Cognitive functioning of patients with a PRL-secreting pituitary adenoma

Bala, Aleksandra; Łojek, Emilia; Marchel, Andrzej

doi:10.1212/wnl.0000000000002252

Cited by 31 publications

(33 citation statements)

References 10 publications

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“…In addition, serum hormone levels including PRL, E2, and LH, presented independent relationships with the mean GMV. These findings provide fundamental evidence for previous reports of cognitive dysfunction in a population with high PRL serum levels ( 4 , 21 , 22 ).…”

Section: Discussionsupporting

confidence: 86%

“…In addition to these physical manifestations ( 2 , 3 ), dysfunctional hormones lead to cognitive impairments ( 4 , 5 ), yet, little is known about changes in brain structure in patients with prolactinomas. In the brain, hormone receptor expression has been identified in several regions and is generally located in the cell membrane or intracellularly in the nucleus, as well as in the glia, spines, and presynaptic terminals.…”

Section: Introductionmentioning

confidence: 99%

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Cognitive Function and Serum Hormone Levels Are Associated with Gray Matter Volume Decline in Female Patients with Prolactinomas

et al. 2018

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Background and objectiveCognitive impairments have been reported in patients with hyperprolactinemia; however, there is a lack of knowledge of brain structure alterations relevant to hyperprolactinemia in prolactinomas. Thus, we aimed to identify changes in brain structure in prolactinomas and to determine whether these changes are related to cognitive performance and clinical characteristics.MethodsParticipants were 32 female patients with prolactinomas and 26 healthy controls (HC) matched for age, sex, education, and handedness. All participants underwent magnetic resonance imaging brain scans, neuropsychological assessments, and clinical evaluations. Voxel-based morphometry analysis was used to identify changes in gray matter volume (GMV). Partial correlation analysis and multiple linear regression were performed to determine the relationship between GMV, cognition, and clinical characteristics.ResultsCompared to HC, patients with prolactinomas demonstrated a decrease in GMV in the left hippocampus, left orbitofrontal cortex, right middle frontal cortex (MFC), and right inferior frontal cortex (IFC). In addition, patients performed worse than controls on tests for verbal memory and executive function, and this was significantly related to the GMV of the left hippocampus and right MFC, respectively. Moreover, in the patients, we found a negative relationship between serum prolactin levels and the GMV of the left hippocampus and right IFC, whereas a positive relationship was found between the GMV of the left hippocampus and serum levels of estradiol and luteinizing hormone.ConclusionIn patients with prolactinomas, specific brain structure abnormalities have been identified and are associated with cognitive impairments and dysfunctional hormones. This study enhances our understanding of brain structure changes that may occur with prolactinomas and provides novel and fundamental evidence for previous behavioral findings relevant to hyperprolactinemia.

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Section: Discussionsupporting

confidence: 86%

Section: Introductionmentioning

confidence: 99%

Cognitive Function and Serum Hormone Levels Are Associated with Gray Matter Volume Decline in Female Patients with Prolactinomas

et al. 2018

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“…The cognitive dysfunction may be caused by both tumor mass compression of the related brain structures and effects of related hormonal imbalance that influence cognitive structures. However, up to now, the detailed mechanism of cognitive impairments is still unexplained [44][45] [46].…”

Section: Discussionmentioning

confidence: 99%

“…Hyperpituitarism can mainly cause cognitive deficits in functioning pituitary adenoma patients [46] Previous studies have suggested that frontal/parietal cortex and subcortical structures (e.g., thalamus) were related to attention selection and shifting [57] [58]. For example, recent studies specifically showed impairments in recognizing and regulating emotion in patients with temporal or frontal tumors [59].…”

Section: Discussionmentioning

confidence: 99%

Improvement in attention following surgery treatment in pituitary adenoma patients: an evidence from ERP study

