Endocrine Abstracts

Among tumors of the diencephalic region there are: pituitary adenomas, craniopharyngiomas, gliomas, meningiomas and others. They differ in location, histology, clinic with corresponding hormonal disorders. Emotional disorders in the clinic of tumors of the diencephalic region are revealed in 2–67% by the literature. Emotional disturbances with hormone-active pituitary adenomas there are 30–60%, and with non-functioning pituitary adenomas there are ones less than 6%. Emotional disturbances are revealed in 67% of patients with craniopharyngiomas on the background of a decrease in hormonal secretion. Psychopathology can be caused by the localization of lesions/irritation of the brain, histology and, possibly, changes in the level of neurohormones. Pituitary adenomas has the leading place among tumors of the diencephalon localizations. This is 15% of all brain tumors, the 1st and 2nd places are detectable at the age of 15 to 54 years. Hormone-active pituitary adenomas differ by prolactinoma (PRL-secreting pituitary adenomas −35%), acromegaly (GH-secreting pituitary adenomas – 15%), cushing’s syndrome (ACTH-secreting pituitary adenomas −10%), thyrotropinoma (TSH-secreting adenomas-1%) and non-functioning pituitary adenomas (40%).

1. Pituitary adenomas with excessive secretion of growth hormone (GH) - Emotional disorders are in 60% of patients, and nonspecific symptoms, mostly asthenia. It is often stable dysphoria - the predominance of “gloomy-spiteful” mood.

2. Pituitary adenomas gland with excessive secretion of adrenocorticotropic hormone (ACTH):

1) Cushing’s disease - changeable mood, depression, apathy, sleep disturbance, with visceral symptoms (tachycardia, fluctuations in blood pressure) are in 50%.

2) Nelson’s syndrome - a decrease in emotional reactions and motor activity. Patients are apathetic, monotonous, poor in mimic manifestations.

3. Pituitary adenomas with excessive secretion of prolactin (PRL) - emotional disorders, sleep disturbance are in 30%. Nonspecific symptoms of the asthenia in almost a quarter of patients.

4. Pituitary adenomas with excessive secretion of thyroid-stimulating hormone (TSH) - increased emotionality, excitability, changeable mood, with frequent “panic attacks” are in 40%.

5. Non-functioning pituitary adenomas:

a) With hormone-inactive tumors of the pituitary psychopathology is present in 6% patient. There are violations of sleep, changeable mood, weakness, decreased memory.

b) In craniopharyngiomas emotional and personality disorders was in 67%. This is combined with cognitive, motivational and other impairments.

Conclusion: Violations of emotions in the defeat of the diencephalic region are caused by the localization of the tumor with the involvement of the corresponding brain structures in the pathological process.