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Cao C, Wen W, Chen A, Wang S, Xu G, Niu C, Song J. Neuropsychological Alterations of Prolactinomas' Cognitive Flexibility in Task Switching. Brain Sci 2023; 13:brainsci13010082. [PMID: 36672063 PMCID: PMC9856801 DOI: 10.3390/brainsci13010082] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2022] [Revised: 12/14/2022] [Accepted: 12/27/2022] [Indexed: 01/03/2023] Open
Abstract
Prolactinomas have been reported to impair cognition in broad aspects. However, few studies investigated the influence of prolactinomas on cognitive flexibility never mentioning the underlying neural and electrophysiological mechanism. We recorded scalp electroencephalography (EEG) in a colour-shape switching task. Patients with prolactinomas showed longer reaction time in switch trials and larger switch costs relative to healthy controls (HCs). Compared to HCs who showed stronger frontal theta activity in switch trials, the generally weak frontal theta activity in patients implied that they could not afford the executive control to configure task sets. Meanwhile, machine-learning based classification revealed that patients manifested non-selective brain patterns in response to different task types (colour vs. shape task) and different task states (switch vs. repeat state), which collectively suggested the cognitive dysfunction in preparation for a changing environment. Compared to HCs who showed stronger frontoparietal synchronization in switch trials, this enhanced frontoparietal connectivity was disrupted among patients with severe prolactinomas. This finding implicated greater hyperprolactinemia was linked to a larger decrease in cognitive performance. Taken together, the present study highlighted frontal theta power, and frontoparietal connectivity at theta band as the electrophysiological markers of the impaired cognitive flexibility and task control in patients with prolactinomas.
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Affiliation(s)
- Chenglong Cao
- Department of Neurosurgery, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei 230001, China
- Department of Cognitive Neuroscience, Faculty of Psychology & Neuroscience, Maastricht University, P.O. Box 616, 6200 MD Maastricht, The Netherlands
- Department of Neurosurgery, The General Hospital of Chinese PLA Central Theater Command, Wuhan 430074, China
| | - Wen Wen
- Department of Psychological & Brain Sciences, Boston University, Boston, MA 02215, USA
| | - Aobo Chen
- Department of Neurosurgery, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei 230001, China
| | - Shuochen Wang
- Department of Neurosurgery, The General Hospital of Chinese PLA Central Theater Command, Wuhan 430074, China
| | - Guozheng Xu
- Department of Neurosurgery, The General Hospital of Chinese PLA Central Theater Command, Wuhan 430074, China
| | - Chaoshi Niu
- Department of Neurosurgery, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei 230001, China
- Correspondence: (C.N.); (J.S.)
| | - Jian Song
- Department of Neurosurgery, The General Hospital of Chinese PLA Central Theater Command, Wuhan 430074, China
- Correspondence: (C.N.); (J.S.)
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Hyperprolactinemia Associated with Attentional Processing and Interference Control Impairments in Patients with Prolactinomas. Brain Sci 2022; 12:brainsci12081091. [PMID: 36009154 PMCID: PMC9406026 DOI: 10.3390/brainsci12081091] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2022] [Revised: 08/10/2022] [Accepted: 08/13/2022] [Indexed: 11/25/2022] Open
Abstract
The cognitive impairment of pituitary adenomas (PAs) has received increasing attention. Hyperprolactinemia and tumor mass effect are the potential causes. The aim of this study was to identify possible cognitive impairment and to further explore the correlation between these indices and prolactin (PRL) levels, based on the control of tumor size. Twenty-seven patients with prolactinomas (patient group) and twenty-six matched health control group (HC group) were enrolled in this study. All participants performed the flanker task while we continuously recorded electroencephalography data. On the behavioral performance level, patients showed a significantly slower reaction time (RT) in both flanker types. Concerning the event-related potentials level, patients elicited reduced P2 and enhanced N2 amplitudes compared with the HC group, suggesting an impairment of attentional processing (P2) and conflict monitoring (N2). Moreover, the patient group also induced lower P3 amplitudes relative to the HC group in both types, indicating that there were deficits in attentional resource allocation ability. We also found a significant correlation between the P3 amplitudes and incongruent condition RTs, as well as the subsequent PRL levels in the patient group. In conclusion, this is an innovative study that reveals the impaired cognition abilities in prolactinomas, and also proposes the possible cognitive toxicity of oversecreted PRL levels, which provides evidence for further research on the cognitive decline in PAs.
