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Neurosurgical Review
Published in: Neurosurgical Review 4/2020

01-08-2020 | Pituitary Adenoma | Review

Pituitary adenomas and neuropsychological status: a systematic literature review

Authors: Marta Pertichetti, Simona Serioli, Francesco Belotti, Davide Mattavelli, Alberto Schreiber, Carlo Cappelli, Alessandro Padovani, Roberto Gasparotti, Piero Nicolai, Marco M. Fontanella, Francesco Doglietto

Published in: Neurosurgical Review | Issue 4/2020

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Abstract

Neurocognitive and psychological dysfunctions associated with pituitary adenomas (PAs) are clinically relevant, though probably under-reported. The aim of the current review is to provide an update on neuropsychological status, psychopathology, and perceived quality of life (QoL) in patients with PAs. A systematic research was performed in PubMed and Scopus in order to identify reports on neurocognitive, psychiatric, and psychological disorders in PAs. Prevalence of alterations, QoL evaluation, and used tests were also recorded. PRISMA guidelines were followed. Of 62,448 identified articles, 102 studies were included in the systematic review. The prevalence of neurocognitive dysfunctions was 15–83% in Cushing’s Disease (CD), 2–33% in acromegaly, mostly affecting memory and attention. Memory was altered in 22% of nonfunctioning (NF) PAs. Worsened QoL was reported in 40% of CD patients. The prevalence of psychiatric disorders in CD reached 77% and in acromegaly 63%, mostly involving depression, followed by psychosis, and anxiety. The prevalence of psychopathology was up to 83% in CD, and 35% in acromegaly. Postoperative improvement in patients with CD was observed for: learning processes, overall memory, visuospatial skills, and language skills. Short-term memory and psychomotor speed improved in NFPAs. Postoperative improvement of QoL, somatic symptoms, obsessive-compulsive disorder, and coping strategies was seen in CD and acromegaly. Reports after radiotherapy are discordant. There is wide variability in used tests. PAs have been recently shown to be associated with altered neurocognitive and neuropsychological functions, as well as QoL. These data suggest the importance of a multidisciplinary evaluation for an optimal management.
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Literature
1.
Alsumali A, Cote DJ, Regestein QR, Crocker E, Alzarea A, Zaidi HA, Bi WL, Dawood HY, Broekman ML, van Zandvoort MJE, Mekary RA, Smith TR (2017) The impact of transsphenoidal surgery on neurocognitive function: a systematic review. J Clin Neurosci 42:1–6PubMedCrossRef
2.
Mussig K et al (2011) Deteriorated executive functions in patients with successful surgery for pituitary adenomas compared with other chronically ill patients. J Int Neuropsychol Soc 17(2):369–375PubMedCrossRef
3.
Baird A, Sullivan T, Zafar S, Rock J (2003) Quality of life in patients with pituitary tumors: a preliminary study. Qual Manag Health Care 12(2):97–105PubMedCrossRef
4.
Guinan EM, Lowy C, Stanhope N, Lewis PDR, Kopelman MD (1998) Cognitive effects of pituitary tumours and their treatments: two case studies and an investigation of 90 patients. J Neurol Neurosurg Psychiatry 65(6):870–876PubMedPubMedCentralCrossRef
5.
Hendrix P, Griessenauer CJ, Hans E, Simgen A, Oertel J, Karbach J (2017) Cognitive function surrounding resection of nonfunctioning pituitary adenomas with suprasellar extension: a prospective matched-control study. J Clin Neurosci 40:109–114PubMedCrossRef
6.
Hendrix P, Hans E, Griessenauer CJ, Simgen A, Oertel J, Karbach J (2017) Neurocognitive status in patients with newly-diagnosed brain tumors in good neurological condition: the impact of tumor type, volume, and location. Clin Neurol Neurosurg 156:55–62PubMedCrossRef
7.
Meyers CA (1998) Neurobehavioral functioning of adults with pituitary disease. Psychother Psychosom 67(3):168–172PubMedCrossRef
8.
Pereira AM et al (2012) Cognitive impairment and psychopathology in patients with pituitary diseases. Neth J Med 70(6):255–260PubMed
9.
Yedinak CG, Fleseriu M (2014) Self-perception of cognitive function among patients with active acromegaly, controlled acromegaly, and non-functional pituitary adenoma: a pilot study. Endocrine 46(3):585–593PubMedCrossRef
10.
Psaras T, Milian M, Hattermann V, Gerlach C, Honegger J (2011) Executive functions recover earlier than episodic memory after microsurgical transsphenoidal resection of pituitary tumors in adult patients—a longitudinal study. J Clin Neurosci 18(10):1340–1345PubMedCrossRef
11.
Van Aken MO et al (2005) Quality of life in patients after long-term biochemical cure of Cushing’s disease. J Clin Endocrinol Metab 90(6):3279–3286PubMedCrossRef
12.
Tiemensma J, Kaptein AA, Pereira AM, Smit JWA, Romijn JA, Biermasz NR (2011) Coping strategies in patients after treatment for functioning or nonfunctioning pituitary adenomas. J Clin Endocrinol Metab 96(4):964–971PubMedCrossRef
13.
14.
Whelan TB et al (1980) Neuropsychological deficits in Cushing’s syndrome. J Nerv Ment Dis 168(12):753–757PubMedCrossRef
15.
Starkman MN, Schteingart DE (1981) Neuropsychiatric manifestations of patients with Cushing’s syndrome: relationship to cortisol and adrenocorticotropic hormone levels. Arch Intern Med 141(2):215–219PubMedCrossRef
16.
