Decision-making and impulsivity in cabergoline-treated prolactinoma: findings from Iowa Gambling, Go/No-Go, and...

PURPOSE: To assess impulsivity, decision-making performance and inhibitory control in prolactinoma patients treated with dopamine agonists (DA), and to compare these parameters with healthy control(HC) subjects. METHODS: A total of 34 patients with prolactinoma, and 35 HCs were included in the study. All patients and controls were screened using demographic information questionnaire, Barratt Impulsiveness Scale–Short Form (BIS-11-SF), Iowa Gambling Task and Go/No-Go Task. Clinical data of all subjects were collected from their electronic medical records. RESULTS: Compared with healthy controls, patients with prolactinoma receiving dopamine agonist therapy showed a significantly higher frequency of gambling urges and sexual desire during the preceding four weeks (p = 0.003 for both). In the Go/No-Go Task, a significant between-group difference was observed in commission error rates (p = 0.041). Treatment duration was positively correlated with both the frequency of sexual desire over the past four weeks and the non-planning subscale of the BIS-11-SF (r = 0.364, p = 0.035; r = 0.429, p = 0.011, respectively). Cumulative dopamine agonist dose was positively correlated with the frequency of sexual desire, the frequency of sexual intercourse attempts over the past four weeks, and the non-planning subscale of the BIS-11-SF (r = 0.405, p = 0.018; r = 0.433, p = 0.011; and r = 0.418, p = 0.014, respectively). CONCLUSIONS: In patients with prolactinoma, dopamine agonist treatment is associated with selective alterations in decision-making–related impulsivity and inhibitory control, influenced by treatment duration and cumulative dopamine agonist exposure.