[Some neurological and psychiatric complications of the disorders of the hypothalamo-hypophyseal system].
Connection between the central nervous system and the endocrine system is extremely complex. The hypothalamus serves as a crucial centre for the integration and coordination of autonomic functions by neuronal and hormonal pathways. It plays a central role in the homeostatic regulation of internal physiological conditions. It controls growth and reproduction, stress reactions, and determines rhythmicity, periodicity and timing of physiological processes. Beside its well-known functions, antidiuretic hormone has a role in social behavior as it enhances aggression via vasopressin receptor 1A. Oxitocin is affected in the formation of maternal behavior, and in other social interactions, like the pair bounding, as well as in analgesia and pain modulation. The corticotrop-releasing hormone acts as a neurotransmitter, it has a special role in stress-behavior, anxiety, and depression, and it blocks deep sleeping. Among the neurotransmitters and neuropeptids of the hypothalamus, serotonin, norepinephrine, GABA, cholecystokinin, neuropeptide-Y, Agouti-related protein, alpha-MSH and ghrelin have essential importance in the eating disorders. The levels of leptin and galanin determine whether formation of anabolic or catabolic neurotransmitters should take place. In the thermoregulation the central thermoreceptors play role, and suprachiasmatic nucleus is responsible for circadian rhythm, through "timing genes". The diseases of the hypothalamus cause most frequently bulimia or anorexia, hypersomnia, impotency, and attacks of anxiety. The most common expansive process of the hypothalamus is craniopharyngioma. The lack or diminution of vasopressin causes diabetes insipidus, while inappropriate antidiuretic hormone secretion induces Schwartz-Barter syndrome. Fröhlich-, Kleine-Levin- or Prader-Willi syndromes have characteristic neuropsychiatric features. The main psychiatric symptom of hypopituitarism is a combination of dementia and delirium. The most characteristic neurological sign of pituitary adenoma is the visual field defect. Carpal tunnel syndrome, obstructive sleeping apnoe and headache are typical neurological features in somatotrop adenomas.
Aszalós
Zsuzsa
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Semmelweis Egyetem, Altalános Orvostudományi Kar, II. Belgyógyászati Klinika, Budapest.aszalos@bel2.sote.hu
D006801:Humans; D007027:Hypothalamic Diseases / Q000150:complications* / Q000503:physiopathology; D007028:Hypothalamic Hormones / Q000378:metabolism*; D007030:Hypothalamo-Hypophyseal System / Q000378:metabolism / Q000503:physiopathology*; D001523:Mental Disorders / Q000209:etiology* / Q000503:physiopathology; D009422:Nervous System Diseases / Q000209:etiology* / Q000503:physiopathology; D010900:Pituitary Diseases / Q000150:complications* / Q000503:physiopathology; D010907:Pituitary Hormones / Q000378:metabolism*; D010911:Pituitary Neoplasms / Q000150:complications
D007028:Hypothalamic Hormones; D010907:Pituitary Hormones