Hypothalamic atrophy is related to body mass index and age at onset in amyotrophic lateral sclerosis

The hypothalamus, energy balance and neurodegeneration

There is growing interest in understanding the specific brain regions underlying the association between metabolic changes and a range of neurodegenerative diseases.1–3 Atrophy of the hypothalamus, a region critical to the regulation of energy balance, has been observed in Huntington’s disease4 and frontotemporal dementia (FTD).5 6 In their JNNP paper, - Gorges and colleagues7 found that people with amyotrophic lateral sclerosis (ALS), part of the spectrum of neurodegenerative disease that includes FTD, also had substantially decreased hypothalamic volumes measured by 3 T MRI.

Why is this finding important? The hypothalamus contains neurons that regulate eating behaviour and autonomic function and has functional projections to the striatum, thalamus, brainstem, orbitofrontal cortex and other brain regions,8 involved in reward processing and decision-making.8 As such structural changes in the hypothalamus (such as a loss of volume/atrophy) could...

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