Assessment of Desmopressin-enhanced Cognitive Function in a Neurosurgical Patient

Dons, Robert F.; House, John F.; Hood, Daniel; Krehbiel, Maryann

doi:10.1093/milmed/154.2.83

Cited by 6 publications

(4 citation statements)

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“…(Table 1) This confirms that effects of desmopressin on ECT-induced memory impairment persist with the continuing administration. This result supports the research by Dons et al (15), which revealed that effects of desmopressin continue with continued administration but will be decreased within a week after discontinuation of drug. In this study we only evaluated the effects of the drug until the last day of administration.…”

Section: Discussionsupporting

confidence: 91%

Effects of desmopressin (DDAVP) on memory impairment following electroconvulsive therapy (ECT)

Abdollahian

Sargolzaee

Hajzade

et al. 2004

Acta Neuropsychiatr.

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Section: Discussionsupporting

confidence: 91%

Effects of desmopressin (DDAVP) on memory impairment following electroconvulsive therapy (ECT)

Abdollahian

Sargolzaee

Hajzade

et al. 2004

Acta Neuropsychiatr.

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“…Neuropsychological studies of patients who have received radiotherapy for nasopharyngeal carcinoma have also found cognitive deficits when compared with newly diagnosed and untreated patients 12 However, Dons et al 31 cited a patient who had a trans-sphenoidal hypophysectomy without postoperative radiotherapy, who manifested memory deficits which impaired her work but which showed improvement on treatment with desmopressin acetate (DDAVP) replacement therapy, suggesting a possible hormonal contribution to the disorder. Patient 1 in the present series showed a particularly severe memory deficit (a 49 point IQ-GMQ discrepancy), and we know that the structures affected by the 90% irradiation dose in her case included the mammillary bodies, the mammillothalamic tract, the anterior thalamus, and the fornix, all of which are known to be critical for memory formation 5…”

Section: Discussionmentioning

confidence: 99%

Cognitive effects of pituitary tumours and their treatments: two case studies and an investigation of 90 patients

Guinan

Lowy

Stanhope

et al. 1998

Journal of Neurology, Neurosurgery & Psychiatry

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Objectives-Two case studies are reported of patients with pituitary adenomas who had been treated with trans-sphenoidal surgery, one with and one without adjunctive radiotherapy, in whom memory impairment was found. Further to this, neuropsychological investigations of 90 patients were carried out (1) to establish the prevalence of such deficits, and (2) to try to determine their cause. Methods-Two case studies are described. For the expanded study, patients were recruited from the data base of the endocrinology department of St Thomas's Hospital, London, if they had previously been treated for a pituitary adenoma in the past 30 years. Ninety patients were contacted and assessed with a wide range of neuropsychological tests. They were divided into five treatment groups: those who had received transfrontal surgery with radiotherapy, trans-sphenoidal surgery with or without radiotherapy, radiotherapy only, and a bromocriptine therapy group, as well as a group of 19 healthy control subjects matched for age and sex. Results-In the two patients presented, both showed severe memory impairments compared with their intact intellectual ability. The more severely aVected patient had received adjunctive radiotherapy, and superimposition of the 90% isodose fields on a postoperative MRI examination suggested involvement of the diencephalic structures. In the group study, significant deficits in anterograde memory were also obtained on two measures (WMS-R, RMT) for all patient groups when compared with the healthy controls, although these impairments varied in degree and were less in the bromocriptine group. However, the individual surgical and radiotherapy treatment groups did not differ significantly from one another. By contrast, general intellectual function (IQ) remained intact for all groups, as did performance on supplementary cognitive tests, including measures of frontal lobe or "executive" function, language comprehension, and speed of mental processing. Psychiatric morbidity and tumour aetiology did not seem to relate to the presence of memory deficits. Conclusions-Anterograde memory deficits were seen in the two case studies and in all our treatment groups when compared with the healthy controls, and these occurred in the context of preserved intellectual function. The present findings suggest that these memory deficits result from treatment rather than from the underlying tumour, but there was no diVerence between the eVects of surgery and radiotherapy. It is suggested that they result from damage to diencephalic structures implicated in memory. (J Neurol Neurosurg Psychiatry 1998;65:870-876) Keywords: pituitary tumours; memory impairments; radiotherapy; surgery Pituitary adenomas account for about 10% of intracranial tumours and, although nearly always benign in nature, usually require treatment to alleviate pressure eVects and hormone hypersecretion. Many structures adjacent to the pituitary are known to be important for normal memory processing and are, therefore, at risk of incidental damage from t...

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“…All these examples involved patients with large tumours and often hydrocephalus where disruption of neural pathways could occur at many sites. Dons et al (15) reported chronic memory dysfunction and impaired job performance in a 24-year-old woman following transsphenoidal resection in a microadenoma where there could be no question of a mass effect. A prospective, double-blind, placebo-controlled trial demonstrated improved memory storage and recall following treatment with the vasopressin analogue desmopressin.…”

Section: Discussionmentioning

confidence: 99%

Neuropsychological abnormalities in patients with pituitary tumours

Grattan-Smith¹,

Morris²,

Shores³

et al. 1992

Acta Neurologica Scandinavica

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Neuropsychological assessment of 65 patients with pituitary tumours revealed impairment of memory and executive function. This did not appear to be related to the size or type of tumour or the effects of radiotherapy or surgery. It is possible that the problems arose from multiple unconnected factors but this observation lends support to the suggestion that pituitary or hypothalamic hormones have a role in the modulation of memory and behavioural pathways. Whatever the cause, neuropsychological impairment is common in patients with pituitary tumours and is an aspect of their disability which has received insufficient attention in the past.

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Assessment of Desmopressin-enhanced Cognitive Function in a Neurosurgical Patient

Cited by 6 publications

References 0 publications

Effects of desmopressin (DDAVP) on memory impairment following electroconvulsive therapy (ECT)

Effects of desmopressin (DDAVP) on memory impairment following electroconvulsive therapy (ECT)

Cognitive effects of pituitary tumours and their treatments: two case studies and an investigation of 90 patients

Neuropsychological abnormalities in patients with pituitary tumours

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