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Brain, Vol. 114, No. 2, 697-708, 1991
© 1991 Oxford University Press

research-article

MODIFICATIONS OF THERMOREGULATION IN PATIENTS WITH SUPRASELLAR PITUITARY ADENOMAS

R. BEHR1,, G. HILDEBRANDT1, M. KOCA1 and K. BRÜCK2

1Department of Neurosurgery Giessen, Germany 2Department of Physiology, Justus-Liebig University Giessen, Germany

Correspondence to: Correspondence to: Dr Robert Behr, Department of Neurosurgery, Jusnis-liebig University, 6300 Giessen, Germany

Thermoregulation was investigated pre and postoperatively in 5 and only preoperatively in 7 patients with suprasellar pituitary adenomas by exposing them to external cold and heat in a climatic chamber. Five healthy subjects served as controls. Body core and skin temperatures, oxygen consumption, electromyographic activity, skin blood flow and local sweating rates were continuously measured. Threshold temperatures for activation of heat production and heat loss were calculated from these data. Hormone analysis was performed before and after stimulation with releasing factors. In the patients, core temperatures as well as threshold temperatures for heat production and heat loss were elevated by about 0.5° C as compared with controls. This elevation of core and threshold temperatures was achieved, despite a reduced resting metabolic rate, by a reduction of skin blood flow indicated by a low mean skin temperature. After successful operation the thermoregulatory alterations normalized. Serum levels of growth hormone were reduced preoperatively and stimulation by GHRF did not cause an appropriate increase. Prolactin was elevated in 6 patients with prolactinomas, but there was no correlation with changes in thermoregulatory threshold temperatures. Stimulation of the other hypophyseal hormones by the combined anterior pituitary function test revealed a normal hormonal response. Apart from prolactin there were no significant hormonal changes postoperatively. It is concluded that disturbances of temperature regulation are preesent in patients with suprousellar adenomas, but that they are not detectable by routine clinical methods. These alterations probably depend on a disturbance of hypothalamic function and are reversible by surgery.

Received September 6, 1989. Revised April 3, 1990. Accepted April 10, 1990.


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