A morphological study of human pineal gland in post-mortem cases.

The current study was conducted in the Department of Anatomy, Osmania Medical College, Koti, Hyderabad over a period of 1year. A total of 30 human pineal glands (16-males,11-females,3 excluded for post-mortem autolysis) from those bodies between the age groups of 1-80years were collected during the post-mortem study at the Mortuary of Osmania General Hospital, Koti, Hyderabad and were included in the study. Morphological parameters like weight and transverse diameter at the maximum width of the pineal glands were measured and then the pineal glands were processed for light microscopy. 4-5micron thick sections were cut and stained with H&E and Masson Trichrome for highlighting the connective tissue pattern of the pineal gland. Under light microscope, the capsular delineation, pattern of septation and lobulation, calcification, intracellular brown pigment, intraparenchymal inflammatory cells, fibrosis, gliosis and cystic changes in the pineal glands were observed in relation to age and gender.

Assessment of the normal pediatric pineal gland - MR findings of a single centre; A retrospective study.

OBJECTIVE: To analyse the size and morphology of the normal pineal gland in the paediatric age group using magnetic resonance imaging. METHODS: The retrospective study was conducted at the Aga Khan University Hospital, Karachi, and comprised data of patients aged <18 years who had magnetic resonance imaging done between 2007 and 2017. Pineal size was estimated measuring its largest anteroposterior and supero-inferior diameters on sagittal T2-weighted sequences on any slice with maximal diameter. The width of pineal gland was measured on axial or coronal T2 sequences. The volume, morphology and enhancement patterns of the gland were also assessed. Data was analysed using SPSS 21. RESULTS: Of the 200 patients, 116(58%) were males and 84(42%) were females. The overall mean age was 7.8±5.5 years. The mean anteroposterior dimension was 4.85±1.46mm, height 3.31±0.95mm, width 4.16±1.19, and volume 39.54±38.12 mm3. Mean size of cyst was 2.77±1.4mm (range: 1.2-7.5mm). No significant differences in the pattern of enhancement were found in different age groups (p>0.05). CONCLUSIONS: Comprehensive knowledge of the size of the typical pineal organ is useful for radiologists in the identification of pineal gland anomalies and the exclusion of neoplastic lesions.

The Paramedian Supracerebellar Approach: A Less Disruptive and More Flexible Operative Corridor to the Pineal and Posterior Upper Brainstem Regions.

The paramedian supracerebellar craniotomy is an underrecognized route to the midline and paramedian regions of the upper posterior brainstem. As compared with its midline supracerebellar counterpart, this less disruptive approach preserves the majority of the midline bridging veins, requires less cerebellar retraction, and is significantly more efficient. In this offering, I will emphasize the realities of this flexible route and its remarkable advantages in reaching deep-seated lesions.

Effect of melatonin on T/B cell activation and immune regulation in pinealectomy mice.

Melatonin is an indole neuroendocrine hormone that is mainly secreted by the pineal gland to regulate circadian rhythm, antioxidation, and immune regulation. Melatonin plays an important role in T cell-mediated immune responses against cancer, infections, and the development of many autoimmune diseases. The aim of this study was to investigate the immunomodulatory effects of melatonin on T/B cell activation in pinealectomy mice. The improved pinealectomy procedure for mice presented in this study is a good animal model to be used in follow-up studies on melatonin. After pinealectomy, the tissue removed was identified as the pineal body using HE staining. The effects of melatonin supplementation on T cell activation and activation-related changes to the MAPK/NF-κ B pathways were analyzed by flow cytometry and real-time PCR. We found that expression levels of Th1, Th2 and Th17-related cytokines in peripheral blood were lower in mice that had undergone pinealectomy, compared with normal mice. After melatonin supplementation, cytokine levels rapidly increased within a short period of time, which resulted in the gradual recovery of cytokine expression levels. Moreover, activation of T/B cells in mice was weakened and decreased after pineal gland removal. Melatonin was found to inhibit the expression of TLR3, p38, JNK, and MAPK/NF-κ B within a short period (2 weeks) of melatonin replenishment. This inhibition gradually weakened with time, since the degree of inhibition is negatively related with the dosage of melatonin. In conclusion, melatonin may regulate the activation of T/B cells, playing a critical role in the regulation of immune balance.