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Cao C, Song J, Lin P, Yan D, Yao S, Yue J, Liu B, Lu Y, Xu G. A Longitudinal, Prospective Study to Evaluate the Effects of Treatment on the Inhibitory Control Function After Transsphenoidal Surgery for Pituitary Adenomas. Clin EEG Neurosci 2021; 52:444-454. [PMID: 32412816 DOI: 10.1177/1550059420922744] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
OBJECTIVES Injured cognitive abilities have been reported in patients with pituitary adenoma. However, to date, few researchers have directly investigated the electrophysiological study of inhibitory control function of pituitary patients both pre- and postsurgery. Thus, this study aimed to identify the factors affecting the inhibitory control function of pituitary patients. METHODS Thirty presurgery pituitary patients were recruited and 26 patients of them completed the postsurgery follow-up. Thirty healthy people were recruited for control group. Visual Go/Nogo tasks were carried out by the patients and controls to assess the inhibitory control function before surgery and 6 months after the surgery, respectively. The function of inhibitory control was analyzed with the components of N2 and P3. RESULTS Across 3 groups, Nogo stimuli evoked larger frontal-central N2nogo and P3nogo than Go stimuli did. Furthermore, N2d of presurgery patients (-1.14 μV) and postsurgery patients(-0.61 μV) were significantly decreased compared with that of control group (-3.09 μV), F(2, 83) = 13.92, P < .01, whereas no difference was detected between pre- and postsurgery groups. There was no remarkable difference in the amplitude of P3d among the 3 groups, F(2, 83) = 0.19, P > .05. With regard to the amplitude of P3 for Go condition, The P3 amplitude of healthy group (4.38 μV) was larger than both pre- and postsurgery (1.00 μV and 3.01 μV). With regard to the amplitude of P3 for Nogo condition, The P3 amplitude of healthy group (5.25 μV) was larger than both pre- and postsurgery groups (2.35 μV and 4.18 μV). CONCLUSIONS These results indicated that presurgery patients showed the dysfunction of inhibition, due to the nerve tissue damage or brain structure alteration caused by the presurgery physical pressure from tumor and abnormal hormone levels. Postsurgery patients showed a tendency toward recovery, but there was no obvious improvement in the inhibitory control function after successful treatments.
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Affiliation(s)
- Chenglong Cao
- The First School of Clinical Medicine, Southern Medical University, Guangzhou, China.,Department of Neurosurgery, General Hospital of Central Theater of the Chinese People's Liberation Army, Wuhan, China
| | - Jian Song
- Department of Neurosurgery, General Hospital of Central Theater of the Chinese People's Liberation Army, Wuhan, China
| | - Pan Lin
- Department of Psychology, Hunan Normal University, Changsha, China
| | - Deqi Yan
- Department of Neurosurgery, The 990th Hospital of the Joint Logistics Support Force of the Chinese People's Liberation Army, Zhumadian, China
| | - Shun Yao
- Department of Neurosurgery, General Hospital of Central Theater of the Chinese People's Liberation Army, Wuhan, China
| | - Jianren Yue
- The First School of Clinical Medicine, Southern Medical University, Guangzhou, China
| | - Binbin Liu
- Wuhan University of Science and Technology, Wuhan, China
| | - Yuzhao Lu
- Wuhan University of Science and Technology, Wuhan, China
| | - Guozheng Xu
- The First School of Clinical Medicine, Southern Medical University, Guangzhou, China.,Department of Neurosurgery, General Hospital of Central Theater of the Chinese People's Liberation Army, Wuhan, China
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Cao C, Huang Y, Chen A, Xu G, Song J. Improvement in Attention Processing After Surgical Treatment in Functional Pituitary Adenomas: Evidence From ERP Study. Front Neurol 2021; 12:656255. [PMID: 34659078 PMCID: PMC8517483 DOI: 10.3389/fneur.2021.656255] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2021] [Accepted: 06/28/2021] [Indexed: 01/20/2023] Open
Abstract
Cognitive abilities are impaired in patients with pituitary adenoma. However, studies on attention processing impairment in preoperative patients and attention processing recovery after transsphenoidal adenomectomy are lacking. The study aims to identify the electrophysiological change that relates to attention processing in pituitary patients before and after treatment. Twenty five preoperative pituitary patients and 25 follow-up postoperative patients were recruited. 27 healthy controls (HCs) were matched to the patients with age, gender, and education. Event-related potentials were used to investigate the attention processing in the preoperative patients, postoperative patients, and HCs. Across three groups, all emotional stimuli evoked P200 components. Compared with the HCs or postoperative patients, the amplitudes of P200 in the preoperative patients were higher. Moreover, The amplitudes of P200 decreased in the postoperative patients, which were similar to that in the HCs. The attention processing was improved after surgery, but no significant differences were detected between the postoperative patients and HCs. Abnormal hormone levels may be relevant to the factor that impair attention processing. Compared with that of the HCs and postoperative patients, the P200 component elicited by negative stimuli is higher in preoperative patients, which may illustrate compensatory activity after attention impairments. Furthermore, these data indicate that improvements in attention processing may be attributed to the amelioration of endocrine disorders. This study shows that the P200 component may be used to diagnose attention processing in preoperative pituitary patients and prove the improvement of attention processing in postoperative patients.
