Hypothalamus

The hypothalamus is a collection of various nuclei within the diencephalon in the center of the brain. The hypothalamus plays a vital role in endocrine regulation as the primary regulator of the pituitary gland Pituitary gland The pituitary gland, also known as the hypophysis, is considered the "master endocrine gland" because it releases hormones that regulate the activity of multiple major endocrine organs in the body. The gland sits on the sella turcica, just below the hypothalamus, which is the primary regulator of the pituitary gland. Pituitary Gland, and it is the major point of integration between the central nervous and endocrine systems. Different nuclei within the hypothalamus play roles in hormone regulation and secretion, autonomic regulation, thermoregulation, food and water intake, sleep Sleep Sleep is a reversible phase of diminished responsiveness, motor activity, and metabolism. This process is a complex and dynamic phenomenon, occurring in 4-5 cycles a night, and generally divided into non-rapid eye movement (NREM) sleep and REM sleep stages. Physiology of Sleep and circadian rhythms, memory, and emotional behavior. The hypothalamus has both neural and circulatory connections with the pituitary gland Pituitary gland The pituitary gland, also known as the hypophysis, is considered the "master endocrine gland" because it releases hormones that regulate the activity of multiple major endocrine organs in the body. The gland sits on the sella turcica, just below the hypothalamus, which is the primary regulator of the pituitary gland. Pituitary Gland. Abnormalities in the hypothalamus can lead to a wide range of clinical conditions.

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Editorial responsibility: Stanley Oiseth, Lindsay Jones, Evelin Maza

Table of Contents

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Development

The hypothalamus is a collection of various nuclei within the center of the brain that develops early during embryologic life.

Neural tube

The 1st step is development of the neural tube.

  • Develops from ectoderm 
  • Trilaminar embryo invaginates to form the neural fold → neural tube (closed by 6 weeks)
  • Neural tube becomes the CNS.
Early embryonic development of the nervous system

Early embryonic development of the nervous system Nervous system The nervous system is a small and complex system that consists of an intricate network of neural cells (or neurons) and even more glial cells (for support and insulation). It is divided according to its anatomical components as well as its functional characteristics. The brain and spinal cord are referred to as the central nervous system, and the branches of nerves from these structures are referred to as the peripheral nervous system. General Structure of the Nervous System

Image: “The neuroectoderm begins to fold inward to form the neural groove. As the two sides of the neural groove converge, they form the neural tube, which lies beneath the ectoderm.” by OpenStax College. License: CC BY 4.0

Primary and secondary neural vesicles

The neural tube develops 3 “bulges” known as the primary vesicles:

  • Prosencephalon (forebrain) → splits into 2 secondary vesicles:
    • Telencephalon → cerebrum
    • Diencephalon goes on to form:
      • Thalamus Thalamus The thalamus is a large, ovoid structure in the dorsal part of the diencephalon that is located between the cerebral cortex and midbrain. It consists of several interconnected nuclei of grey matter separated by the laminae of white matter. The thalamus is the main conductor of information that passes between the cerebral cortex and the periphery, spinal cord, or brain stem. Thalamus
      • Hypothalamus
      • Epithalamus (includes the pineal gland)
      • Subthalamus
  • Mesencephalon (midbrain, no secondary vesicles) → midbrain
  • Rhombencephalon (hindbrain) → splits into 2 secondary vesicles:
    • Metencephalon:
      • Pons
      • Cerebellum Cerebellum The cerebellum, Latin for "little brain," is located in the posterior cranial fossa, dorsal to the pons and midbrain, and its principal role is in the coordination of movements. The cerebellum consists of 3 lobes on either side of its 2 hemispheres and is connected in the middle by the vermis. Cerebellum
    • Myelencephalon → medulla oblongata
Neural tube development

Neural tube development:
Primary and secondary vesicle formation

Image: “The embryonic brain develops complexity through enlargements of the neural tube called vesicles” by OpenStax College. License: CC BY 4.0

