NEUROHORMONAL REGULATION OF ENERGY BALANCE AMONG PEDIATRIC BRAIN TUMOR SUBJECTS

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This subproject is one of many research subprojects utilizing the resources provided by a Center grant funded by NIH/NCRR. The subproject and investigator (PI) may have received primary funding from another NIH source, and thus could be represented in other CRISP entries. The institution listed is for the Center, which is not necessarily the institution for the investigator. Survivors of certain types of pediatric brain tumors are at significant risk for developing morbid obesity. The mechanism is thought to be largely due to hypothalamic dysregulation of feeding. While many of the neurohormonal signaling pathways for the regulation of feeding have been identified, none have been evaluated specifically in the neuro-oncology subjects most at risk for obesity. Given that many of these subjects pre-operatively have normal energy balance and then rapidly decline post-operatively, an observational study looking at the longitudinal changes in neurohormonal signals could further elucidate the underlying mechanisms for obesity in these patients, as well as providing insight into the hormonal regulation of obesity in general. In this pilot study, we will prospectively evaluate newly diagnosed subjects with primary pediatric brain tumors and compare those with tumors associated with weight gain (diencephalic tumors) to those with tumors not associated with weight gain. Specifically, we will evaluate changes in neurohormone concentrations, monitor diet and exercise as the vehicle for weight gain, and assess underlying endocrine dysfunction that may contribute to energy balance dysregulation. With a better understanding of the underlying neurohormonal physiology of obesity, potential therapeutic targets for this challenging complication can ultimately be identified.