Tiemensma J, Kaptein AA, Pereira AM, Smit JWA, Romijn JA, Biermasz NR (2011) Negative illness perceptions are associated with impaired quality of life in patients after long-term remission of Cushing’s syndrome. Eur J Endocrinol 165(4):527–535PubMedCrossRef
17.
Tooze A, Hiles CL, Sheehan JP (2012) Neurocognitive changes in pituitary adenoma patients after gamma knife radiosurgery: a preliminary study. World Neurosurgery 78(1–2, 122):–128
18.
Flitsch J, Spitzner S, Ludecke DK (2000) Emotional disorders in patients with different types of pituitary adenomas and factors affecting the diagnostic process. Exp Clin Endocrinol Diabetes 108(7):480–485PubMedCrossRef
19.
Hudson JI, Hudson MS, Griffing GT, Melby JC, Pope HG Jr (1987) Phenomenology and family history of affective disorder in Cushing’s disease. Am J Psychiatry 144(7):951–953PubMedCrossRef
20.
Starkman MN, Schteingart DE, Schork MA (1981) Depressed mood and other psychiatric manifestations of Cushing’s syndrome: relationship to hormone levels. Psychosom Med 43(1):3–18PubMedCrossRef
21.
Sievers C, Sämann PG, Pfister H, Dimopoulou C, Czisch M, Roemmler J, Schopohl J, Stalla GK, Zihl J (2012) Cognitive function in acromegaly: description and brain volumetric correlates. Pituitary 15(3):350–357PubMedCrossRef
22.
Siegel S, Milian M, Kleist B, Psaras T, Tsiogka M, Führer D, Koltowska-Häggström M, Honegger J, Müller O, Sure U, Menzel C, Buchfelder M, Kreitschmann-Andermahr I (2016) Coping strategies have a strong impact on quality of life, depression, and embitterment in patients with Cushing’s disease. Pituitary 19(6):590–600PubMedCrossRef
23.
Ragnarsson O, Berglund P, Eder DN, Johannsson G (2012) Long-term cognitive impairments and attentional deficits in patients with Cushing’s disease and cortisol-producing adrenal adenoma in remission. J Clin Endocrinol Metab 97(9):E1640–E1648PubMedCrossRef
24.
Starr AM (1952) Personality changes in Cushing’s syndrome. J Clin Endocrinol Metab 12(5):502–505PubMedCrossRef
25.
Kelly WF, Kelly MJ, Faragher B (1996) A prospective study of psychiatric and psychological aspects of Cushing’s syndrome. Clin Endocrinol 45(6):715–720CrossRef
26.
Kelly WF (1996) Psychiatric aspects of Cushing’s syndrome. QJM - Monthly Journal of the Association of Physicians 89(7):543–551PubMedCrossRef
27.
Dorn LD, Burgess ES, Dubbert B, Simpson SE, Friedman T, Kllng M, Gold PW, Chrousos GP (1995) Psychopathology in patients with endogenous Cushing’s syndrome: ‘atypical’ or melancholic features. Clin Endocrinol 43(4):433–442CrossRef
28.
Milian M, Honegger J, Gerlach C, Hemeling X, Psaras T (2014) Similar psychopathological profiles in female and male Cushing’s disease patients after treatment but differences in the pathogenesis of symptoms. Neuroendocrinology 100(1):9–16PubMedCrossRef
29.
Loosen PT et al (1992) Psychiatric phenomenology in Cushing’s disease. Pharmacopsychiatry 25(4):192–198PubMedCrossRef
30.
Nader S et al (2016) Health-related quality of life in patients after treatment of Cushing’s disease. Exp Clin Endocrinol Diabetes 124(3):187–191PubMedCrossRef
31.
Haskett RF (1985) Diagnostic categorization of psychiatric disturbance in Cushing’s syndrome. Am J Psychiatry 142(8):911–916PubMedCrossRef
32.
Mattoo SK, Bhansali AK, Gupta N, Grover S, Malhotra R (2008) Psychosocial morbidity in acromegaly: a study from India. Endocrine 34(1–3):17–22PubMedCrossRef
33.
Leon-Carrion J et al (2010) Evidence of cognitive and neurophysiological impairment in patients with untreated naive acromegaly. J Clin Endocrinol Metab 95(9):4367–4379PubMedCrossRef
34.
Vilar L, Vilar CF, Lyra R, Lyra R, Naves LA (2017) Acromegaly: clinical features at diagnosis. Pituitary 20(1):22–32PubMedCrossRef
35.
Ezzat S et al (1994) Acromegaly. Clinical and biochemical features in 500 patients. Medicine (Baltimore) 73(5):233–240CrossRef
36.
Sievers C, Dimopoulou C, Pfister H, Lieb R, Steffin B, Roemmler J, Schopohl J, Mueller M, Schneider HJ, Ising M, Wittchen HU, Stalla GK (2009) Prevalence of mental disorders in acromegaly: a cross-sectional study in 81 acromegalic patients. Clin Endocrinol 71(5):691–701CrossRef
37.
Korali Z, Wittchen HU, Pfister H, Hofler M, Oefelein W, Stalla GK (2003) Are patients with pituitary adenomas at an increased risk of mental disorders? Acta Psychiatr Scand 107(1):60–68PubMedCrossRef
38.
Grattan-Smith PJ, Morris JGL, Shores EA, Batchelor J, Sparks RS (1992) Neuropsychological abnormalities in patients with pituitary tumours. Acta Neurol Scand 86(6):626–631PubMedCrossRef
39.
