Cognitive functioning in patients with nonfunctioning pituitary adenoma before and after endoscopic endonasal transsphenoidal surgery

Butterbrod, Elke; Gehring, Karin; Voormolen, Eduard; Depauw, P.R.A.M.; Nieuwlaat, Willy-Anne; Rutten, Geert‐Jan; Sitskoorn, Margriet M.

doi:10.3171/2019.5.jns19595

Cited by 7 publications

(13 citation statements)

References 38 publications

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“…Significant differences were found between patients with acromegaly and patients with NFPA on the QoL aspects of general health, vitality, and physical component summary. This finding may indicate that patients with NFPA have poor QoL (Butterbrod et al, 2019;Pertichetti et al, 2020); poor mental health is a common problem in such patients. Patients with acromegaly had low physical component summary scores.…”

Section: Discussionmentioning

confidence: 95%

Variables Associated With Body Image Concerns in Acromegaly Patients: A Cross-Sectional Study

Zhang

Zhong

et al. 2022

Front. Psychol.

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ObjectiveAcromegaly is often characterized by altered physical (including facial) appearance. However, there is little medical or psychological research on body image concerns in patients with acromegaly. The aim of this study was to identify factors influencing the body image distress in patients with acromegaly and to explore the possible effects of stigma on body image concerns.DesignCross-sectional study.MethodsA total of 68 individuals with acromegaly were enrolled in the study. A total of 70 persons with nonfunctional pituitary adenomas were randomly recruited as a healthy control group. Using structured questionnaires, we explored perceived body image using the Body Image Concern Inventory. We also used the Hamilton Anxiety Scale, the Stigma Scale for Chronic Illness, the Brief Illness Perception Questionnaire, and the 36-Item Short-Form Health Survey to evaluate health-associated variables and to analyze factors that affect body image concerns in patients with acromegaly.ResultsOf the 68 participants, 31 were men and 37 women (mean age ± standard deviation: 46.36 ± 12.47 years). The mean body image concern score was 47.49 ± 13.81 for patients with acromegaly and 21.10 ± 7.44 for patients with nonfunctional pituitary adenoma. The difference between the two groups was statistically significant. A multiple stepwise regression analysis showed that the related factors for body image distress were gender (P = 0.001), age at diagnosis (P = 0.01), and internalized stigma (P < 0.001, Adj. R2 = 0.756).ConclusionsPeople with acromegaly have substantial body image concerns, and these concerns are increased by the stigma associated with this disease; such concerns lead to poor quality of life (QoL). Physicians need to find better ways to control patients' hormone levels, and nurses should provide more information on how to improve body image or find ways to reduce patients' body image distress.

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Section: Discussionmentioning

confidence: 95%

Variables Associated With Body Image Concerns in Acromegaly Patients: A Cross-Sectional Study

Zhang

Zhong

et al. 2022

Front. Psychol.

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“…However, a similar pattern of cognitive impairment was also revealed in non-functioning PAs (NFPAs). Butterbrod et al [ 18 ] found that 45 patients with NFPAs also showed cognitive deficits that could only be associated with the tumor size. To date, it remains unclear whether these presentations were the results of hormone secretion [ 19 ], local tumor pressure [ 20 ], or a combination of both.…”

Section: Introductionmentioning

confidence: 99%

Hyperprolactinemia Associated with Attentional Processing and Interference Control Impairments in Patients with Prolactinomas

Chen

Cao

Liu³

et al. 2022

Brain Sciences

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The cognitive impairment of pituitary adenomas (PAs) has received increasing attention. Hyperprolactinemia and tumor mass effect are the potential causes. The aim of this study was to identify possible cognitive impairment and to further explore the correlation between these indices and prolactin (PRL) levels, based on the control of tumor size. Twenty-seven patients with prolactinomas (patient group) and twenty-six matched health control group (HC group) were enrolled in this study. All participants performed the flanker task while we continuously recorded electroencephalography data. On the behavioral performance level, patients showed a significantly slower reaction time (RT) in both flanker types. Concerning the event-related potentials level, patients elicited reduced P2 and enhanced N2 amplitudes compared with the HC group, suggesting an impairment of attentional processing (P2) and conflict monitoring (N2). Moreover, the patient group also induced lower P3 amplitudes relative to the HC group in both types, indicating that there were deficits in attentional resource allocation ability. We also found a significant correlation between the P3 amplitudes and incongruent condition RTs, as well as the subsequent PRL levels in the patient group. In conclusion, this is an innovative study that reveals the impaired cognition abilities in prolactinomas, and also proposes the possible cognitive toxicity of oversecreted PRL levels, which provides evidence for further research on the cognitive decline in PAs.

