ECE2015 Eposter Presentations Pituitary: clinical (121 abstracts)
Psychological and neurocognitive evaluation in patients with pituitary adenoma
Elisa Sala 1, , Barbara Zarino 3 , Elena Malchiodi 1, , Elisa Verrua 1, , Giulia Carosi 1, , Marco Locatelli 3 , Paolo Rampini 3 , Giorgio Carrabba 3 , Anna Spada 1, & Giovanna Mantovani 1,
1Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy; 2Endocrinology and Diabetology Unit, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Milan, Italy; 3Unit of Neurosurgery, Fondazione IRCCS C Granda Ospedale Maggiore Policlinico, Milan, Italy.
Reduced health-related quality of life (HRQoL) and impairment in neurocognitive functions are a possible complaint in patients with pituitary adenoma. Psychiatric comorbidities in Cushing’s disease are well known. However recent studies showed HRQoL reduction and psychiatric symptoms in patients with pituitary disease with or without hormonal excess. Aim of this study is to analyse HRQoL, psychiatric symptoms and neurocognitive functions in patients with pituitary adenomas, with either Cushing’s disease or non-functioning pituitary adenoma (NPFA) before and after surgery. Through three validated questionnaires (SF-36, BDI-II, MMPI-II) and an interview with a psychologist, we assessed HRQoL, psychiatric symptoms and neurocognitive functions in 20 adult patients (age 49.6±11.4, M/F=12/8) harboring pituitary tumors (ten Cushing’s disease and ten NPFA, macro/micro=12/8). We conducted a baseline measurement before transphenoidal surgery as well as after 12 months. All Cushing’s patients were in remission at the follow-up visit and pituitary deficiencies, when present, were adequately substituted. 20 healthy subjects, age- and sex-matched, were analysed as controls. Regarding HRQoL, patients with NFPA did not show significant differences compared to controls. On the contrary, patients with Cushing’s disease had significantly lower HRQoL than NFPA and controls in all scales of SF-36 questionary, both at baseline and at follow-up. At follow-up NFPA patients showed an improvement in all scales while patients with Cushing improved only in role-physical and general health ones. Furthermore, BDI-II and MPI-II scales showed a significant increase of depression (P=0.045) and social inversion (P=0.031) in the Cushing’s group. Lastly, both groups of patients, without any difference, showed a significant impairment in all neurocognitive functions tests at baseline compared to controls. At follow up, though, the difference had disappeared. According to the literature, this study confirms that Cushing’s disease leads to a much larger impact on HRQoL and psychiatric comorbidities, with significant improvement after treatment but without a complete remission, probably due to irreversible changes in neural function. Interestingly, however, neurocognitive impairment is present and appears in all patients with pituitary tumors, independently of hormone secretion.
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Endocrine Abstracts
ISSN 1470-3947 (print) | ISSN 1479-6848 (online)
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