Wang X, Tong X, Zou Y, Tian X, Mao Z, Sun Z (2017) The impact on cognitive functions of patients with pituitary adenoma before and after surgery. Neurol Sci 38(7):1315–1321PubMedCrossRef
40.
Peace KA, Orme SM, Thompson AR, Padayatty S, Ellis AW, Belchetz PE (1997) Cognitive dysfunction in patients treated for pituitary tumours. J Clin Exp Neuropsychol 19(1):1–6PubMedCrossRef
41.
Cao C et al (2017) The dysfunction of inhibition control in pituitary patients: evidence from the GoNogo event-related potential study. NeuroReport 28(5):272–278PubMedCrossRef
42.
Pereira AM (2015) Neuropsychological functioning in acromegaly: towards identification of modifiable factors to improve long-term care after remission. Endocrine 50(3):523–525PubMedCrossRef
43.
Sonino N, Ruini C, Navarrini C, Ottolini F, Sirri L, Paoletta A, Fallo F, Boscaro M, Fava GA (2007) Psychosocial impairment in patients treated for pituitary disease: a controlled study. Clin Endocrinol 67(5):719–726CrossRef
44.
Sievers C, Ising M, Pfister H, Dimopoulou C, Schneider HJ, Roemmler J, Schopohl J, Stalla GK (2009) Personality in patients with pituitary adenomas is characterized by increased anxiety-related traits: comparison of 70 acromegalic patients with patients with non-functioning pituitary adenomas and age- and gender-matched controls. Eur J Endocrinol 160(3):367–373PubMedCrossRef
45.
46.
47.
Dorn LD, Burgess ES, Friedman TC, Dubbert B, Gold PW, Chrousos GP (1997) The longitudinal course of psychopathology in Cushing’s syndrome after correction of hypercortisolism. J Clin Endocrinol Metab 82(3):912–919PubMed
48.
Regestein QR, Rose LI, Williams GH (1972) Psychopathology in Cushing’s syndrome. Arch Intern Med 130(1):114–117PubMedCrossRef
49.
Tiemensma J, Biermasz NR, Middelkoop HAM, van der Mast RC, Romijn JA, Pereira AM (2010) Increased prevalence of psychopathology and maladaptive personality traits after long-term cure of Cushing’s disease. J Clin Endocrinol Metab 95(10):E129–E141PubMedCrossRef
50.
Tiemensma J et al (2010) Increased psychopathology and maladaptive personality traits, but normal cognitive functioning, in patients after long-term cure of acromegaly. J Clin Endocrinol Metab 95(12):E392–E402PubMedCrossRef
51.
Nehra R, Grover S, Bhansali A, Khehra N (2009) Effect of corrective surgery on neurocognitive functions in endogenous Cushing syndrome. Endocrinologist 19(5):205–207CrossRef
52.
Starkman MN, Gebarski SS, Berent S, Schteingart DE (1992) Hippocampal formation volume, memory dysfunction, and cortisol levels in patients with Cushing’s syndrome. Biol Psychiatry 32(9):756–765PubMedCrossRef
53.
Hook JN et al (2007) Patterns of cognitive change over time and relationship to age following successful treatment of Cushing’s disease. J Int Neuropsychol Soc 13(1):21–29PubMedCrossRef
54.
Starkman MN, Schteingart DE, Schork MA (1986) Correlation of bedside cognitive and neuropsychological tests inpatients with Cushing’s syndrome. Psychosomatics 27(7):508–511PubMedCrossRef
55.
Starkman MN, Giordani B, Berent S, Schork MA, Schteingart DE (2001) Elevated cortisol levels in Cushing’s disease are associated with cognitive decrements. Psychosom Med 63(6):985–993PubMedCrossRef
56.
Chen YF et al (2013) Neuropsychiatric disorders and cognitive dysfunction in patients with Cushing’s disease. Chin Med J 126(16):3156–3160PubMed
57.
Crespo I, Esther GM, Santos A, Valassi E, Yolanda VG, de Juan-Delago M, Webb SM, Gómez-Ansón B, Resmini E (2014) Impaired decision-making and selective cortical frontal thinning in Cushing’s syndrome. Clin Endocrinol 81(6):826–833CrossRef
58.
Santos A, Resmini E, Crespo I, Pires P, Vives-Gilabert Y, Granell E, Valassi E, Gómez-Anson B, Martínez-Momblán MA, Mataró M, Webb SM (2014) Small cerebellar cortex volume in patients with active Cushing’s syndrome. Eur J Endocrinol 171(4):461–469PubMedCrossRef
59.
Andela CD, van der Werff SJA, Pannekoek JN, van den Berg SM, Meijer OC, van Buchem MA, Rombouts SARB, van der Mast RC, Romijn JA, Tiemensma J, Biermasz NR, van der Wee NJA, Pereira AM (2013) Smaller grey matter volumes in the anterior cingulate cortex and greater cerebellar volumes in patients with long-term remission of Cushing’s disease: a case-control study. Eur J Endocrinol 169(6):811–819PubMedCrossRef
60.
van der Werff SJ et al (2014) Widespread reductions of white matter integrity in patients with long-term remission of Cushing’s disease. Neuroimage Clin 4:659–667PubMedPubMedCentralCrossRef
61.
van der Werff SJ et al (2015) Resting-state functional connectivity in patients with long-term remission of Cushing’s disease. Neuropsychopharmacology 40(8):1888–1898PubMedPubMedCentralCrossRef
62.
