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Polish Journal of Radiology 2021Abnormalities in melatonin physiology and circadian rhythm are detected in patients with autism. Melatonin is produced predominantly in the pineal gland and the amount...
PURPOSE
Abnormalities in melatonin physiology and circadian rhythm are detected in patients with autism. Melatonin is produced predominantly in the pineal gland and the amount of melatonin released is proportional to the pineal gland volume. This study aimed to examine whether the pineal gland volume in children with autism is different from that in healthy children.
MATERIAL AND METHODS
Brain magnetic resonance images (MRI) of 120 paediatric patients with autism and 82 control paediatric subjects were examined; pineal parenchymal volume (PPV), pineal cyst rate (PCR), and total pineal gland volume (TPGV) were measured using a multimodality viewer (MMV), but only the TPGVs were measured using a tumour tracking (TT) method. Measurements were taken by 2 separate radiologists.
RESULTS
In patients with autism, the PPV and TPGV according to MMV, and the TPGV according to TT were significantly lower, and the PCR was significantly higher. Moreover, the ratio of PPV to TPGV was significantly lower in the autism patient group. In both groups, the TPGVs were significantly lower in the autism patient group than the controls among all age groups.
CONCLUSIONS
Our study was the first to examine TPGVs in detail in paediatric patients with autism using 2 different methods. Low PPV-TPGV and high PCR have been observed in autism. This study also provides comparable reference values for pineal gland size in healthy children or autistic children aged 2-17 years. These results show promising potential for further research to understand the relationship between autism pathogenesis and the pineal gland.
PubMed: 34093919
DOI: 10.5114/pjr.2021.105689 -
Journal of Pineal Research Aug 2020Circadian clocks are cell-autonomous self-sustaining oscillators that allow organisms to anticipate environmental changes throughout the solar day and persist in nearly... (Review)
Review
Circadian clocks are cell-autonomous self-sustaining oscillators that allow organisms to anticipate environmental changes throughout the solar day and persist in nearly every cell examined. Environmental or genetic disruption of circadian rhythms increases the risk of several types of cancer, but the underlying mechanisms are not well understood. Here, we discuss evidence connecting circadian rhythms-with emphasis on the cryptochrome proteins (CRY1/2)-to cancer through in vivo models, mechanisms involving known tumor suppressors and oncogenes, chemotherapeutic efficacy, and human cancer risk.
Topics: Animals; Circadian Clocks; Cryptochromes; Humans; Neoplasms; Tumor Suppressor Proteins
PubMed: 32291799
DOI: 10.1111/jpi.12658 -
NeuroImage. Clinical 2021Magnetic resonance imaging (MRI) studies reported pineal gland atrophy in schizophrenia patients and individuals at a clinical high risk of developing psychosis,...
BACKGROUND
Magnetic resonance imaging (MRI) studies reported pineal gland atrophy in schizophrenia patients and individuals at a clinical high risk of developing psychosis, implicating abnormalities in melatonin secretion in the pathophysiology of psychosis. However, it currently remains unclear whether the morphology of the pineal gland contributes to symptomatology and sociocognitive functions.
METHODS
This MRI study examined pineal gland volumes and the prevalence of pineal cysts as well as their relationship with clinical characteristics in 57 at risk mental state (ARMS) subjects, 63 patients with schizophrenia, and 61 healthy controls. The Social and Occupational Functioning Assessment Scale (SOFAS), the Schizophrenia Cognition Rating Scale (SCoRS), and the Brief Assessment of Cognition in Schizophrenia (BACS) were used to assess sociocognitive functions, while the Positive and Negative Syndrome Scale was employed to evaluate clinical symptoms in ARMS subjects and schizophrenia patients.
RESULTS
Pineal gland volumes were significantly smaller in the ARMS and schizophrenia groups than in the controls, while no significant differences were observed in the prevalence of pineal cysts. Although BACS, SCoRS, and SOFAS scores were not associated with pineal morphology, patients with pineal cysts in the schizophrenia group exhibited severe positive psychotic symptoms with rather mild negative symptoms.
CONCLUSION
The present results indicate the potential of pineal atrophy as a vulnerability marker in various stages of psychosis and suggest that pineal cysts influence the clinical subtype of schizophrenia.
