Chapter 20 - Acromegaly and Brain Function: Effects on the Human Brain during Conditions with Increased Growth Hormone Concentrations

Abstract

Hyper secretion of endogenous and exogenous growth hormone (GH) can affect all cell systems in the human body. However, beneficial effects on the central nervous system, such as improved cognition, learning capacity, quality of life, or memory are not known. Possible anabolic effects of growth hormone have also been studied in patients with Turner's syndrome who show diminished height and a spectrum of characteristic cognitive disturbances. Long-term GH administration is not associated with abbreviations of these urocognitive deficits nor does long-term growth hormone administration induce improved mental development in patients with Down's syndrome. Furthermore, the chapter discuses treatment approaches for GH-producing tumor. Surgery has been the most commonly chosen first treatment in acromegaly. However, surgery followed by photon irradiation shows significantly lowers quality of life. Other approaches involve somatostatin analogues and genetically engineered GH receptor antagonist pegvisomant or trovert, which inhibits GH action on cells. This GH receptor antagonist is remarkably effective, controlling disease activity and normalizing IGF-I levels in serum in over 90% of patients.