Andela CD et al (2015) Cushing’s syndrome causes irreversible effects on the human brain: a systematic review of structural and functional magnetic resonance imaging studies. Eur J Endocrinol 173(1):R1–R14PubMedCrossRef
63.
Santos A, Resmini E, Gómez-Ansón B, Crespo I, Granell E, Valassi E, Pires P, Vives-Gilabert Y, Martínez-Momblán MA, de Juan M, Mataró M, Webb SM (2015) Cardiovascular risk and white matter lesions after endocrine control of Cushing’s syndrome. Eur J Endocrinol 173(6):765–775PubMedCrossRef
64.
Valassi E, Crespo I, Keevil BG, Aulinas A, Urgell E, Santos A, Trainer PJ, Webb SM (2017) Affective alterations in patients with Cushing’s syndrome in remission are associated with decreased BDNF and cortisone levels. Eur J Endocrinol 176(2):221–231PubMedCrossRef
65.
Starkman MN, Giordani B, Gebarski SS, Berent S, Schork MA, Schteingart DE (1999) Decrease in cortisol reverses human hippocampal atrophy following treatment of Cushing’s disease. Biol Psychiatry 46(12):1595–1602PubMedCrossRef
66.
Bourdeau I, Bard C, Forget H, Boulanger Y, Cohen H, Lacroix A (2005) Cognitive function and cerebral assessment in patients who have Cushing’s syndrome. Endocrinol Metab Clin N Am 34(2):357–369CrossRef
67.
Toffanin T, Nifosì F, Follador H, Passamani A, Zonta F, Ferri G, Scanarini M, Amistà P, Pigato G, Scaroni C, Mantero F, Carollo C, Perini GI (2011) Volumetric MRI analysis of hippocampal subregions in Cushing’s disease: a model for glucocorticoid neural modulation. European Psychiatry 26(1):64–67PubMedCrossRef
68.
Bourdeau I et al (2002) Loss of brain volume in endogenous Cushing’s syndrome and its reversibility after correction of hypercortisolism. J Clin Endocrinol Metab 87(5):1949–1954PubMed
69.
Heald AH, Ghosh S, Bray S, Gibson C, Anderson SG, Buckler H, Fowler HL (2004) Long-term negative impact on quality of life in patients with successfully treated Cushing’s disease. Clin Endocrinol 61(4):458–465CrossRef
70.
Michaud K, Forget H, Cohen H (2009) Chronic glucocorticoid hypersecretion in Cushing’s syndrome exacerbates cognitive aging. Brain Cogn 71(1):1–8PubMedCrossRef
71.
Pereira AM, Tiemensma J, Romijn JA (2010) Neuropsychiatric disorders in Cushing’s syndrome. Neuroendocrinology 92(Suppl 1):65–70PubMedCrossRef
72.
Tiemensma J et al (2010) Subtle cognitive impairments in patients with long-term cure of Cushing’s disease. J Clin Endocrinol Metab 95(6):2699–2714PubMedCrossRef
73.
Bas-Hoogendam JM, Andela CD, van der Werff SJA, Pannekoek JN, van Steenbergen H, Meijer OC, van Buchem MA, Rombouts SARB, van der Mast RC, Biermasz NR, van der Wee NJA, Pereira AM (2015) Altered neural processing of emotional faces in remitted Cushing’s disease. Psychoneuroendocrinology 59:134–146PubMedCrossRef
74.
Forget H et al (2000) Cognitive decline in patients with Cushing’s syndrome. J Int Neuropsychol Soc 6(1):20–29PubMedCrossRef
75.
Forget H, Lacroix A, Cohen H (2002) Persistent cognitive impairment following surgical treatment of Cushing’s syndrome. Psychoneuroendocrinology 27(3):367–383PubMedCrossRef
76.
Forget H, Lacroix A, Bourdeau I, Cohen H (2016) Long-term cognitive effects of glucocorticoid excess in Cushing’s syndrome. Psychoneuroendocrinology 65:26–33PubMedCrossRef
77.
Cohen SI (1980) Cushing’s syndrome: a psychiatric study of 29 patients. Br J Psychiatry 136(2):120–124PubMedCrossRef
78.
Sablowski N, Pawlik K, Lüdecke DK, Herrmann HD (1986) Aspects of personality in patients with pituitary adenomas. Acta Neurochir 83(1–2):8–11PubMedCrossRef
79.
Martignoni E, Costa A, Sinforiani E, Liuzzi A, Chiodini P, Mauri M, Bono G, Nappi G (1992) The brain as a target for adrenocortical steroids: cognitive implications. Psychoneuroendocrinology 17(4):343–354PubMedCrossRef
80.
Dorn LD, Cerrone P (2000) Cognitive function in patients with Cushing syndrome a longitudinal perspective. Clin Nurs Res 9(4):420–440PubMedCrossRef
81.
Mao WY, You H, Xing B, Zhu HJ, Feng F (2016) Advances in evaluation of cognitive impairment in patients with Cushing’s disease. Zhongguo Yi Xue Ke Xue Yuan Xue Bao 38(6):735–738PubMed
82.
Wagenmakers MAEM, Netea-Maier RT, Prins JB, Dekkers T, den Heijer M, Hermus ARMM (2012) Impaired quality of life in patients in long-term remission of Cushing’s syndrome of both adrenal and pituitary origin: a remaining effect of long-standing hypercortisolism? Eur J Endocrinol 167(5):687–695PubMedCrossRef
83.