Cao

Song

Huang

et al. 2020

Preprint

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Background: Cognitive abilities are impaired in patients with pituitary adenoma, which are mostly treated with surgery. However, the study on neurocognitive recovery after transsphenoidal adenomectomy is lacking. The study aims to identify the electrophysiological change that relates to the attention function of pituitary adenoma patients after treatment. Methods: 27 preoperative pituitary patients and 25 follow up postoperative patients were recruited. 27 healthy controls (HCs) were matched to the patients with age, sex, and education. All the pituitary adenoma patients had successfully gone through transsphenoidal adenomectomy under microscope or endoscope. Event-related potentials were used to investigate the cognitive processes of attention for preoperative patients, postoperative patients and healthy controls. In addition, eyesight and blood hormone levels were examined. Six months after surgery, blood hormone levels, pituitary MRI and electrophysiological tests were re-examined. Results: Across three groups, all emotional stimuli could evoke P200 components. Compared with HCs or postoperative patients, the amplitudes of P200 in the preoperative patients were higher. Moreover, The amplitude of P200 decreased in postoperative patients, which was similar to that in HCs. The attention was improved after surgery, but no significant differences were detected between postoperative patients and HCs. Conclusion: The tumor mass effect and abnormal hormone may be relevant to the factors that impair the attention. Compared with that of the HCs and postoperative patients, the P200 component elicited by negative stimuli is higher in preoperative patients, which is associated with the attention impairments. Furthermore, these data indicate the improvement in attention may be attributed to the tumor resection and the amelioration of endocrine disorders. This study shows that P200 component can be used to diagnose the attention in preoperative pituitary patients, and prove the improvement of the attention in postoperative patients.

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“…Therefore, apart from the physical damages, abnormal cognition appears commonly in pituitary adenoma patients. Substantial evidence has shown that pituitary patients frequently complain about problems in attention [5], working memory [6], executive function [7], depression [8], and emotion processing [9], which affect the quality of patients' life [10] [11].…”

Section: Introductionmentioning

confidence: 99%

The dysfunction of affective picture processing in pituitary patients: an ERPs study

Cao

Song

Liu

et al. 2020

Preprint

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Background: Cognitive impairments have been reported in patients with pituitary adenoma; however, there is a lack of knowledge of investigating the emotional stimuli processing in pituitary patients. Thus, we aimed to investigate whether there is emotional processing dysfunction in pituitary patients by recording and analyzing the late positive potential (LPP) elicited by affective stimuli.Methods: Evaluation of emotional stimuli processing by LPP Event related potentials (ERPs) was carried out through central- parietal electrode sites (C3, Cz, C4, P3, Pz, P4) on the head of the patients and healthy controls (HCs).Results: In the negative stimuli, the amplitude of LPP was 2.435 ± 0.419μV for HCs and 0.656 ± 0.427μV for patient group respectively ( p = 0.005). In the positive stimuli, the elicited electric potential 1.450 ± 0.316μV for HCs and 0.495 ± 0.322μV for patient group respectively ( p = 0.040). Moreover, the most obvious difference of LPP amplitude between the two groups existed in the right parietal region. On the right hemisphere (at the P4 site), the elicited electric potential was 1.993 ± 0.299μV for HCs and 0.269 ± 0.305μV for patient group respectively( p = 0.001).Conclusion: There are functional dysfunction of emotional stimuli processing in pituitary adenoma patients. Our research provides the electrophysiological evidence for the presence of cognitive dysfunction which need to be intervened in the pituitary adenoma patients.

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Cognitive functioning of patients with a PRL-secreting pituitary adenoma

Cited by 31 publications

References 10 publications

Cognitive Function and Serum Hormone Levels Are Associated with Gray Matter Volume Decline in Female Patients with Prolactinomas

Cognitive Function and Serum Hormone Levels Are Associated with Gray Matter Volume Decline in Female Patients with Prolactinomas

Improvement in attention following surgery treatment in pituitary adenoma patients: an evidence from ERP study

The dysfunction of affective picture processing in pituitary patients: an ERPs study

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