Clinical Study On Cognitive Dysfunction In Patients With Pituitary Adenomas

Objective The aim of this research was to demonstrate the effect of tumor and age on cognitive decline in patients with PAs.Methods A total of 64 patients with PAs and 69 healthy controls subjects(HCs)were recruited for this study.Both PAs and HCs were divided into a younger group(< 50 years of age)and an older group(? 50 years of age).Neurocognitive domains were assessed using the Wechsler Adult Intelligence Scale-Chinese Revision(WAIS-RC)and Wechsler Memory Scale-Chinese Revision(WMS-RC)tests.Furthermore,we also investigated the relationship between cognitive domains and tumor volume,as well as PAs patients' hormone levels and age.Result Several of the cognitive impairments found on the WAIS-RC and WMS-RC tests were more frequently observed in untreated PAs patients.Our results showed that the main effect of tumor was significant in all tested cognitive domains(P<0.05).And the main effect of age was significant in all tested cognitive domains(P<0.05),except for block design and similarity(P>0.05).Moreover the interaction effect of tumor and age was significant in digit span,arithmetic,picture completion and similarity(P<0.05).The logged FSH was found to be associated with a decreased socre in the similarity task(r=-0.311,P=0.016)in PAs patients.And the logged GH was found associated with an increase in digit symbol(r=0.269,P=0.039)task socres.Meanwhile,the logged GH and FT4 were found to be associated with an increase in the picture recall task score(GH: r=0.29,P=0.026;FT4: r=0.331,P=0.01).Moreover,logged ACTH,FSH and LH were found to be associated with a decrease in arithmetic socre(ACTH,r=-0.278,P=0.033;FSH,r=-0.3,P=0.02;LH,r=-0.258,P=0.046).Importantly,the age of patients was also found to be correlated with part of the cognitive functions assessed(Figure 3).The age of patients was associated with a decrease in picture recall(r=-0.469,P<0.001),similarity(r=-0.304,P=0.015)and digit symbol(r=-0.289,P=0.022)task scores.And no significant correlations were found between cognitive domains and tumor volume.Conclusions Our findings demonstrate a significant decline in the cognitive performance of PAs patients prior medical treatment,especially in older patients,which suggests that tumor and age have the ability to interact and aggravate cognitive decline in patients with PAs.