Specific behaviour, mood and personality traits may contribute to obesity in patients with craniopharyngioma

Roemmler-Zehrer, Josefine; Geigenberger, Veronika; Störmann, Sylvère; Ising, Marcus; Pfister, Hildegard; Sievers, Caroline; Stalla, G. K.; Schopohl, Jochen

doi:10.1111/cen.12523

Cited by 20 publications

(9 citation statements)

References 45 publications

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“…Roemmler-Zehrer et al [ 107 ▪ ] compared eating behaviour in 26 craniopharyngioma patients (four childhood-onset cases) with 26 patients with nonfunctioning pituitary adenoma. Whereas craniopharyngioma patients scored higher in conscious hunger perception, the rate of eating disorders was similar in both groups, supporting the speculation that eating disorders in patients with hypothalamic obesity are not disease specific.…”

Section: Eating Behaviourmentioning

confidence: 99%

“…Hypothalamic obesity has significant negative impact on long-term quality of survival [ 9 ▪▪ ]. Increased daytime sleepiness, fatigue, disturbances of circadian rhythms [ 74 , 78 , 110 ▪ ], gastrointestinal and pulmonary complaints (diarrhea, dypnea) [ 9 ▪▪ ], memory deficits [ 111 ▪▪ , 112 ▪ ], and neuropsychological imbalances [ 69 , 107 ▪ , 113 – 115 ] are major long-term side-effects in patients with hypothalamic obesity.…”

Section: Sequelae Prognosis and Quality Of Lifementioning

confidence: 99%

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Craniopharyngioma and hypothalamic injury

Müller

2016

Current Opinion in Endocrinology, Diabetes &Amp; Obesity

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Purpose of reviewHypothalamic alterations, pathological or treatment induced, have major impact on prognosis in craniopharyngioma patients mainly because of consequent hypothalamic obesity. Recent insight in molecular genetics, treatment strategies, risk factors and outcomes associated with hypothalamic obesity provide novel therapeutic perspectives. This review includes relevant publications since 2013.Recent findingsRecent findings confirm that alterations in posterior hypothalamic areas because of tumour location and/or treatment-related injuries are associated with severe hypothalamic obesity, reduced overall survival and impaired quality of life in long-term survivors of childhood-onset craniopharyngioma. However, eating disorders are observed because of hypothalamic obesity without clear disease-specific patterns. Treatment options for hypothalamic obesity are very limited. Treatment with invasive, nonreversible bariatric methods such as Roux-en-Y gastric bypass is most efficient in weight reduction, but controversial in the paediatric population because of medical, ethical, and legal considerations. Accordingly, treatment in craniopharyngioma should focus on prevention of (further) hypothalamic injury. Presurgical imaging for grading of hypothalamic involvement should be the basis for hypothalamus-sparing strategies conducted by experienced multidisciplinary teams.SummaryUntil a nonsurgical therapeutic option for hypothalamic obesity for paediatric patients is found, prevention of hypothalamic injury should be the preferred treatment strategy, conducted exclusively by experienced multidisciplinary teams.

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Section: Eating Behaviourmentioning

confidence: 99%

Section: Sequelae Prognosis and Quality Of Lifementioning

confidence: 99%

Craniopharyngioma and hypothalamic injury

Müller

2016

Current Opinion in Endocrinology, Diabetes &Amp; Obesity

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“…In addition, 2-AG mediates the consumption of palatable food (42), increases during fasting (43) and is associated with feelings of hunger (39). While most, but not all studies (44), could not confirm an increase in food intake in CP patients (9,11), there is at least evidence for an increase in hunger perception (10).…”

Section: Discussionmentioning

confidence: 99%

“…While hyperphagia does not seem to be the main culprit in these patients, autonomic dysfunction (6) resulting in reduced sympathetic activity (7) has been reported, potentially explaining a reduction in energy expenditure (8,9). In addition, patients often complain about persistent fatigue (10) and show reduced physical activity (9,11).…”

Section: Introductionmentioning

confidence: 99%

Altered endocannabinoid-dynamics in craniopharyngioma patients and their association with HPA-axis disturbances

