95% of researchers rate our articles as excellent or good
Learn more about the work of our research integrity team to safeguard the quality of each article we publish.
Find out more
SYSTEMATIC REVIEW article
Front. Endocrinol.
Sec. Pituitary Endocrinology
Volume 16 - 2025 | doi: 10.3389/fendo.2025.1534635
This article is part of the Research Topic Surgery and Management of Pituitary Region Tumours and Their Endocrine Outcomes View all 7 articles
The Impact of Pituitary Adenomas on Cognitive Performance: A Systematic Review
Provisionally accepted- 1 Mackay Medical College, New Taipei, Taiwan
- 2 Taipei Veterans General Hospital, Taipei, Taipei County, Taiwan
- 3 Mackay Memorial Hospital, Taipei, Taipei County, Taiwan
We aim to provide an updated understanding of the neurocognitive implications in patients with pituitary adenoma (PA).Methods: A systematic review of studies that reported cognitive performance in patients with PA were examined. Tumor type, treatment interventions, hormone status and psychological outcomes were also recorded.Results: This systematic review included 70 studies comprising 3842 patients with PA. There were 60 studies using either objective test or subjective questionnaire to measure subjects' cognitive level. The most commonly used measure was the Digit Span, of which 42.9% studies documented a significant decreased complex attention and executive function among PA patients. Twelve studies reported structural changes detected by Magnetic Resonance Imaging as primary outcome, of which 6 studies reported volume change in gray matter in patients with PA. A consistent decline in specific cognitive domains was observed across PA subtypes, with memory and executive function being the most frequently reported. A total of 59 studies provided details regarding the treatments. Perioperatively cognitive difference was reported in 14 studies; of which 11 studies found post-operational improvement in at least one domain of cognition. Twenty studies investigated potential negative impact on patients' cognitive performance by radiotherapy, of which 16 studies reported no significant difference. Eight studies addressed association between tumor size and cognitive impairment; of which 7 studies found no significant correlation. Besides, 24 studies reported a significant correlation between hormonal abnormalities and declines in cognitive performance.The literature contains heterogeneous findings about the cognition performance, nature of cognitive impairment, and subsequent effects of treatment. Patients with PA may experience cognitive decline in specific areas and are notably affected by hormone levels, while treatment may lead to cognitive recovery. The proposed tiered cognitive evaluation approach can improve assessment consistency in future practice.
Keywords: pituitary tumor, Cognition performance, Neuropsychological abnormalities, transsphenoidal, Radiotherapy
Received: 26 Nov 2024; Accepted: 31 Mar 2025.
Copyright: © 2025 Young, Lin, Li, Huang and Tsai. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence:
Wen-Hsuan Tsai, Mackay Memorial Hospital, Taipei, Taipei County, Taiwan
Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.