Gross Anatomy

Location

  • Located in the center of the brain
  • Just superior to the brain stem Brain Stem The brain stem is a stalk-like structure that connects the cerebrum with the spinal cord and consists of the midbrain, pons, and medulla oblongata. It also plays a critical role in the control of cardiovascular and respiratory function, consciousness, and the sleep-wake cycle. Brain Stem
  • Forms part of the walls and floor of the 3rd ventricle
  • Symmetrical; has right and left halves
Hypothalamus within the brain

Location of the hypothalamus within the brain

Image: “The cerebrum is a large component of the CNS in humans, and the most obvious aspect of it is the folded surface called the cerebral cortex Cerebral cortex The cerebral cortex is the largest and most developed part of the human brain and CNS. Occupying the upper part of the cranial cavity, the cerebral cortex has 4 lobes and is divided into 2 hemispheres that are joined centrally by the corpus callosum. Cerebral Cortex” by OpenStax College. License: CC BY 4.0

Boundaries

Table: Boundaries of the hypothalamus
Boundary Structures
Superior
  • Thalamus Thalamus The thalamus is a large, ovoid structure in the dorsal part of the diencephalon that is located between the cerebral cortex and midbrain. It consists of several interconnected nuclei of grey matter separated by the laminae of white matter. The thalamus is the main conductor of information that passes between the cerebral cortex and the periphery, spinal cord, or brain stem. Thalamus
  • Floor of the 3rd ventricle
Anterior
  • Anterior commissure
  • Lamina terminalis
Lateral Cerebral hemispheres
Medial Medial 3rd ventricle
Posterior
  • Posterior commissure
  • Aqueduct of Sylvius
Inferior
  • Optic chiasm
  • Pituitary (hypophysial) stalk and gland
  • Brain stem

Parasagittal zones

Each ½ of the hypothalamus contain 3 primary zones or areas (from lateral to medial):

  • Lateral hypothalamic area: diffuse fiber systems
  • Medial hypothalamic area: contains the defined nuclei
  • Periventricular gray zone: immediately adjacent to the 3rd ventricle

Rostrocaudal levels

The hypothalamus can also be divided into 4 primary levels, moving from anterior (rostral) to posterior (caudal). These levels describe the locations of different functional nuclei within the hypothalamus (all of which are in the medial hypothalamic area). The levels include:

  1. Preoptic: found between the optic chiasm and the anterior commissure:
    • Lateral preoptic area
    • Medial preoptic area
  2. Supraoptic: anteriormost level behind the preoptic area:
    • Paraventricular nucleus
    • Anterior nucleus
    • Supraoptic nucleus
    • Suprachiasmatic nucleus
  3. Tuberal: between the supraoptic and mammillary levels:
    • Lateral hypothalamus
    • Dorsomedial nucleus
    • Ventromedial nucleus
    • Arcuate nucleus
  4. Mammillary: posteriormost (caudal) level:
    • Posterior nucleus
    • Mammillary bodies
Sagittal cut of diencephalon with hypothalamic nuclei and areas highlighted

Sagittal diagram of the hypothalamus and pituitary gland Pituitary gland The pituitary gland, also known as the hypophysis, is considered the "master endocrine gland" because it releases hormones that regulate the activity of multiple major endocrine organs in the body. The gland sits on the sella turcica, just below the hypothalamus, which is the primary regulator of the pituitary gland. Pituitary Gland

Image by Lecturio.

Neurovasculature

The hypothalamus is a major coordinating center within the body. It receives information and can exert its effects via nerves, blood, and CSF.

Afferent nerve connections of the hypothalamus

The hypothalamus gets afferent input from:

  • Somatic nerves
  • Visceral nerves 
  • Visual/optic nerves 
  • Olfactory nerves
  • Cerebral cortex
  • Hippocampus (via the fornix)
  • Amygdala (via the stria terminalis)
  • Thalamus Thalamus The thalamus is a large, ovoid structure in the dorsal part of the diencephalon that is located between the cerebral cortex and midbrain. It consists of several interconnected nuclei of grey matter separated by the laminae of white matter. The thalamus is the main conductor of information that passes between the cerebral cortex and the periphery, spinal cord, or brain stem. Thalamus
  • Other nuclei within the hypothalamus

