The impairment of cognitive function found in patients treated for pituitary adenomas has been associated with the effects of conventional radiotherapy (CR). Our aim was to compare the results of an examination of verbal memory function in acromegalic patients treated with transsphenoidal surgery (TS) alone to those obtained from patients treated with TS followed by CR. We retrospectively compared these two outcome groups and carried out a story recall test that included free and stimulated recalls, immediately and 20 minutes after auditory presentation. 66 patients, 26 men and 40 women, aged 55.2±12.4 years, with an average duration of symptoms before diagnosis of 5.1±3.7 years, were included in this study. Forty-two patients were treated only by TS and 24 received additional CR. There were no significant differences between groups in sex, age, average duration of symptoms before diagnosis, and mean GH and IGF-1 levels before TS (18.1 and 21.1 μg/l for GH, and 820.1 and 889 μg/l for IGF-1, respectively in both radiated and not radiated groups). Although there were more pituitary deficits in the radiated group when their verbal memory was assessed, the prevalence of growth hormone deficiency was similar in both groups, as well as the percentage of patients meeting cure criteria. The CR group performed significantly worse in the immediate recall, either free, with mean scores based on age-adjusted normative data of 23.4 and 39.2, for CR and not CR groups (P=0.001), or after questions, showing scores of 23.3 and 39.3 (P=0.001). These differences increased in the delayed recall, where mean scores were 20.6 and 40.2 for free recall (P<0.0001), and 18.1 and 42.2 after questions (P<0.0001). In our study, postoperative CR in patients with acromegaly is associated with a decrease in verbal memory function when compared to TS alone.
03 - 07 May 2008
European Society of Endocrinology