Abstract
Objective: Acromegalic patients display a distinct neuropsychological profile and suffer from chronic physical complaints. We aimed to investigate in more detail these aspects in acromegalic patients, dependent on influencing factors like disease activity, age, sex, chronic medication, surgery, pituitary radiation, pituitary insufficiency and comorbidities.Design: Cross sectional, multicentric.Methods: 129 patients (M/W 65/64, 58.3 ± 12.7 years, 53/76 with active/controlled disease). Acromegalic patients completed the following inventories: NEO-FFI, IIP-D, and the Giessen Complaints List (GBB-24), after written informed consent. Age, sex, IGF-1 concentrations, comorbidities, treatment modalities and pituitary insufficiency were documented.Results: Acromegalic patients or specific patient-subgroups were more agreeable, neurotic, exploitable/permissive, introverted/socially avoidant, non-assertive/insecure, nurturant and less open to experience, cold/denying, domineering, compared to normal values from the healthy population (controls). Multivariable analysis demonstrated that these overall results were due to the specific patient subgroups as patients on chronic medication, with arthrosis and pituitary insufficiency. Disease activity was only associated with the trait nurturant. Higher scores for introversion were associated with arthrosis. Lower domineering was independent of any disease- or treatment related variable or comorbidity. The GBB inventory showed overall higher scores in patients, with higher scores for exhaustion and general complaints being associated with pituitary insufficiency, coronary heart disease and history of malignancy in the multivariable analysis. Joint complaints were independent of any disease- or treatment- related variable.Conclusions: We define new aspects of a distinct neuropsychological profile in patients with acromegaly, which are largely independent of disease activity. Chronic physical complaints are more pronounced in patients than in controls, with exhaustion and general complaints showing no association with disease activity.
Highlights
Treatment goals in acromegaly are the achievement of hormonal control and remission of symptoms, removal of the adenoma with preservation of pituitary function, the cure of comorbidities, the prevention of recurrence and the improvement in quality of life [1,2,3].Patients with acromegaly have been reported to display specific personality traits and physical complaints
Pereira et al observed that, compared to subjects with other pituitary tumors, schwannomas or chronic pain, patients with acromegaly displayed more cognitive impairment and personality disorders. One third of these patients were diagnosed with anxiety and depression. These findings were common for patients with active and controlled disease with long-lasting remission, and possibly caused by irreversible alterations of the central nervous system due to long term growth hormone (GH) excess or by residual disabilities like chronic arthrosis-associated pain [12, 13]
For each questionnaire we used the main subscale-scores as well as the total score as the respective dependent variable. We considered those that are linked to the disease/disease activity and variables to control for confounding due to comorbidities such as coronary heart disease, arterial hypertension, diabetes, history of malignancy and arthrosis
Summary
Acromegalic patients display a distinct neuropsychological profile and suffer from chronic physical complaints.
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