Eating behaviour in craniopharyngioma version 1
Research type
Research Study
Full title
Evaluating eating behaviours, energy homeostasis and obesity in childhood craniopharyngioma: A feasibility study.
IRAS ID
250104
Contact name
Elanor Hinton
Contact email
Duration of Study in the UK
1 years, 5 months, 31 days
Research summary
Research Summary
Craniopharyngioma, although a non-malignant brain tumour, causes major health problems because of its location. It is near vision nerves, the pituitary gland controlling many hormones, and brain centres controlling appetite. Treatment involves surgery and radiotherapy, which can cause further damage. Obesity and associated long-term risks are common, and the reasons are complex. Through this project, we will investigate obesity in young people with craniopharyngioma. We want to find out if obesity is related to overeating from a lack of feeling full, appetite hormones not functioning or low metabolic rate. First, we will assess whether patients and their families are prepared to take part in research. Second, we will investigate which tests are best to use. We will measure the brain's response to food cues using special MRI scans and appetite hormones levels in the blood, as well as metabolic rate and questionnaires on quality of life and typical eating. Patients will eat lunch, so we can assess food choice and portion size. These measures will be analysed in relation to each patient’s craniopharyngioma severity and treatment, number and type of hormone problems and level of obesity. Although craniopharyngiomas are rare (1-2 new childhood patients/per year in the South-west), this project has the potential to identify novel interventions. It will make a real impact to improve quality of life and health in craniopharyngioma patients with unmet complex needs related to obesity. These projects could also help us understand how weight problems could develop after other brain injuries.
Summary of Results
Eating behaviour in craniopharyngioma Craniopharyngioma is a type of tumour found in the brain near an area called the hypothalamus. The hypothalamus is an area known to be involved in the control of appetite and eating. We know that weight problems and obesity can be linked to craniopharyngioma and can lead to long term health problems. However, we do not know how or why obesity occurs in craniopharyngioma. Through this project, we investigated eating behaviour in young people with craniopharyngioma.
The study was set-up to find out if the craniopharyngioma has affected the ability to feel full, impaired appetite hormones or the rate at which the body uses energy (metabolic rate). We wanted to understand what happens in the brain when young people who have had craniopharyngioma are shown pictures about food. To do so, we used a combination of blood tests, questionnaires and MRI brain scanning, which was carried out over one morning at the Clinical Research Centre in Bristol.
Eleven young people with craniopharyngioma and eleven young people without craniopharyngioma, but matched for sex, and age and whether they had started puberty, took part in the study. We asked all the participants to fill in a questionnaire to tell us what they thought about each of the tests and their experience of taking part.Overall, participants found the various aspects of the study highly acceptable and well tolerated. Many participants and their parents thought the study was important, e.g. “I have always been intrigued around my eating habits since my op so it has really interested me being asked to do this research project.” The participants and their parents made lots of helpful comments that we can use to make our research more relevant and acceptable to young people living with craniopharyngioma.
Compared to the control group, participants with craniopharyngioma had higher body weight, but no differences were seen in their metabolic rate or food intake. The answers to the questionnaires showed us that participants with craniopharyngioma had a much greater appetite and responsiveness for food, which sometimes interfered with their daily lives. They also show less slowness in eating. Patients and their parents reported lower quality of life, as they found their health limited their activities.
Using the brain imaging, we found that participants with craniopharyngioma showed greater responses to food pictures when they were hungry compared to the control group. We also found that the connections between brain areas involved in appetite control were disrupted in those with a brain tumour.
With the information gained from doing this study, we aim to explore new methods to manage eating in young people with craniopharyngioma to reduce the chance of obesity developing. We have applied for more research funding to continue this work. This study was conducted by researchers at the NIHR Bristol Biomedical Research Centre at the University of Bristol and was funded by the Above & Beyond charity at University Hospitals Bristol and Weston NHS trust.
REC name
South West - Frenchay Research Ethics Committee
REC reference
18/SW/0235
Date of REC Opinion
16 Nov 2018
REC opinion
Further Information Favourable Opinion