Efferent nerve connections of the hypothalamus

The hypothalamus sends efferent signals to:

  • Descending fibers in the brain stem Brain Stem The brain stem is a stalk-like structure that connects the cerebrum with the spinal cord and consists of the midbrain, pons, and medulla oblongata. It also plays a critical role in the control of cardiovascular and respiratory function, consciousness, and the sleep-wake cycle. Brain Stem and spinal cord Spinal cord The spinal cord is the major conduction pathway connecting the brain to the body; it is part of the CNS. In cross section, the spinal cord is divided into an H-shaped area of gray matter (consisting of synapsing neuronal cell bodies) and a surrounding area of white matter (consisting of ascending and descending tracts of myelinated axons). Spinal Cord → affect peripheral autonomic nervous system Autonomic nervous system The ANS is a component of the peripheral nervous system that uses both afferent (sensory) and efferent (effector) neurons, which control the functioning of the internal organs and involuntary processes via connections with the CNS. The ANS consists of the sympathetic and parasympathetic nervous systems. Autonomic Nervous System:
    • Vagus nerve
    • Sympathetic preganglionic neurons
  • Mammillothalamic tract: mammillary body → thalamus
  • Mammillotegmental tract: mammillary body → tegmentum of the midbrain ( brain stem Brain Stem The brain stem is a stalk-like structure that connects the cerebrum with the spinal cord and consists of the midbrain, pons, and medulla oblongata. It also plays a critical role in the control of cardiovascular and respiratory function, consciousness, and the sleep-wake cycle. Brain Stem)
  • Limbic system Limbic system The limbic system is a neuronal network that mediates emotion and motivation, while also playing a role in learning and memory. The extended neural network is vital to numerous basic psychological functions and plays an invaluable role in processing and responding to environmental stimuli. Limbic System

Connections with the pituitary gland Pituitary gland The pituitary gland, also known as the hypophysis, is considered the "master endocrine gland" because it releases hormones that regulate the activity of multiple major endocrine organs in the body. The gland sits on the sella turcica, just below the hypothalamus, which is the primary regulator of the pituitary gland. Pituitary Gland

The hypothalamus is the primary regulator of the pituitary. The hypothalamus is therefore key in converting and integrating nerve signals with endocrine signals. The hypothalamus is connected to the pituitary in 2 ways: via nerve fibers and via the circulation.

Nerve fiber connections: the hypothalamohypophysial tract

  • Neurons in the paraventricular and supraoptic nuclei have direct projections that end in the posterior pituitary.
  • Secretions include:
    • Paraventricular nuclei: primarily produce oxytocin (stimulate uterine contractions in labor Labor Labor is the normal physiologic process defined as uterine contractions resulting in dilatation and effacement of the cervix, which culminates in expulsion of the fetus and the products of conception. Normal and Abnormal Labor and milk release during lactation)
    • Supraoptic nuclei: primarily produce antidiuretic hormone (ADH; a vasoconstrictor that stimulates ↑ absorption of water from the renal tubules)
Diagram of the nervous connections

Diagram of the nervous connections between the hypothalamus and the posterior pituitary gland Pituitary gland The pituitary gland, also known as the hypophysis, is considered the "master endocrine gland" because it releases hormones that regulate the activity of multiple major endocrine organs in the body. The gland sits on the sella turcica, just below the hypothalamus, which is the primary regulator of the pituitary gland. Pituitary Gland:

ADH: antidiuretic hormone
OT: oxytocin
Image: “Neurosecretory cells in the hypothalamus release oxytocin (OT) or ADH into the posterior lobe of the pituitary gland Pituitary gland The pituitary gland, also known as the hypophysis, is considered the "master endocrine gland" because it releases hormones that regulate the activity of multiple major endocrine organs in the body. The gland sits on the sella turcica, just below the hypothalamus, which is the primary regulator of the pituitary gland. Pituitary Gland” by OpenStax College. License: CC BY 4.0, edited by Lecturio.

