Skip to main content
Erschienen in: Endocrine 3/2015

01.12.2015 | Original Article

Impaired decision making and delayed memory are related with anxiety and depressive symptoms in acromegaly

verfasst von: Iris Crespo, Alicia Santos, Elena Valassi, Patricia Pires, Susan M. Webb, Eugenia Resmini

Erschienen in: Endocrine | Ausgabe 3/2015

Einloggen, um Zugang zu erhalten

Abstract

Evaluation of cognitive function in acromegaly has revealed contradictory findings; some studies report normal cognition in patients with long-term cured acromegaly, while others show attention and memory deficits. Moreover, the presence of affective disorders in these patients is common. Our aim was to evaluate memory and decision making in acromegalic patients and explore their relationship with affective disorders like anxiety and depressive symptoms. Thirty-one patients with acromegaly (mean age 49.5 ± 8.5 years, 14 females and 17 males) and thirty-one healthy controls participated in this study. The Iowa Gambling Task (IGT), Rey Auditory Verbal Learning Test, State-Trait Anxiety Inventory, and Beck Depression Inventory-II (BDI-II) were used to evaluate decision making, verbal memory, anxiety, and depressive symptoms, respectively. Acromegalic patients showed impairments in delayed verbal memory (p < 0.05) and more anxiety and depressive symptoms (p < 0.05) than controls. In the IGT, acromegalic patients presented an altered decision-making strategy compared to controls, choosing a lower number of the safer cards (p < 0.05) and higher number of the riskier cards (p < 0.05). Moreover, multiple correlations between anxiety and depressive symptoms and performance in memory and decision making were found. Impaired delayed memory and decision making observed in acromegalic patients are related to anxiety and depressive symptoms. Providing emotional support to the patients could improve their cognitive function. A key clinical application of this research is the finding that depressive symptoms and anxiety are essentially modifiable factors.
Literatur
1.
Zurück zum Zitat N. Sonino, C. Ruini, C. Navarrini, F. Ottolini, L. Sirri, A. Paoletta, F. Fallo, M. Boscaro, G.A. Fava, Psychosocial impairment in patients treated for pituitary disease: a controlled study. Clin. Endocrinol. 67, 719–726 (2007)CrossRef N. Sonino, C. Ruini, C. Navarrini, F. Ottolini, L. Sirri, A. Paoletta, F. Fallo, M. Boscaro, G.A. Fava, Psychosocial impairment in patients treated for pituitary disease: a controlled study. Clin. Endocrinol. 67, 719–726 (2007)CrossRef
2.
Zurück zum Zitat C. Sievers, C. Dimopoulou, H. Pfister, R. Lieb, B. Steffin, J. Roemmler, J. Schopohl, M. Mueller, H.J. Schneider, M. Ising, H.U. Wittchen, G.K. Stalla, Prevalence of mental disorders in acromegaly: a cross-sectional study in acromegalic patients. Clin. Endocrinol. 71, 691–701 (2009)CrossRef C. Sievers, C. Dimopoulou, H. Pfister, R. Lieb, B. Steffin, J. Roemmler, J. Schopohl, M. Mueller, H.J. Schneider, M. Ising, H.U. Wittchen, G.K. Stalla, Prevalence of mental disorders in acromegaly: a cross-sectional study in acromegalic patients. Clin. Endocrinol. 71, 691–701 (2009)CrossRef
3.
Zurück zum Zitat J. Tiemensma, N.R. Biermasz, R.C. van der Mast, M.J. Wassenaar, H.A. Middelkoop, A.M. Pereira, J.A. Romijn, Increased psychopathology and maladaptive personality traits, but normal cognitive functioning, in patients after long-term cure of acromegaly. J. Clin. Endocrinol. Metab. 95, E392–E402 (2010)CrossRefPubMed J. Tiemensma, N.R. Biermasz, R.C. van der Mast, M.J. Wassenaar, H.A. Middelkoop, A.M. Pereira, J.A. Romijn, Increased psychopathology and maladaptive personality traits, but normal cognitive functioning, in patients after long-term cure of acromegaly. J. Clin. Endocrinol. Metab. 95, E392–E402 (2010)CrossRefPubMed
