Acta Neurochirurgica

, Volume 159, Issue 5, pp 865–871 | Cite as

Fine morphological evaluation of hypothalamus in patients with hyperphagia

  • Yoshikazu Ogawa
  • Kuniyasu Niizuma
  • Teiji Tominaga
Original Article - Brain Tumors

Abstract

Background

Various metabolic diseases induced by eating disorders are some of the most serious and difficult problems for modern public healthcare. However, little is known about hyperphagia, partly because of the lack of a clear definition. Several basic studies have analyzed eating habits using endocrinological or neurophysiological approaches, which have suggested a controlled balance between the hunger and satiety centers in the central nervous system. However, more detailed neuro-radiologic evaluations have not been achieved for the hypothalamus, and evaluations were limited only to the floor of the third ventricles.

Methods

Fine structures of hypothalamic morphology were investigated using high-resolution magnetic resonance imaging in seven patients with hypothalamo-pituitary tumors, who suffered from preoperative hyperphagia-induced severe obesity and metabolic disorders. Body mass index (BMI) varied from 22.4 to 40.5 kg/m2 (mean 32.8 kg/m2). Clinical data were compared with the data of nine patients without hyperphagia and seven healthy volunteers.

Results

Morphological evaluation was possible in all patients and control subjects, and patients with hyperphagia had significantly shortened maximum distances between the ependymal layers of the lateral wall of the third ventricle and fornixes (hyperphagia group right side 0.30 mm, left side 0.23 mm vs. patients without hyperphagia group right side 1.60, left side 1.53 vs. healthy group right side 1.73 mm, left side 1.85 mm) (p < 0.01). Two patients achieved postoperative improvement in both clinical and neuro-radiological findings.

Conclusion

Eating and metabolic disorders are related to strong dysfunction of the medial nuclei of the hypothalamus in patients with hypothalamo-pituitary tumors. We report the first case of dynamic improvement from hyperphagia, with both symptomatic and neuro-radiological findings.

Keywords

Hyperphagia Hypothalamus Magnetic resonance imaging Satiety center 

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Copyright information

© Springer-Verlag Wien 2017

Authors and Affiliations

  • Yoshikazu Ogawa
    • 1
  • Kuniyasu Niizuma
    • 2
  • Teiji Tominaga
    • 2
  1. 1.Department of NeurosurgeryKohnan HospitalSendaiJapan
  2. 2.Department of NeurosurgeryTohoku University Graduate School of MedicineSendaiJapan

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