Pituitary adenomas and neuropsychological status: a systematic literature review

Pertichetti, Marta; Serioli, Simona; Belotti, Francesco; Mattavelli, Davide; Schreiber, Alberto; Cappelli, Carlo; Padovani, Alessandro; Gasparotti, Roberto; Nicolai, Piero; Fontanella, Marco Maria; Doglietto, Francesco

doi:10.1007/s10143-019-01134-z

Cited by 38 publications

(28 citation statements)

References 181 publications

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“…The effect of nutritional limitation in POF is far less than that of major abdominal surgery. In order to avoid leakage of cerebrospinal fluid caused by increased intracranial pressure after surgery, patients usually need to stay in bed for 5-7 days, and their activities are still restricted after discharge [36,37]. Decreased activity will cause the lack of stress stimulation of skeletal muscles, resulting in decreased muscle volume, reduced muscle strength and cardiopulmonary function, and patients feel extra exertion during normal activities, resulting in POF [38,39].…”

Section: Discussionmentioning

confidence: 99%

Progressive resistance exercise in patients with pituitary adenoma: it does work

Zhao

Wang

et al. 2021

Arch Med Sci

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IntroductionIt is necessary to investigate the effects of progressive resistance exercise (PRE) in patients with pituitary adenomas after surgery, to provide insights to the clinical management of pituitary adenomas.Material and methodsThis study is a pre- and post-control experimental study design with hypothesis that PRE can reduce the postoperative fatigue. Patients with pituitary adenoma were included. The control group received conventional postoperative rehabilitation guidance, and the PRE group received the PRE on the basis of routine rehabilitation. We measured the patient's muscle mass, muscle strength, vital capacity and postoperative fatigue level 1 day before and 12 weeks after the operation. SPSS 22.0 was used for data analysis.ResultsA total of 89 patients were enrolled, including 44 in the control group and 45 in the PRE group. There was no significant difference in muscle mass between the two groups in the 12th week after surgery, but the muscle loss of the left upper limb, trunk, and lower limbs of the control group was significantly higher than that of the PRE group (all P<0.05). The muscle strength and vital capacity of the control group were significantly lower than that of the intervention group, and the fatigue level was significantly higher than that of the PRE group(all P<0.05).ConclusionsProgressive resistance exercise is helpful to combat muscle loss, muscle strength and lung function decline caused by long-term bed rest in patients with pituitary adenoma after operation, thereby improving the postoperative fatigue level of patients.

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Section: Discussionmentioning

confidence: 99%

Progressive resistance exercise in patients with pituitary adenoma: it does work

Zhao

Wang

et al. 2021

Arch Med Sci

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“…Besides the most prevalent metabolic and cardiovascular morbidities, a recent systematic review on neuropsychiatric symptoms underlines once more the clinical relevance of psychiatric morbidities in pituitary disease that are often underdiagnosed and undertreated (19). In acromegaly, neurocognitive alterations were detected in 2-33% of study patients while psychiatric disorders occurred in up to 63% of patients (with depression being the most common).…”

Section: Somatic and Neuropsychiatric Comorbiditiesmentioning

confidence: 99%

GEOFFREY HARRIS AWARD 2019: Translational research in pituitary tumours

Stalla

Dimopoulou

Jung-Sievers

et al. 2020

European Journal of Endocrinology

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Although effective treatment regimens (surgical resection, drug treatment with dopamine agonists or somatostatin analogues, radiotherapy) have been established for the therapy of most pituitary tumours, a considerable proportion of affected patients cannot completely cured due to incomplete resection or drug resistance. Moreover, even if hormone levels have been normalized, patients with hormone-secreting tumours still show persistent pathophysiological alterations in metabolic, cardiovascular or neuropsychiatric parameters and have an impaired quality of life. In this review reasons for the discrepancy between biochemical cure and incomplete recovery from tumour-associated comorbidities are discussed and the clinical management is delineated exemplarily for patients with acromegaly and Cushing’s disease. In view of the development of additional treatment concepts for the treatment of pituitary adenomas we speculate about the relevance of RSUME as a potential target for the development of an anti-angiogenic therapy. Moreover, the role of BMP-4 which stimulates prolactinoma development through the Smad signalling cascade is described and its role as putative drug target for the treatment of prolactinomas is discussed. Regarding the well-known resistance of a part of somatotropinomas to somatostatin analogue treatment, recently identified mechanisms responsible for the drug resistance are summarized and ways to overcome them in future treatment concepts are presented. Concerning novel therapeutic options for patients with Cushing’s disease the impact of retinoic acid, which is currently tested in clinical studies, is shown, and the action and putative therapeutic impact of silibinin to resolve glucocorticoid resistance in these patients is critically discussed.

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“…Pituitary adenomas (PAs) account for approximately 15% of all intracranial tumors that originate in the anterior pituitary gland (1)(2)(3). As the tumor increases in size, it often grows beyond the confines of the sella turcica (4).…”

Section: Introductionmentioning

confidence: 99%

Identification of the Extradural and Intradural Extension of Pituitary Adenomas to the Suprasellar Region: Classification, Surgical Strategies, and Outcomes

et al. 2021

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ObjectiveSuprasellar pituitary adenomas (PAs) can be located in either extradural or intradural spaces, which impacts surgical strategies and outcomes. This study determined how to distinguish these two different types of PAs and analyzed their corresponding surgical strategies and outcomes.MethodsWe retrospectively analyzed 389 patients who underwent surgery for PAs with suprasellar extension between 2016 to 2020 at our center. PAs were classified into two main grades according to tumor topography and their relationships to the diaphragm sellae (DS) and DS-attached residual pituitary gland (PG). Grade 1 tumors were located extradurally and further divided into grades 1a and 1b, while grade 2 tumors were located intradurally.ResultsOf 389 PAs, 292 (75.1%) were surrounded by a bilayer structure formed by the DS and the residual PG and classified as grade 1a, 63 (16.2%) had lobulated or daughter tumors resulting from the thinning or absence of the residual PG and subsequently rendering the bilayer weaker were classified as Grade 1b, and the remaining 34 (8.7%) PAs that broke through the DS or traversed the diaphragmic opening and encased suprasellar neurovascular structures were classified as Grade 2. We found that the gross total removal of the suprasellar part of grade 1a, 1b, and 2 PAs decreased with grading (88.4%, 71.4%, and 61.8%, respectively). The rate of major operative complications, including cerebrospinal fluid leakage, hemorrhage, and death, increased with grading.ConclusionsIt is essential to identify whether PAs with suprasellar extension are located extradurally or intradurally, which depends on whether the bilayer structure is intact. PAs with an intact bilayer structure were classified as grade 1. These were extradural and usually had good surgical outcomes and lower complications. PAs with no bilayer structure surrounding them were classified as grade 2. These were intradural, connected to the cranial cavity, and had increased surgical complications and a lower rate of gross total removal. Different surgical strategies should be adopted for extradural and intradural PAs.

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Pituitary adenomas and neuropsychological status: a systematic literature review

Cited by 38 publications

References 181 publications

Progressive resistance exercise in patients with pituitary adenoma: it does work

Progressive resistance exercise in patients with pituitary adenoma: it does work

GEOFFREY HARRIS AWARD 2019: Translational research in pituitary tumours

Identification of the Extradural and Intradural Extension of Pituitary Adenomas to the Suprasellar Region: Classification, Surgical Strategies, and Outcomes

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