Bloodstream connections: the hypothalamohypophysial portal system

  • Formed from branches off the internal carotid arteries Arteries Arteries are tubular collections of cells that transport oxygenated blood and nutrients from the heart to the tissues of the body. The blood passes through the arteries in order of decreasing luminal diameter, starting in the largest artery (the aorta) and ending in the small arterioles. Arteries are classified into 3 types: large elastic arteries, medium muscular arteries, and small arteries and arterioles. Arteries
  • Arteries travel through the median eminence (the pituitary “stalk”) → capillaries Capillaries Capillaries are the primary structures in the circulatory system that allow the exchange of gas, nutrients, and other materials between the blood and the extracellular fluid (ECF). Capillaries are the smallest of the blood vessels. Because a capillary diameter is so small, only 1 RBC may pass through at a time. Capillaries
  • Capillaries surround cells within the anterior lobe of the pituitary.
  • Neurosecretory cells in the medial zone of the hypothalamus have projections to the median eminence and secrete hormones Hormones Hormones are messenger molecules that are synthesized in one part of the body and move through the bloodstream to exert specific regulatory effects on another part of the body. Hormones play critical roles in coordinating cellular activities throughout the body in response to the constant changes in both the internal and external environments. Hormones: Overview into the portal system:
    • Releasing hormones Hormones Hormones are messenger molecules that are synthesized in one part of the body and move through the bloodstream to exert specific regulatory effects on another part of the body. Hormones play critical roles in coordinating cellular activities throughout the body in response to the constant changes in both the internal and external environments. Hormones: Overview:
      • Corticotropin-releasing hormone (CRH)
      • Thyrotropin-releasing hormone (TRH)
      • Gonadotropin-releasing hormone (GnRH)
      • Growth hormone–releasing hormone (GHRH)
    • Release-inhibiting hormones Hormones Hormones are messenger molecules that are synthesized in one part of the body and move through the bloodstream to exert specific regulatory effects on another part of the body. Hormones play critical roles in coordinating cellular activities throughout the body in response to the constant changes in both the internal and external environments. Hormones: Overview:
      • Somatostatin
      • Dopamine
Diagram of the hypothalamohypophysial portal system

Diagram of the hypothalamohypophysial portal system connecting the hypothalamus and the anterior pituitary

Image: “The hypothalamus produces separate hormones Hormones Hormones are messenger molecules that are synthesized in one part of the body and move through the bloodstream to exert specific regulatory effects on another part of the body. Hormones play critical roles in coordinating cellular activities throughout the body in response to the constant changes in both the internal and external environments. Hormones: Overview that stimulate or inhibit hormone production in the anterior pituitary” by OpenStax College. License: CC BY 4.0, edited by Lecturio.

Vasculature

Arterial supply:

The hypothalamus is supplied by the circle of Willis:

  • Anterior cerebral artery → anteromedial branches
  • Posterior communicating artery → posteromedial branches
  • Posterior cerebral artery → thalamoperforating branches
Circle_of_willis

The circle of Willis: The anterior cerebral artery, posterior communicating artery, and posterior cerebral artery supply blood to the hypothalamus.

Image: “Circle of Willis” by OpenStax. License: CC BY 4.0

Venous drainage:

  • Circle of intercavernous sinuses
  • Hypothalamohypophysial portal system

Functions

Overview

The hypothalamus is a sensory and motor integration center and is a primary regulator of the endocrine and autonomic nervous systems. The hypothalamus plays a major role in:

  • Hormone regulation and secretion
  • Autonomic effects (e.g., HR, blood pressure, GI secretions and motility, etc.)
  • Thermoregulation
  • Food and water intake
  • Sleep and circadian rhythms
  • Memory
  • Emotional behavior

Preoptic level

The preoptic area contains:

  • Lateral preoptic area: a continuation of the lateral hypothalamic nuclei
  • Medial preoptic area:
    • Associated with sexual arousal and sexual dimorphism
    • Produces/secretes GnRH → released into the hypothalamohypophysial portal system
    • Involved in thermoregulation
    • Lesions in this region are associated with: 
      • Loss of control of sexual behavior
      • Amenorrhea
      • Impotence

