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

Abstract

Patients with pituitary adenoma have often suffered cognitive impairment. The study aims to identify the factors, and their impact, that affect the cognitive functions of pituitary adenoma patients. Seventy-six patients with pituitary adenoma were recruited, together with 76 healthy subjects as control. Patients (34 functioning and 42 non-functioning) were randomly assigned into either microscopic (n=44) or neural endoscopic (n=32) group. All surgeries were performed through single-nostril transsphenoidal approach under general anesthesia with endotracheal intubation. All patients were examined with cognitive assessments (CAMCOG-C and MMSE tests), tumor size, eyesight, and hormone levels before surgery. Three months after surgery, all patients were examined again to check hormone level changes by blood samples, tumor excision status via MRI, and cognitive assessments. Compared with healthy control, total score and multiple cognitive scores of CAMCOG-C and MMSE were significantly lower before surgery. There were no correlations between cognitive functions and tumor size or eyesight. Significant difference in cognitive functions was found between functioning and non-functioning pituitary adenoma patients. Significant increase in cognitive functions occurred after surgery, whereas no difference was detected between the two different surgical treatments. The hormone levels were improved significantly in patients with hormone disorders after surgery. The physical compression from tumor might not play a key role in cognitive impairment. However, hormone disorders could be a major factor to cognitive impairment. The improvement in cognitive functions is attributed to the amelioration of endocrine disorders. There were no differences between two surgical treatments.