Milian M, Honegger J, Teufel P, Wolf A, Psaras T (2013) Tuebingen CD-25 is a sensitive tool to investigate health-related quality of life in Cushing’s disease patients in the course of the disease. Neuroendocrinology 98(3):188–199PubMedCrossRef
84.
Psaras T, Milian M, Hattermann V, Will BE, Tatagiba M, Honegger J (2011) Predictive factors for neurocognitive function and quality of life after surgical treatment for Cushing’s disease and acromegaly. J Endocrinol Investig 34(7):e168–e177
85.
Yordanova G, Martin L, Afshar F, Sabin I, Alusi G, Plowman NP, Riddoch F, Evanson J, Matson M, Grossman AB, Akker SA, Monson JP, Drake WM, Savage MO, Storr HL (2016) Long-term outcomes of children treated for Cushing’s disease: a single center experience. Pituitary 19(6):612–624PubMedPubMedCentralCrossRef
86.
Mattoo SK, Bhansali AK, Gupta N, Grover S, Malhotra R (2009) Psychosocial morbidity in Cushing disease: a study from India. Endocrine 35(3):306–311PubMedCrossRef
87.
Santos A, Resmini E, Pascual JC, Crespo I, Webb SM (2017) Psychiatric symptoms in patients with Cushing’s syndrome: prevalence, diagnosis and management. Drugs 77(8):829–842PubMedCrossRef
88.
Feelders RA, Pulgar SJ, Kempel A, Pereira AM (2012) The burden of Cushing’s disease: clinical and health-related quality of life aspects. Eur J Endocrinol 167(3):311–326PubMedCrossRef
89.
Ammini AC et al (2014) Etiology and clinical profile of patients with Cushing’s syndrome: a single center experience. Indian J Endocrinol Metab 18(1):99–105PubMedPubMedCentralCrossRef
90.
Jeffcoate WJ, Silverstone JT, Edwards CR, Besser GM (1979) Psychiatric manifestations of Cushing’s syndrome: response to lowering of plasma cortisol. Q J Med 48(191):465–472PubMed
91.
Bratek A et al (2015) Psychiatric disorders associated with Cushing’s syndrome. Psychiatr Danub 27:S339–S343PubMed
92.
Burgess E et al (1996) Sociotropy, autonomy, stress, and depression in Cushing syndrome. J Nerv Ment Dis 184(6):362–367PubMedCrossRef
93.
Cohen SI (1982) Psychiatric aspects of Cushing’s syndrome. Br J Hosp Med 27(5):548PubMed
94.
95.
Frank R, Doerr HG (1989) Mania in a girl with Cushing’s disease. J Am Acad Child Adolesc Psychiatry 28(4):610–611PubMedCrossRef
96.
Starkman MN (2013) Neuropsychiatric findings in Cushing syndrome and exogenous glucocorticoid administration. Endocrinol Metab Clin N Am 42(3):477–488CrossRef
97.
Tang A et al (2013) Psychiatric symptoms as a clinical presentation of Cushing’s syndrome. Ann General Psychiatry 12(1):23CrossRef
98.
99.
Rasmussen SA et al (2015) Cushing disease presenting as primary psychiatric illness: a case report and literature review. J Psychiatr Pract 21(6):449–457PubMedCrossRef
100.
Sonino N, Fallo F, Fava GA (2010) Psychosomatic aspects of Cushing’s syndrome. Rev Endocr Metab Disord 11(2):95–104PubMedCrossRef
101.
Dimopoulou C et al (2013) Increased prevalence of anxiety-associated personality traits in patients with Cushing’s disease: a cross-sectional study. Neuroendocrinology 97(2):139–145PubMedCrossRef
102.
103.
Sonino N, Fava GA (2001) Psychiatric disorders associated with Cushing’s syndrome: epidemiology, pathophysiology and treatment. CNS Drugs 15(5):361–373PubMedCrossRef
104.
Sonino N et al (1993) Course of depression in Cushing’s syndrome:response to treatment and comparison with graves’ disease. Hormone Research in Paediatrics 39(5–6):202–206CrossRef
105.
Sonino N, Fava GA (1998) Psychosomatic aspects of Cushing’s disease. Psychother Psychosom 67(3):140–146PubMedCrossRef
106.
Kelly WF et al (1983) Cushing’s syndrome and depression—a prospective study of 26 patients. Br J Psychiatry 142(1):16–19PubMedCrossRef
107.
Loosen PT (1994) Cushing’s syndrome and depression. Endocrinologist 4(5):373–382CrossRef
108.
Reed K, Watkins M, Dobson H (1983) Mania in Cushing’s syndrome: case report. J Clin Psychiatry 44(12):460–462PubMed
109.
Saad MF et al (1984) Occult Cushing’s disease presenting with acute psychosis. Am J Med 76(4):759–766PubMedCrossRef
110.
Santos A, Resmini E, Martínez-Momblán MA, Crespo I, Valassi E, Roset M, Badia X, Webb SM (2012) Psychometric performance of the CushingQoL questionnaire in conditions of real clinical practice. Eur J Endocrinol 167(3):337–342PubMedCrossRef
111.
Lindsay JR et al (2006) Long-term impaired quality of life in Cushing’s syndrome despite initial improvement after surgical remission. J Clin Endocrinol Metab 91(2):447–453PubMedCrossRef
112.
Tiemensma J, Depaoli S, Felt JM (2016) Using subscales when scoring the Cushing’s quality of life questionnaire. Eur J Endocrinol 174(1):33–40PubMedCrossRef
113.
van der Klaauw AA et al (2008) Disease-specific impairments in quality of life during long-term follow-up of patients with different pituitary adenomas. Clin Endocrinol 69(5):775–784CrossRef
114.
