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Cited by 96Pituitary Gland Disorders and TreatmentsRegulation of Appetite and ObesityHypothalamic control of reproductive hormones

Semiquantitative analysis of hypothalamic damage on MRI predicts risk for hypothalamic obesity

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Roth, Christian L., Eslamy, Hedieh, Werny, David, Elfers, Clinton, Shaffer, Michele L., Pihoker, Catherine, Ojemann, Jeffrey, Dobyns, William B.·2015·Obesity
DOI 10.1002/oby.21067PMC PMC5029599
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Abstract

OBJECTIVE: Excessive weight gain frequently occurs in patients with hypothalamic tumors and lesions leading to hypothalamic obesity (HO). METHODS: Digital brain magnetic resonance imaging (MRI) and clinical outcomes were studied retrospectively in a single center, including 45 children with postoperative lesions in the sellar region (41 craniopharyngiomas, 4 with Rathke's cleft cysts), ∼5 years post-surgery, mean age 13.9 years. Four standard sections covering hypothalamic areas critical to energy homeostasis were used to assess lesions and calculate a hypothalamic lesion score (HLS); the association with HO was examined. RESULTS: Compared to subjects who did not develop HO (n = 23), subjects with HO (n = 22) showed more frequently lesions affecting the third ventricular floor, mammillary bodies, and anterior, medial (all P < 0.05), and most importantly posterior hypothalamus (P < 0.01). The HLS correlated significantly with BMI z-score changes 12 and 30 months post-surgery, even after adjusting for potential confounders of gender, age at surgery, surgery date, surgery BMI z-score, hydrocephalus, and residual hypothalamic tumor (r = 0.34, P = 0.03; r = 0.40, P = 0.02, respectively). Diabetes insipidus was found to be an endocrine marker for HO risk. CONCLUSIONS: The extent of damage following surgery in the sellar region can be assessed by MRI using a novel scoring system for early HO risk assessment.

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  • A separate scoring system produces a composite score (0-7) based on the extent of the lesion in several key areas: the floor of the third ventricle (0-1), mamillary bodies (0-1), and anterior (0-1), medial (0-1), and posterior (0-1) hypothalamus, as well as the absence or presence of third ventriculomegaly (0-1) and lateral ventriculomegaly (0-1).

    “A separate system produces a composite score (0-7) based on the extent of the lesion in several key areas: the floor of the third ventricle (0-1), mamillary bodies (0-1), and anterior (0-1), medial (0-1), and posterior (0-1) hypothalamus, as well as the absence or presence of third ventriculomegaly (0-1) and lateral ventriculomegaly (0-1).”

    From Approach to the patient with acquired hypothalamic syndrome (2026) · cites this paper as [11]

  • The composite score is predictive of weight gain.

    “The resulting score is predictive not only of weight gain (11)”

    From Approach to the patient with acquired hypothalamic syndrome (2026) · cites this paper as [11]

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Cited by

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Authors
Roth, C. L., Eslamy, H., Werny, D., Elfers, C., Shaffer, M. L., Pihoker, C., Ojemann, J., & Dobyns, W. B.
Affiliations
  • Seattle Children's Hospital (US)
  • Neuroradiology Seattle Children's Hospital &amp; Research Institute Seattle Washington USA
Corresponding author
Roth, Christian L.
ORCID
Venue
Obesity
Publisher
Wiley
Published
2015-04-17
Volume
23
Issue
6
Pages
1226-1233
ISSN
  • 1930-7381 (ISSN-L)
  • 1930-739X
DOI
10.1002/oby.21067
PMC
PMC5029599
OpenAlex
W1552809078
Cited by
96
References
3
Citations by year
2026: 6 · 2025: 3 · 2024: 8 · 2023: 5 · 2022: 16 · 2021: 11 · 2020: 8 · 2019: 14 · 2018: 8 · 2017: 8 · 2016: 7 · 2015: 2
FWCI
7.24
Type
journal article
Language
en
Open access
Licence
Locations
  • Obesity (publishedVersion, cc-by-nc)
  • Europe PMC (PubMed Central) (publishedVersion, cc-by-nc)
  • PubMed Central (publishedVersion, cc-by-nc)
  • PubMed (publishedVersion)
Funders
Seattle Children's Hospital from the Nordstrom and Gittinger families
Topics
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Pituitary Gland Disorders and Treatments
  • Life Sciences › Neuroscience › Endocrine and Autonomic Systems › Regulation of Appetite and Obesity
  • Health Sciences › Medicine › Reproductive Medicine › Hypothalamic control of reproductive hormones
Keywords
hypothalamic obesity, hypothalamic tumors, craniopharyngioma, Rathke's cleft cyst, BMI z-score, diabetes insipidus, childhood obesity, energy homeostasis
MeSH terms
Adolescent, Child, Craniopharyngioma, Female, Humans, Hydrocephalus, Hypothalamic Diseases, Hypothalamus, Magnetic Resonance Imaging, Male, Pituitary Neoplasms, Retrospective Studies, Weight Gain, Body Mass Index, Risk Assessment, Pediatric Obesity

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