Social Cognition in Patients With Hypothalamic-Pituitary Tumors

Özyurt, Jale; Mehren, Aylin; Boekhoff, Svenja; Müller, Hermann L.; Thiel, Christiane M.

doi:10.3389/fonc.2020.01014

Cited by 12 publications

(12 citation statements)

References 47 publications

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“…Consistent with our findings, previous studies also have shown higher depression scores in those with severe forms of “common” obesity (BMI > 99th percentile) compared to children with BMI 85th-99th percentile ( 36 ). Prior studies also identified impairments in social cognition in survivors of childhood craniopharyngioma, including difficulties correctly interpreting tone of voice and others’ mental states that may underlie our findings ( 38 – 41 ). Given the importance of social relationships to youth mental health, these findings are highly concerning for this already at-risk population and worthy of additional investigation for factors impacting social functioning and opportunities to intervene ( 39 , 40 ).…”

Section: Discussionmentioning

confidence: 54%

A Survey of Patient-Relevant Outcomes in Pediatric Craniopharyngioma: Focus on Hypothalamic Obesity

et al. 2022

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ContextIndividuals treated for pediatric craniopharyngioma, a rare, grade 1 brain tumor, frequently develop hypothalamic obesity, a complication often recalcitrant to intervention. Although hypothalamic obesity is known to adversely impact quality of life, less is known about how caregivers and patients experience this condition.ObjectiveOur goal was to examine the approaches that families take towards weight management and the impact on social function in individuals with craniopharyngioma and obesity. Individuals with craniopharyngioma without obesity were included as a comparison.Subjects and MethodsAdult caregivers of children <18y with craniopharyngioma completed a web-based survey posted by a patient advocacy organization between February and July 2020. Questions related to the child’s diagnosis, medications, lifestyle modifications, and social function along with research priorities. Descriptive statistics were generated. Linear regression was used to assess the independent effects of obesity and other covariates on social function.ResultsOf 106 respondents, 60 (57%) reported their child had obesity at the time of survey completion. In contrast, only 6 (5.7%) had obesity prior to craniopharyngioma diagnosis. A majority (92%) of those with obesity had tried limiting calories or carbohydrates; 31% and 69% found these helpful, respectively. Thirty-eight percent had tried weight loss medications (stimulants, metformin, GLP1R-agonists, and topiramate) and 48% found at least one helpful. Both stimulant and anti-depressant use were reported more frequently with obesity. An index (T-score) reflecting social function was lower in the cohort than a population reference, 41 (SD 11) vs. 50 (SD 10), p<0.001. In a linear model, both older age and obesity were independently associated with greater social impairment. Ninety-four percent of respondents caring for a child with obesity (and 79% of all respondents) identified “improving treatments and prevention for hypothalamic obesity” as a key research priority.ConclusionsOnly a minority of individuals with hypothalamic obesity had trialed medication, even though many reported that lifestyle modification was inadequate. Furthermore, social function was significantly impaired overall in survivors compared to a reference cohort, and even more so in individuals with obesity. These findings highlight the opportunity to improve social functioning as an additional potential benefit of improved treatments for hypothalamic obesity.

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Section: Discussionmentioning

confidence: 54%

A Survey of Patient-Relevant Outcomes in Pediatric Craniopharyngioma: Focus on Hypothalamic Obesity

et al. 2022

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“…A recent study showed that paediatric-onset craniopharyngioma patients with hypothalamic lesions were less able to identify the correct emotional content of vocal expressions and to infer others’ thoughts, feelings and intentions compared to healthy controls. 55 However, there is still no evidence for a possible role of the hypocretinergic system in developing these cognitive functions.…”

