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垂体功能减退症患者的神经心理学功能受损。

Impaired neuropsychological functioning in patients with hypopituitarism.

机构信息

Amsterdam UMC, Vrije Universiteit Amsterdam, Department of Internal Medicine, Section of Endocrinology, Amsterdam Neuroscience Amsterdam The Netherlands.

Hersencentrum Mental Health Institute Amsterdam The Netherlands.

出版信息

Endocrinol Diabetes Metab. 2020 Jun 29;4(1):e00165. doi: 10.1002/edm2.165. eCollection 2021 Jan.

Abstract

BACKGROUND

Treatment of pituitary pathology mostly does not result in complete recovery of impairment in cognitive functioning. The primary aim of the current study was to assess cognitive impairment in patients with stable replacement therapy for hypopituitarism during the last 6 months prior to inclusion. It was expected that patients showed subjective and objective subnormal scores on neuropsychological functioning.

METHODS

Forty-two patients (40% men, 49 ± 15 years) treated for hypopituitarism conducted a neuropsychological test battery, including the Cognitive Failures Questionnaire (CFQ), 15-Word test (15-WT), Cambridge Neuropsychological Test Automated Battery (CANTAB) Motor Screening Task (MOT), Spatial Working Memory (SWM) and Affective Go/No-go (AGN). Results were compared to reference values of healthy norm groups.

RESULTS

Male and female participants scored significantly worse on the CFQ ( < .01,  = 0.91-4.09) and AGN mean correct latency ( < .01,  = 1.66 and 1.29, respectively). Female participants scored significantly worse on 15-WT direct recall ( = .01,  = 0.66), 15-WT delayed recall ( = .01,  = 0.79), SWM total errors ( = .05,  = 0.41), SWM strategy ( = .04,  = 0.43), AGN errors of commission ( = .02,  = 0.56) and omission ( = .04,  = 0.41).

CONCLUSION

This study shows that subjective cognitive functioning is worse in patients treated for hypopituitarism compared to reference data. Also, female participants treated for hypopituitarism score worse on objective aspects of memory and executive functioning compared to reference data. Besides worse focus attention, this objective cognitive impairment was not found in male participants. It is recommended to conduct additional research, which focuses on the design and evaluation of a cognitive remediation therapy, aimed at compensation of impairments in different aspects of memory and executive functioning.

摘要

背景

治疗垂体病变大多不能完全恢复认知功能障碍。本研究的主要目的是评估纳入前 6 个月接受稳定替代治疗的垂体功能减退症患者的认知障碍。预计患者在神经心理功能上表现出主观和客观的低于正常分数。

方法

42 名(40%为男性,49±15 岁)接受垂体功能减退症治疗的患者进行了神经心理测试,包括认知失败问卷(CFQ)、15 字测试(15-WT)、剑桥神经心理测试自动化电池(CANTAB)运动筛查任务(MOT)、空间工作记忆(SWM)和情感 Go/No-go(AGN)。结果与健康对照组的参考值进行了比较。

结果

男性和女性参与者在 CFQ 上的得分明显较差(<0.01,=0.91-4.09),AGN 平均正确潜伏期也明显较差(<0.01,=1.66 和 1.29)。女性参与者在 15-WT 直接回忆(=0.01,=0.66)、15-WT 延迟回忆(=0.01,=0.79)、SWM 总错误(=0.05,=0.41)、SWM 策略(=0.04,=0.43)、AGN 错误的发生率(=0.02,=0.56)和遗漏(=0.04,=0.41)上的得分明显较差。

结论

本研究表明,与参考数据相比,接受垂体功能减退症治疗的患者主观认知功能更差。此外,接受垂体功能减退症治疗的女性参与者在记忆和执行功能的客观方面的得分也比参考数据差。除了注意力不集中外,男性参与者没有发现这种客观的认知障碍。建议进行额外的研究,重点是设计和评估认知矫正治疗,旨在补偿记忆和执行功能不同方面的损伤。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/45ee/7831215/4a0372aaf932/EDM2-4-e00165-g001.jpg

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