In Vivo Characterization of Cortical and White Matter Microstructural Pathology in Growth Hormone-Secreting Pituitary Adenoma

Yuan, Taoyang; Ying, Jianyou; Li, Chuzhong; Kang, Jie; Shi, Yuanyu; Gui, Songbai; Liu, Chunhui; Wang, Rui; Zuo, Zhentao; Zhang, Yazhou

doi:10.3389/fonc.2021.641359

Cited by 4 publications

(3 citation statements)

References 51 publications

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“…Webb et al [22] found FA were significantly lower in the isolated growth hormone deficiency group. Yuan and his colleagues [23] reported long-term persistent and excess serum GH/IGF-1 levels alter the microstructure in white matter in growth hormonesecreting pituitary adenoma (acromegaly), and found lower fractional anisotropy (FA) and higher mean diffusivity (MD), in extensive bundles in acromegaly compared to non-functional pituitary adenoma controls. More research on association of brain white matter and GH/IGF-1 levels needed to be conducted.…”

Section: Discussionmentioning

confidence: 99%

Non-contrast MRI of Brain White Matter in Young Male Patients with Childhood-onset Adult Growth Hormone Deficiency: A Diffusion Tensor Imaging Study

Luo

Zhou

et al. 2022

Preprint

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BACKGROUND The brain structure and function of adult growth hormone deficiency (AGHD) have not been fully investigated so far. No previous studies have evaluated alterations in brain white matter degree and integrity in AGHD. PURPOSE To evaluate alterations in brain white matter degree and integrity in AGHD compared to age and gender-matched healthy controls and further explore the correlation between endocrine hormone and brain white matter. METHODS 17 young AGHD patients and 17 healthy controls were assessed by 3D volumetric T1-weighted magnetic resonance imaging (MRI). Whole brain and white matter volume were compared between two groups. Fractional anisotropy (FA) and mean diffusivity (MD) of brain white matter were calculated for group comparison based on DTI. Effect of disease status and hormone levels on FA and MD of brain white matter were evaluated. RESULTS AGHD had significantly lower serum insulin-like growth factor 1 (IGF-1)，free triiodothyronine (FT3) and free thyroxine (FT4) levels compared with control (p<0.001). AGHD presents no significant change compared with control neither on the whole brain volume (p =0.2) nor the white matter volume (p =0.78). Comparing with controls, brain regions mainly including Middle cerebellar peduncle were decreased on FA and Middle cerebellar peduncle were increased on MD in AGHD. MD of the Left superior longitudinal fasciculus was prominently only associated with serum levels of FT4 in control adjusting for IGF-1 levels. CONCLUSIONS Young adult male AGHD patients presented alteration of brain white matter on MD and FA in some brain regions.

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Section: Discussionmentioning

confidence: 99%

Non-contrast MRI of Brain White Matter in Young Male Patients with Childhood-onset Adult Growth Hormone Deficiency: A Diffusion Tensor Imaging Study

Luo

Zhou

et al. 2022

Preprint

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“…Recently, considerable attention has been directed to the impairment of brain function in acromegaly ( 25 ). Some studies demonstrated that a considerable proportion of patients with acromegaly perform below average in several cognitive tests, particularly in the domains of attention and memory ( 5 ).…”

Section: Discussionmentioning

confidence: 99%

Presence of cerebral microbleeds is associated with cognitive decline in acromegaly

Xie

Zhou

Zhang³

et al. 2022

Front. Oncol.

