Neurocognitive evaluation of patients with non-functioning pituitary adenoma

We aimed to evaluate the neurocognitive functions of patients with non-functioning pituitary adenoma (NFPA).

Eighty patients with NFPA and 80 control subjects matched for age, sex, body mass index (BMI) and educational status were included. The Beck Depression Inventory (BDI) for depression, the Cognitive Failures Questionnaire (CFQ), the Prospective and Retrospective Memory Questionnaire (PRMQ) and the Memory Functioning Questionnaire (MFQ) for assessing cognitive functions were administered.

NFPA patients had significantly higher CFQ and PRMQ scores than controls (p < 0.05), reflecting greater cognitive failure and memory impairment. MFQ subscales revealed increased general forgetfulness, severity of forgetting, and impaired retrospective function in NFPA patients (p < 0.05). Name recall was worse among those who underwent surgery or received radiotherapy/gamma-knife treatment. Social dysfunction was more common in patients with secondary adrenal insufficiency (p = 0.038), higher corticosteroid doses (p < 0.05), and greater concentration problems (p = 0.036). Hypogonadism was associated with impaired name recall (p = 0.040) and social failure (p = 0.024). Name recall declined as postoperative time increased (p = 0.029). Low IGF-1 levels were linked to worse prospective memory, more frequent forgetfulness, and greater social dysfunction (p = 0.042).

Our findings suggest that the cognitive impairments observed in patients with NFPA may result not only from pituitary dysfunction but also from treatment approaches such as reoperations, gamma-knife or radiotherapy. These results highlight the importance of comprehensive neurocognitive assessment and long-term follow-up in the management of NFPA patients, particularly those with hormonal deficiencies or who undergo repeated interventions.