Revisiting the pineal gland: a review of calcification, masses, precocious puberty, and melatonin functions.

Introduction: The pineal gland, an endocrine organ of the posterior cranial fossa famously involved in sleep and wakefulness, has continually been a topic of scientific advancement and curiosity. Methods: We review present an up-to-date review including the anatomy, embryology, and physiology of the pineal gland and its ability to secrete hormones including melatonin, pathophysiology of pineal gland tumors, cysts, and calcifications, their clinical presentation including their association with parkinsonism and precocious puberty, and various treatment approaches. Results: Exploring the biochemistry of melatonin, various calcification morphologies, and pineal tumors may uncover a wider role and the exhaustive case study consolidation allows clinicians to carefully review the literature and aid their treatment approaches. Conclusion: It is imperative that clinicians and diagnosticians are able to distinguish manifestations of an overlooked gland.

Sex Difference in the Morphology of Pineal Gland in Adults Based on Brain Magnetic Resonance Imaging.

PURPOSE: We aimed to figure out the anatomical features of pineal gland region on magnetic resonance imaging (MRI) and to explore the sex difference in pineal gland-related parameters with increasing age. METHODS: We measured the pineal gland on MRI images from 198 healthy adults (96 males and 102 females). Included subjects were divided into 4 age groups. After 3-dimensional reconstruction, the anatomic features of pineal gland and its distances to superior colliculus and splenium of corpus callosum were analyzed in each group. The prevalence of cystic pineal gland was calculated. Moreover, we calculated the volume of pineal gland (PGV) and explored the differences of PGV in males and females across different age groups. Linear regression analysis was performed to detect the relationship between age and pineal gland-related parameters. RESULTS: In 198 subjects, the mean length, width, and height of pineal gland were 7.58 ±â€Š0.45 mm, 4.92 ±â€Š0.40 mm, and 2.90 ±â€Š0.20 mm. The distances between pineal gland and superior colliculus as well as splenium of corpus callosum were 3.96 ±â€Š0.92 mm and 4.3 ±â€Š1.89 mm, respectively. The PGV was 54.1 ±â€Š7.02 mm. Significant sex differences were found in pineal gland length (P < 0.001), cranial cavity diameter (P < 0.001), pineal gland index (P < 0.001) and PGV values (P = 0.02). The prevalence of cystic pineal gland was 36.4% in total subjects, 41.7% in males and 32.4% in females. No linear relationship was found between age and pineal gland parameters. CONCLUSION: We measured the pineal gland morphology based on MRI images. Significant influences on pineal gland parameters were found in subjects with different sex, whereas no effect was observed from age.

The origins of the circumventricular organs.

The circumventricular organs (CVOs) are specialised neuroepithelial structures found in the midline of the brain, grouped around the third and fourth ventricles. They mediate the communication between the brain and the periphery by performing sensory and secretory roles, facilitated by increased vascularisation and the absence of a blood-brain barrier. Surprisingly little is known about the origins of the CVOs (both developmental and evolutionary), but their functional and organisational similarities raise the question of the extent of their relationship. Here, I review our current knowledge of the embryonic development of the seven major CVOs (area postrema, median eminence, neurohypophysis, organum vasculosum of the lamina terminalis, pineal organ, subcommissural organ, subfornical organ) in embryos of different vertebrate species. Although there are conspicuous similarities between subsets of CVOs, no unifying feature characteristic of their development has been identified. Cross-species comparisons suggest that CVOs also display a high degree of evolutionary flexibility. Thus, the term 'CVO' is merely a functional definition, and features shared by multiple CVOs may be the result of homoplasy rather than ontogenetic or phylogenetic relationships.

Pineal Gland Volume Assessed by MRI and Its Correlation with 6-Sulfatoxymelatonin Levels among Older Men.