Section: Discussionmentioning

confidence: 99%

Theory of Mind impairment in childhood narcolepsy type 1: a case–control study

Veneruso,

Del Sette,

Cordani

et al. 2024

Brain Communications

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Narcolepsy type 1 is a central disorder of hypersomnolence characterized by excessive daytime sleepiness, cataplexy, and other rapid eye movement sleep-related manifestations. Neurophysiological studies suggest that Narcolepsy type 1 patients may experience impairment in emotional processing due to structural and functional changes in limbic structures and associated areas. However, the only study exploring Narcolepsy behavioral responses found no impairment in the ability to recognize emotions, possibly due to compensatory mechanisms. The present study was designed to fill this gap in the literature by investigating the behavioral impairment related to emotional processing focusing on an advanced socio-cognitive skill, namely Theory of Mind, in pediatric Narcolepsy type 1 patients. Twenty-two Narcolepsy type 1 children and adolescents (6 Female; Age range: 8.0–13.5) and 22 healthy controls matched for age and sex (6 Female; Age range: 8; 9–13; 0) underwent a neuropsychological evaluation to assess socio–economic status, verbal abilities, working memory, social anxiety, and Theory of Mind via a verbal (i.e., Strange Stories task) and a visual task (i.e., Silent Films). Narcolepsy type 1 patients were also evaluated for disease severity. Patients exhibited impairment in ToM skills, as assessed both through both verbal (Controls Median = 8; Patients Median = 5; p = .009) and visual tasks (Controls Median = 8; Patients Median = 6; p = .003), compared to healthy controls. Correlation analyses showed that verbal and visual Theory of Mind was negatively related to narcolepsy severity (ρ = -.45, p = .035 and ρ = -.52, p = .012), and daytime sleepiness (ρ = -.48, p = .025 and ρ = -.45, p = .038). Our study shows a selective impairment in the Theory of Mind domain in children and adolescents with Narcolepsy type 1. In addition, our results highlight a link between symptom severity and Theory of Mind, suggesting that lower Theory of Mind levels are associated with higher symptom severity. Further, longitudinal studies are needed to disentangle the direction of this relation and to disambiguate if Narcolepsy severity impaired children's Theory of Mind or if Theory of Mind skills modulate the severity of Narcolepsy symptoms by providing a greater ability to avoid cataplexy.

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“…Accordingly, decreased salivary concentrations of basal and/or stimulated oxytocin have been observed in craniopharyngioma patients 82,[122][123][124] when compared with healthy controls. Reduced oxytocin levels were associated with anxiety 125 and worse social cognition 126 .…”

Section: Hypopituitarismmentioning

confidence: 98%

“…Craniopharyngioma patients may suffer from behavioral, psychosocial or psychiatric disorders, such as anxiety, impulse-control disorders, depression, apathy 124,[128][129][130] or severe food craving behaviors requiring additional specific psychiatric and/or psychosocial support. Pharmacotherapeutic interventions with central stimulating agents, such as dextroamphetamines may help to decrease daytime sleepiness and increase concentration and may be considered to target psychosocial symptoms.…”

Section: Psychosocial Disordersmentioning

confidence: 99%

Contemporary Biological Insights and Clinical Management of Craniopharyngioma

et al. 2022

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Craniopharyngiomas are clinically aggressive tumours due to their invasive behaviour and recalcitrant tendency to recur after therapy. There are two types based on their distinct histology and molecular features: The papillary craniopharyngioma (PCP), which is associated with BRAF-V600E mutations and the adamantinomatous craniopharyngioma (ACP), characterised by mutations in CTNNB1 (encoding β-catenin). Patients with craniopharyngioma show symptoms linked to the location of the tumour close to the optic pathways, hypothalamus and pituitary gland, such as increased intracranial pressure, endocrine deficiencies and visual defects. Treatment is not specific and mostly non-curative, and frequently includes surgery, which may achieve gross-total or partial resection, followed by radiotherapy. In cystic tumours, frequent drainage is often required and intracystic instillation of drugs has been used to help manage cyst refilling. More recently targeted therapies have been used, particularly in papillary craniopharyngioma, but also now in adamantinomatous craniopharyngioma and clinical trials are underway or in development. Although patient survival is high, the consequences of the tumour and its treatment can lead to severe comorbidities resulting in poor quality of life, in particular for those patients that bear tumours with hypothalamic involvement. Accordingly, in these patients at risk for the development of a hypothalamic syndrome hypothalamus-sparing treatment strategies such as limited resection followed by irradiation are recommended. In this review, we provide an update on various aspects of craniopharyngioma, with emphasis on recent advances in the understanding of tumour pathogenesis, clinical consequences, management and therapies.

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Social Cognition in Patients With Hypothalamic-Pituitary Tumors

Cited by 12 publications

References 47 publications

A Survey of Patient-Relevant Outcomes in Pediatric Craniopharyngioma: Focus on Hypothalamic Obesity

A Survey of Patient-Relevant Outcomes in Pediatric Craniopharyngioma: Focus on Hypothalamic Obesity

Theory of Mind impairment in childhood narcolepsy type 1: a case–control study

Contemporary Biological Insights and Clinical Management of Craniopharyngioma

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