Photo Credit: iStock.com/janulla

The following is a summary of “Impact of pituitary adenomas on cognitive performance: a systematic review,” published in the April 2025 issue of Frontiers in Endocrinology by Young et al. 

Increasing evidence suggested that, in addition to classical endocrine and visual symptoms, patients with pituitary adenoma (PA) experienced neurocognitive impairment, which potentially reduced productivity and QoL.  

Researchers conducted a retrospective study to systematically analyze the assessment batteries used in prior research and clarify their corresponding cognitive domains, aiming to provide a more consistent understanding of the neurocognitive implications associated with PAs.  

They followed the Preferred Reporting Items for Systematic Reviews and Meta-analyses reporting guidelines. Individual patient-level data, including clinical characteristics, tumor subtype, treatment interventions, hormonal status, and psychological outcomes, were systematically collected. Cognitive assessment tools were categorized by their respective cognitive domains to facilitate domain-specific analyses.  

The results showed that 70 studies, including 3,842 patients with PA, were analyzed. Of these, 60 studies used objective neuropsychological tests or subjective questionnaires to assess cognitive function. The Digit Span test was the most common assessment, with 42.9% of studies reporting significant impairments in complex attention and executive function and the 12 studies examined structural brain changes through magnetic resonance imaging, with half showing volumetric reductions in gray matter. Cognitive declines were consistently observed across PA subtypes, particularly in memory and executive function. Treatment-related data were provided by 59 studies, and 14 studies described perioperative cognitive changes, with 11 reporting post-surgical improvement in at least 1 cognitive domain. Radiotherapy’s adverse effects on cognitive function were explored in 20 studies, with 16 showing no significant differences post-treatment while, 8 studies estimated the link between tumor size and cognitive impairment, with 7 finding no significant correlation. However, 24 studies found a significant association between hormonal dysregulation and cognitive decline.  

Investigators concluded that the literature revealed varied findings on cognitive performance, in patients with PA experiencing cognitive decline in specific areas influenced by hormone levels, while treatment may facilitate cognitive recovery, and a tiered cognitive evaluation approach could enhance assessment consistency in future practice. 

Source: frontiersin.org/journals/endocrinology/articles/10.3389/fendo.2025.1534635/full