4.
Zurück zum Zitat P. Pantanetti, N. Sonino, G. Arnaldi, M. Boscaro, The quality of life in acromegaly. J. Endocrinol. Invest. 26, 35–38 (2003)CrossRefPubMed P. Pantanetti, N. Sonino, G. Arnaldi, M. Boscaro, The quality of life in acromegaly. J. Endocrinol. Invest. 26, 35–38 (2003)CrossRefPubMed
5.
Zurück zum Zitat N.D. Aberg, K.G. Brywe, J. Isgaard, Aspects of growth hormone and insulin-like growth factor-1 related to neuroprotection, regeneration and functional plasticity in the adult brain. ScientificWorldJournal. 6, 53–80 (2006)CrossRefPubMed N.D. Aberg, K.G. Brywe, J. Isgaard, Aspects of growth hormone and insulin-like growth factor-1 related to neuroprotection, regeneration and functional plasticity in the adult brain. ScientificWorldJournal. 6, 53–80 (2006)CrossRefPubMed
6.
Zurück zum Zitat J.F. Martín-Rodríguez, A. Madrazo-Atutxa, E. Venegas-Moreno, P. Benito-Lopez, M.A. Galvez, D.A. Cano, F.J. Tinahones, E. Torres-Vela, A. Soto-Moreno, A. Leal-Cerro, Neurocognitive function in acromegaly after surgical resection of GH-secreting adenoma versus naïve acromegaly. PLoS ONE 8, e60041 (2013)PubMedCentralCrossRefPubMed J.F. Martín-Rodríguez, A. Madrazo-Atutxa, E. Venegas-Moreno, P. Benito-Lopez, M.A. Galvez, D.A. Cano, F.J. Tinahones, E. Torres-Vela, A. Soto-Moreno, A. Leal-Cerro, Neurocognitive function in acromegaly after surgical resection of GH-secreting adenoma versus naïve acromegaly. PLoS ONE 8, e60041 (2013)PubMedCentralCrossRefPubMed
7.
Zurück zum Zitat C. Sievers, P.G. Samann, H. Pfister, C. Dimopoulou, M. Czisch, J. Roemmler, J. Schopohl, G.K. Stalla, J. Zihl, Cognitive function in acromegaly: description and brain volumetric correlates. Pituitary. 15, 350–357 (2012)CrossRefPubMed C. Sievers, P.G. Samann, H. Pfister, C. Dimopoulou, M. Czisch, J. Roemmler, J. Schopohl, G.K. Stalla, J. Zihl, Cognitive function in acromegaly: description and brain volumetric correlates. Pituitary. 15, 350–357 (2012)CrossRefPubMed
8.
Zurück zum Zitat P. Brummelman, J. Koerts, R.P. Dullaart, G. van den Berg, O. Tucha, B.H. Wolffenbuttel, A.P. van Beek, Effects of previous growth hormone excess and current medical treatment for acromegaly on cognition. Eur. J. Clin. Invest. 42, 1317–1324 (2012)CrossRefPubMed P. Brummelman, J. Koerts, R.P. Dullaart, G. van den Berg, O. Tucha, B.H. Wolffenbuttel, A.P. van Beek, Effects of previous growth hormone excess and current medical treatment for acromegaly on cognition. Eur. J. Clin. Invest. 42, 1317–1324 (2012)CrossRefPubMed
9.
Zurück zum Zitat C.G. Yedinak, M. Fleseriu, Self-perception of cognitive function among patients with active acromegaly, controlled acromegaly, and non-functional pituitary adenoma: a pilot study. Endocrine 46, 585–593 (2014)CrossRefPubMed C.G. Yedinak, M. Fleseriu, Self-perception of cognitive function among patients with active acromegaly, controlled acromegaly, and non-functional pituitary adenoma: a pilot study. Endocrine 46, 585–593 (2014)CrossRefPubMed
10.
Zurück zum Zitat K. Müssig, B. Besemer, R. Saur, S. Klingberg, H.U. Häring, B. Gallwitz, T. Leyhe, Deteriorated executive functions in patients with successful surgery for pituitary adenomas compared with other chronically ill patients. J. Int. Neuropsychol. Soc. 17, 369–375 (2011)CrossRefPubMed K. Müssig, B. Besemer, R. Saur, S. Klingberg, H.U. Häring, B. Gallwitz, T. Leyhe, Deteriorated executive functions in patients with successful surgery for pituitary adenomas compared with other chronically ill patients. J. Int. Neuropsychol. Soc. 17, 369–375 (2011)CrossRefPubMed
11.
Zurück zum Zitat L. Pessoa, On the relationship between emotion and cognition. Nat. Rev. Neurosci. 9, 148–158 (2008)CrossRefPubMed L. Pessoa, On the relationship between emotion and cognition. Nat. Rev. Neurosci. 9, 148–158 (2008)CrossRefPubMed