Auer

Gebert

Biedermann

et al. 2021

European Journal of Endocrinology

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Objective Patients with craniopharyngioma (CP) frequently suffer from morbid obesity. Endocannabinoids (ECs) are involved in weight gain and rewarding behavior but have not been investigated in this context. Design Cross-sectional single-center study. Methods Eighteen patients with CP and 16 age- and sex-matched controls were included. Differences in endocannabinoids (2-arachidonoylglycerol (2-AG) and N-arachidonoylethanolamine (AEA)) and endocannabinoid-like molecules (oleoyl ethanolamide (OEA), palmitoyl ethanolamide (PEA), and arachidonic acid (AA) were measured at baseline and following endurance exercise. We further explored ECs-dynamics in relation to markers of HPA-axis activity (ACTH, cortisol, copeptin) and hypothalamic damage. Results Under resting conditions, independent of differences in BMI, 2-AG levels were more than twice as high in CP patients compared to controls. In contrast, 2-AG and OEA level increased in response to exercise in controls but not in CP patients, while AEA levels decreased in controls. As expected, exercise increased ACTH and copeptin levels in controls only. In a mixed model analysis across time and group, HPA measures did not provide additional information for explaining differences in 2-AG levels. However, AEA levels were negatively influenced by ACTH and copeptin levels, while OEA levels were negatively predicted by copeptin levels only. There were no significant differences in endocannabinoids depending on hypothalamic involvement. Conclusion Patients with CP show signs of a dysregulated endocannabinoid system under resting conditions as well as following exercise in comparison to healthy controls. Increased 2-AG levels under resting conditions and the missing response to physical activity could contribute to the metabolic phenotype of CP patients.

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“…While replacement therapy can normalize hormonal function, these children have persistent problems with obesity. Weight gain is both organic [ 5 ] and behavioral [ 6 ], manifested as elevated BMI, increased waist circumference, and an abnormal waist to height ratio [ 7 ]. In long-term survivors of childhood cancer, particularly among those with untreated growth hormone deficiency, BMI abnormalities are associated with muscle weakness and suboptimal cardiorespiratory fitness [ 8 ].…”

Section: Introductionmentioning

confidence: 99%

Physical function, body mass index, and fitness outcomes in children, adolescents, and emerging adults with craniopharyngioma from proton therapy through five years of follow-up

et al. 2022

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Purpose Children diagnosed with craniopharyngioma are vulnerable to adverse health outcomes. Characterization of body mass index (BMI), physical function, and cardiopulmonary fitness in those treated with proton radiotherapy (PRT) will serve to design interventions to improve outcomes. Methods Ninety-four children with craniopharyngioma completed physical function testing prior to PRT and annually for 5 years. For each outcome, age- and sex-specific z-scores were calculated using normative values. Participants with z-scores > 1.5 or < − 1.5 were classified as impaired. Those with z-scores > 2.0 or < − 2.0 were classified as significantly impaired. Descriptive statistics were used to describe study outcomes and change in prevalence of impairments from 2 to 5 years after treatment. Results Nearly half of participants [45.2%, 95% confidence interval (CI) 39.4, 51.0] had mean BMI z-scores > 1.5 at baseline, with prevalence increasing to 66.7% (95% CI 61.5, 71.9) at 5 years. More than half of participants (54.2%, 95% CI 48.4, 60.0) had knee extension strength z-scores < − 1.5 at baseline, with prevalence increasing to 81.3% (95% CI 77.7, 84.9) at 5 years. BMI and knee extension strength had the largest proportion of participants impaired at both 2 and 5 years (53.2% and 62.3%, respectively). Resting heart rate had the highest proportion of participants not impaired at 2 years but became impaired at 5 years (26.6%). Conclusions Children with craniopharyngioma have BMI and fitness abnormalities at diagnosis and continue 5 years after treatment. This cohort may benefit from interventions designed to improve BMI, strength, and resting indicators of cardiopulmonary fitness. Supplementary Information The online version contains supplementary material available at 10.1007/s11060-022-04116-2.

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Specific behaviour, mood and personality traits may contribute to obesity in patients with craniopharyngioma

Abstract: Obesity in patients with CP might be influenced by eating disorders, negative mood alterations and increased anxiety-related personality traits.

Cited by 20 publications

References 45 publications

Craniopharyngioma and hypothalamic injury

Craniopharyngioma and hypothalamic injury

Altered endocannabinoid-dynamics in craniopharyngioma patients and their association with HPA-axis disturbances

Physical function, body mass index, and fitness outcomes in children, adolescents, and emerging adults with craniopharyngioma from proton therapy through five years of follow-up

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