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BackgroundCognitive decline in acromegaly has gained increasing attention. Cerebral microbleeds (CMBs) as radiographic markers for microvascular injury have been linked to various types of cognitive decline. However, the association between CMB formation and acromegaly has not yet been quantified. This study is designed to investigate the prevalence and the radiographic patterns of CMBs and the association between cognitive function and acromegaly-related CMBs in growth hormone (GH)-secreting pituitary adenoma, which is characterized by acromegaly. MethodsIn a cohort of 55 patients with GH-secreting pituitary adenoma (acromegaly) and 70 healthy control (HC) patients, we determined the presence of CMBs using a 3.0-T MRI scanner. The numbers, locations, and grades of CMBs were determined via susceptibility-weighted imaging (SWI) and the Microbleed Anatomical Rating Scale. Obstructive sleep apnea (OSA) was assessed using the criteria of the American Academy of Sleep Medicine (AASM) Scoring Manual Version 2.2. The Montreal Cognitive Assessment (MoCA) was used to assess cognitive performance within 3 days of admission. The association between CMBs and cognitive function as well as clinical characteristics was explored.ResultsThe incidence of CMBs was 29.1%, whereas that of OSA was 65.5% in acromegaly. There was a statistically significant difference in the prevalence of CMBs between subjects with and without acromegaly (29.1% and 5.3%, respectively) (p < 0.01). The age of acromegaly patients with CMBs was much younger compared with HCs with CMBs. Compared with HCs, a significant cognitive decline and the occurrence of OSA were demonstrated in patients with acromegaly (p < 0.01). Binary logistic regression analysis adjusted for age, education, and body mass index (BMI) revealed that CMB was an independent risk factor for cognitive impairment in patients with acromegaly (OR = 3.19, 95% CI 1.51–6.76, p = 0.002). Furthermore, in the logistic regression models adjusted for age, BMI, diabetes, and hypertension, OSA was independently associated with the occurrence of CMBs in patients with acromegaly (OR = 13.34, 95% CI 3.09–57.51, p = 0.001).ConclusionsA significant increase of CMBs was demonstrated in patients with acromegaly, which may be a result of OSA in acromegaly. The present study indicated that increasing CMBs are responsible for cognitive decline in patients with acromegaly.

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“…This finding was confirmed by Yuan et al [ 71 ] in 2020, further finding a decrease in cerebrospinal fluid volume (CSFV) and that these changes significantly correlated with serum GH and IGF-1 levels. A subsequent in-depth study by Yuan et al [ 36 ] showed a general decrease in T1/T2 weighted ratio in most cortical and white matter in patients with acromegaly, implying extensive cortical and white matter demyelination and myelin regeneration. Alterations in structures such as the cerebral cortex, gray matter, and white matter may be responsible for neuropsychological dysfunction, including cognitive impairment, in patients.…”

Section: Mechanism Of Excess Gh and Igf-1 In Cognitive Impairmentsmentioning

confidence: 99%

Cognitive Dysfunction, an Increasingly Valued Long-Term Impairment in Acromegaly

Chen

Xiang

Zhang

et al. 2023

JCM

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Acromegaly is a chronic disease caused by the overproduction of growth hormone (GH) and accompanying insulin-like growth factor-1 (IGF-1), which is often caused by GH-secreting pituitary adenomas. In addition to its somatic burden, a growing number of studies have found that patients suffering from acromegaly exhibit psychosocial and personality changes. Over the past 70 years, there has been increasing interest in the cognitive impairment and neuropsychological issues of patients with acromegaly, and a variety of neuropsychological and neurophysiological tests have been used to measure cognitive changes in patients. The impact of disease progression status, treatment modalities, and various comorbidities on cognitive function and the mechanisms of cognitive impairment in patients with acromegaly are therefore outlined in this review. Multidisciplinary assessment has important implications for the management of acromegaly, particularly in relation to cognitive function. Here, we summarize the relevant literature concerning cognitive-behavioral research on acromegaly to demonstrate the impact of long-term impairment caused by GH and IGF-1 on the cognitive behavior of patients.

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In Vivo Characterization of Cortical and White Matter Microstructural Pathology in Growth Hormone-Secreting Pituitary Adenoma

Cited by 4 publications

References 51 publications

Non-contrast MRI of Brain White Matter in Young Male Patients with Childhood-onset Adult Growth Hormone Deficiency: A Diffusion Tensor Imaging Study

Non-contrast MRI of Brain White Matter in Young Male Patients with Childhood-onset Adult Growth Hormone Deficiency: A Diffusion Tensor Imaging Study

Presence of cerebral microbleeds is associated with cognitive decline in acromegaly

Cognitive Dysfunction, an Increasingly Valued Long-Term Impairment in Acromegaly

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