Andela CD et al (2015) Towards a better quality of life (QoL) for patients with pituitary diseases: results from a focus group study exploring QoL. Pituitary 18(1):86–100PubMedCrossRef
115.
Badia X et al (2014) Disease-specific quality of life evaluation and its determinants in Cushing’s syndrome: what have we learnt? Pituitary 17(2):187–195PubMedCrossRef
116.
Ye VC, Akagami R (2017) Perioperative quality of life in Cushing’s disease. Can J Neurol Sci 44(1):69–77PubMedCrossRef
117.
van Dam PS et al (2000) Growth hormone, insulin-like growth factor I and cognitive function in adults. Growth Hormon IGF Res 10(Suppl B):S69–S73
118.
Van Dam PS, Aleman A (2004) Insulin-like growth factor-I, cognition and brain aging. Eur J Pharmacol 490(1–3):87–95PubMed
119.
Oertel H et al (2004) The effect of growth hormone substitution on cognitive performance in adult patients with hypopituitarism. Psychoneuroendocrinology 29(7):839–850PubMedCrossRef
120.
Alibas H et al (2017) Evaluation of depressive mood and cognitive functions in patients with acromegaly under somatostatin analogue therapy. J Endocrinol Investig 40(12):1365–1372CrossRef
121.
Hatipoglu E et al (2015) Acromegaly and aging: a comparative cross-sectional study. Growth Hormone and IGF Research 25(1):47–52PubMedCrossRef
122.
Szcześniak D, Jawiarczyk-Przybyłowska A, Rymaszewska J (2015) The quality of life and psychological, social and cognitive functioning of patients with acromegaly. Adv Clin Exp Med 24(1):167–172PubMedCrossRef
123.
Shan S et al (2017) Evidence of dysexecutive syndrome in patients with acromegaly. Pituitary 20(6):661–667PubMedCrossRef
124.
Brummelman P et al (2012) Effects of previous growth hormone excess and current medical treatment for acromegaly on cognition. Eur J Clin Investig 42(12):1317–1324CrossRef
125.
Martín-Rodríguez JF et al (2013) Neurocognitive function in acromegaly after surgical resection of GH-secreting adenoma versus naïve acromegaly. PLoS One 8(4):e60041PubMedPubMedCentralCrossRef
126.
Sievers C et al (2009) Macroscopic brain architecture changes and white matter pathology in acromegaly: a clinicoradiological study. Pituitary 12(3):177–185PubMedCrossRef
127.
Anagnostis P et al (2014) Psychological profile and quality of life in patients with acromegaly in Greece. Is there any difference with other chronic diseases? Endocrine 47(2):564–571PubMedCrossRef
128.
129.
Crespo I et al (2015) Impaired decision making and delayed memory are related with anxiety and depressive symptoms in acromegaly. Endocrine 50(3):756–763PubMedCrossRef
130.
Avery TL (1973) A case of acromegaly and gigantism with depression. Br J Psychiatry 122(570):599–600PubMedCrossRef
131.
Furman K, Ezzat S (1998) Psychological features of acromegaly. Psychother Psychosom 67(3):147–153PubMedCrossRef
132.
Sivakumar K, Williams M (1991) Psychiatric aspects of acromegaly—a review and case report. Ir J Psychol Med 8(1):55–56CrossRef
133.
Spence S (1995) The psychopathology of acromegaly. Ir J Psychol Med 12(4):142–144CrossRef
134.
135.
Szczesniak DM et al (2017) Is there any difference in acromegaly and other chronic disease in quality of life and psychiatric morbidity? Endokrynol Pol 68(5):524–532PubMed
136.
Siegel S et al (2013) Diagnostic delay is associated with psychosocial impairment in acromegaly. Pituitary 16(4):507–514PubMedCrossRef
137.
Dimopoulou C et al (2017) Body image perception in acromegaly is not associated with objective acromegalic changes but depends on depressive symptoms. Neuroendocrinology 105(2):115–122PubMedCrossRef
138.
Celik O, Kadioglu P (2013) Quality of life in female patients with acromegaly. J Endocrinol Investig 36(6):412–416
139.
Webb SM, Badia X, Surinach NL, Spanish AcroQol Study Group (2006) Validity and clinical applicability of the acromegaly quality of life questionnaire, AcroQoL: a 6-month prospective study. Eur J Endocrinol 155(2):269–277PubMedCrossRef
140.
Yoshida K, Fukuoka H, Matsumoto R, Bando H, Suda K, Nishizawa H, Iguchi G, Ogawa W, Webb SM, Takahashi Y (2015) The quality of life in acromegalic patients with biochemical remission by surgery alone is superior to that in those with pharmaceutical therapy without radiotherapy, using the newly developed Japanese version of the AcroQoL. Pituitary 18(6):876–883PubMedCrossRef
141.
Crespo I, Valassi E, Webb SM (2017) Update on quality of life in patients with acromegaly. Pituitary 20(1):185–188PubMedCrossRef
142.
Matta MP et al (2008) Impaired quality of life of patients with acromegaly: control of GH/IGF-I excess improves psychological subscale appearance. Eur J Endocrinol 158(3):305–310PubMedCrossRef
143.
Andela CD et al (2015) Quality of life (QoL) impairments in patients with a pituitary adenoma: a systematic review of QoL studies. Pituitary 18(5):752–776PubMedCrossRef
144.
