Time since first operation was 23 years (range 4–49) and median age at investigation was 35 years. Hypothalamic damage was found in 23 patients. All subjects were examined with a battery of cognitive tests and 35 patients underwent magnetic resonance imaging (MRI). A novel delineation procedure based on T1-weighted MRI and landmarks used in histologically processed postmortem hypothalamic tissue was used to estimate hypothalamic volume. Comparisons were made with 32 healthy matched controls.
Results: CP patients with hypothalamic damage (n=23) had lower cognitive performance pertaining to vocabulary (P=0.02) short term memory (P=0.04 and P=0.01), spatial ability (P=0.02), and executive functions (P=0.01 and P=0.02). A significantly positive correlation was found between the tests of vocabulary (r=0.352, P=0.04) and short term memory (r=0.354, P=0.04), (r=0.357, P=0.04) and hypothalamic volume.
Conclusion: Adults with hypothalamic damage due to CO-CP have impaired memory, spatial ability and executive function. Patients with smaller hypothalamic volume have worse cognitive outcome. To be able to preserve hypothalamic function we need tailored surgical and radiation strategies. Long-term follow up should include training programs pertaining to impaired cognitive function.
Disclosure: The Swedish Children’s Cancer Foundation, the Medical Faculty, Lund University, Sweden.
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Endocrine Abstracts
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