Introduction: The patients with pituitary tumor could experience neurocognitive deficit. The tumor may compress adjacent structures such as optic nerve, third ventricular floor, mammillary body, and hypothalamus. The endocrine dysfunction such as low levels of cortisol is associated with memory function decline. In general, transsphenoid surgery is considered less invasive then transcranial surgery. Therefore, we conducted this prospective study to evaluate the neurocognitive function change before and after the operation.
Methods: This is a prospective, longitudinal study since January, 2012. We performed nerocognitive studies at three time points, which were before operation, 3 months after operation, and 6 months after operation.
The neurocognitive tests included, MMSE, WAIS 3rd Taiwan ed, Wisconsin Card Sorting Test - Modeified, Trail Making Test, Word Sequence Learning Test, Paced Auditory Serial Addition Test. The Quwstionnaires included, piutitary symptoms scale, Beck depression inventory, Beck anxiety inventory (Self-access), Beck anxiety inventory (Family-access), WHO QOL, NTU irritability scale (Self-access), NTU irritability scale (Family-access).
Results: There were 36 cases enrolled. Patients with nonfunctional pituitary macroadenma have mild impairment of neurocognitive function, and it was partially reversed by transsphenoidal operation.
Emontional disturbance also improved after surgery. The tumor mass effect exerted negative effect on cognitive function and affected adversely the quality of life.
Conclusions: Large tumor size, apoplexy, and 3rd ventricular compression could result in more neuroognitive function impairment. Quality of life is influenced by mood and tumor mass effect.
Patient Care: Be ware of this situation and have better patient education
Learning Objectives: By the conclusion of this session, participants should be able to: 1) Stay aware of the neurocognitive decline of the pituitary, 2) Transsphenoidal surgery could reverse the nurocognitive deficit.