Research Paper Volume 13, Issue 7 pp 10087—10098

Predicting the location of the preoptic and anterior hypothalamic region by visualizing the thermoregulatory center on fMRI in craniopharyngioma using cold and warm stimuli

Jie Kang1, , Lei Cao1, , Taoyang Yuan5, , Lu Jin1, , Yuanyu Shi2, , Guofo Ma1, , Ning Qiao1, , Chuzhong Li1,5, , Yazhuo Zhang5, , Zhentao Zuo2,3,4, , Songbai Gui1, ,

  • 1 Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
  • 2 State Key Laboratory of Brain and Cognitive Science, Institute of Biophysics, Chinese Academy of Sciences, Beijing, China
  • 3 CAS Center for Excellence in Brain Science and Intelligence Technology, Chinese Academy of Sciences, Shanghai, China
  • 4 Sino-Danish College, University of Chinese Academy of Sciences, Beijing, China
  • 5 Beijing Neurosurgical Institute, Capital Medical University, Beijing, China

Received: November 18, 2020       Accepted: December 23, 2020       Published: March 26, 2021
How to Cite

Copyright: © 2021 Kang et al. This is an open access article distributed under the terms of the Creative Commons Attribution License (CC BY 3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.


Hypothalamic nuclei in the preoptic and anterior hypothalamic region (POAH) are critically involved in thermoregulation and neuroendocrine regulation and can be displaced by craniopharyngiomas (CPs). We aimed to locate the POAH by visualizing hypothalamic thermoregulation through task-related functional magnetic resonance imaging (fMRI) to guide hypothalamus protection intraoperatively. Nine adult healthy volunteers (HVs) and thirty-two adult primary CP patients underwent task-related fMRI for POAH localization by warm (60° C) and cold (0° C) cutaneous thermoreceptor stimulation. Approach selection and intraoperative POAH protection were performed based on preoperative POAH localization. In all HVs and patients, significant single positive blood oxygen level-dependent (BOLD) signal changes were located in the POAH. The BOLD activity was significantly greater for cold (P=0.03) and warm (P=0.03) stimuli in patients than in HVs. Gross total resection and near-total resection were achieved in 28 (87.5%) and 4 (12.5%) patients, respectively. New-onset diabetes insipidus and new-onset hypopituitarism occurred in 6 patients (18.8%) and 10 patients (31.3%), respectively. Our findings suggest that cutaneous thermoreceptor stimulation could accurately activate the hypothalamic thermoregulatory center and allow POAH localization through task-related fMRI. Preoperative POAH localization could help neurosurgeons protect hypothalamic function intraoperatively. The CP patients were more sensitive to thermal stimulation.


CPs: craniopharyngiomas; fMRI: functional magnetic resonance imaging; POAH: preoptic and anterior hypothalamic region; HVs: healthy volunteers; DH: dorsal horn; LPB: lateral parabrachial nucleus; BOLD: blood oxygen level-dependent; EEA: endoscopic endonasal approach; GTR: gross total resection; NTR: near-total resection; TCORE: constant body core temperature; CPC: chiasm-pituitary corridor; EETLT: endoscopic endonasal trans-lamina terminalis approach.