Altered functional resting-state hypothalamic connectivity and abnormal pituitary morphology in children with Prader-Willi syndrome.
BACKGROUND
Prader-Willi syndrome (PWS) is a complex neurodevelopmental disorder, characterized by endocrine problems and hyperphagia, indicating hypothalamic-pituitary dysfunction. However, few studies have explored the underlying neurobiology of the hypothalamus and its functional connectivity with other brain regions. Thus, the aim of this study was to examine the anatomical differences of the hypothalamus, mammillary bodies, and pituitary gland as well as resting state functional connectivity of the hypothalamus in children with PWS.


METHODS
Twenty-seven children with PWS (13 DEL, 14 mUPD) and 28 typically developing children were included. Manual segmentations by a blinded investigator were performed to determine the volumes of the hypothalamus, mammillary bodies, and pituitary gland. In addition, brain-wide functional connectivity analysis was performed using the obtained masks of the hypothalamus.


RESULTS
Children with PWS showed altered resting state functional connectivity between hypothalamus and right and left lateral occipital complex, compared to healthy controls. In addition, children with PWS had on average a 50% smaller pituitary volume, an irregular shape of the pituitary, and a longer pituitary stalk. Pituitary volume did not increase in volume during puberty in PWS. No volumetric differences in the hypothalamus and mammillary bodies were found. In all subjects, the posterior pituitary bright spot was observed.


CONCLUSIONS
We report altered functional hypothalamic connectivity with lateral occipital complexes in both hemispheres, which are implicated in response to food and reward system, and absence of connectivity might therefore at least partially contribute to the preoccupation with food in PWS.
Dutch Growth Research Foundation, Postbus 23068, 3001 KB Rotterdam, The Netherlands.|Department of Pediatrics, Erasmus MC-Sophia Children's Hospital, Postbus 2060, 3000 CB Rotterdam, The Netherlands.
Akvile
0000-0003-1901-8625
A
Lukoshe
Department of Child and Adolescent Psychiatry, Erasmus MC-Sophia Children's Hospital, Postbus 2060, 3000 CB Rotterdam, The Netherlands.
Suzanne E
SE
van Dijk
Intensive Care and department of pediatric surgery, Erasmus MC-Sophia Children's Hospital, Postbus 2060, 3000 CB Rotterdam, The Netherlands.
Gerbrich E
GE
van den Bosch
Department of Radiology, Erasmus Medical Centre-Sophia Children's Hospital, Postbus 2040, 3000 CA Rotterdam, The Netherlands.
Aad
A
van der Lugt
Department of Child and Adolescent Psychiatry, Erasmus MC-Sophia Children's Hospital, Postbus 2060, 3000 CB Rotterdam, The Netherlands.|Department of Radiology, Erasmus Medical Centre-Sophia Children's Hospital, Postbus 2040, 3000 CA Rotterdam, The Netherlands.
Tonya
T
White
Dutch Growth Research Foundation, Postbus 23068, 3001 KB Rotterdam, The Netherlands.|Department of Pediatrics, Erasmus MC-Sophia Children's Hospital, Postbus 2060, 3000 CB Rotterdam, The Netherlands.
Anita C
AC
Hokken-Koelega
15q11-q13; Functional resting-state connectivity; Hypothalamus; Neurodevelopmental disorders; Pituitary gland; Prader-Willi syndrome