Endocrine Abstracts

Context: In untreated acromegalic patients, decreased cognitive functioning is reported to be associated with the degree of GH and IGF1 excess. Whether previous GH excess or current medical treatment for acromegaly specifically affects cognition remains unclear.

Objective: To compare cognitive functioning in patients who are treated for acromegaly and non-functioning pituitary adenomas (NFA). In addition, we assessed the influence of prolonged medical treatment after initial transsphenoidal surgery (TSS) on cognition.

Methods: In this cross-sectional study 128 patients participated, who were previously treated for acromegaly (n=50; median (IQR) age: 53 (45–65) years) or NFA (n=78; age: 61 (55–70) years). In all patients, TSS was performed, followed by radiotherapy in 39%. Of the acromegalic patients, 28 had achieved cure, while 22 were still treated with long-acting somatostatin analogs and/or somavert. Memory and executive functioning were assessed by the 15 words test (15 WT) and the Ruff figural fluency test (RFFT), and reported as z-scores.

Results: All patient groups scored significantly poorer than the reference population on memory and executive functioning (P<0.05). However, cognitive test performance was not significantly different between patients with acromegaly and NFA (15 WT total memory −0.90 (−1.60; 0.05), −0.95 (−1.60; 0.13), P=0.891; RFFT unique designs −0.52 (−1.47; 0.30) and −0.90 (−1.60; 0.14), P=0.232) although acromegalic patients had a significantly higher IGF1 z-score mean±S.D., 0.24±1.02 vs −1.04±1.15, P<0.001. Acromegalic patients with medical treatment at time of study had similar test results compared to patients who achieved cure for acromegaly (15 WT total memory −0.85 (−1.63; 0.23), −0.90 (−1.53; −0.10), P=0.853; RFFT unique designs −0.83 (−1.51; 0.00), −0.29 (−1.42; 0.74), P=0.379). The IGF1 z-scores between both acromegaly patient groups were comparable (P=0.381).

Conclusion: We found no association between previous GH excess and cognition. In addition, current medical treatment for GH excess was not related to memory and executive functioning.

Declaration of interest: The authors declare that there is no conflict of interest that could be perceived as prejudicing the impartiality of the research project.

Funding: This research did not receive any specific grant from any funding agency in the public, commercial or not-for-profit sector.