De-masking oxytocin-deficiency in craniopharyngioma and assessing its link with affective function

Gebert, Dorothea; Auer, Matthias; Stieg, Mareike R.; Freitag, Martin T.; Lahne, Madlen; Fuß, Johannes; Schilbach, Katharina; Schopohl, Jochen; Stalla, G. K.; Kopczak, Anna

doi:10.1016/j.psyneuen.2017.11.006

Cited by 45 publications

(56 citation statements)

References 49 publications

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“…The existing literature suggests that central and peripheral OXT secretion as a result of stressful stimuli is mostly coupled . Therefore, it is unlikely that OXT release as a result of an emotional stressor occurs only in the blood circulation and not within the CNS . After axonal or dendritic release, OXT fulfils its action on OXT‐receptors in various brain regions .…”

Section: Discussionmentioning

confidence: 99%

“…5,21 Therefore, it is unlikely that OXT release as a result of an emotional stressor occurs only in the blood circulation and not within the CNS. 22 After axonal or dendritic release, OXT fulfils its action on OXT-receptors in various brain regions. 3,23 Subsequently, OXT diffuses via the extracellular fluid in the ventricular system.…”

Section: Perioperative Time Coursementioning

confidence: 99%

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Influence of perioperative stress on central and peripheral oxytocin and arginine‐vasopressin concentrations

Kagerbauer

Martin

Ulm

et al. 2019

J Neuroendocrinology

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Perioperative stress provides not only physical, but also psychic and emotional aspects, which may influence the hypothalamic neuropeptide system. Studies investigating the perioperative course of central neuropeptide activity are missing. Therefore, the present study aimed to determine perioperative fluctuations in central and concomitant peripheral concentrations of the hypothalamic neuropeptides oxytocin (OXT) and arginine‐vasopressin (AVP), as well as their impact on perioperative anxiety and depression. Cerebrospinal fluid (CSF), blood and saliva were collected from 12 patients who underwent elective endovascular aortic repair with a routinely inserted spinal catheter. AVP and OXT concentrations were analysed at four timepoints: (i) the evening before the operation; (ii) the operation day immediately before anaesthesia induction; (iii) intraoperatively after the stent was placed; and (iv) on day 1 after the operation. Patients completed the Hospital Anxiety and Depression Scale (HADS) at timepoints 1 and 4. For CSF OXT, the present study showed a significant intraoperative decline, accompanied by a decrease in saliva. OXT blood concentrations before anaesthesia induction were higher than at the evening before the operation. OXT concentrations in CSF and saliva correlated well at timepoints 2‐4. AVP concentrations in CSF, blood and saliva did not show any significant changes perioperatively. However, postoperative AVP blood concentrations showed a significant negative correlation with anxiety and depression scores according to the HADS. This pilot study demonstrates perioperative fluctuations in central OXT concentrations, which are better reflected by saliva than by blood. Further studies are required to determine whether OXT and AVP can predict postoperative post‐traumatic stress disorder.

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Section: Discussionmentioning

confidence: 99%

Section: Perioperative Time Coursementioning

confidence: 99%

Influence of perioperative stress on central and peripheral oxytocin and arginine‐vasopressin concentrations

Kagerbauer

Martin

Ulm

et al. 2019

J Neuroendocrinology

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“…Counter to expectation, OT levels were not lowered in patients with more extensive hypothalamic involvement (anterior and posterior regions), for reasons that aren't immediately clear. Gebert and colleagues subsequently compared salivary OT levels, at baseline and following an exercise stimulus, in 26 adult craniopharyngioma patients and 26 age/sex‐matched controls . OT concentrations as a whole were not different between groups, but were reduced in patients with hypothalamic damage as assessed by MRI.…”

