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The Role of Oxytocin in the Development of Social Dysfunction in Patients with Damage to the Hypothalamic-Pituitary Region and Considerations for These Patients’ Neurorehabilitation

Lauren Clarke, MHA (Stanford University School of Medicine, Sunnyvale, California); Olena Zyga; Psalm L. Pineo-Cavanaugh; Michael Jeng; Nancy J. Fischbein; Sonia Partap; Laurence Katznelson; Karen J. Parker

Meeting: AAPM&R Annual Assembly 2022

Categories: Neurological Rehabilitation (2022)

Session Information

Session Title: Research Hub - Live Theater Research Spotlight: Neurological Rehabilitation

Session Time: None. Available on demand.

Disclosures: Lauren Clarke, MHA: No financial relationships or conflicts of interest

Background and/or Objectives: Some patients with damage to the hypothalamic-pituitary region develop social dysfunction that persists after standard endocrine replacement therapies, and this has become an emerging area of clinical concern. Oxytocin, one of the neuropeptides most implicated in human social functioning, is of hypothalamic origin; however, no review has examined how damage to the hypothalamic-pituitary region may disrupt oxytocin signaling and, in turn, impact patients’ social functioning. In this presentation, we will review three disorders that frequently disrupt hypothalamic-pituitary function–craniopharyngioma, central nervous system (CNS) Langerhans cell histiocytosis, and CNS germ cell tumors–and detail clinical evidence describing the social dysfunction and oxytocin dysregulation experienced by patients with these disorders. We will also explore the role of exogenous oxytocin administration in the neurorehabilitation of these patients.

Design: A literature review was performed to identify the impact of damage to the hypothalamic-pituitary region on oxytocin signaling and social functioning.

Setting: N/A

Participants: N/A

Interventions: N/A

Main Outcome Measures: N/A

Results: There is robust clinical evidence for the development of social dysfunction across disorders of hypothalamic-pituitary involvement. Patients with craniopharyngioma, CNS Langerhans cell histiocytosis, and CNS germ cell tumors often develop pathology in the hypothalamic-pituitary region. Surgical resection and/or radiation therapy can further contribute to the injury of these structures. Exogenous oxytocin administration has been shown to improve patients’ social functioning.

Conclusions: The results of this review provide ample evidence to suggest that oxytocin signaling disruptions contribute to the social dysfunction experienced by a subset of patients with disorders of the hypothalamic-pituitary region. Gaining a better understanding of the biological underpinnings of the social dysfunction frequently observed in these patients will help inform clinical care and guide the development of best practices in neurorehabilitation.

Level of Evidence: Level III

To cite this abstract in AMA style:

Clarke L, Zyga O, Pineo-Cavanaugh PL, Jeng M, Fischbein NJ, Partap S, Katznelson L, Parker KJ. The Role of Oxytocin in the Development of Social Dysfunction in Patients with Damage to the Hypothalamic-Pituitary Region and Considerations for These Patients’ Neurorehabilitation [abstract]. PM R. 2022; 14(S1)(suppl 1). https://pmrjabstracts.org/abstract/the-role-of-oxytocin-in-the-development-of-social-dysfunction-in-patients-with-damage-to-the-hypothalamic-pituitary-region-and-considerations-for-these-patients-neurorehabilitation/. Accessed May 18, 2025.
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