Natalia García-Casares1,2,3, Marina Fernández-Andújar4, Inmaculada González-Molero5, Silvia Maraver-Selfa6, Mario Gutiérrez-Bedmar7, José R Ramos-Rodriguez2, Francisco Alfaro-Rubio2, Nuria Roé-Vellvé2, Isabel Garcia-Garcia8, Juan A García-Arnés5,9. 1. Department of Medicine, Faculty of Medicine, University of Malaga, Málaga, Spain. 2. Centro de Investigaciones Médico-Sanitarias (C.I.M.E.S), University of Malaga, Málaga, Spain. 3. Área de Enfermedades cardiovasculares, obesidad y diabetes, Instituto de Investigación Biomédica de Málaga (IBIMA), Malaga, Spain. 4. Universitat Abat Oliba CEU, CEU Universities, Facultad de Ciencias Sociales, Departamento Psicología. 5. Department of Endocrinology, Regional University Hospital of Malaga, Malaga, Spain. 6. Department of Endocrinology, Virgen de la Victoria University Hospital, Malaga, Spain. 7. Department of Public Health and Psychiatry, University of Malaga, Malaga, Spain. 8. Department of Clinical Psychology and Psychobiology, Faculty of Psychology, University of Barcelona, Barcelona, Spain. 9. Department of Pharmacology, Faculty of Medicine, University of Malaga, Malaga, Spain.
Abstract
OBJECTIVE: Cognitive effects in acromegaly patients are poorly understood and the mechanisms involved are still unclear. The aim of this study was to evaluate the cognitive function, depression, and quality of life of acromegaly patients treated with pegvisomant versus somatostatin analogues (SRLs) and to analyze the effect of the different treatments on cognition and possible structural brain changes. METHODS: This cross-sectional study involved 23 acromegaly patients divided into two groups according to treatment modality: One group of 9 patients treated with pegvisomant and another group of 14 patients treated with SRLs. All participants underwent blood analysis, neuropsychological tests, depression tests, quality of life assessment, and 3-Tesla magnetic resonance imaging. RESULTS: We found no significant differences between groups in the neuropsychological tests, depression or quality of life; nor in the whole-brain cortical thickness. In the SRL group, the volume of the thalamus correlated positively with executive function, a correlation not found in the pegvisomant group. In addition, the pegvisomant group had significantly higher levels of insulin than the SRL group. CONCLUSIONS: In conclusion, in this pilot study, the type of pharmacological treatment in patients with acromegaly and good glycemic control did not influence the cognitive function and cortical brain thickness. However, pegvisomant could play a neuroprotective role on the thalamus that will have to be demonstrated with larger samples in future studies.
OBJECTIVE: Cognitive effects in acromegalypatients are poorly understood and the mechanisms involved are still unclear. The aim of this study was to evaluate the cognitive function, depression, and quality of life of acromegalypatients treated with pegvisomant versus somatostatin analogues (SRLs) and to analyze the effect of the different treatments on cognition and possible structural brain changes. METHODS: This cross-sectional study involved 23 acromegalypatients divided into two groups according to treatment modality: One group of 9 patients treated with pegvisomant and another group of 14 patients treated with SRLs. All participants underwent blood analysis, neuropsychological tests, depression tests, quality of life assessment, and 3-Tesla magnetic resonance imaging. RESULTS: We found no significant differences between groups in the neuropsychological tests, depression or quality of life; nor in the whole-brain cortical thickness. In the SRL group, the volume of the thalamus correlated positively with executive function, a correlation not found in the pegvisomant group. In addition, the pegvisomant group had significantly higher levels of insulin than the SRL group. CONCLUSIONS: In conclusion, in this pilot study, the type of pharmacological treatment in patients with acromegaly and good glycemic control did not influence the cognitive function and cortical brain thickness. However, pegvisomant could play a neuroprotective role on the thalamus that will have to be demonstrated with larger samples in future studies.