Cognitive decline in acoustic neuroma patients: An investigation based on resting-state functional magnetic resonance imaging and voxel-based morphometry

OBJECTIVE: Acoustic neuroma (AN) is a clinically common benign tumor. There are few neuropsychological investigations for AN, especially cognitive neuropsychology. Herein, the study probed into cognitive function changes in AN patients and expounded possible mechanisms through structural and functional magnetic resonance imaging (fMRI). MATERIALS AND METHODS: Neuropsychological tests were performed between 64 patients with AN and 67 healthy controls. Then, using resting-state fMRI, the possible mechanisms of cognitive decline in AN patients were further explored by calculating the amplitude of low-frequency fluctuations (ALFF) and regional homogeneity (ReHo). Furthermore, using high-resolution T1-weighted images, voxel-based morphometry (VBM) was adopted to investigate the changes in gray matter volume (GMV) and white matter volume (WMV) in AN patients. RESULTS: AN patients had worse cognitive performance than those in the healthy controls. Relative to the healthy individuals, the mALFF value was increased in the right caudate nucleus of the patients with left-sided AN (LAN) and the right rectus region of the patients with right-sided AN (RAN). The mReHo values of the bilateral superior frontal gyrus and middle frontal gyrus were decreased in LAN patients. Compared with healthy subjects, the GMV values were elevated in the left fusiform gyrus, parahippocampal gyrus, calcarine gyrus, and cuneus in LAN patients as well as in the right fusiform gyrus and parahippocampal gyrus in RAN patients. Meanwhile, the WMV values showed elevations in the bilateral putamen, left rectal gyrus, and thalamus in LAN patients. CONCLUSION: Cognitive dysfunction occurs in AN patients. Cognitive decline in AN patients activates functional activity in some brain regions, thereby compensating for cognition decline. Additionally, the ReHo values were reduced in the frontal lobe in LAN patients, and the connectivity was decreased, affecting the functional differentiation and integration of the brain, which may be associated with the decline in cognitive function. Lateralized brain reorganization induced by unilateral hearing loss was presented in AN patients. LAN caused a more significant interference effect on the brain while RAN patients showed more stable cerebral cortices. Altogether, responding to cognition decline in AN patients, structural reorganization occurs, and compensative increases in cognitive-related brain regions, which compensates for cognitive impairment.