Table_1_Research on the Mechanism of Cognitive Decline in Patients With Acoustic Neuroma.DOCX

Little is known about neuropsychological research on patients with acoustic neuroma (AN), especially cognitive neuropsychology. We aim to compare the cognitive function of patients with AN and healthy controls (HCs) and explore possible underlying mechanisms. Various neuropsychological assessments were performed on all participants. Tract-based spatial statistics (TBSS) was used to compare DTI metrics such as fractional anisotropy (FA), axial diffusivity (AD), radial diffusivity (RD), and mean diffusivity (MD). Correlation analysis was analyzed between DTI metrics and cognitive scales. Compared with the HC group, the AN group performed worse in the neuropsychological evaluations, and TBSS analysis showed widespread alteration of the FA, AD, RD, and MD, which correlated with the cognitive function. These white matter tracts include minor forceps, major forceps, anterior thalamic radiation, superior longitudinal fasciculus, corticospinal tract, and right inferior fronto-occipital fasciculus. Meanwhile, we found for the first time that cognitive decline was related to the decrease of FA in minor forceps, which can be used as a neurobiological marker of cognitive impairment in patients with AN. The occurrence of cognition impairment is common in patients with AN. Including neuropsychological evaluation in the routine clinical assessment and appropriate treatment may strengthen clinical management and improve the quality of life of patients.

目前针对听神经瘤（acoustic neuroma, AN）患者的神经心理学研究，尤其是认知神经心理学领域，相关报道尚且有限。本研究旨在对比听神经瘤患者与健康对照（healthy controls, HCs）的认知功能水平，并探讨其潜在的病理生理机制。所有受试者均接受了多维度神经心理学评估。采用基于纤维束追踪的空间统计分析（Tract-based spatial statistics, TBSS）方法，对比两组的弥散张量成像（diffusion tensor imaging, DTI）指标，包括各向异性分数（fractional anisotropy, FA）、轴向弥散系数（axial diffusivity, AD）、径向弥散系数（radial diffusivity, RD）及平均弥散系数（mean diffusivity, MD）。同时，对DTI指标与认知量表得分进行相关性分析。结果显示，与健康对照组相比，听神经瘤患者在各项神经心理学评估中的表现均更差；TBSS分析表明，患者的FA、AD、RD及MD均存在广泛异常改变，且上述弥散张量指标的变化与认知功能显著相关。受累的脑白质纤维束包括小钳（minor forceps）、大钳（major forceps）、丘脑前辐射、上纵束、皮质脊髓束及右侧额枕下束。本研究首次证实，认知功能下降与小钳的FA值降低存在显著关联，该指标可作为听神经瘤患者认知损害的潜在神经生物学标志物。临床数据表明，听神经瘤患者的认知损害发生率较高，将神经心理学评估纳入常规临床评估体系，并给予针对性干预措施，有助于优化临床管理策略，进而提升患者的生活质量。