The pineal gland produces the hormone melatonin, and its volume may influence melatonin levels. We describe an innovative method for estimating pineal volume in humans and present the association of pineal parenchyma volume with levels of the primary melatonin metabolite, 6-sulfatoxymelatonin. We selected a random sample of 122 older Icelandic men nested within the AGES-Reykjavik cohort and measured their total pineal volume, their parenchyma volume, and the extent of calcification and cysts. For volume estimations we used manual segmentation of magnetic resonance images in the axial plane with simultaneous side-by-side view of the sagittal and coronal plane. We used multivariable adjusted linear regression models to estimate the association of pineal parenchyma volume and baseline characteristics, including 6-sulfatoxymelatonin levels. We used logistic regression to test for differences in first morning urinary 6-sulfatoxymelatonin levels among men with or without cystic or calcified glands. The pineal glands varied in volume, shape, and composition. Cysts were present in 59% of the glands and calcifications in 21%. The mean total pineal volume measured 207 mm(3) (range 65-536 mm(3)) and parenchyma volume 178 mm(3) (range 65-503 mm(3)). In multivariable-adjusted models, pineal parenchyma volume was positively correlated with 6-sulfatoxymelatonin levels (ß = 0.52, p < 0.001). Levels of 6-sulfatoxymelatonin did not differ significantly by presence of cysts or calcification. By using an innovative method for pineal assessment, we found pineal parenchyma volume to be positively correlated with 6-sulfatoxymelatonin levels, in line with other recent studies.

Evidence of Pineal Gland Calcification on CBCT is Not Insignificant: What Else You Might Discover about Your Patient.

The use of CBCT technology in the dental office is increasing rapidly. These scans provide information on anatomy not previously evaluated with traditional 2D films. One structure often mentioned in a CBCT radiology report is the pineal gland. The pineal gland will show evidence of calcification, but this calcification is often dismissed as a normal aging process. This review of the function and influence of the pineal gland may influence the doctor to complete further evaluation of the patient.

Operative results of keyhole supracerebellar-infratentorial approach to the pineal region.

The supracerebellar-infratentorial approach to the pineal region is typically accomplished with a craniotomy that extends to at least the rim of the foramen magnum. Minimally invasive techniques that limit the inferior extent of the craniotomy have been described for this approach but, to our knowledge, no operative results have been published demonstrating the feasibility and safety of such techniques. We present a series of patients who underwent surgical resection of pineal region lesions using the minimally invasive method at our institution. Clinical, radiologic, and operative data were prospectively collected on patients treated for lesions of the pineal region by the senior author from January 2012 to July 2014. Seven patients were identified. The sitting position was employed in each patient. Keyhole craniotomies were limited to a maximum diameter of 2.5 cm. Adequate working corridors were attained, and in no patient was resection limited by the exposure. No neurological or systemic complications were seen in the perioperative and early follow-up periods. In this feasibility study, we demonstrate that it is not necessary to extend a craniotomy inferiorly to the rim of the foramen magnum in order to gain access to the pineal region via relaxation of the cerebellum. The same surgical goals can be safely accomplished with a smaller craniotomy.

Pineal gland plays a role in gonadal development after eyelids separation in puppies / La glándula pineal juega un rol en el desarrollo gonadal luego de la separación de los párpados en cachorros

Several functional and morphological studies have been conducted on the pineal gland in many mammalian species; however, no published reports are available on the role of pineal gland on the gonadal development before and after eyelids separation in puppies. Therefore, this study aimed to trace the postnatal histo-morphological changes in the pineal gland and gonads of puppies before (2, 10 and 11 days old) and after (25, 35 and 40 days old) eyelids separation in an attempt to investigate the possible role of pineal gland on the gonadal development. In general, the differentiation of pineal cells, interstitial endocrine cells of testes and stromal ovarian cells coincides with the start of eyelids separation in puppies. Histological examination of stained pineal and gonadal slices of puppies after eyelids separation revealed a remarkable differentiation of pinealocytes and testicular interstitial endocrine cells, as well as presence of some evidence of folliculogenesis in ovary. Surprisingly, melatonin receptor (MT1) protein expression levels were significantly increased in the ovaries and testes of puppies after eyelids separation. Moreover, the mRNA and protein expression of AANAT, a rate-limiting enzyme in melatonin biosynthesis, was notably increased in the pineal gland of opened eyes puppies. Our results suggest an increase of melatonin production from the pineal gland of opened eyes puppies and this could play a vital role in the developmental changes observed in the gonads of these puppies.