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Affiliation(s)
- Chenglong Cao
- Department of Cognitive Neuroscience, Faculty of Psychology & Neuroscience, Maastricht University, Maastricht, Netherlands
- The First School of Clinical Medical University, Southern Medical University, Guangzhou, China
| | - Yujing Huang
- Key Laboratory of Structural Biology of Zhejiang Province, Westlake University, Hangzhou, China
| | - Aobo Chen
- The First School of Clinical Medical University, Southern Medical University, Guangzhou, China
| | - Guozheng Xu
- The First School of Clinical Medical University, Southern Medical University, Guangzhou, China
| | - Jian Song
- Department of Neurosurgery, Central Theater Command General Hospital of the Chinese People's Liberation Army, Wuhan, China
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Cao C, Wang Y, Liu J, Chen A, Lu J, Xu G, Song J. Altered Connectivity of the Frontoparietal Network During Attention Processing in Prolactinomas. Front Neurol 2021; 12:638851. [PMID: 34526949 PMCID: PMC8435841 DOI: 10.3389/fneur.2021.638851] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2021] [Accepted: 07/12/2021] [Indexed: 11/22/2022] Open
Abstract
Prolactinomas have been reported for the failure of cognitive functions. However, the electrophysiological mechanisms of attention processing in prolactinomas remain unclear. In a visual mission, we monitored the scalp electroencephalography (EEG) of the participants. Compared with the healthy controls (HCs), larger frontoparietal theta and alpha coherence were found in the patients, especially in the right-lateralized hemisphere, which indicated a deficit in attention processing. Moreover, the frontoparietal coherence was positively correlated with altered prolactin (PRL) levels, implying the significance of PRL for adaptive brain compensation in prolactinomas. Taken together, this research showed the variations in attention processing between the HCs and prolactinomas. The coherence between frontal and parietal regions may be one of the possible electrophysiological biomarkers for detecting deficient attention processing in prolactinomas.
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Affiliation(s)
- Chenglong Cao
- Department of Neurosurgery, The First School of Clinical Medicine, Southern Medical University, Guangzhou, China.,Department of Cognitive Neuroscience, Faculty of Psychology and Neuroscience, Maastricht University, Maastricht, Netherlands
| | - Yu Wang
- The Key Laboratory of Biomedical Information Engineering of Ministry of Education, Institute of Biomedical Engineering, School of Life Science and Technology, Xi'an Jiaotong University, Xi'an, China
| | - Jia Liu
- Foreign Linguistics and Applied Linguistics, Research Institute of Foreign Languages, Beijing Foreign Studies University, Beijing, China
| | - Aobo Chen
- Department of Neurosurgery, The First School of Clinical Medicine, Southern Medical University, Guangzhou, China
| | - Jinjiang Lu
- Department of Neurosurgery, The First School of Clinical Medicine, Southern Medical University, Guangzhou, China
| | - Guozheng Xu
- Department of Neurosurgery, The First School of Clinical Medicine, Southern Medical University, Guangzhou, China.,Department of Neurosurgery, The General Hospital of Chinese PLA Central Theater Command, Wuhan, China
| | - Jian Song
- Department of Neurosurgery, The First School of Clinical Medicine, Southern Medical University, Guangzhou, China.,Department of Neurosurgery, The General Hospital of Chinese PLA Central Theater Command, Wuhan, China
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Cao C, Wen W, Liu B, Ma P, Li S, Xu G, Song J. Theta oscillations in prolactinomas: Neurocognitive deficits in executive controls. Neuroimage Clin 2020; 28:102455. [PMID: 33038668 PMCID: PMC7554198 DOI: 10.1016/j.nicl.2020.102455] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2020] [Revised: 08/19/2020] [Accepted: 09/27/2020] [Indexed: 02/07/2023]
Abstract
Impairment of cognitive functions has been reported in prolactinomas. However, the electrophysiological mechanisms of response activation and response inhibition in prolactinomas remain unclear. We recorded participants' scalp electroencephalography (EEG) in a visual Go/Nogo task. Compared to the healthy controls (HCs), the patients demonstrated worse performance and their prolactin (PRL) levels negatively correlated with behavioral results. Meanwhile, patients' P300 amplitudes in the Go and Nogo conditions were smaller than the HCs. The amplitudes of N200nogo in patients were smaller than the HCs as well. Lower frontal theta power was found in the patients than the HCs in both Go and Nogo conditions, which indicated a deficit in response activation and inhibition. Moreover, the PRL levels mediated the relationship between frontal theta power and behavior performance, implying that lower frontal theta power caused the dysfunction of response control by abnormally high PRL levels. Patients also showed lower occipital alpha power than the HCs, which suggested that the impaired response inhibition may arise from deficient attention control. Taken together, the present study revealed the neurocognitive discrepancies between prolactinomas and the HCs. The frontal theta oscillation was highlighted as the electrophysiological markers of the impaired response control in prolactinomas.