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“…A mean z-score AE 1 SD of HCs was considered within the normal range, while a z-score greater or below this range indicated abnormality. 11 The level of statistical significance was set at p < 0.05. performance compared to HCs (DST, p = 0.020; DST-s, p = 0.006), although no deficits were observed in general cognitive function, executive function, or attention. Individual-level analysis revealed memory deficits in 42 (28.76%) PitNET patients.…”

Section: Discussionmentioning

confidence: 99%

“…For individual‐level analyses, we conducted z‐tests to compare the mean standardized z‐scores for each cognitive and affective scale of preoperative PitNET patients to the HCs. A mean z‐score ± 1 SD of HCs was considered within the normal range, while a z‐score greater or below this range indicated abnormality 11 . The level of statistical significance was set at p < 0.05.…”

Section: Methodsmentioning

confidence: 99%

“…Prior researches have reported cognitive impairments in PitNET patients, 11,12 encompassing domains such as attention, 13 memory, 11,13,14 and executive function, 15 alongside affective disturbances like depression 16 and anxiety 12,17 . However, it remains unclear the distinction between neuropsychological status in PitNET patients and those with intra‐axial tumors, as well as the effect of the surgical intervention on their neuropsychological improvement, which limits selecting clinical management approaches for neuropsychological status in these brain tumors from different locations.…”

Section: Introductionmentioning

confidence: 99%

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Pituitary neuroendocrine tumor: A neuropsychological comparison with intra‐axial tumor

Tang,

Fang,

Bie

et al. 2024

Ann Clin Transl Neurol

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ObjectiveDespite pituitary neuroendocrine tumor (PitNET) being extra‐axial tumors without direct damage to brain tissue, patients with PitNET exhibit neuropsychological impairments. However, it remains unclear whether there are neuropsychological differences between PitNET and intra‐axial tumors that directly destroy the brain parenchyma. This prospective study aims to clarify this distinction to inform decision‐making for intracranial tumors of diverse origins.MethodsA total of 146 patients with PitNET, 74 patients with glioma representing intra‐axial tumors, and 52 age‐, sex‐, and education‐matched healthy controls were recruited. All patients received standard treatment and postoperative rehabilitation. Clinical data were meticulously collected, and neuropsychological tests were administered to all participants both before and 3 months after surgery.ResultsBoth PitNET and glioma patients experience the dual burden of cognitive and affective deficits. However, the feature of these deficits differs substantially. In PitNET patients, the deficits are relatively mild and focal, whereas in glioma patients, they are severe and extensive. Specifically, PitNET patients exhibit deficits in memory, anxiety, and negative affect. In contrast, glioma patients display deficits in executive function, attention, anxiety, positive/negative affect, and empathy. Notably, except for persistent memory deficits, the majority of neuropsychological scores declines in PitNET patients are restorable and can reach improvement within a short period after standard surgical therapy and perioperative management. Conversely, glioma patients not only fail to show improvements but also demonstrate worsening in terms of general cognition and memory postoperatively.InterpretationAs an extra‐axial tumor, PitNET may exhibit distinctive cognitive and affective functioning compared to intra‐axial tumors, highlighting the need for specific treatment approaches for PitNET patients.

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Cognitive functioning in patients with nonfunctioning pituitary adenoma before and after endoscopic endonasal transsphenoidal surgery

Cited by 7 publications

References 38 publications

Variables Associated With Body Image Concerns in Acromegaly Patients: A Cross-Sectional Study

Variables Associated With Body Image Concerns in Acromegaly Patients: A Cross-Sectional Study

Hyperprolactinemia Associated with Attentional Processing and Interference Control Impairments in Patients with Prolactinomas

Pituitary neuroendocrine tumor: A neuropsychological comparison with intra‐axial tumor

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