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Midline brain lesions in children with hormone insufficiency indicate early prenatal damage
A Hellström1, L M Wiklund, E Svensson
1Department of Clinical Neurosciences, International Paediatric Growth Research Centre, Göteborg, Sweden.
Insights
Children with impaired growth and hormone deficiencies show abnormal midline brain and visual pathway structures. Greater growth hormone (GH) insufficiency correlated with more severe abnormalities in these brain regions.
Area of Science:
- Pediatric Endocrinology
- Neuroimaging
- Developmental Neuroscience
Background:
- Impaired growth in children often involves hormonal imbalances.
- Midline brain structures and visual pathways are crucial for development and hormonal regulation.
- Understanding the interplay between morphology and hormonal status is vital for diagnosis and treatment.
Purpose of the Study:
- To investigate the relationship between midline brain morphology, anterior visual pathway structure, and hormonal status in children with impaired growth.
- To determine if growth hormone (GH) secretion levels correlate with specific neuroanatomical findings.
- To explore potential common etiological factors for observed abnormalities.
Main Methods:
- Magnetic resonance imaging (MRI) was used to assess intracranial morphology.
- 47 children (14 female, 33 male) undergoing GH treatment were studied.
- Participants represented diverse birth sizes and varying degrees of hormone insufficiency.
Main Results:
- A significant correlation was found between GH secretion and the morphology of the neurohypophysis, pituitary stalk, and anterior visual pathways.
- Children with greater GH insufficiency exhibited more abnormal midline brain and visual pathway structures.
- Individuals with anterior visual pathway abnormalities had the lowest GH levels and smallest adenohypophysis.
Conclusions:
- Abnormalities in anterior visual pathways are linked to hypothalamo-pituitary structural issues.
- These associations suggest a potential common prenatal neural damage affecting closely related embryological structures.
- The findings highlight the importance of neuroimaging in evaluating children with impaired growth and hormonal deficiencies.
Abstract:
The relationships between midline brain morphology, anterior visual pathway morphology and hormonal status in children with impaired growth were studied. Intracranial morphology was studied by magnetic resonance imaging in 47 children (14F, 33M), median age 9.7y (range 2.6-18.7y) undergoing growth hormone treatment (GH; 0.1 U/kg/d). They were chosen to represent various birth sizes and a spectrum of hormone insufficiencies. There was a relationship between GH secretion and the morphology of the neurohypophysis, the pituitary stalk and the anterior visual pathways, i.e. the greater the GH insufficiency, the more abnormal were these structures. The children with anterior visual pathway abnormalities had the lowest GH levels and the smallest adenohypophysis. The association between abnormalities of the anterior visual pathways and the hypothalamo-pituitary structures may reflect a common prenatal neural damage in embryologically and anatomically closely related structures.