Diversos estudios morfológicos y funcionales han sido realizados sobre la glándula pineal en distintas especies de mamíferos. Sin embargo, no hay informes publicados acerca del rol de la glándula pineal en el desarrollo gonadal antes y después de la separación de los párpados en cachorros. Este estudio tuvo como objetivo trazar los cambios histo-morfológicos postnatales en la glándula pineal y las gónadas de los cachorros antes (2, 10 y 11 días de edad) y después (25, 35 y 40 días de edad) de la separación de los párpados, en un intento por investigar el posible rol de la glándula pineal en el desarrollo gonadal. En general, la diferenciación de los pinealocitos, células intersticiales endocrinas de los testículos y las células estromales del ovario coincide con el inicio de la separación de los párpados en cachorros. El examen histológico de glándula pineal y los cortes gonadales de los cachorros, después de la separación de los párpados, reveló una notable diferenciación de los pinealocitos y las células intersticiales endocrinas testiculares, así como la posible evidencia de foliculogénesis en el ovario. Sorprendentemente, en el receptor de melatonina (MT1) los niveles de expresión de proteínas fueron significativamente superiores en los ovarios y los testículos de los cachorros después de la separación de los párpados. Además, el ARNm y la expresión de la proteína AANAT, una enzima limitante de la velocidad en la biosíntesis de la melatonina, aumentaron notablemente en la glándula pineal de los cachorros con los ojos abiertos. Nuestros resultados sugieren que existe un aumento de la producción de melatonina por parte de la glándula pineal en los cachorros con los ojos abiertos, lo que podría jugar un rol vital en los cambios evolutivos observados enlas gónadas de estos cachorros.

Pineal region masses--imaging findings and surgical approaches.

The anatomy of the pineal region is complex. Despite advances in surgical techniques since the first reported successful pineal region surgery in the early 20th century, pineal region surgery remains challenging owing to the proximity of deep cerebral veins and dorsal midbrain structures critical for vision. In this article, we review the relevant surgical anatomy of the pineal region and discuss historically important and current surgical approaches. We describe specific imaging features of pineal region masses that may affect surgical planning and review neoplastic and nonneoplastic masses that occur in the pineal region.

[MRI of the pineal gland].

The pineal gland (CP) is located centrally in the brain and produces melatonin. Cysts and concrements are frequent findings on MRI but their significance is still unclear. The visualization of CP is difficult due to its location and surrounding structures and so far, no standardized method exists. New studies suggest a correlation between CP-morphology and melatonin secretion as well as a connection between melatonin, disturbed circadian rhythm, and the development of cancer and cardiovascular diseases, underlining the need for a standardized approach to CP on MRI.

Morfología de la glándula pineal: revisión de la literatura / Pineal gland morphology: a literature review

La glándula pineal es una pequeña estructura ubicada en el techo del diencéfalo, su principal función es la de regular los ritmos circadianos, tales como sueño-vigilia, secretar melatonina, hormona con fuerte efecto sobre la acción gonadal, además de oncostática, geroprotectora y antioxidante. La presente revisión tiene por objetivo conocer los aspectos morfológicos de la glándula pineal, desde su desarrollo a nivel embriológico como su descripción anatómica e histológica con el fin de comprender su función desde un punto de vista integral.

Pineal gland is a small structure located on the roof of the diencephalon, and its principal function is to play an important role in circadian rhythm regulation, such as sleep/wake, besides secreting melatonin, a hormone with a strong effect on gonadal action, and playing oncostatic, geroprotector and antioxidant roles. This review aims to know the morphological aspects of the pineal gland, from its embryological development, its anatomic and histological description, in order to understand its function from an integral view.

Morphology and function: MR pineal volume and melatonin level in human saliva are correlated.