Rowles SV et al (2005) Quality of life (QOL) in patients with acromegaly is severely impaired: use of a novel measure of QOL: acromegaly quality of life questionnaire. J Clin Endocrinol Metab 90(6):3337–3341PubMedCrossRef
145.
146.
Keil MF et al (2009) Quality of life in children and adolescents 1-year after cure of Cushing syndrome: a prospective study. Clin Endocrinol 71(3):326–333CrossRef
147.
Biermasz NR et al (2004) Decreased quality of life in patients with acromegaly despite long-term cure of growth hormone excess. J Clin Endocrinol Metab 89(11):5369–5376PubMedCrossRef
148.
Celik O et al (2013) Acromegaly is associated with higher frequency of female sexual dysfunction: experience of a single center. Endocr J 60(6):753–761PubMedCrossRef
149.
Ezzat S et al (1992) Octreotide treatment of acromegaly. A randomized, multicenter study Ann Intern Med 117(9):711–718PubMed
150.
Feldt-Rasmussen U et al (2002) Growth hormone deficiency and replacement in hypopituitary patients previously treated for acromegaly or Cushing’s disease. Eur J Endocrinol 146(1):67–74PubMedCrossRef
151.
Johnson MD, Woodburn CJ, Vance ML (2003) Quality of life in patients with a pituitary adenoma. Pituitary 6(2):81–87PubMedCrossRef
152.
Kauppinen-Makelin R et al (2006) Quality of life in treated patients with acromegaly. J Clin Endocrinol Metab 91(10):3891–3896PubMedCrossRef
153.
Miller A et al (2008) Impact of musculoskeletal disease on quality of life in long-standing acromegaly. Eur J Endocrinol 158(5):587–593PubMedCrossRef
154.
Pantanetti P et al (2003) The quality of life in acromegaly. J Endocrinol Investig 26(8 Suppl):35–38
155.
Papoian V et al (2016) Patients’ perception on clinical outcome and quality of life after a diagnosis of Cushing syndrome. Endocrine practice : official journal of the American College of Endocrinology and the American Association of Clinical Endocrinologists 22(1):51–67CrossRef
156.
Webb SM et al (2002) Acromegaly quality of life questionnaire (ACROQOL) a new health-related quality of life questionnaire for patients with acromegaly: development and psychometric properties. Clin Endocrinol 57(2):251–258CrossRef
157.
Kyriakakis N et al (2017) Impaired quality of life in patients with treated acromegaly despite long-term biochemically stable disease: results from a 5-years prospective study. Clin Endocrinol 86(6):806–815CrossRef
158.
Tiemensma J et al (2015) Persistent negative illness perceptions despite long-term biochemical control of acromegaly: novel application of the drawing test. Eur J Endocrinol 172(5):583–593PubMedCrossRef
159.
Deijen JB et al (2005) Differential effect sizes of growth hormone replacement on quality of life, well-being and health status in growth hormone deficient patients: a meta-analysis. Health Qual Life Outcomes 3
160.
Paisley AN, Rowles SV, Roberts ME, Webb SM, Badia X, Prieto L, Shalet SM, Trainer PJ (2007) Treatment of acromegaly improves quality of life, measured by AcroQol. Clin Endocrinol 67(3):358–362CrossRef
161.
Fujio S et al (2013) Severe growth hormone deficiency is rare in surgically-cured acromegalics. Pituitary 16(3):326–332PubMed
162.
Fujio S et al (2017) Changes in quality of life in patients with acromegaly after surgical remission—a prospective study using SF-36 questionnaire. Endocr J 64(1):27–38PubMedCrossRef
163.
Sardella C et al (2010) Short- and long-term changes of quality of life in patients with acromegaly: results from a prospective study. J Endocrinol Investig 33(1):20–25CrossRef
164.
Geraedts VJ et al (2014) Health outcomes in acromegaly: depression and anxiety are promising targets for improving reduced quality of life. Front Endocrinol 5:229
165.
Crespo I, Webb SM (2014) Perception of health and cognitive dysfunction in acromegaly patients. Endocrine 46(3):365–367PubMedCrossRef
166.
167.
Bala A, Łojek E, Marchel A (2016) Cognitive functioning of patients with a PRL-secreting pituitary adenoma. Neurology 86(8):731–734PubMedCrossRef
168.
169.
Athanasoulia AP et al (2012) Distinct dopaminergic personality patterns in patients with prolactinomas: a comparison with nonfunctioning pituitary adenoma patients and age-and gender-matched controls. Neuroendocrinology 96(3):204–211PubMedCrossRef
170.
Ali S, Miller KK, Freudenreich O (2010) Management of psychosis associated with a prolactinoma: case report and review of the literature. Psychosomatics 51(5):370–376PubMedPubMedCentralCrossRef
171.
Liao WT, Bai YM (2014) Major depressive disorder induced by prolactinoma—a case report. Gen Hosp Psychiatry 36(1):125.e1–125.e2CrossRef
172.
Sandyk R, Bergsneider M, Iacono RP (1987) Acute psychosis in a woman with a prolactinoma. Int J Neurosci 37(3–4):187–190PubMedCrossRef
173.
Reavley A et al (1997) Psychological distress in patients with hyperprolactinaemia. Clin Endocrinol 47(3):343–348CrossRef
174.
Kars M et al (2007) Quality of life is decreased in female patients treated for microprolactinoma. Eur J Endocrinol 157(2):133–139PubMedCrossRef
175.
