Endocrine Abstracts

Introduction: The morbidity of craniopharyngioma (CP) includes cognitive dysfunction with attention deficits, impaired episodic memory and processing speed (Fjalldal et al., 2013) and CP patients with hypothalamic damage are more affected. fMRI is a technique used to investigate cortical activity by detecting alterations in blood flow in response to stimuli or actions. Previously pre- and post-meal fMRI responses to visual food cues were investigated showing higher activation in patients with CP compared to controls (Christian et al., 2012). Further, fMRI was used in an emotional face recognition task where neural activity revealed differential recruitment of fronto-limbic brain regions during recognition in patients with CP (Ozyurt et al., 2014). The multi-source interference task is an fMRI paradigm that reliably activates the cingulo-fronto-parietal cognitive/attention network (Bush et al., 2006). Our aim was to study activation in the cingulo-fronto-parietal cognitive/attention network using fMRI. We hypothesized that the patient group would demonstrate different cortical activation patterns compared to controls.

Methods: Included were 29 adult childhood craniopharyngioma patients (median age 36 [18–49] years) surgically treated, 13 with hypothalamic damage, and 15 without. Twenty-nine controls were matched for age, sex, and smoking habits. A gradient echo EPI sequence (TR/TE 1500/30 ms/ms) with a number of 25 slices, a number of 64 dynamics, and a voxel size of 3 × 3 × 4 mm³ was used for the fMRI task. An additional MP-RAGE sequence (TR/TE 1900/2.54 ms/ms, 1 mm³ isotropic resolution) was acquired to be able to perform the data analysis. The multi-source interference task was performed (Bush et al., 2006). fMRI data processing was carried out using FEAT (FMRI Expert Analysis Tool) Version 6.00, part of FSL (FMRIB’s Software Library, www.fmrib.ox.ac.uk/fsl). Z (Gaussianised T/F) statistic images were thresholded non-parametrically using clusters determined by Z > 3.1 and a (corrected) cluster significance threshold of P = 0.05 (Woolrich et al., 2001). Higher-level analysis was carried out using FLAME (FMRIB’s Local Analysis of Mixed Effects) stage 1 (Beckmann et al., 2003).

Results: Activation maps demonstrate activation in expected areas (i.e. cingulo-fronto-parietal activation). No significant differences in activation was found between the patients gorup and controls.

Conclusion: In spite of well-known cognitive impairment in patients with CP we found no functional alterations in the cingulo-frontoparietal cognitive/attention network using fMRI.