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

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

doi:10.3389/fonc.2021.641359

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

Front Oncol. 2021 Apr 12:11:641359. doi: 10.3389/fonc.2021.641359. eCollection 2021.

Authors

Taoyang Yuan¹, Jianyou Ying¹, Chuzhong Li¹, Lu Jin², Jie Kang², Yuanyu Shi^{3

4}, Songbai Gui², Chunhui Liu², Rui Wang¹, Zhentao Zuo^{3

4

5}, Yazhuo Zhang^{1

2

6}

Affiliations

¹ Beijing Neurosurgical Institute, Capital Medical University, Beijing, China.
² Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.
³ State Key Laboratory of Brain and Cognitive Science, Institute of Biophysics, Chinese Academy of Sciences, Beijing, China.
⁴ University of Chinese Academy of Sciences, Chinese Academy of Sciences, Beijing, China.
⁵ CAS Center for Excellence in Brain Science and Intelligence Technology, Chinese Academy of Sciences, Beijing, China.
⁶ Beijing Institute for Brain Disorders Brain Tumour Center, China National Clinical Research Center for Neurological Diseases, Key Laboratory of Central Nervous System Injury Research, Beijing, China.

Abstract

Background: The growth hormone (GH) and insulin-like-growth factor 1 (IGF-1) axis has long been recognized for its critical role in brain growth, development. This study was designed to investigate microstructural pathology in the cortex and white matter in growth hormone-secreting pituitary adenoma, which characterized by excessive secretion of GH and IGF-1.

Methods: 29 patients with growth hormone-secreting pituitary adenoma (acromegaly) and 31 patients with non-functional pituitary adenoma as controls were recruited and assessed using neuropsychological test, surface-based morphometry, T1/T2-weighted myelin-sensitive magnetic resonance imaging, neurite orientation dispersion and density imaging, and diffusion tensor imaging.

Results: Compared to controls, we found 1) acromegaly had significantly increased cortical thickness throughout the bilateral cortex (pFDR < 0.05). 2) T1/T2-weighted ratio in the cortex were decreased in the bilateral occipital cortex and pre/postcentral central gyri but increased in the bilateral fusiform, insular, and superior temporal gyri in acromegaly (pFDR < 0.05). 3) T1/T2-weighted ratio were decreased in most bundles, and only a few areas showed increases in acromegaly (pFDR < 0.05). 4) Neurite density index (NDI) was significantly lower throughout the cortex and bundles in acromegaly (pTFCE < 0.05). 5) lower fractional anisotropy (FA) and higher mean diffusivity (MD), axial diffusivity (AD) and radial diffusivity (RD) in extensive bundles in acromegaly (pTFCE < 0.05). 6) microstructural pathology in the cortex and white matter were associated with neuropsychological dysfunction in acromegaly.

Conclusions: Our findings suggested that long-term persistent and excess serum GH/IGF-1 levels alter the microstructure in the cortex and white matter in acromegaly, which may be responsible for neuropsychological dysfunction.

Keywords: DTI (diffusion tensor imaging); growth hormone-secreting pituitary adenoma; myelin imaging; neurite orientation dispersion and density imaging (NODDI); neuropsychological dysfunction.