BACKGROUND Affective symptoms are frequent in brain tumor patients. The origin of such symptoms remains unknown; either focal brain injury or reactive emotional distress may be responsible. This cross-sectional pilot study linked depressive symptoms and anxiety to white matter integrity. Its objective was to test the hypothesis of a relation between tissue damage and brain function in brain tumor patients and to provide a basis for further studies in this field. METHODS Thirty-nine patients with newly diagnosed supratentorial primary brain tumor underwent diffusion tensor imaging (DTI) scanning. Patients filled in the Beck Depression Inventory (BDI-1A) and examiners rated them on the Hamilton Depression Rating Scale (HDRS). State and trait anxiety were measured using the State-Trait Anxiety Inventory (STAI-G). Correlations between fractional anisotropy (FA) and psychological measures were assessed on a regions of interest (ROIs) basis; the defined ROIs corresponded to clearly specified white matter tracts. RESULTS Statistical analysis revealed correlations between FA in the left internal capsule and scores on the HDRS, BDI-1A and STAI-G (p<0.05). HDRS scores were also correlated with FA in the right medial uncinate fasciculus and state anxiety scores were significantly correlated with FA in the left lateral and medial uncinate fasciculus (p<0.05). CONCLUSIONS Our results suggest that neurobiological mechanisms related to the integrity of tissue in specific white matter tracts can be investigated with DTI and may influence affective symptoms in patients with brain tumors. However, prospective observational studies are needed to further investigate the links between brain structures and the severity of affective symptoms in this population.