Section: Oxytocin In Hypopituitarismmentioning

confidence: 99%

“…A second challenge lies in the confirmation of a diagnosis of OT deficiency, since the physiological mechanisms involved in OT regulation are still not fully understood. Akin to the demonstration of ACTH or GH deficiency in patients with hypopituitarism, a stimulation test might be required to completely unmask OT deficiency . The optimal method by which this can be confirmed reproducibly needs to be established, whilst studies have already suggested that the presence of central diabetes insipidus is not a reliable enough surrogate …”

Section: Diagnostic Challengesmentioning

confidence: 99%

Oxytocin therapy in hypopituitarism: Challenges and opportunities

Bhargava

Daughters

Rees

2018

Clinical Endocrinology

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Summary Patients with hypopituitarism display impaired quality of life and excess morbidity and mortality, despite apparently optimal pituitary hormone replacement. Oxytocin is a neuropeptide synthesized in the anterior hypothalamus which plays an important role in controlling social and emotional behaviour, body weight and metabolism. Recent studies have suggested that a deficiency of oxytocin may be evident in patients with hypopituitarism and craniopharyngioma, and that this may be associated with deficits in cognitive empathy. Preliminary data hint at potential benefits of oxytocin therapy in improving these deficits and the accompanying metabolic disturbances that are common in these conditions. However, several challenges remain, including an incomplete understanding of the regulation and mechanisms of action of oxytocin, difficulties in accurately measuring oxytocin levels and in establishing a diagnosis of oxytocin deficiency, and a need to determine both the optimal mode of administration for oxytocin therapy and an acceptable safety profile with long‐term use. This review considers the data linking oxytocin to the neuropsychological and metabolic disturbances evident in patients with craniopharyngioma and hypopituitarism, and describes the challenges that need to be overcome before replacement therapy can be considered as a therapeutic option in clinical practice.

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“…Previous research has found a high prevalence for social and emotional deficits in this patient group, 34,35 although the underlying cause for the higher rate of such deficits has not been established. Recently, several studies have been able to show that the oxytocin system is impaired in these patients 36‐38 . Importantly, in healthy people, oxytocin increases in different situations such as social stress, sexual stimulation or physical exercise, 5 whereas craniopharyngioma patients cannot release additional oxytocin in response to stimulation 36 .…”

Section: Introductionmentioning

confidence: 99%

Oxytocin release deficit and social cognition in craniopharyngioma patients

Brandi

Gebert

Kopczak

et al. 2020

J Neuroendocrinology

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Oxytocin is a neuropeptide known to affect social behaviour and cognition. Craniopharyngioma patients are considered to have an oxytocin‐release‐deficit caused by a rare tumour affecting the pituitary and/or the hypothalamus relevant for oxytocin production and release. To assess social behaviour and socio‐cognitive abilities in this patient group, we tested 13 patients and 23 healthy controls on self‐report questionnaires and an eye‐tracking paradigm including fast facial emotion recognition. Additionally, saliva oxytocin levels acquired before and after a physical stress induction were available from a previous study, representing the reactivity of the oxytocin system. The data revealed three major results. First, patients with an oxytocin‐release‐deficit scored higher on self‐reported autistic traits and reduced levels of hedonia for social encounters, although they showed no impairments in attributing mental states. Second, patients showed more difficulties in the fast emotion recognition task. Third, although automatic gaze behaviour during emotion recognition did not differ between groups, gaze behaviour was related to the reactivity of the oxytocin system across all participants. Taken together, these findings demonstrate the importance of investigating the reactivity of the oxytocin system and its relationship with social cognition. Our findings suggest that reduced emotional processing abilities may represent a pathological feature in a group of craniopharyngioma patients, indicating that this patient group might benefit from specific treatments within the social domain.

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De-masking oxytocin-deficiency in craniopharyngioma and assessing its link with affective function

Cited by 45 publications

References 49 publications

Influence of perioperative stress on central and peripheral oxytocin and arginine‐vasopressin concentrations

Influence of perioperative stress on central and peripheral oxytocin and arginine‐vasopressin concentrations

Oxytocin therapy in hypopituitarism: Challenges and opportunities

Oxytocin release deficit and social cognition in craniopharyngioma patients

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