The impact on cognitive functions of patients with pituitary adenoma before and after surgery

Wang, Xianxiang; Tong, Xuanxia; Zou, Yanfeng; Tian, Xuefeng; Mao, Zhongxiang; Sun, Zhongwu

doi:10.1007/s10072-017-2980-z

Cited by 19 publications

(23 citation statements)

References 25 publications

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“…However, with physiologically normal levels of the hormone, the postoperative pituitary patients manifested improvement of attention processing, showing similar amplitudes of P200 as the HCs did. Improvement in cognitive functions after surgery was related to the normal endocrine (75). This suggests improvement in attention processing, which could be due to the normalization of hypothalamic-pituitary axes and secretory rhythms of pituitary hormones after removal of the tumor.…”

Section: Discussionmentioning

confidence: 86%

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

et al. 2021

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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.

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Section: Discussionmentioning

confidence: 86%

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

et al. 2021

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“…(85) Endocrine dysfunction plays an important role in cognitive impairment, and may be reversible after surgical intervention. (86) 1.17 Headache due to genetic vascular disorders 1.17.1. Cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy (CADASIL) Various types of migraine headaches have been reported in 20-40% of patients with CADASIL, including migraine with typical aura, which accounts for the majority of cases, migraine without aura, migraine aura without headache, basilar migraine, hemiplegic migraine, acute onset aura without headache, migraine with acute onset aura, migraine with prolonged aura and retinal migraine.…”

Section: Headache Due To Pituitary Apoplexymentioning

confidence: 99%

Classification of Head, Neck, and Face Pains First Edition (WHS-MCH1): Position paper of the WHS Classification Committee

Thomas¹,

Kumar²,

Subir³

et al. 2021

HMC

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The WHS classification of Head, Neck and Face pain, Edition 1 Version 1 (WHS-MCH1) is the official document of the World Headache Society. It was conceptualized and developed by the Society's Classification Committee. The work began with a clean slate to create a comprehensive, updated and holistic classification of headache disorders; where 'headache' was defined as any pain above the shoulders, thus including head, neck and face pain. This new classification reflects a scientifically robust understanding of disease and also places patient experience in the qualia of pain. It is a training manual to be used at the bedside and office as an aid to the diagnosis and management of headache disorders. The dynamic nature of this first ever live classification of headaches also means that ultra-rapid updates, or versions, will be available electronically. It is not a disease criteria but a classification criteria (1) and is useful to pick extended spectra and 'mimickers' of diseases. Although increased sensitivity usually comes at the expense of reduced specificity, an expanded spectrum of diseases in this case also means increased specificity. WHS-MCH1 is a syndromic classification. A syndrome is a recognizable complex of symptoms and physical findings which may have more than one aetiology. Although disease is nominalist and culture-relativistic (2) , a syndrome based approach reflects the discipline of first widening the view of possibilities before analysing each to formulate a diagnostic hypothesis. Such an approach provides a useful framework for organizing the complexity of clinical experience in order to derive inferences about outcome and guide decisions about treatment. WHS-MCH1 has a vertical grouping designed for use by clinicians of all levels of experience; this is linked to the horizontal groupings which are syndrome-based. The syndrome groups are also interlinked to one another. This design enables clinicians to efficiently create the 'big picture' so as not to miss any diagnosis. Axis 1 and 2 are the vertical and horizontal grouping categories, respectively. Axis 3 is the patient narrative of bothersome symptoms and level of impairment. Axis 4 are biomarkers that may be derived from investigations and this is the best example of the continuum of better understanding of disease defining markers. Axis 5 is an objective impairment scale that clinicians may choose based on availability. The World Headache Society hopes that the use of such a robust and inclusive framework will lead to better patient outcomes and improved patient and clinician satisfaction with the investigative and diagnostic process.

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“…One study found that younger patients had better outcomes than older patients after pituitary surgery, 22 while others have not reported a difference. 8,9,24,26,27,34,35 Another study found that presurgery tumor size is negatively correlated with postsurgery outcome, 28 whereas other studies have not. 16,35 Finally, Tooze 33 found a sex difference, with men performing significantly worse than women on tests of immediate memory across a cohort of patients treated for NFA, regardless of treatment group.…”

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confidence: 99%

“…8,9,24,26,27,34,35 Another study found that presurgery tumor size is negatively correlated with postsurgery outcome, 28 whereas other studies have not. 16,35 Finally, Tooze 33 found a sex difference, with men performing significantly worse than women on tests of immediate memory across a cohort of patients treated for NFA, regardless of treatment group. Interestingly, a previous study 14 added patient sex as a covariate in its analyses, suggesting a difference between men and women in their sample, although this was not independently reported.…”

mentioning

confidence: 99%

“…Other studies have not reported whether they found a sex difference. 24,26,27,34,35 Studies on the cognitive effects of GKRS have started to appear. A preliminary pilot study of the effects of GKRS on cognition found that while patients treated for pituitary adenoma demonstrated memory impairment, there were no cognitive differences between those treated with and those treated without GKRS.…”

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confidence: 99%

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Neurocognitive changes in pituitary adenoma patients after Gamma Knife radiosurgery

Tooze

Sheehan

2018

Journal of Neurosurgery

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OBJECTIVEPituitary adenomas and the treatment required for the underlying neuropathology have frequently been associated with cognitive dysfunction. However, the mechanisms for these impairments remain the subject of much debate. The authors evaluated cognitive outcomes in patients treated with or without Gamma Knife radiosurgery (GKRS) for an underlying pituitary adenoma.METHODSThis was a retrospective, institutional review board–approved, single-institution study. A total of 51 patients (23 male, 28 female) treated for pituitary adenoma were included in this neurocognitive study. Twenty-one patients underwent GKRS following transsphenoidal surgery, 22 patients were treated with transsphenoidal surgery alone, and eight patients were conservatively managed or were treated with medical management alone. Comparisons using psychometric tests of general intellectual abilities, memory, and executive functions were made between the treatment groups, between male and female patients, and between patients with Cushing’s disease and those with nonfunctioning adenoma (NFA).RESULTSThe entire patient sample, the NFA group, and the GKRS group scored significantly below expected on measures of both immediate and delayed memory, particularly for visually presented information (p ≤ 0.05); however, there were no significant differences between the patients with Cushing’s disease and those with NFA (t ≤ 0.56, p ≥ 0.52). In those who underwent GKRS, memory scores were not significantly different from those in the patients who did not undergo GKRS (t ≤ 1.32, p ≥ 0.19). Male patients across the sample were more likely to demonstrate impairments in both immediate memory (t = −3.41, p = 0.003) and delayed memory (t = −3.80, p = 0.001) than were female patients (t ≤ 1.09, p ≥ 0.29). There were no impairments on measures of general intellectual functioning or executive functions in any patient group. The potential contributions of tumor size and hormone levels are discussed.CONCLUSIONSOverall, pituitary adenoma patients demonstrated relative impairment in anterograde memory. However, GKRS did not lead to adverse effects for immediate or delayed memory in pituitary adenoma patients. Cognitive assessment of pituitary adenoma patients is important in their longitudinal care.

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The impact on cognitive functions of patients with pituitary adenoma before and after surgery

Cited by 19 publications

References 25 publications

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

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

Classification of Head, Neck, and Face Pains First Edition (WHS-MCH1): Position paper of the WHS Classification Committee

Neurocognitive changes in pituitary adenoma patients after Gamma Knife radiosurgery

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