PURPOSE: To investigate the relation between circadian saliva melatonin levels and pineal volume as determined by MRI. Plasma melatonin levels follow a circadian rhythm with a high interindividual variability. MATERIALS AND METHODS: In 103 healthy individuals saliva melatonin levels were determined at four time points within 24 h and MRI was performed once (3.0 Tesla, including three-dimensional T2 turbo spin echo [3D-T2-TSE], susceptibility-weighted imaging [SWI]). Pineal volume as well as cyst volume were assessed from multiplanar reconstructed 3D-T2-TSE images. Pineal calcification volume tissue was determined on SWI. To correct for hormonal inactive pineal tissue, cystic and calcified areas were excluded. Sleep quality was assessed with the Landeck Inventory for sleep quality disturbance. RESULTS: Solid and uncalcified pineal volume correlated to melatonin maximum (r = 0.28; P < 0.05) and area under the curve (r = 0.29; P < 0.05). Of interest, solid and uncalcified pineal volume correlated negatively with the sleep rhythm disturbances subscore (r = -0.17; P < 0.05) despite a very homogenous population. CONCLUSION: Uncalcified solid pineal tissue measured by 3D-T2-TSE and SWI is related to human saliva melatonin levels. The analysis of the sleep quality and pineal volume suggests a linkage between better sleep quality and hormonal active pineal tissue.

James L. Poppen and surgery of the "seat of the soul": a contemporary perspective.

Dr. James Leonard Poppen (1903-1978) was one of the most renowned American neurosurgeons of the 20th century. The now eponymous Poppen approach to the pineal region is still used routinely in current neurosurgical practice. He was also one of the first to describe and practice the prefrontal lobotomy and appears to be one of the surgeons in the case of Eva Peron in 1952. Poppen was born in a Dutch family on February 28, 1903, in the town of Drenthe, Michigan. Poppen described the occipital transtentorial approach to the pineal region, this operative technique to access a deep-seated area was novel and effective, and now bears his name. His other well-known contribution includes the description of a tacking suture to prevent the formation of postoperative extradural hematomas (Poppen's stitch). Besides these, he described many novel procedures including bilateral lumbar sympathectomy, cervical rhizotomy for torticollis, and thoracolumbar sympathectomy and splanchnicectomy through small incisions. He was the first to advocate wrapping of an aneurysm neck with muscle or plastic rather than sacrificing the parent artery in difficult-to-clip aneurysms. His famous atlas on neurosurgical techniques was published in 1960. He retired from this post in 1970; however, he continued his practice of neurosurgery until his death. This historical vignette aims to highlight the work of James L. Poppen and the evolution of the surgery of the "Seat of the Soul." His work has had a lasting influence on neurosurgeons and neuroscientists over the years.

Comparison of three methods for the estimation of pineal gland volume using magnetic resonance imaging.

Pineal gland is a very important neuroendocrine organ with many physiological functions such as regulating circadian rhythm. Radiologically, the pineal gland volume is clinically important because it is usually difficult to distinguish small pineal tumors via magnetic resonance imaging (MRI). Although many studies have estimated the pineal gland volume using different techniques, to the best of our knowledge, there has so far been no stereological work done on this subject. The objective of the current paper was to determine the pineal gland volume using stereological methods and by the region of interest (ROI) on MRI. In this paper, the pineal gland volumes were calculated in a total of 62 subjects (36 females, 26 males) who were free of any pineal lesions or tumors. The mean ± SD pineal gland volumes of the point-counting, planimetry, and ROI groups were 99.55 ± 51.34, 102.69 ± 40.39, and 104.33 ± 40.45 mm(3), respectively. No significant difference was found among the methods of calculating pineal gland volume (P > 0.05). From these results, it can be concluded that each technique is an unbiased, efficient, and reliable method, ideally suitable for in vivo examination of MRI data for pineal gland volume estimation.

