EP1067 - ECE_2795 - Changes in cognitive and psychological functioning in patients with prolactinoma after treatment

European Journal of Endocrinology, vol. 195

Abstract

Abstract Objective To examine the reversibility of cognitive impairment and psychological complaints in patients with prolactinomas following treatment and subsequent biochemical control. Methods Sixteen patients, among whom 13 (81.3%) females, with active hyperprolactinemia and without any comorbidities potentitally affecting cognition (depressive disorders, anxiety disorders, subtracne abuse) were included. In this prospective longitudinal study, 16 patients, underwent comprehensive neuropsychological assessment (8 cognitive tests and 7 validated questionnaires) at baseline. All 16 patients were re-evaluated after a mean of 19.8 months of follow-up. Results Following biochemical remission, significant improvements were observed in delayed verbal memory (Rey 15-words delayed recall: 11.0 ± 2.5 vs 12.3 ± 2.7, P = .004) and executive functioning, specifically planning (D-KEFS Tower Test: 10.8 ± 2.9 vs 12.9 ± 2.6, P < .001) and cognitive flexibility (TMT-B 59.5[49.3 − 71.5] vs 47.4[40.3 − 60.0] sec, P = .011). Also, selective attention errors (Digit Deletion Test) decreased significantly (3.5[2.0-5.0] vs 1.0[0.0-3.8]), P = .014). Disease-specific quality of life improved significantly at both burden (LBNQ-Bothers: 22.4[10.8-33.5] vs 13.4[5.3-15.9], P = .001) and care needs (LBNQ-Needs: 23.5[7.8-36.6] vs 13.9[1.5-23.5], P < .001). Furthermore, reductions were seen in fatigue (FSS: 41.4 ± 14.8 vs 31.3 ± 15.5, P = .026) and depressive symptoms (HADS-D: 5.5[2.0-7.8] vs 1.0[1.0-7.0], P = .013). Higher baseline prolactin levels were associated with less improvement in verbal memory (immediate learning phase, Verbal Learning Test of Rey: rS = −0.58, P = .019). Conclusions Cognitive deficits in prolactinoma patients are largely reversible state-dependent impairments that resolve significantly upon biochemical control. While substantial recovery occurs in memory and executive functioning, severe baseline hyperprolactinemia may reduce the recovery trajectory of immediate verbal memory.

Authors 6

1. Iris C. M. Pelsma Aachen Endocrinology

   Leiden University Medical Center

   Affiliation as printed

   Endocrinology, Leiden University Medical Center , Leiden ,

2. Willem Verbeek Aachen Endocrinology

   Leiden University Medical Center

   Affiliation as printed

   Endocrinology, Leiden University Medical Center , Leiden ,

3. Victoria River van Trigt Aachen Endocrinology

   Leiden University Medical Center

   Affiliation as printed

   Endocrinology, Leiden University Medical Center , Leiden ,

4. Leontine E. H. Bakker Aachen Endocrinology

   Leiden University Medical Center

   Affiliation as printed

   Endocrinology, Leiden University Medical Center , Leiden ,

5. Cornelie D. Andela Aachen Endocrinology

   Leiden University Medical Center

   Affiliation as printed

   Endocrinology, Leiden University Medical Center , Leiden ,

6. Nienke Ruurdje Biermasz Aachen Endocrinology

   Leiden University Medical Center

   Affiliation as printed

   Endocrinology, Leiden University Medical Center , Leiden ,