Research On Lateralized Attention Networks In Patients With Pituitary Adenoma Based On Event-Related Potentials

Objectives Previous evidences suggested that multiple domains of cognitive dysfunction have been revealed in the patients with pituitary adenoma,but little research has been reported on the alteration in attention networks and lateralization status in patients with pituitary adenoma.In this study,we used the Lateralized Attention Network Test(LANT)combined with Event-related potentials(ERPs)to investigate the alteration of each attention network and its lateralization status in patients with pituitary adenoma,and to further provide evidence for the diagnosis and rehabilitation of attentional dysfunction in patients with pituitary adenoma.Methods 20 patients with pituitary adenoma were included in the Pituitary Adenoma(PA)group,and 25 healthy adults matched for age,gender,and education background were included in the Healthy Controls(HCs)group.All subjects performed a lateralized attention network test and simultaneously recorded EEG using a 64-channel EEG system.All subjects’ERP data were analyzed offline using MATLAB 2020b software and combined with behavioral results to assess the effect of pituitary adenoma on patients’ lateralized attention networks.Results behavioral results suggested prolonged reaction time for all conditions(No cue,Central cue,Double cue,Spatial cue,Congruent,Incongruent)in patients with pituitary adenoma compared to HCs(p<0.05),but error rates were not significantly different from HCs(ER:Group:F(1,37)=0.480,p=0.493);Reduced alertness network efficiency in the patients group suggested dysfunction of the alerting network(F(1,37)=8.363,p=0.006);While no significant difference in the orienting network was found between the two groups(F(1,37)=0.399,p=0.531),the executive control network efficiency was significantly enhanced in the patients group(F(1,37)=14.596,p<0.001)and suggested decreased executive control function.The ERP results showed no statistical difference in the alerting network between groups(Group:F(1,37)=0.022,p=0.884).Although there was still no between-group effect(Group:F(1,37)=0.044,p=0.834),the orienting network was consistent with the visual field-brain region contralateral influence pattern across two groups.Overall,executive control networks differed between two groups(HCs vs.PA=1.136 μV vs.0.098 μV,F(1,37)=6.554,p=0.015).Executive control-related P3 was significantly biased toward the righ hemisphere(R>L=0.828 μV>0.407 μV,F(1,37)=5.361,p=0.026),showing that the right central parietal area dominated the bilateral visual field,while the left central parietal area dominated only the left visual field.When conflict load was increased(incongruent condition),the patients group exhibited disappearance of its right hemisphere lateralization when the right visual field stimuli was presented,reflecting increased compensatory activation of the contralateral hemisphere due to decreased right central parietal function under high conflict effect.Serum prolactin correlation analysis suggested a significant positive correlation between serum prolactin levels and left hemisphere P3 under high-load right visual field(r=0.498,p=0.035),possibly reflecting the disruptive effect of hyperprolactinemia on the lateralized activation pattern of executive control network,which to some extent reduces the processing efficiency of this network.Conclusions The present study revealed the functional status and altered lateralization of each attention network in patients with pituitary tumors from multiple aspects.The behavioral results of the alerting network were not predictable for ERP evidence and need to be confirmed by following studies.Although there was no group difference in the orienting network,it further verified the hypothesis of hemispheric lateralization and provided more detailed evidence for the following studies.Consistent behavioral and ERPs results revealed executive control dysfunction in patients with pituitary adenoma,and elevated prolactin levels may further impair executive control efficiency.In addition,decreased right central parietal P3 under lateralized condition and absence of lateralization effects under high conflict condition may serve as potential biological markers of early attentional dysfunction in pituitary adenoma patients.