Hypothalamic lesions in multiple sclerosis
Abstract
Demyelinating lesions of fiber bundles in and adjacent to the hypothalamus (i.e. the fornix. anterior commissure, internal capsule, and optic system) may be the basis for autonomic and endocrine alterations in multiple sclerosis (MS) patients. Therefore we investigated the presence and immunological activity of lesions in hypothalamic fiber bundles of 17 MS patients and 14 controls. In the MS group, 16 of 17 patients showed demyelinated lesions. The incidence of active lesions was high (60%) and outnumbered chronic inactive lesions in the internal capsule (p = 0.005). In 4 of 17 MS patients, axonal damage was observed and in 3 of 17 MS patients grey matter lesions were apparent. Duration of MS was inversely related to the active hypothalamic MS lesion score (r = -0.72, p = 0.001). Since comparison of hypothalamic lesions with MS lesions in other areas of the brain in the same patients (n = 7) showed a great similarity both as stage and appearance was concerned, this negative relation in all likelihood reflects the clinical consequences of high disease activity throughout the whole brain. In controls no demyelinating lesions were seen but in 11 control cases HLA expression was observed that was lower than that present in MS patients (p = 0.02). In the median eminence region that lacks a blood-brain barrier, all controls showed a strong HLA expression around the blood vessels. We conclude that systematic pathological investigation of the hypothalamus in MS patients reveals an unexpected high incidence of active lesions that may impact on hypothalamic functioning.
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Neuropathological studies reported a high proportion of patients with inflammatory and demyelinating lesions of the hypothalamus, with indices of altered HPA activity.
“Additionally, neuropathological studies reported a high proportion of patients with inflammatory and demyelinating lesions of the hypothalamus, with indices of altered HPA activity (Huitinga et al., 2001, 2004).”
From Allostatic Self-efficacy: A Metacognitive Theory of Dyshomeostasis-Induced Fatigue and Depression (2016) · cites this paper as Huitinga et al., 2001
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Allostatic Self-efficacy: A Metacognitive Theory of Dyshomeostasis-Induced Fatigue and Depression
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- Authors
- Huitinga, I., De Groot, C. J. A., Van der Valk, P., Kamphorst, W., Tilders, F. J. H., & Swaab, D. F.
- Affiliations
- Vrije Universiteit Amsterdam (NL)
- Corresponding author
- Huitinga, Inge
- Venue
- Journal of Neuropathology & Experimental Neurology
- Publisher
- Oxford University Press (OUP)
- Published
- 2001-12
- Volume
- 60
- Issue
- 12
- Pages
- 1208-1218
- ISSN
- 0022-3069 (ISSN-L)
- 1554-6578
- OpenAlex
- W1503805158
- Cited by
- 120
- References
- 60
- Citations by year
- 2026: 2 · 2025: 3 · 2024: 2 · 2023: 5 · 2022: 2 · 2021: 4 · 2020: 6 · 2019: 4 · 2018: 7 · 2017: 2 · 2016: 3 · 2015: 10 · 2014: 5 · 2013: 6 · 2012: 6
- FWCI
- 1.09
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Journal of Neuropathology & Experimental Neurology (publishedVersion)
- PubMed (publishedVersion)
- Data Archiving and Networked Services (DANS) (submittedVersion)
- Pure Amsterdam UMC (submittedVersion)
- KNAW Research Portal (The Royal Netherlands Academy of Arts and Sciences) (submittedVersion)
- Topics
- Health Sciences › Medicine › Pathology and Forensic Medicine › Multiple Sclerosis Research Studies
- Health Sciences › Medicine › Neurology › Peripheral Neuropathies and Disorders
- Health Sciences › Medicine › Oncology › Polyomavirus and related diseases
- Keywords
- multiple sclerosis, hypothalamus, demyelinating lesions, fornix, anterior commissure, internal capsule, autonomic dysfunction, endocrine dysfunction, HLA expression, axonal injury, gray matter lesions, disease duration, median eminence, blood-brain barrier
- MeSH terms
- Adult, Aged, Aged, 80 and over, Axons, Demyelinating Diseases, Female, Humans, Hypothalamus, Male, Median Eminence, Middle Aged, Multiple Sclerosis, Nerve Fibers, Myelinated, Severity of Illness Index, Chi-Square Distribution, Disease Progression, Statistics, Nonparametric
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