Improvement in Attention Processing After Surgical Treatment in Functional Pituitary Adenomas: Evidence From ERP Study

Abstract

Cognitive abilities are impaired in patients with pituitary adenoma. However, studies on attention processing impairment in preoperative patients and attention processing recovery after transsphenoidal adenomectomy are lacking. The study aims to identify the electrophysiological change that relates to attention processing in pituitary patients before and after treatment. Twenty five preoperative pituitary patients and 25 follow-up postoperative patients were recruited. 27 healthy controls (HCs) were matched to the patients with age, gender, and education. Event-related potentials were used to investigate the attention processing in the preoperative patients, postoperative patients, and HCs. Across three groups, all emotional stimuli evoked P200 components. Compared with the HCs or postoperative patients, the amplitudes of P200 in the preoperative patients were higher. Moreover, The amplitudes of P200 decreased in the postoperative patients, which were similar to that in the HCs. The attention processing was improved after surgery, but no significant differences were detected between the postoperative patients and HCs. Abnormal hormone levels may be relevant to the factor that impair attention processing. Compared with that of the HCs and postoperative patients, the P200 component elicited by negative stimuli is higher in preoperative patients, which may illustrate compensatory activity after attention impairments. Furthermore, these data indicate that improvements in attention processing may be attributed to the amelioration of endocrine disorders. This study shows that the P200 component may be used to diagnose attention processing in preoperative pituitary patients and prove the improvement of attention processing in postoperative patients.

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

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Reporting of Participants' Sex, Race, Ethnicity, and Socioeconomic Status in Pituitary Surgery Literature

“…Two papers included education-level data. Both papers were by Cao et al, evaluating cognition and attention processing in patients with pituitary adenoma 19 . The authors collected and matched subgroups for the patient's highest education level.…”

Glymphatic transport is reduced in rats with spontaneous pituitary tumor

“…Although the underlying mechanisms leading to neurocognitive deficits in patients with pituitary tumors remain to be fully elucidated, growing evidence suggests that aberrant hormone secretion may be a major factor for cognitive impairment (11,22,23). However, while the abrogation of abnormal hormone level is associated with the improvement of cognitive function (21,23,24), incomplete recovery from structural alterations (6,7,25) and partial restoration from cognitive deficits with diverse courses (6,26,27) are observed in patients with normalized hormone level after successful treatment. Moreover, cerebrovascular pathology (e.g., cerebral infarction) arising from non-functioning pituitary tumor is independent of hormone replacement therapy (28), and cerebrovascular mortality remains elevated in the treated patients regardless of post-treatment hormone levels (18,29).…”