Topics: Atrophy; Cysts; Humans; Magnetic Resonance Imaging; Pineal Gland; Psychotic Disorders; Schizophrenia
PubMed: 34461434
DOI: 10.1016/j.nicl.2021.102805 -
Journal of Pediatric Neurosciences 2021Pineal glioblastomas (GBMs) are extremely rare tumors. Herein we will present a pediatric patient with GBM located in pineal region who was admitted with the symptoms of...
UNLABELLED
Pineal glioblastomas (GBMs) are extremely rare tumors. Herein we will present a pediatric patient with GBM located in pineal region who was admitted with the symptoms of increased intracranial pressure and treated with surgical resection and radiotherapy.
INTRODUCTION
Pineal region tumors are extremely rare accounting for less than 1% of all brain tumors. The most common type of pineal region tumors is germ cell tumor, followed by pineal parenchymal tumors, gliomas, atypical tumors, and the others.
CASE REPORT
A 5-year-old girl was admitted with complaints of headache, dizziness, imbalance in walking, and impaired vision for 1 month. Her neurological examination revealed a tendency to sleep, anisocoric pupillae, mesh eye pupil, dilated lateral gaze paralysis, and left hemiparasia (4/5 muscle strength). In magnetic resonance imaging, a mass was observed in the pineal region that infiltrates the right thalamus and right superior peduncle, isointense and hyperintense in T1 sections, hyperintense in T2 sections, having centrally contrasted areas in post-contrast sections. Due to the presence of evident hydrocephalus, a ventricular shunt was inserted and then through supracerebellar to infratentorial approach the lesion was removed subtotally. The histopathological diagnosis was GBM. GBMs in the pineal region are extremely rare tumors carrying poor prognosis. The patients are generally presented with the signs and symptoms of increased intracranial pressure. GBMs should be kept in mind in differential diagnosis of tumors in the pineal region.
PubMed: 36531780
DOI: 10.4103/jpn.JPN_232_20 -
World Neurosurgery: X Oct 2023Published literature on epidemiological profile of paediatric brain tumours in India is limited. : To present a retrospective analysis of the histological spectrum of...
BACKGROUND
Published literature on epidemiological profile of paediatric brain tumours in India is limited. : To present a retrospective analysis of the histological spectrum of 158 paediatric age group central nervous system tumours operated in a single tertiary care hospital in Coastal South India between January 2015 and December 2021.
MATERIAL AND METHODS
Retrospective analysis of the data regarding frequencies of various primary brain tumours among 158 paediatric patients (<18 years of age). The tumours were categorised according to the revised 4th edition of World Health Organization (WHO) classification of tumours of the Central Nervous system.
RESULTS
Paediatric CNS constituted 8.5% of total intracranial tumours (158/1860) operated in the study period. The mean age of the patients was 10.2 years and a definite male predominance was noted (1.54:1) Astrocytomas, glioneuronal tumours, and neuronal tumours constituted the majority (72/158; 45.6%) followed by embryonal tumours (31/158; 19.6%) and craniopharyngiomas(24/158; 15.4%).Of the glial neoplasms majority were pilocytic and other astrocytic tumours(41.6%), followed by mixed neuroglial tumours (19.4%), diffuse high grade astrocytomas (Grade III/IV) (11.1%), diffuse low -grade astrocytomas (Grade II) (9.7%) and ependymomas (13.8%). Our series also included six meningiomas (3.8%), five germ cell tumours (3.16%), four nerve sheath tumours (2.53%), two choroid plexus tumours (1.26%), two pineal parenchymal tumours (1.26%) and one metastasis from a soft tissue sarcoma from the thigh. Supratentorial tumours (58.2%) were more common than posterior fossa (34.6%) and spinal tumours (7.6%) and visual pathway gliomas accounted for 5.6% of all our tumours.
CONCLUSIONS
Paediatric central nervous system tumours are more common in boys and in the second decade of life. Astrocytomas are the most common paediatric brain tumours followed by medulloblastomas and craniopharyngiomas. Pediatric tumours affect the supratentorial compartment more often than the infratentorial compartment. The profile of paediatric brain tumours in our series is similar to that reported from other Indian centres as well as most western literature.
