Improvement in attention  following surgery treatment in pituitary adenoma patients: an evidence from ERP study

Background: Cognitive abilities are impaired in patients with pituitary adenoma, which are mostly treated with surgery. However, the study on neurocognitive recovery after transsphenoidal adenomectomy is lacking. The study aims to identify the electrophysiological change that relates to the attention function of pituitary adenoma patients after treatment. Methods: 27 preoperative pituitary patients and 25 follow up postoperative patients were recruited. 27 healthy controls (HCs) were matched to the patients with age, sex, and education. All the pituitary adenoma patients had successfully gone through transsphenoidal adenomectomy under microscope or endoscope. Event-related potentials were used to investigate the cognitive processes of attention for preoperative patients, postoperative patients and healthy controls. In addition, eyesight and blood hormone levels were examined. Six months after surgery, blood hormone levels, pituitary MRI and electrophysiological tests were re-examined. Results: Across three groups, all emotional stimuli could evoke P200 components. Compared with HCs or postoperative patients, the amplitudes of P200 in the preoperative patients were higher. Moreover, The amplitude of P200 decreased in postoperative patients, which was similar to that in HCs. The attention was improved after surgery, but no significant differences were detected between postoperative patients and HCs. Conclusion: The tumor mass effect and abnormal hormone may be relevant to the factors that impair the attention. Compared with that of the HCs and postoperative patients, the P200 component elicited by negative stimuli is higher in preoperative patients, which is associated with the attention impairments. Furthermore, these data indicate the improvement in attention may be attributed to the tumor resection and the amelioration of endocrine disorders. This study shows that P200 component can be used to diagnose the attention in preoperative pituitary patients, and prove the improvement of the attention in postoperative patients.