Brain tumor location and psychiatric symptoms: is there any association? A meta-analysis of published case studies

Abstract

A meta-analytic study of reports of brain tumors and psychiatric symptoms for the past 50 years was conducted to examine potential associations between tumor location and psychiatric symptoms. Results demonstrated that there is a statistically significant association between anorexia symptoms and hypothalamic tumors. For the rest of the brain regions a statistically significant association could not be definitively determined. However, several of the regions demonstrated an increased likelihood of associated symptoms when compared with other regions. The methodological limitations of this analysis are discussed.

Neuropsychiatric profile of paediatric hypothalamic hamartoma: systematic review and case series

“…Aside from 'rage', symptoms that did not make clinical diagnostic threshold for a disorder were not recorded. Degrees of cognitive dysfunction were assigned on the basis of documented formal cognitive assessments, or case reports according to reported Fullscale IQ criteria of mild (50-69), moderate (35)(36)(37)(38)(39)(40)(41)(42)(43)(44)(45)(46)(47)(48)(49), severe (20)(21)(22)(23)(24)(25)(26)(27)(28)(29)(30)(31)(32)(33)(34), or unspecified as to type. Central precocious puberty was defined in females by onset of breast stage 2 before 8 years and in males as testicular volume greater than 4ml by 9 years and/or needing treatment with a gonadotropin-releasing hormone antagonist.…”

“…[22][23][24][25][26] It is of interest that the psychiatric phenotypes seem distinct from other in vivo presentations of 'classical' hypothalamic dysfunction (which are more apparently related to disruption of the hypothalamic nuclei responsible for homeostasis of the organism). For example, the hypersomnia and extreme hyperphagia seen in Prader-Willi syndrome (proposed to be a result of abnormal oxytocin signalling in the hypothalamic paraventricular nucleus) 27 and eating disorders seen in hypothalamic germinoma and pinealoma 28 have not been well described in children with hypothalamic hamartomas. It is possible that the physical phenotype(s) in hypothalamic hamartomas are more relevant than direct hypothalamic dysfunction in explaining the neuropsychiatric sequelae.…”

Antriebsstörung und Verhaltensauffälligkeiten bei Makroprolactinom

“…Der Zusammenhang zwischen Tumorlokalisation und Art der assoziierten psychiatrischen Störung ist nicht gut untersucht. In einer Metaanalyse publizierter Fälle von Patienten mit hirneigenen Tumoren und psychiatrischen Symptomen fand sich lediglich ein signifikanter Zusammenhang zwischen hypothalamisch lokalisierten Tumoren und Symptomen einer Anorexia nervosa, während die Zusammenhänge zwischen anderen Lokalisationen und Symptomen nicht signifikant waren (5). Wir berichten über einen Patienten mit geringgradigen Verhaltensauffälligkeiten und Antriebsstörung im Zusammenhang eines Tumors der Adenohypohyse.…”

Commentary

“…[121314] However, the association between specific areas in the brain and psychiatric manifestations can be seen, such as psychotic symptoms and pituitary tumors, anorexia, and hypothalamic tumors. [115]…”