Abstract
Cognitive 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. Participants 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. Compared 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. In 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.
Highlights
Prolactin (PRL)-secreting pituitary adenomas are highly prevalent in females [1] and are the main pathologic cause of hyperprolactinemia [2]
We found that patients with greater volumes of the left hippocampus and right middle frontal cortex (MFC) performed better on tests for verbal memory (Story Recall Test: r = 0.538, PFDR-corrected = 0.003) and executive function (WCST: r = 0.375, PFDR-corrected = 0.045), respectively (Figures 3A,B)
We found that patients with prolactinomas showed gray matter volume (GMV) decline in the left hippocampus and prefrontal cortex including the left orbitofrontal cortex (OFC), the right MFC, and the right inferior frontal cortex (IFC), suggesting brain structure damages in patients with prolactinomas
Summary
Prolactin (PRL)-secreting pituitary adenomas (prolactinomas) are highly prevalent in females [1] and are the main pathologic cause of hyperprolactinemia [2]. Clinical symptoms in women include galactorrhea, amenorrhea, anovulatory infertility, loss of bone mineral mass, and headache or visual disturbance due to tumor mass effects [2, 3] 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. Hoekzema et al explored how pregnancy affects the brain and found a substantial reduction in gray matter volume (GMV) in brain areas correlated with social cognition, such as the bilateral inferior and middle frontal cortex (MFC), cingulate cortex, and hippocampus [13] They did not investigate the relationship between endogenous hormones and brain structure at the pre-pregnancy stage. We aimed to identify changes in brain structure in prolactinomas and to determine whether these changes are related to cognitive performance and clinical characteristics
Sign-in/Register to view highlights & summary 
Published Version (
Free)
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call