Supraoptic level

The supraoptic level contains several important nuclei including (from superior to inferior):

  • Paraventricular nucleus: 
    • Medial division: synthesizes and secretes a number of hormones Hormones Hormones are messenger molecules that are synthesized in one part of the body and move through the bloodstream to exert specific regulatory effects on another part of the body. Hormones play critical roles in coordinating cellular activities throughout the body in response to the constant changes in both the internal and external environments. Hormones: Overview that regulate the pituitary gland Pituitary gland The pituitary gland, also known as the hypophysis, is considered the "master endocrine gland" because it releases hormones that regulate the activity of multiple major endocrine organs in the body. The gland sits on the sella turcica, just below the hypothalamus, which is the primary regulator of the pituitary gland. Pituitary Gland
      • CRH 
      • TRH
      • GHRH
      • Somatostatin (inhibits growth hormone and thyroid-stimulating hormone (TSH) release)
      • Dopamine (inhibits prolactin secretion)
    • Intermediate division: synthesizes hormones Hormones Hormones are messenger molecules that are synthesized in one part of the body and move through the bloodstream to exert specific regulatory effects on another part of the body. Hormones play critical roles in coordinating cellular activities throughout the body in response to the constant changes in both the internal and external environments. Hormones: Overview that are released from the posterior pituitary gland Pituitary gland The pituitary gland, also known as the hypophysis, is considered the "master endocrine gland" because it releases hormones that regulate the activity of multiple major endocrine organs in the body. The gland sits on the sella turcica, just below the hypothalamus, which is the primary regulator of the pituitary gland. Pituitary Gland
      • Oxytocin (primary secretion)
      • ADH produced in small amounts
    • Lateral division: has some direct projections into the vagus nerve
  • Anterior nucleus: 
    • A caudal continuation of the medial preoptic area
    • Involved in thermoregulation (cooling) and sleep Sleep Sleep is a reversible phase of diminished responsiveness, motor activity, and metabolism. This process is a complex and dynamic phenomenon, occurring in 4-5 cycles a night, and generally divided into non-rapid eye movement (NREM) sleep and REM sleep stages. Physiology of Sleep
    • Lesions in this region may lead to hyperthermia.
  • Supraoptic nucleus:
    • Has direct projections to the posterior pituitary
    • Produces:
      • ADH (primarily)
      • Oxytocin (smaller amounts)
  • Suprachiasmatic nucleus: 
    • Located just above the optic chiasm
    • Gets direct input from the retina
    • A “master biologic clock”

Tuberal level

The tuberal level contains:

  • Lateral hypothalamic nuclei:
    • Involved in:
      • Regulating appetite and satiety
      • Digestive function
      • Sleep
      • Pain Pain Pain has accompanied humans since they first existed, first lamented as the curse of existence and later understood as an adaptive mechanism that ensures survival. Pain is the most common symptomatic complaint and the main reason why people seek medical care. Physiology of Pain perception
      • Blood pressure
    • Lesions here may lead to: 
      • Narcolepsy Narcolepsy Narcolepsy is a neurological sleep disorder marked by daytime sleepiness and associated with cataplexy, hypnagogic hallucinations, and sleep paralysis. There are 2 types of narcolepsy: type 1 is associated with cataplexy and type 2 has no association with cataplexy. Narcolepsy
      • Motility or functional GI disorders
      • Eating disorders (due to ↓↓ desire to eat)
  • Dorsomedial nucleus:
    • Involved in:
      • Physiologic circadian rhythms (e.g., eating and drinking, energy consumption)
      • Ingestive behavior
      • Cardiovascular response to stress
    • Lesions here may lead to: overeating (hyperphagia), obesity Obesity Obesity is a condition associated with excess body weight, specifically with the deposition of excessive adipose tissue. Obesity is considered a global epidemic. Major influences come from the western diet and sedentary lifestyles, but the exact mechanisms likely include a mixture of genetic and environmental factors. Obesity
  • Ventromedial nucleus:
    • Involved in:
      • Appetite, satiety, and energy regulation
      • Fear response via afferent input from the amygdala
    • Lesions here may lead to: hyperphagia, obesity Obesity Obesity is a condition associated with excess body weight, specifically with the deposition of excessive adipose tissue. Obesity is considered a global epidemic. Major influences come from the western diet and sedentary lifestyles, but the exact mechanisms likely include a mixture of genetic and environmental factors. Obesity
  • Arcuate nucleus: 
    • A primary regulator of the anterior pituitary gland Pituitary gland The pituitary gland, also known as the hypophysis, is considered the "master endocrine gland" because it releases hormones that regulate the activity of multiple major endocrine organs in the body. The gland sits on the sella turcica, just below the hypothalamus, which is the primary regulator of the pituitary gland. Pituitary Gland via the hypothalamohypophysial portal system
    • Secretes:
      • GnRH
      • Dopamine → regulates prolactin secretion
      • Neuropeptide Y → regulates appetite and body weight
    • Lesions here may lead to: galactorrhea, hyperphagia

