Characteristics of Perioperative Cognitive and Affective Function in Patients with Somatotroph Adenoma

In the present study, we evaluate the characteristics of cognitive and affective function in patients with somatotroph adenomas (SAs) that secrete excess growth hormone and the effects of surgical intervention.

We conducted a prospective longitudinal study, recruiting 27 patients with SAs, 29 patients with nonfunctional pituitary adenomas (NFPAs) as the lesion control group, and 24 healthy participants as the healthy controls (HCs). These three groups were matched for sex, age, and years of education. We performed multidimensional cognitive function and neuropsychological assessments 1-2 days before endoscopic endonasal transsphenoidal surgery and at 3 months postoperatively. The Mini-mental state examination, Montreal cognitive assessment, Frontal assessment battery, Trail making test, and Digit span test were used to assess multidimensional cognitive function, including general intelligence, frontal lobe function, executive function, and memory. The Hamilton anxiety scale, Beck depression inventory, and Positive and Negative Affect Schedule scale were used for the neuropsychological assessment, including anxiety, depressed mood, and positive and negative emotions.

Compared with the HCs, the patients with SAs showed poor performance in the memory (P = 0.009) and anxiety (P = 0.013) assessments. However, no statistically significant difference was observed between patients with SAs and NFPAs for either cognitive function or effective performance. Moreover, patients with SAs did not show significant changes in cognition and affective behavior after surgery. In contrast, patients with NFPAs displayed significant improvements in memory (P = 0.015), executive function (P < 0.001), and anxiety mood (P = 0.001) performance postoperatively.

Patients with SAs showed specific cognitive deficits and abnormal moods, which might be attributed to the overproduction of growth hormone. However, surgical intervention had a limited effect on improving the impaired cognitive function and abnormal moods in patients with SAs at short-term follow-up.