Analysis Of Related Factors Of Cognition Disorderst In Patients With Pituitary Adenoma

Objective:To clarify the presence of cognitive dysfunction in patients with pituitary adenoma and to explore the factors affecting it.Methods:1.Clinical data from 40 patients with pituitary adenoma and 40 healthy controls were collected for the study.The patient groups were divided into functional and non-functional groups based on endocrine function,and the functional groups were further divided into growth hormone,prolactin and adrenocorticotropic groups;aggressive and non-aggressive groups based on tumor biological behavior;and T-pit spectrum,PIT-1 spectrum and SF-1 spectrum groups,and high-risk and non-high-risk groups based on patient pathological diagnosis.All control group members were immediate relatives from the patient group with similar age,sex,and education.2.All subjects in the patient group underwent pituitary magnetic resonance imaging,pituitary hormone level testing,visual acuity,and visual field examination during their hospitalization in the Department of Neurosurgery I of the First Affiliated Hospital of Kunming Medical University.The Montreal Cognitive Assessment Scale and the Simple Mental Status Examination Scale were used to test and assess the cognitive function of the patient group and the control group.Basic information such as age,gender,and educational water was collected from the patient group and the control group.3.Statistical tests of cognitive function were performed using one-way ANOVA for the functional versus non-functional groups.Statistical tests of cognitive function in the invasive versus non-invasive group using two independent samples t-test and wilcoxon signed rank sum test,and cognitive function before and after surgery using paired samples t-test.Correlation analysis of cognitive function with tumor volume and aggressiveness,and correlation analysis of growth hormone,lactogen and cortisol levels with cognitive function,using Spearman’s correlation coefficient test.Finally,multiple linear regression analysis was performed to analyze the influencing factors leading to cognitive impairment.Results:1.A comparison of 80 subjects after controlling for age,gender,and education level found that the patient group had significantly lower cognitive function scores than the control group(P<0.001).Differences were mainly in the areas of visuospatial and executive function,attention,and recall.Gender,age,tumor stroke,comorbid diabetes,or hypertension are not risk factors for cognitive dysfunction in patients with pituitary adenoma.2.Subgroup analysis of tumor volume and tumor aggressiveness revealed that tumor aggressive growth direction and degree of growth had no significant effect on cognitive function,and there was a negative correlation between tumor volume and disorientation in patients with pituitary adenoma(r=-0.361,P=0.022).3.Comparing patients with functional pituitary adenoma and patients without functional pituitary adenoma,cognitive function scores were found to be significantly lower in the functional group than in the non-functional group(P<0.05).4.Patients with functional pituitary adenoma were further grouped into growth hormone,prolactin and pro-adrenocorticotropic hormone groups and then compared(P<0.05).Correlation analysis of hormone levels and cognitive function scores suggested a significant negative correlation between lactogen and cognitive function(MoCA scale r=-0.41,P<0.01,MMSE scale r=-0.31,P=0.04).5.Patients with pituitary adenoma were divided into three groups according to the type of tumor pathology,with the pit-1 spectrum group having significantly lower MoCA scale scores than the T-pit spectrum and SF-1 spectrum groups(P<0.01),MMSE scale scores were significantly lower than those of the SF-1 spectrum group(P<0.01).6.Multiple linear regression analysis was performed and the regression equation was statistically significant(MoCA scale F1=2.663,P1=0.039;MMSE scale F2=4.244,P2=0.004),with age(β=-0.358,P=0.028),GH level(β=-0.398,P=0.014),and PRL level(β=-0.303,P=0.050)significantly affecting MoCA scale scores,and age(β=-0.360,P=0.017),GH level(β=-0.520,P=0.001),PRL level(β=-0.347,P=0.020),and 8AM-ACTH level(β=0.322,P=0.029)significantly affecting MMSE scale scores.7.All patients showed significant improvement in cognitive functions such as executive function,attention and recall after surgical treatment(P<0.05).Conclusion:1.Patients with pituitary adenomas have significant mild cognitive impairment.2.Tumor volume was negatively correlated with orienting power,but had no significant effect on other higher neurological functions.3.Growth hormone had a greater effect on cognitive function than cortisol,and prolactin was negatively associated with cognitive function.4.Patients with pituitary adenomas on the pit-1 spectrum perform worse on cognitive function tests.5.Age,growth hormone levels,prolactin levels,and adrenocorticotropic hormone levels are factors that cause altered cognitive function in patients with pituitary adenoma.6.The cognitive function of pituitary adenoma patients could be improved after receiving endoscopic surgery.