Brain structural network to investigate the mechanism of cognitive impairment in patients with acoustic neuroma

Abstract

ObjectiveAcoustic neuroma (AN) is a common benign tumor. Little is known of neuropsychological studies in patients with acoustic neuroma, especially cognitive neuropsychology, and the neuropsychological abnormalities of patients affect their life quality. The purpose of this study was to explore the changes in the cognitive function of patients with acoustic neuroma, and the possible mechanism of these changes by structural magnetic resonance imaging.Materials and methodsWe used a neuropsychological assessment battery to assess cognitive function in 69 patients with acoustic neuroma and 70 healthy controls. Then, we used diffusion tensor imaging data to construct the structural brain network and calculate topological properties based on graph theory, and we studied the relation between the structural brain network and cognitive function. Moreover, three different subnetworks (short-range subnetwork, middle-range subnetwork, and long-range subnetwork) were constructed by the length of nerve fibers obtained from deterministic tracking. We studied the global and local efficiency of various subnetworks and analyzed the correlation between network metrics and cognitive function. Furthermore, connectome edge analysis directly assessed whether there were differences in the number of fibers in the different brain regions. We analyzed the relation between the differences and cognitive function.ResultsCompared with the healthy controls, the general cognitive function, memory, executive function, attention, visual space executive ability, visual perception ability, movement speed, and information processing speed decreased significantly in patients with acoustic neuroma. A unilateral hearing loss due to a left acoustic neuroma had a greater impact on cognitive function. The results showed that changes in the global and local metrics, the efficiency of subnetworks, and cognitively-related fiber connections were associated with cognitive impairments in patients with acoustic neuroma.ConclusionPatients exhibit cognitive impairments caused by the decline of the structure and function in some brain regions, and they also develop partial compensation after cognitive decline. Cognitive problems are frequent in patients with acoustic neuroma. Including neuropsychological aspects in the routine clinical evaluation and appropriate treatments may enhance the clinical management and improve their life quality.

Executive functions in patients with bilateral and unilateral peripheral vestibular dysfunction

“…We are able to exclude some alternative explanations for the impaired verbal initiation and working memory span in patients with bilateral PVD. First, contrary to some earlier studies [ 26 , 31 , 56 ], we used nonspatial tasks and can therefore rule out visuo-spatial influences on executive performance. The working memory span task may have a visuo-spatial component (mental number line), but the verbal initiation task does not rely on visuo-spatial performance.…”

“…However, patients with bilateral PVD performed equally as healthy controls in a verbal fluency task, a subdomain of initiation [ 101 ]. Inhibition and working memory were found to be reduced in patients with bilateral, chronic unilateral, and acute unilateral PVD [ 1 , 4 , 23 , 26 , 31 , 56 , 70 , 71 , 75 , 77 , 98 ]. Some other studies, however, did not find reduced inhibition or working memory performance in patients with bilateral or chronic unilateral PVD [ 1 , 23 , 75 , 98 ].…”

“…Some other studies, however, did not find reduced inhibition or working memory performance in patients with bilateral or chronic unilateral PVD [ 1 , 23 , 75 , 98 ]. Cognitive flexibility was reduced in patients with chronic unilateral [ 26 , 31 ], but normal in patients with bilateral [ 101 ] or a mixed sample of bilateral and chronic unilateral PVD [ 74 , 98 ].…”

“…Therefore, previous studies do not allow for a general conclusion about impaired executive functions. Second, in some studies, executive components were measured with spatial tests [ 26 , 31 , 56 ], thus making it impossible to disentangle spatial from executive deficits. Third, some studies did not control for processing speed when assessing reaction time in executive tasks [ 31 , 77 ].…”

A Novel Multi-Model High Spatial Resolution Method for Analysis of DCE MRI Data: Insights from Vestibular Schwannoma Responses to Antiangiogenic Therapy in Type II Neurofibromatosis

“…In this NF2 patient cohort, a significant positive correlation between total VS disease burden and K trans values in NAGM/NAWM was observed. In patients with VS, there is emerging evidence that there can be effects on the brain remote to the tumour, with previous diffusion and functional MRI studies demonstrating widespread changes in activity networks, grey matter volume, and white matter fibre integrity in auditory and non-auditory regions in patients with these tumours [ 57 , 58 , 59 , 60 , 61 ]. To date, however, changes in DCE-MRI parameters within the normal-appearing brain of patients with NF2 have not been evaluated and further large, detailed studies are required to better understand the pathophysiology of the observed K trans changes and their relationship to the tumour burden in these patients.…”