Surgery and radiotherapy are used in the treatment of pituitary tumours. Treatment regimens for pituitary tumours vary depending upon perceived risks of radiotherapy.
The aim of the study was to determine whether pituitary disease itself, surgery or radiotherapy, affect cognitive function. This was a controlled prospective design. Two groups were studied, transphenoidal adenomectomy (TSA) pituitary patients (active), and functional endoscopic sinus surgery (FESS) patients (control). TSA patients received radiotherapy post surgery if clinically necessary.
All participants (aged 18-65) completed assessments of cognitive function, pre-surgery, three and twelve months post surgery. The tests chosen were standardised neuropsychological tests. The results for the two groups pre-surgery and three months post surgery are presented.
There were 64 TSA patients and 36 FESS patients recruited to the study. Between group demographics were compared, there were no significant differences on age, TSA mean 47.42 (sd 10.84) years, FESS mean 43.08 (sd 10.84) years (t=1.922, df=98, p=0.058), pre-morbid IQ, TSA mean 100.97 (sd 13.45), FESS mean 104.94 (sd 13.16) (t=-1.422, df=98, p=0.158) and gender TSA 40.6 percent male, FESS 38.9 percent male, (Chi square=0.029, df=1, p= 0.865).
Cognitive assessment scores were compared using Mann-Whitney U tests. Pre-surgery -there were significant differences between groups on Adult Memory and Information Processing Battery (AMIPB) List Learning (U=690, p=0.009), AMIPB List Recall (U=715.5, p=0.016), Rey Figure Copy (U=687, p=0.002) and Rey Figure Delayed Recall (U=688.5, p=0.002). At three months post surgery significant differences were shown on AMIPB List Learning (U=445, p=0.013) and Rey Figure Delayed Recall (U=325, p=0.001).
Prior to surgery the TSA group showed significantly lower scores than the control group, indicating a deficit. This may indicate a disease effect on learning and memory. Surgery was not detrimental to cognitive function. There were no significant differences in other cognitive functions.
22 - 24 Mar 2004
British Endocrine Societies