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PEDIATRICS Vol. 111 No. 6 June 2003, pp. e720-e724

ELECTRONIC ARTICLE

Rest-Activity Patterns in Children With Hypopituitarism

Scott A. Rivkees, MD

From the Department of Pediatrics, Yale University School of Medicine, New Haven, Connecticut

Objectives. Physical lesions in the region of the suprachiasmatic nuclei, which are the site of a circadian clock, result in abnormal circadian rhythmicity in animals, yet the extent of biological rhythm problems in individuals with anatomic or functional lesions in the hypothalamic-pituitary region are largely unknown. To address this issue, we examined patterns of rest and activity of children with hypopituitarism.

Methods. Children who were between the ages of 2 and 18 years and had the diagnosis of panhypopituitarism were evaluated. Twenty children were studied, including children with septo-optic dysplasia (SOD), congenital hypopituitarism, brain tumors, closed head trauma, and head irradiation. For assessing patterns of activity, individuals wore Actiwatches for 3–4 weeks to measure patterns of gross motor activity.

Results. Seventeen children had normal patterns of rest and activity, with an average period length of 24.01 ± 0.01 hours. Three children, including 2 with SOD and 1 with a hypothalamic germinoma, showed abnormal activity patterns in which there was not consolidated rest at night. One patient with an optic glioma had nonentrained circadian phase.

Conclusions. A proportion of children with hypopituitarism have abnormal daily rest-activity patterns. Children with anterior hypothalamic tumors and SOD seem to be at risk for circadian system dysfunction.

Key Words: septo-optic dysplasia • actigraphy • pediatric circadium rhythm • hypopituitarism

Abbreviations: SCN, suprachiasmatic nuclei • SOD, septo-optic dysplasia

Received for publication Nov 7, 2002; Accepted Feb 4, 2003.