Artikel
Cognitive function surrounding resection of nonfunctioning pituitary adenomas with suprasellar extension: a prospective matched-control study
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Autoren
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Philipp Hendrix
- Klinik für Neurochirurgie, Universitätsklinik des Saarlandes, Homburg/Saar, Germany, Homburg/Saar, Deutschland
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Elisa Hans
- Klinik für Neurochirurgie, Universitätsklinik des Saarlandes, Homburg/Saar, Germany, Homburg/Saar, Deutschland
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Christoph J. Griessenauer
- Department of Neurosurgery, Geisinger Health System, Danville, PA, Danville, United States
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Andreas Simgen
- Department of Neuroradiology, Saarland University Medical Center and Saarland University Faculty of Medicine, Homburg/Saar, Germany, Homburg/Saar, Deutschland
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Joachim Oertel
- Homburg/Saar, Deutschland
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Julia Karbach
- Department of Psychology, Goethe-University, Frankfurt, Deutschland
| Veröffentlicht: | 9. Juni 2017 |
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Gliederung
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Objective: Cognitive dysfunction in patients suffering from pituitary adenomas may derive from hormonal imbalances or suprasellar tumor extension displacing adjacent neural structures. Symptomatic or progressively enlarging nonfunctioning pituitary adenomas with suprasellar extension generally are resected. The literature on neurocognitive performance surrounding resection of these lesions is sparse.
Methods: The performed a prospective matched-control study to investigate the preoperative and postoperative cognitive performance of patients suffering from nonfunctioning pituitary adenomas with suprasellar extension. Healthy controls were matched for the following criteria: age, sex, handedness, education, and profession. Extensive neurocognitive testing assessed: perceptual speed, executive function, visual-spatial and verbal working memory, short- and long-term memory, verbal fluency, fluid intelligence, anxiety, and depression.
Results: A total of 10 patients and 10 healthy controls underwent cognitive assessment. In all patients, the suprasellar tumor extension compressed adjacent neural structures. Median sagittal suprasellar tumor extension scored 8 mm. Median sagittal tumor diameter was 21 mm. Preoperatively, patients displayed worse performance in perceptual speed and short-term memory tasks. All patients underwent surgical therapy. Either through a transnasal, transsphenoidal approach or a supraorbital frontolateral keyhole approach. Postoperatively at day 7, the short-term memory deficit was not measurable anymore. Two months after surgery, the performance of perceptual speed tasks of patients and controls showed equal scores, demonstrating patient recovery in this cognitive domain. None of the patients experienced worsening of cognitive function. Routine postoperative imaging at six months revealed regular postoperative radiological conditions.
Conclusion: Nonfunctioning pituitary adenomas with suprasellar extension may cause neurocognitive impairments in specific cognitive domains. However, after surgical therapy these deficits appear to resolve within two months. The risk for cognitive deterioration with surgery seems to be low.