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Affiliation(s)
- Chenglong Cao
- The First School of Clinical Medicine, Southern Medical University, Guangzhou 510515, China; Department of Neurosurgery, The General Hospital of Chinese PLA Central Theater Command, Wuhan 430070, China
| | - Wen Wen
- School of Psychological and Cognitive Sciences, Peking University, Beijing 100871, China
| | - Binbin Liu
- Wuhan University of Science and Technology, Wuhan 430000, China
| | - Pan Ma
- Wuhan Children's Hospital, Tongji Medical College of Huazhong University of Science & Technology, China
| | - Sheng Li
- School of Psychological and Cognitive Sciences, Peking University, Beijing 100871, China
| | - Guozheng Xu
- The First School of Clinical Medicine, Southern Medical University, Guangzhou 510515, China; Department of Neurosurgery, The General Hospital of Chinese PLA Central Theater Command, Wuhan 430070, China.
| | - Jian Song
- Department of Neurosurgery, The General Hospital of Chinese PLA Central Theater Command, Wuhan 430070, China.
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Song J, Cao C, Wang Y, Yao S, Catalino MP, Yan D, Xu G, Ma L. Response Activation and Inhibition in Patients With Prolactinomas: An Electrophysiological Study. Front Hum Neurosci 2020; 14:170. [PMID: 32848659 PMCID: PMC7396600 DOI: 10.3389/fnhum.2020.00170] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2019] [Accepted: 04/20/2020] [Indexed: 11/25/2022] Open
Abstract
Impairment of executive function has been reported in patients with prolactinomas. However, few studies have investigated the electrophysiological mechanisms of response activation and response inhibition in these patients. In this study, we employ an event-related potentials (ERPs) technique to quantitatively assess response activation and inhibition before and after the surgical treatment of prolactinomas. A 64-electrode electroencephalogram (EEG) skullcap was used to record the brain activity in 20 pre-operative patients, 20 follow-up post-operative patients, and 20 healthy controls (HCs) while performing the visual Go/Nogo task. As expected, we identified P300 across all study populations that could reflect response activation and inhibition. Across the three groups, the Nogo stimuli evoked larger frontal-central P300 than the Go stimuli did. In contrast, the Go trials elicited larger parietal P300 than the Nogo trials did. The peak latency of P300 was significantly delayed in both the pre-operative and the post-operative groups compared to the HCs. The amplitude of P300 in both the Go and the Nogo conditions was significantly decreased in the pre-operative patients compared with that of the HCs. At 6 months post-operatively, the prolactinoma patients showed an increase in amplitude of P300 during both the Go and the Nogo tasks. These findings indicate that the prolactinoma patients suffer from deficits in response activation and inhibition, which could be improved by surgical treatment.
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Affiliation(s)
- Jian Song
- Department of Neurosurgery, The General Hospital of Chinese People's Liberation Army Central Theater Command, Wuhan, China
| | - Chenglong Cao
- The First School of Clinical Medicine, Southern Medical University, Guangzhou, China
| | - Yu Wang
- Key Laboratory of Cognitive Science, College of Biomedical Engineering, South- Central University for Nationalities, Wuhan, China
| | - Shun Yao
- Center for Pituitary Tumor Surgery, Department of Neurosurgery, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China.,Department of Neurosurgery, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, United States
| | - Michael P Catalino
- Department of Neurosurgery, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, United States.,Department of Neurosurgery, University of North Carolina, Chapel Hill, NC, United States
| | - Deqi Yan
- Traditional Chinese Medicine College, Xinjiang Medical University, Urumqi, China
| | - Guozheng Xu
- Department of Neurosurgery, The General Hospital of Chinese People's Liberation Army Central Theater Command, Wuhan, China
| | - Lianting Ma
- Department of Neurosurgery, The General Hospital of Chinese People's Liberation Army Central Theater Command, Wuhan, China
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