Depressive Burden and Interoceptive Disturbance Improve after Bromocriptine Treatment in Women With...

Treatment decisions for microprolactinoma are based primarily on endocrine and radiographic outcomes, whereas neuropsychological changes remain underappreciated. As both bromocriptine therapy and surgery may be considered in selected patients, treatment selection can be challenging. This study aimed to provide additional evidence to inform treatment decision-making from neuropsychological perspective.

This prospective study included 52 women with microprolactinoma and 39 female healthy controls. Baseline depressive symptoms and interoceptive awareness were assessed using the Beck Depression Inventory (BDI) and Body Perception Questionnaire (BPQ). Among the patients, 20 completed both baseline and post-treatment assessments after 6 months of bromocriptine therapy. Baseline between group differences were analyzed using independent samples t-tests, and longitudinal changes were evaluated using linear mixed effects models.

At baseline, patients had significantly higher BDI scores than controls (P = .011) and significantly higher BPQ scores (P = .049). In longitudinal analyses, bromocriptine treatment was associated with significant decreases in BPQ (P < .001) and BDI scores (P = .026). Prolactin level was significantly associated with BPQ (P = .001) but not with BDI (P = .259). When BPQ was added to the BDI model, BPQ remained a significant predictor of depressive symptoms (P < .001), whereas the effects of time and prolactin were no longer significant.

Women with microprolactinomas showed improvements in both emotional symptoms and interoceptive awareness following bromocriptine treatment. Emotional disturbances in these patients may be more closely associated with altered interoceptive processing than with prolactin levels themselves.