Affiliation:
1. Department of Neurosurgery Beijing Tiantan Hospital, Capital Medical University Beijing China
2. Clinical College of Neurology, Neurosurgery and Neurorehabilitation Tianjin Medical University Tianjin 300070 China
3. School of Instrumentation and Optoelectronic Engineering Beihang University Beijing 100191 China
4. School of Psychological and Cognitive Sciences and Beijing Key Laboratory of Behavior and Mental Health Peking University Beijing 100871 China
5. IDG/McGovern Institute for Brain Research Peking University Beijing 100871 China
6. Peking‐Tsinghua Center for Life Sciences Peking University Beijing 100871 China
7. Key Laboratory of Machine Perception, Ministry of Education Peking University Beijing 100871 China
8. Department of Neural Reconstruction Beijing Neurosurgery Institute, Capital Medical University Beijing China
Abstract
AbstractObjectiveDespite pituitary neuroendocrine tumor (PitNET) being extra‐axial tumors without direct damage to brain tissue, patients with PitNET exhibit neuropsychological impairments. However, it remains unclear whether there are neuropsychological differences between PitNET and intra‐axial tumors that directly destroy the brain parenchyma. This prospective study aims to clarify this distinction to inform decision‐making for intracranial tumors of diverse origins.MethodsA total of 146 patients with PitNET, 74 patients with glioma representing intra‐axial tumors, and 52 age‐, sex‐, and education‐matched healthy controls were recruited. All patients received standard treatment and postoperative rehabilitation. Clinical data were meticulously collected, and neuropsychological tests were administered to all participants both before and 3 months after surgery.ResultsBoth PitNET and glioma patients experience the dual burden of cognitive and affective deficits. However, the feature of these deficits differs substantially. In PitNET patients, the deficits are relatively mild and focal, whereas in glioma patients, they are severe and extensive. Specifically, PitNET patients exhibit deficits in memory, anxiety, and negative affect. In contrast, glioma patients display deficits in executive function, attention, anxiety, positive/negative affect, and empathy. Notably, except for persistent memory deficits, the majority of neuropsychological scores declines in PitNET patients are restorable and can reach improvement within a short period after standard surgical therapy and perioperative management. Conversely, glioma patients not only fail to show improvements but also demonstrate worsening in terms of general cognition and memory postoperatively.InterpretationAs an extra‐axial tumor, PitNET may exhibit distinctive cognitive and affective functioning compared to intra‐axial tumors, highlighting the need for specific treatment approaches for PitNET patients.