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Pituitary adenomas and neuropsychological status: a systematic literature review

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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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Funding

MP work was funded by a University of Brescia research grant.

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Authors and Affiliations

  1. Unit of Neurosurgery, Department of Medical and Surgical Specialties, Radiological Sciences, and Public Health, University of Brescia, Largo Spedali Civili, 1, 25123, Brescia, Italy

    Marta Pertichetti, Simona Serioli, Francesco Belotti, Marco M. Fontanella & Francesco Doglietto

  2. Unit of Otorhinolaryngology, Department of Surgical Specialties, Radiological Sciences, and Public Health, University of Brescia, Brescia, Italy

    Davide Mattavelli, Alberto Schreiber & Piero Nicolai

  3. Unit of Endocrinology, Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy

    Carlo Cappelli

  4. Unit of Neurology, Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy

    Alessandro Padovani

  5. Unit of Neuroradiology, Department of Surgical Specialties, Radiological Sciences, and Public Health, University of Brescia, Brescia, Italy

    Roberto Gasparotti

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Pertichetti, M., Serioli, S., Belotti, F. et al. Pituitary adenomas and neuropsychological status: a systematic literature review. Neurosurg Rev 43, 1065–1078 (2020). https://doi.org/10.1007/s10143-019-01134-z

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