Learning Objective 1: 1. Describe the assessment of disease specific cognitive function and dysfunction.
Learning Objective 2: 2. Relate cognitive dysfunction to treatment outcomes in a disease specific population.
The prevalence of pituitary tumors (PT) has been estimated from 15 % of all brain tumors. Both physiologic and psychologic functions can be disturbed, affecting the individual’s life functions and quality(Qol). PT are classified by size and hormonal productivity: Macroadenomas (MA) > 1cm and microadenomas (mA) <1cm tumors; those producing excess hormonal secretions as functional adenomas (FA) and those with normal hormonal function as non-functional adenomas (NFA).
Hormonal deficiencies can occur in association with all PTs. Patient complaints of cognitive dysfunction and QoL changes have been validated to occur in patients with hormonally active tumors, but not for patients with microadenomas and non-functional tumors.
To determine if cognitive deficits are perceived by patients with NFmA when compared to patients with NFMA.
Cognitive function was evaluated using a modified, disease specific version of the FACT-Cog questionnaire, limited to perception of cognitive capacity. Perceived ability to learn and concentrate, distractibility, mental agility, factual and short term memory and verbal recall were evaluated and scored on a 6 point Likert scale from none to very much dysfunction.
28 pre treatment patients enrolled, 14 in each group (8F/6M). Neither group reported co-morbidities, and pituitary deficiencies were similar and the mean age in mA group was younger (37vs 51years). 26 patients reported experiencing one or more cognitive dysfunction(s). There was a significantly greater perception of cognitive function for patients with NFmA (M=3.3, SD=1.13) than NFMA (M=2.6, SD=6.1) t (27)=2.33, p = 0.027). This was consistent for all parameters except memory, which was perceived as equally problematic.
Patients with PTs perceive cognitive dysfunction regardless of the size of tumor. Further evaluation is warranted to determine if this translates to performance deficits. Likewise, the etiology of cognitive deficits requires further elucidation.