PubMed: 37456693
DOI: 10.1016/j.wnsx.2023.100227 -
Frontiers in Oncology 2023Pediatric diencephalic tumors represent a histopathologically and molecularly diverse group of neoplasms arising in the central part of the brain and involving eloquent... (Review)
Review
Pediatric diencephalic tumors represent a histopathologically and molecularly diverse group of neoplasms arising in the central part of the brain and involving eloquent structures, including the hypothalamic-pituitary axis (HPA), optic pathway, thalamus, and pineal gland. Presenting symptoms can include significant neurological, endocrine, or visual manifestations which may be exacerbated by injudicious intervention. Upfront multidisciplinary assessment and coordinated management is crucial from the outset to ensure best short- and long-term functional outcomes. In this review we discuss the clinical and pathological features of the neoplastic entities arising in this location, and their management. We emphasize a clear move towards 'function preserving' diagnostic and therapeutic approaches with novel toxicity-sparing strategies, including targeted therapies.
PubMed: 37886179
DOI: 10.3389/fonc.2023.1178553 -
Surgical Neurology International 2020Pineal cysts are common entities, with a reported prevalence between 10 and 54%. Management of pineal cysts has historically been expectant, with surgical treatment of... (Review)
Review
BACKGROUND
Pineal cysts are common entities, with a reported prevalence between 10 and 54%. Management of pineal cysts has historically been expectant, with surgical treatment of these lesions usually reserved for patients with a symptomatic presentation secondary to mass effect. The appropriate management of pineal cysts in patients presenting with headache in the absence of hydrocephalus - often the most common clinical scenario - has been more ambiguous. Here, we report the results of a comprehensive systematic review of headache outcomes for surgically treated, non-hydrocephalic pineal cyst patients without signs of increased intracranial pressure (ICP).
METHODS
Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines were followed to construct a systematic review. A comprehensive search of the PubMed, Embase, Scopus, and Web of Science databases was conducted from through June 2020. Relevant English-language articles were identified using the search terms "pineal cyst" and "headache." The following eligibility criteria were applied: the inclusion of at least one surgically-treated, non-hydrocephalic pineal cyst patient presenting with headache in the absence of hemorrhage or signs and symptoms of increased ICP. Patient demographics and post-operative headache outcomes for the included studies were extracted and summarized.
RESULTS
A total of 24 pineal cyst cases meeting our selection criteria were identified across 11 included studies. Postoperative improvement or resolution of headaches was reported for 23/24 patients. Our systematic review of the literature demonstrates that non-hydrocephalic patients with pineal cysts have a high rate of headache improvement following surgical intervention.
CONCLUSION
The results indicate a need for further investigation of the link between headache and pineal cysts in the non-hydrocephalic patient.
PubMed: 33408918
DOI: 10.25259/SNI_541_2020 -
Neurosurgical Review Oct 2022Indications for surgery of pineal cysts without ventriculomegaly are still under debate. In view of the limited data for pineal cyst resection in the absence of... (Review)
Review
Indications for surgery of pineal cysts without ventriculomegaly are still under debate. In view of the limited data for pineal cyst resection in the absence of hydrocephalus, and the potential risk of this approach, we have analyzed our patient cohort focusing on strategies to avoid complications according to our experience in a series of 73 pineal cyst patients. From 2003 to 2015, we reviewed our database retrospectively for all patients operated on a pineal cyst. Furthermore, we prospectively collected patients from 2016 to 2020. In summary, 73 patients with a pineal cyst were treated surgically between 2003 and 2020. All patients were operated on via a microscopic supracerebellar-infratentorial (SCIT) approach. The mean follow-up period was 26.6 months (range: 6-139 months). Seventy-three patients underwent surgery for a pineal cyst. An absence of enlarged ventricles was documented in 62 patients (51 female, 11 male, mean age 28.1 (range 4-59) years). Main presenting symptoms included headache, visual disturbances, dizziness/vertigo, nausea/emesis, and sleep disturbances. Complete cyst resection was achieved in 59/62 patients. Fifty-five of 62 (89%) patients improved after surgery with good or even excellent results according to the Chicago Chiari Outcome Scale, with complete or partial resolution of the leading symptoms. Pineal cysts resection might be an indication in certain patients for surgery even in the absence of ventriculomegaly. The high percentage of postoperative resolution of quality-of-life impairing symptoms in our series seems to justify surgery. Preoperatively, other causes of the leading symptoms have to be excluded.
