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成年患者经蝶窦显微手术后执行功能比情节记忆恢复得更早——一项纵向研究。

Executive functions recover earlier than episodic memory after microsurgical transsphenoidal resection of pituitary tumors in adult patients--a longitudinal study.

机构信息

Department of Neurosurgery, University Hospital Tuebingen, Hoppe-Seyler-Strasse 3, 72076 Tuebingen, Germany.

出版信息

J Clin Neurosci. 2011 Oct;18(10):1340-5. doi: 10.1016/j.jocn.2011.01.027. Epub 2011 Jul 22.

Abstract

Pituitary tumors may lead to cognitive dysfunction, and the most prevalent deficits are impaired memory and attention. To investigate whether memory and executive functions improve after surgical treatment we performed a prospective longitudinal study comprising 106 patients with pituitary tumors. Psychometric evaluation was performed with the d2-Letter Cancellation test, the Trail Making test, the Digit Span test and the Intelligence Structure test-Verbal Memory test at three timepoints: preoperatively, and at 3 months and 12 months after surgery. The preoperative and postoperative maximum suprasellar tumor extension and hormone status was assessed in all participants. The main finding was that concentration, working memory, and attentional speed improved significantly within the first 3 months after surgery (p<0.05), while improvement of episodic memory was not observed until 12 months after surgery (p<0.001). In the patients harbouring non-functioning adenomas, prolactinomas or other sellar lesions, the most important factor promoting improvement of neurocognitive function was the removal of the suprasellar tumor extension.

摘要

垂体瘤可能导致认知功能障碍,最常见的缺陷是记忆力和注意力受损。为了研究手术治疗后记忆和执行功能是否改善,我们进行了一项前瞻性纵向研究,纳入了 106 例垂体瘤患者。使用 d2 字母删除测试、连线测试、数字跨度测试和智力结构测试-言语记忆测试在三个时间点进行心理测量评估:术前,以及术后 3 个月和 12 个月。所有参与者均评估术前和术后最大鞍上肿瘤扩展和激素状态。主要发现是,术后 3 个月内注意力、工作记忆和注意力速度显著改善(p<0.05),而情景记忆的改善直到术后 12 个月才观察到(p<0.001)。在存在无功能腺瘤、泌乳素瘤或其他鞍内病变的患者中,促进神经认知功能改善的最重要因素是切除鞍上肿瘤扩展。

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