Cesar de Oliveira Naliato E et al (2008) Quality of life in women with microprolactinoma treated with dopamine agonists. Pituitary 11(3):247–254PubMedCrossRef
176.
Raappana A et al (2012) Long-term health-related quality of life of surgically treated pituitary adenoma patients: a descriptive study. ISRN Endocrinol 2012:675310PubMedPubMedCentral
177.
Brummelman P et al (2011) Cognitive functioning in patients treated for nonfunctioning pituitary macroadenoma and the effects of pituitary radiotherapy. Clin Endocrinol 74(4):481–487CrossRef
178.
Chang HA et al (2007) Mood disorder due to nonfunctioning pituitary adenoma with a major depressive-like episode in a postmenopausal woman. J Med Sci 27(1):41–45
179.
Elbornsson M et al (2017) Seven years of growth hormone (GH) replacement improves quality of life in hypopituitary patients with adult-onset GH deficiency. Eur J Endocrinol 176(2):99–109PubMedCrossRef
180.
Maric NP et al (2010) Psychiatric and neuropsychological changes in growth hormone-deficient patients after traumatic brain injury in response to growth hormone therapy. J Endocrinol Investig 33(11):770–775CrossRef
181.
Webb SM (2008) Measurements of quality of life in patients with growth hormone deficiency. J Endocrinol Investig 31(9 Suppl):52–55
182.
Tanemura E, Nagatani T, Aimi Y, Kishida Y, Takeuchi K, Wakabayashi T (2012) Quality of life in nonfunctioning pituitary macroadenoma patients before and after surgical treatment. Acta Neurochir 154(10):1895–1902PubMedCrossRef
183.
Biermasz NR et al (2011) Patients previously treated for nonfunctioning pituitary macroadenomas have disturbed sleep characteristics, circadian movement rhythm, and subjective sleep quality. J Clin Endocrinol Metab 96(5):1524–1532PubMedCrossRef
184.
Page RCL et al (1997) An account of the quality of life of patients after treatment for non- functioning pituitary tumours. Clin Endocrinol 46(4):401–406CrossRef
185.
Milian M et al (2013) Health-related quality of life and psychiatric symptoms improve effectively within a short time in patients surgically treated for pituitary tumors—a longitudinal study of 106 patients. Acta Neurochir 155(9):1637–1645 discussion 1645 PubMedCrossRef
186.
Peace KA et al (1998) Cognitive dysfunction in patients with pituitary tumour who have been treated with transfrontal or transsphenoidal surgery or medication. Clin Endocrinol 49(3):391–396CrossRef
187.
Baum HB et al (1998) Effects of physiological growth hormone (GH) therapy on cognition and quality of life in patients with adult-onset GH deficiency. J Clin Endocrinol Metab 83(9):3184–3189PubMed
188.
Brummelman P et al (2015) Cognition and brain abnormalities on MRI in pituitary patients. Eur J Radiol 84(2):295–300PubMedCrossRef
189.
Noad R et al (2004) Evaluation of the effect of radiotherapy for pituitary tumours on cognitive function and quality of life. Clin Oncol (R Coll Radiol) 16(4):233–237CrossRef
190.
Petry C et al (2011) Assessment of cognitive function, mood, and quality of life in hypopituitary patients after pituitary adenomectomy with or without radiotherapy. International Journal of Endocrinology and Metabolism 9(2):306–310CrossRef
191.
van Beek AP et al (2007) Radiotherapy is not associated with reduced quality of life and cognitive function in patients treated for nonfunctioning pituitary adenoma. Int J Radiat Oncol Biol Phys 68(4):986–991PubMedCrossRef
192.
Van Der Klaauw AA et al (2008) Previous radiotherapy negatively influences quality of life during 4 years of follow-up in patients cured from acromegaly. Clin Endocrinol 69(1):123–128CrossRef
193.
194.
Jackson IM, Noren G (1999) Role of gamma knife therapy in the management of pituitary tumors. Endocrinol Metab Clin N Am 28(1):133–142CrossRef
195.
Armstrong CL et al (2002) Late cognitive and radiographic changes related to radiotherapy: initial prospective findings. Neurology 59(1):40–48PubMedCrossRef
196.
Murovic J, Chang S (2012) Neurocognitive changes in pituitary adenoma patients after fractionated external beam radiotherapy versus gamma knife radiosurgery. World Neurosurgery 78(1–2):53–57PubMedCrossRef
197.
Lee IT, Lin SY, Sheul WH (2003) Mood disorder and secondary adrenal insufficiency after pituitary tumor operation and radiotherapy. J Chin Med Assoc 66(6):375–378PubMed
198.
Sonino N et al (2006) Personality characteristics and quality of life in patients treated for Cushing’s syndrome. Clin Endocrinol 64(3):314–318CrossRef
199.
Alcalar N et al (2013) Evaluation of depression, quality of life and body image in patients with Cushing’s disease. Pituitary 16(3):333–340PubMedCrossRef
Metadata
Title
Pituitary adenomas and neuropsychological status: a systematic literature review
Authors
Marta Pertichetti
Simona Serioli
Francesco Belotti
Davide Mattavelli
Alberto Schreiber
Carlo Cappelli
Alessandro Padovani
Roberto Gasparotti
Piero Nicolai
Marco M. Fontanella
Francesco Doglietto
Publication date
01-08-2020
Publisher
Springer Berlin Heidelberg
Published in
Neurosurgical Review / Issue 4/2020
Print ISSN: 0344-5607
Electronic ISSN: 1437-2320
DOI
https://doi.org/10.1007/s10143-019-01134-z

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