Crespo Iris, Santos Alicia, Valassi Elena, Pires Patricia, Webb Susan M, Resmini Eugenia
Endocrinology/Medicine Department, Hospital Sant Pau, Centro de Investigación Biomédica en Red de Enfermedades Raras (CIBER-ER, Unidad 747), IIB-Sant Pau, ISCIII and Universitat Autònoma de Barcelona (UAB), Barcelona, Spain.
INNDACYT, CR Laureà Miró, 107, Sant Feliu de Llobregat, Barcelona, Spain.
Endocrine. 2015 Dec;50(3):756-63. doi: 10.1007/s12020-015-0634-6. Epub 2015 May 28.
Evaluation of cognitive function in acromegaly has revealed contradictory findings; some studies report normal cognition in patients with long-term cured acromegaly, while others show attention and memory deficits. Moreover, the presence of affective disorders in these patients is common. Our aim was to evaluate memory and decision making in acromegalic patients and explore their relationship with affective disorders like anxiety and depressive symptoms. Thirty-one patients with acromegaly (mean age 49.5 ± 8.5 years, 14 females and 17 males) and thirty-one healthy controls participated in this study. The Iowa Gambling Task (IGT), Rey Auditory Verbal Learning Test, State-Trait Anxiety Inventory, and Beck Depression Inventory-II (BDI-II) were used to evaluate decision making, verbal memory, anxiety, and depressive symptoms, respectively. Acromegalic patients showed impairments in delayed verbal memory (p < 0.05) and more anxiety and depressive symptoms (p < 0.05) than controls. In the IGT, acromegalic patients presented an altered decision-making strategy compared to controls, choosing a lower number of the safer cards (p < 0.05) and higher number of the riskier cards (p < 0.05). Moreover, multiple correlations between anxiety and depressive symptoms and performance in memory and decision making were found. Impaired delayed memory and decision making observed in acromegalic patients are related to anxiety and depressive symptoms. Providing emotional support to the patients could improve their cognitive function. A key clinical application of this research is the finding that depressive symptoms and anxiety are essentially modifiable factors.
肢端肥大症患者认知功能的评估结果相互矛盾;一些研究报告称,长期治愈的肢端肥大症患者认知功能正常,而另一些研究则显示其存在注意力和记忆缺陷。此外,这些患者中情感障碍很常见。我们的目的是评估肢端肥大症患者的记忆和决策能力,并探讨它们与焦虑和抑郁症状等情感障碍之间的关系。31例肢端肥大症患者(平均年龄49.5±8.5岁,14例女性,17例男性)和31名健康对照者参与了本研究。爱荷华赌博任务(IGT)、雷伊听觉词语学习测验、状态-特质焦虑量表和贝克抑郁量表第二版(BDI-II)分别用于评估决策能力、言语记忆、焦虑和抑郁症状。肢端肥大症患者在言语延迟记忆方面存在损害(p<0.05),且焦虑和抑郁症状比对照组更多(p<0.05)。在IGT中,与对照组相比,肢端肥大症患者的决策策略发生了改变,选择较安全牌的数量较少(p<0.05),而选择风险较高牌的数量较多(p<0.05)。此外,还发现焦虑和抑郁症状与记忆和决策能力表现之间存在多重相关性。肢端肥大症患者观察到的延迟记忆和决策能力受损与焦虑和抑郁症状有关。为患者提供情感支持可以改善他们的认知功能。这项研究的一个关键临床应用是发现抑郁症状和焦虑本质上是可改变的因素。