Research progress of neuropsychiatric disorder in pituitary neuroendocrine tumor
Journal Title: Chinese Journal of Nervous and Mental Diseases - Year 2024, Vol 50, Issue 6
Abstract
This article seeks to delve into the correlation between pituitary neuroendocrine tumors (PitNET) and neuropsychiatric disorders while summarizing the most recent advancements in related research. Some patients with PitNET, benign tumors arising from pituitary gland cells, may develop specific clinical symptoms due to either tumor compression or abnormal hormone secretion. In recent years, investigators have identified a significant association between PitNET and neurological as well as psychiatric disorders. Patients with PitNET frequently manifest neurological and psychiatric symptoms, including depression, anxiety, and cognitive impairment, significantly impacting their quality of life and prognosis. These symptoms may be associated with distorted body image, hormonal imbalances, and inadequate treatment. The holistic approach to PitNET encompasses surgical intervention, radiation therapy, and drug therapy, each with its distinct set of advantages and drawbacks. Presently, transsphenoidal resection stands out as the most frequently employed method in treating PitNET to ameliorate the patient's neurological and psychiatric disorders. However, the use of dopamine agonists (DAs) in the treatment of prolactin (PRL) tumors and growth hormone (GH) adenomas may potentially induce or exacerbate neurological and psychiatric symptoms. The impact of radiation therapy on PitNET patients varies depending on the radiation dose and treatment area. Given that both the PitNET disease itself and its treatment may lead to neurological and psychiatric disorders, it is essential to assess and address the neurological and psychiatric status of all PitNET patients. Careful consideration should be given to PitNET patients with neurological and psychiatric disorders to determine whether these issues stem from dopamine agonist (DAs) treatment. The primary consideration should be given to patients with PRL microadenomas with normal PRL levels to minimize the dose of bromocriptine or cabergoline to the most effective level or even discontinue the medication with subsequent follow-up. Caution is advised when considering the discontinuation or reduction of medication for PRL large adenomas. A gradual reduction approach may be undertaken based on related factors such as PRL levels and tumor size. Close follow-up through monitoring patient PRL levels and enhanced pituitary MRI is crucial to prevent tumor enlargement following the reduction of medication. While some PitNET patients have experienced improvement or recovery from neurological and psychiatric disorders through personalized comprehensive treatment, it is important to note that certain patients may exhibit irreversible symptoms. Currently, research on the combination of PitNET and neuropsychiatric disorders remains relatively limited. Moving forward, it is imperative to delve deeper into its pathogenesis, aiming to enhance diagnostic methods for neuropsychiatric disorders in PitNET patients. This includes refining and updating diagnostic criteria and expanding intervention methods. These efforts are crucial in mitigating the incidence of PitNET in conjunction with neuropsychiatric disorders, ultimately improving the overall quality of life for patients.
Authors and Affiliations
CHEN Sainan,CUI Siyuan,WANG Qing,
Keywords
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