Mammillary level

The mammillary level includes:

  • Posterior nucleus: 
    • Involved in thermoregulation (heating the body)
    • Lesion here may lead to: hypothermia Hypothermia Hypothermia can be defined as a drop in the core body temperature below 35°C (95°F) and is classified into mild, moderate, severe, and profound forms based on the degree of temperature decrease. Hypothermia
  • Mammillary bodies: 
    • Involved in regulating emotions and recollective memory
    • Lesion here may lead to:
      • Memory deficits
      • Pathogenesis of Wernicke encephalopathy Wernicke encephalopathy Wernicke encephalopathy is an acute, reversible condition that is caused by severe thiamine deficiency. This condition is most commonly seen in alcohol abusers. The classic triad of symptoms is encephalopathy, oculomotor dysfunction, and gait ataxia, although all 3 features are only present in one-third of patients. Wernicke Encephalopathy and Korsakoff Syndrome

Clinical Relevance

  • Central diabetes insipidus Central Diabetes Insipidus Diabetes insipidus (DI) is a condition in which the kidneys are unable to concentrate urine. There are 2 subforms of DI: central DI (CDI) and nephrogenic DI (NDI). In CDI, the amount of antidiuretic hormone (ADH) produced by the hypothalamus or released from the pituitary gland is decreased. Both conditions result in the kidneys being unable to concentrate urine, leading to polyuria, nocturia, and polydipsia. Diabetes Insipidus (DI): condition in which the kidneys Kidneys The kidneys are a pair of bean-shaped organs located retroperitoneally against the posterior wall of the abdomen on either side of the spine. As part of the urinary tract, the kidneys are responsible for blood filtration and excretion of water-soluble waste in the urine. Kidneys are unable to concentrate urine because of a lack of circulating ADH. These low levels of ADH are due to either decreased production within the hypothalamus or decreased release from the posterior pituitary gland Pituitary gland The pituitary gland, also known as the hypophysis, is considered the "master endocrine gland" because it releases hormones that regulate the activity of multiple major endocrine organs in the body. The gland sits on the sella turcica, just below the hypothalamus, which is the primary regulator of the pituitary gland. Pituitary Gland. Presentation is with polyuria, nocturia, and polydipsia. Central and nephrogenic DI are differentiated based on measured ADH levels and response to the water deprivation test. Central DI is treated with desmopressin.
  • Functional hypothalamic amenorrhea: primary cause of secondary amenorrhea Secondary Amenorrhea Secondary amenorrhea is defined as the absence of menses for 3 months in a woman with previously regular menstrual cycles or for 6 months in a woman with previously irregular cycles. Etiologies involve either disruptions to the hypothalamic-pituitary-ovarian (HPO) axis or acquired obstructions in the uterus or outflow tract. Secondary Amenorrhea (cessation of menses). Functional hypothalamic amenorrhea results from the decreased pulsation of GnRH from the hypothalamus that occurs during times of severe physical or psychologic stress. The condition is most commonly seen in association with eating disorders or overexercise (common in female athletes). Management usually requires nutritional support and counseling.
  • Hyperthermia: may occur if there is a lesion (stroke or CNS damage) in the anterior nucleus of the hypothalamus, which is involved in thermoregulation, specifically, cooling the body down. Damage to this region prevents the body from being able to cool itself. 
