Dextroamphetamine Treatment in Children With Hypothalamic Obesity

Schaik, Jiska van; Welling, Mila S; Groot, Corjan J. de; Eck, Judith P. van; Juriaans, Alicia F; Burghard, Marcella; Ophuis, S B J Oude; Bakker, Boudewijn; Tissing, Wim J. E.; Meeteren, Antoinette Y. N. Schouten–van; Akker, Erica L T van den; Santen, Hanneke M van

doi:10.3389/fendo.2022.845937

Cited by 10 publications

(9 citation statements)

References 40 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…For these children, specific interventions aiming to increase REE, either by increasing physical activity, such as high intensity interval training or medical (e.g. dextroamphetamine) may be helpful ( 24 , 25 ). Prescribing amphetamines must however be considered experimental and should only be done in experienced multidisciplinary setting.…”

Section: Discussionmentioning

confidence: 99%

“…In this light, measurement of REE may be an interesting tool; when decreased REE is found, therapeutic interventions aiming to increase REE by stimulating sympathetic activity may be considered ( 21 , 22 , 23 ). Amphetamine treatment has been attempted in children with HO with good response in some, but not all, which may perhaps be explained by differences in REE ( 24 , 25 ).…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Resting energy expenditure in children at risk of hypothalamic dysfunction

Schaik

Burghard

Lequin

et al. 2022

Endocrine Connections

View full text Add to dashboard Cite

Objective: Children with suprasellar brain damage are at risk for hypothalamic dysfunction (HD). HD may lead to decreased resting energy expenditure (REE). Decreased REE, however, is not present in all children with HD. Our aim was to assess which children suspect for HD have low REE, and its association with clinical severity of HD or radiological hypothalamic damage. Patients and methods: A retrospective cohort study was performed. Measured REE (mREE) of children at risk for HD was compared to predicted REE (pREE). Low REE was defined as mREE <90% of predicted. The mREE/pREE quotient was associated to a clinical score for HD symptoms and to radiological hypothalamic damage. Results: Sixty-seven children at risk for HD (96% brain tumor diagnosis) with a mean BMI SDS of +2.3 ± 1.0 were included. Of these, 45 (67.2%) had low mREE. Children with severe HD had a significant lower mean mREE/pREE quotient compared to children with no, mild, or moderate HD. Mean mREE/pREE quotient of children with posterior hypothalamic damage was significantly lower compared to children with no or anterior damage. Tumor progression or tumor recurrence, severe clinical HD, and panhypopituitarism with DI were significant risk factors for reduced REE. Conclusion: REE may be lowered in children with hypothalamic damage and is associated to the degree of clinical HD. REE is, however, not lowered in all children suspect for HD. For children with mild or moderate clinical HD symptoms, REE measurements may be useful to distinguish between those who may benefit from obesity treatment that increases REE from those who would be better helped using other obesity interventions.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Resting energy expenditure in children at risk of hypothalamic dysfunction

Schaik

Burghard

Lequin

et al. 2022

Endocrine Connections

View full text Add to dashboard Cite

show abstract

“…Historically, treatment of hyperphagia and HO with the central nervous stimulant dextroamphetamine is reported to result in stabilization of weight gain and may improve body mass index (BMI) and hunger. 85,86,91 A pilot study of caffeine and ephedrine given to three individuals with HO resulted in a mean weight loss of 14%, with two sustaining weight loss for at least 2 years; however, long-term safety, particularly in the paediatric population, is unknown. 79 As individuals with HO typically also have multiple pituitary hormone deficiencies including central hypothyroidism, practitioners often target free thyroxine (FT4) levels in the upper part of the reference range when using levothyroxine.…”

Section: Currently Available Therapies 21 | Sympathomimeticsmentioning

confidence: 99%

Acquired hypothalamic obesity: A clinical overview and update

Roth,

McCormack

2024

Diabetes Obesity Metabolism

View full text Add to dashboard Cite

Hypothalamic obesity (HO) is a rare and complex disorder that confers substantial morbidity and excess mortality. HO is a unique subtype of obesity characterized by impairment in the key brain pathways that regulate energy intake and expenditure, autonomic nervous system function, and peripheral hormonal signalling. HO often occurs in the context of hypothalamic syndrome, a constellation of symptoms that follow from disruption of hypothalamic functions, for example, temperature regulation, sleep–wake circadian control, and energy balance. Genetic forms of HO, including the monogenic obesity syndromes, often impact central leptin–melanocortin pathways. Acquired forms of HO occur as a result of tumours impacting the hypothalamus, such as craniopharyngioma, surgery or radiation to treat those tumours, or other forms of hypothalamic damage, such as brain injury impacting the region. Risk for severe obesity following hypothalamic injury is increased with larger extent of hypothalamic damage or lesions that contain the medial and posterior hypothalamic nuclei that support melanocortin signalling pathways. Structural damage in these hypothalamic nuclei often leads to hyperphagia, central insulin and leptin resistance, decreased sympathetic activity, low energy expenditure, and increased energy storage in adipose tissue, the collective effect of which is rapid weight gain. Individuals with hyperphagia are perpetually hungry. They do not experience fullness at the end of a meal, nor do they feel satiated after meals, leading them to consume larger and more frequent meals. To date, most efforts to treat HO have been disappointing and met with limited, if any, long‐term success. However, new treatments based on the distinct pathophysiology of disturbed energy homeostasis in acquired HO may hold promise for the future.

show abstract

“…Appetite suppression is a well‐documented side effect of stimulant treatment. There are no published studies examining the impact of psychostimulant treatment for children with PWS; however, it has been recognised to potentially play a role in other instances of hypothalamic obesity 7–9 . We report the case of an adolescent with PWS and morbid obesity for whom lisdexamphetamine was prescribed.…”

mentioning

confidence: 97%

“…There are no published studies examining the impact of psychostimulant treatment for children with PWS; however, it has been recognised to potentially play a role in other instances of hypothalamic obesity. [7][8][9] We report the case of an adolescent with PWS and morbid obesity for whom lisdexamphetamine was prescribed. Lisdexamphetamine therapy was associated with significant appetite suppression, marked weight loss and improved functional ability.…”

mentioning

confidence: 99%