Topics: Adolescent; Adult; Brain Neoplasms; Central Nervous System Cysts; Child; Child, Preschool; Female; Humans; Hydrocephalus; Male; Middle Aged; Pineal Gland; Retrospective Studies; Treatment Outcome; Young Adult
PubMed: 35829978
DOI: 10.1007/s10143-022-01831-2 -
Journal of Neuro-oncology Jan 2024To provide a treatment-focused review and develop basic treatment guidelines for patients diagnosed with pineal anlage tumor (PAT).
PURPOSE
To provide a treatment-focused review and develop basic treatment guidelines for patients diagnosed with pineal anlage tumor (PAT).
METHODS
Prospectively collected data of three patients with pineal anlage tumor from Germany was combined with clinical details and treatment information from 17 published cases.
RESULTS
Overall, 20 cases of PAT were identified (3 not previously reported German cases, 17 cases from published reports). Age at diagnosis ranged from 0.3 to 35.0 (median: 3.2 ± 7.8) years. All but three cases were diagnosed before the age of three years. For three cases, metastatic disease at initial staging was described. All patients underwent tumor surgery (gross-total resection: 9, subtotal resection/biopsy: 9, extent of resection unknown: 2). 15/20 patients were alive at last follow-up. Median follow-up for 10/15 surviving patients with available follow-up and treatment data was 2.4 years (0.3-6.5). Relapse was reported for 3 patients within 0.8 years after diagnosis. Five patients died, 3 after relapse and 2 from early postoperative complications. Two-year-progression-free- and -overall survival were 65.2 ± 12.7% and 49.2 ± 18.2%, respectively. All 4 patients who received intensive chemotherapy including high-dose chemotherapy combined with radiotherapy (2 focal, 2 craniospinal [CSI]) had no recurrence. Focal radiotherapy- and CSI-free survival rates in 13 evaluable patients were 46.2% (6/13) and 61.5% (8/13), respectively.
CONCLUSION
PAT is an aggressive disease mostly affecting young children. Therefore, adjuvant therapy using intensive chemotherapy and considering radiotherapy appears to comprise an appropriate treatment strategy. Reporting further cases is crucial to evaluate distinct treatment strategies.
Topics: Adolescent; Adult; Child; Child, Preschool; Humans; Infant; Young Adult; Brain Neoplasms; Neoplasm Recurrence, Local; Pineal Gland; Pinealoma; Recurrence; Supratentorial Neoplasms; Treatment Outcome
PubMed: 38253790
DOI: 10.1007/s11060-023-04547-5 -
American Journal of Translational... 2021Pineal region tumors (PRTs) affect all ages, with a remarkable proportion of cases occurring in children. They are mainly classified into three categories, namely germ... (Review)
Review
Pineal region tumors (PRTs) affect all ages, with a remarkable proportion of cases occurring in children. They are mainly classified into three categories, namely germ cell tumors (GCTs), pineal parenchymal tumors (PPTs), and other tumors such as gliomas and tumors of the surrounding structures. The purpose of this article is to review the current literature regarding pathophysiological mechanisms of the presenting clinical features of patients with PRT. The usual presentation of PRTs is the symptoms of obstructive hydrocephalus and intracranial hypertension, such as headache and vomiting. However, there is a remarkable spectrum of clinical findings that can be caused by such lesions. These include ophthalmologic and endocrinologic disturbances, motor and sensory abnormalities, and cognitive and psychiatric symptoms. The unique anatomic location of the pineal gland, which is close to many vital brain structures, is crucial for the explanation of most of those findings. In rare cases, manifestations of intracranial bleeding may be the presenting feature of a PRT. Tumor histology and patient's age can affect the clinical presentation. Hydrocephalus is the most common clinical syndrome of a PRT because of the location of the pineal gland. Presenting symptoms also include ophthalmologic, endocrinologic, motor, sensory, cognitive, and psychiatric symptoms. Clinicians should be aware of the initial symptoms of PRTs, including the misleading ones, in order to avoid delay in the diagnosis and management of these life-threatening lesions.
PubMed: 34306324
DOI: No ID Found