  • Narcolepsy Narcolepsy Narcolepsy is a neurological sleep disorder marked by daytime sleepiness and associated with cataplexy, hypnagogic hallucinations, and sleep paralysis. There are 2 types of narcolepsy: type 1 is associated with cataplexy and type 2 has no association with cataplexy. Narcolepsy: occurs when the lateral hypothalamus is unable to secrete orexin, a substance that promotes wakefulness in many areas of the brain, allowing inappropriate sudden transitions to sleep Sleep Sleep is a reversible phase of diminished responsiveness, motor activity, and metabolism. This process is a complex and dynamic phenomenon, occurring in 4-5 cycles a night, and generally divided into non-rapid eye movement (NREM) sleep and REM sleep stages. Physiology of Sleep, cataplexy, sleep Sleep Sleep is a reversible phase of diminished responsiveness, motor activity, and metabolism. This process is a complex and dynamic phenomenon, occurring in 4-5 cycles a night, and generally divided into non-rapid eye movement (NREM) sleep and REM sleep stages. Physiology of Sleep paralysis, and hypnagogic hallucinations.
  • Hyperprolactinemia Hyperprolactinemia Hyperprolactinemia is defined as a condition of elevated levels of prolactin (PRL) hormone in the blood. The PRL hormone is secreted by the anterior pituitary gland and is responsible for breast development and lactation. The most common cause is PRL-secreting pituitary adenomas (prolactinomas). Hyperprolactinemia: elevated levels of prolactin in the blood. Although the most common cause of hyperprolactinemia is a prolactin-secreting pituitary adenoma Pituitary adenoma Pituitary adenomas are tumors that develop within the anterior lobe of the pituitary gland. Non-functioning or non-secretory adenomas do not secrete hormones but can compress surrounding pituitary tissue, leading to hypopituitarism. Secretory adenomas secrete various hormones depending on the cell type from which they evolved, leading to hyperpituitarism. Pituitary Adenomas, loss of inhibitory dopamine secretion by the hypothalamus can also be a cause. This condition can occur when dopaminergic neurons from the hypothalamus are damaged or if the infundibulum is transected during suprasellar surgery. Presentations can include galactorrhea (milky discharge), oligomenorrhea, and erectile dysfunction Erectile Dysfunction Erectile dysfunction (ED) is defined as the inability to achieve or maintain a penile erection, resulting in difficulty to perform penetrative sexual intercourse. Local penile factors and systemic diseases, including diabetes, cardiac disease, and neurological disorders, can cause ED. Erectile Dysfunction.

References

  1. Castro, A., Merchut, M., Neafsey, E., Wurster R. (2002). Neuroscience: An Outline Approach. St. Louis: Mosby, pp. 369–375.
  2. Saladin, K.S., Miller, L. (2004). Anatomy and Physiology, 3rd ed., pp. 530–531. 
  3. Bear, M. (2021). Neuroanatomy, hypothalamus. StatPearls. Retrieved August 10, 2021, from https://www.statpearls.com/articlelibrary/viewarticle/901/ 
  4. Kibble, J.D., Halsey, C.R. (2015). Neurophysiology. Chapter 2 of Medical Physiology: The Big Picture. New York: McGraw-Hill Education. https://accessmedicine.mhmedical.com/content.aspx?bookid=1291&sectionid=75575843 
  5. Barrett, K.E., Barman, S.M., Brooks, H.L., Yuan, J.X. (2019). Hypothalamic regulation of hormonal functions. Chapter 17 of Ganong’s Review of Medical Physiology, 26th ed. New York: McGraw-Hill Education. Retrieved August 10, 2021, from https://accessmedicine.mhmedical.com/content.aspx?bookid=2525&sectionid=204292033

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