Morphologic analysis of mice’s pineal gland

The pineal gland or pineal body is an endocrine gland that constitutes an important part of the neuroendocrine system, due to the secretion of melatonin, a hormone responsible for the seasonal organization of several physiologic and behavioral events of an individual’s life. Experimental researches using animals such as rats, mice and rabbits are often found in the extensive specific literature but aspects related to the morphology of mice’s pineal gland are few. Concerning its small size, the present paper performed a microscopic analysis of serial median sagittal sections of the pineal gland of 13 (thirteen) Swiss mice. The pineal gland of Swissmice was found to be in the median plane below the splenium of the corpus callosus, superior and dorsal to the habenular commissure, and rostral to the rostral colliculi. The pineal gland is closely related to the third ventricle and presents itself with a characteristic tonsillar shape with a stalk. Two types of different cells were identified in the gland, that is, astrocytes and pinealocytes, spreading randomly all over the glandular tissue. Calcifications of the pineal gland were not found in any of the observed animals.

Neural regulation of dark-induced abundance of arylalkylamine N-acetyltransferase (AANAT) and melatonin in the carp (Catla catla) pineal: an in vitro study.

In all the vertebrates, synthesis of melatonin and its rhythm-generating enzyme arylalkylamine N-acetyltransferase (AANAT) reaches its peak in the pineal during the night in a daily light-dark cycle, but the role of different neuronal signals in their regulation were unknown for any fish. Hence, the authors used specific agonist and antagonists of receptors for different neuronal signals and regulators of intracellular calcium (Ca(2+)) and adenosine 3',5'-cyclic monophosphate (cAMP) in vitro to study their effects on the abundance of AANAT and titer of melatonin in the carp (Catla catla) pineal. Western blot analysis followed by quantitative analysis of respective immunoblot data for AANAT protein, radioimmunoassay of melatonin, and spectrophotometric analysis of Ca(2+) in the pineal revealed stimulatory effects of both adrenergic (α(1) and ß(1)) and dopaminergic (D(1)) agonists and cholinergic (both nicotinic and muscarinic) antagonists, inhibition by both adrenergic and dopaminergic antagonists and cholinergic agonists, but independent of the influence of any agonists or antagonists of α(2)-adrenergic receptors. Band intensity of AANAT and concentration of melatonin in the pineal were also enhanced by the intracellular calcium-releasing agent, activators of both calcium channel and adenylate cyclase, and phophodiesterase inhibitor, but suppressed by inhibitor of calcium channel and adenylate cyclase as well as activator of phophodiesterase. Moreover, an inhibitory effect of light on the pineal AANAT and melatonin was blocked by both cAMP and proteasomal proteolysis inhibitor MG132. Collectively, these data suggest that dark-induced abundance of AANAT and melatonin synthesis in the carp pineal are a multineuronal function, in which both adrenergic (α(1) and ß(1), but not α(2)) and dopaminergic signals are stimulatory, whereas cholinergic signals are inhibitory. This study also provides indications, though arguably not conclusive evidence, that in either case the neuronal mechanisms follow a signal-transduction pathway in which Ca(2+) and cAMP may act as the intracellular messengers. It also appears that proteasomal proteolysis is a conserved event in the regulation of AANAT activity in vertebrates.

MRI exploration of pineal volume in bipolar disorder.

BACKGROUND: Circadian rhythm instability and abnormalities of melatonin secretion are considered as trait markers of bipolar disorder. Melatonin is secreted by the pineal gland. We investigated pineal volume in patients with bipolar disorder, and expected to observe smaller than normal pineal glands in cases of bipolar disorder. METHODS: The primary outcome was the total pineal volume measured for each pineal gland with T1 MRI sequence. Twenty patients with bipolar I and II disorder and twenty controls were recruited. Pineal glands with large cysts (type 3) were excluded. RESULTS: After exclusion of individuals with type 3 cysts, 32 subjects were analyzed for total pineal volume (16 patients with bipolar disorder and 16 controls). Total pineal volume did not differ significantly between patients (total pineal volume=115+/-54.3mm(3)) and controls (total pineal volume=110+/-40.5mm(3)). CONCLUSIONS: Contrary to our hypothesis, no difference in total pineal volume between patients with bipolar disorder and healthy subjects was observed. These results indicate that the putative dysfunction of the pineal gland in bipolar disorder could be not directly related to an abnormal volume of the pineal gland.