12.
Zurück zum Zitat M. Kirsch, S. Windmann, The role of anxiety in decision making. Rev. Psychol. 16, 19–28 (2009) M. Kirsch, S. Windmann, The role of anxiety in decision making. Rev. Psychol. 16, 19–28 (2009)
13.
Zurück zum Zitat M.P. Paulus, A.J. Yu, Emotions and decision-making: affects-driven belief systems in anxiety and depression. Trends Cog. Sci. 16, 476–483 (2012)CrossRef M.P. Paulus, A.J. Yu, Emotions and decision-making: affects-driven belief systems in anxiety and depression. Trends Cog. Sci. 16, 476–483 (2012)CrossRef
14.
Zurück zum Zitat O.J. Robinson, R.L. Bond, J.P. Roiser, The impact of stress on financial decision-making varies as a function of depression and anxiety symptoms. PeerJ. 3, e770 (2015)PubMedCentralCrossRefPubMed O.J. Robinson, R.L. Bond, J.P. Roiser, The impact of stress on financial decision-making varies as a function of depression and anxiety symptoms. PeerJ. 3, e770 (2015)PubMedCentralCrossRefPubMed
15.
Zurück zum Zitat L.M. Williams, E. Gordon, Dynamic organization of the emotional brain: responsivity, stability and instability. Neuroscientist. 13, 349–370 (2007)CrossRefPubMed L.M. Williams, E. Gordon, Dynamic organization of the emotional brain: responsivity, stability and instability. Neuroscientist. 13, 349–370 (2007)CrossRefPubMed
17.
Zurück zum Zitat A.C. Miu, R.M. Heilman, D. Houser, Anxiety impairs decision-making: psychophysiological evidence from an Iowa gambling task. Biol. Psychol. 77, 353–358 (2008)CrossRefPubMed A.C. Miu, R.M. Heilman, D. Houser, Anxiety impairs decision-making: psychophysiological evidence from an Iowa gambling task. Biol. Psychol. 77, 353–358 (2008)CrossRefPubMed
18.
Zurück zum Zitat C. Sievers, M. Ising, H. Pfister, C. Dimopoulou, H.J. Schneider, J. Roemmler, J. Schopohl, G.K. Stalla, Personality in patients with pituitary adenomas is characterized by increased anxiety related traits: comparison of 70 Acromegalic patients to patients with non-functioning pituitary adenomas and age and gender matched controls. Eur. J. Endocrinol. Metab. 160, 367–373 (2009)CrossRef C. Sievers, M. Ising, H. Pfister, C. Dimopoulou, H.J. Schneider, J. Roemmler, J. Schopohl, G.K. Stalla, Personality in patients with pituitary adenomas is characterized by increased anxiety related traits: comparison of 70 Acromegalic patients to patients with non-functioning pituitary adenomas and age and gender matched controls. Eur. J. Endocrinol. Metab. 160, 367–373 (2009)CrossRef
19.
Zurück zum Zitat S. Melmed, A. Colao, A. Barkan, M. Molitch, A.B. Grossman, D. Kleinberg, D. Clemmons, P. Chanson, E. Laws, J. Schlechte, M.L. Vance, K. Ho, A. Giustina, Guidelines for acromegaly management: an update. J. Clin. Endocrinol. Metab. 94, 1509–1517 (2009)CrossRefPubMed S. Melmed, A. Colao, A. Barkan, M. Molitch, A.B. Grossman, D. Kleinberg, D. Clemmons, P. Chanson, E. Laws, J. Schlechte, M.L. Vance, K. Ho, A. Giustina, Guidelines for acromegaly management: an update. J. Clin. Endocrinol. Metab. 94, 1509–1517 (2009)CrossRefPubMed
20.
Zurück zum Zitat P. Whitney, J.M. Hinson, The role of source memory in gambling task decision making. J. Clin. Exp. Neuropsychol. 34, 826–835 (2012)CrossRefPubMed P. Whitney, J.M. Hinson, The role of source memory in gambling task decision making. J. Clin. Exp. Neuropsychol. 34, 826–835 (2012)CrossRefPubMed
21.
Zurück zum Zitat M.T. Buelow, J.A. Suhr, Construct validity of the Iowa Gambling Task. Neuropsychol. Rev. 19, 102–114 (2009)CrossRefPubMed M.T. Buelow, J.A. Suhr, Construct validity of the Iowa Gambling Task. Neuropsychol. Rev. 19, 102–114 (2009)CrossRefPubMed
22.
Zurück zum Zitat A. Must, Z. Szabó, N. Bódi, A. Szász, Z. Janka, S. Kéri, Sensitivity to reward and punishment and the prefrontal cortex in major depression. J. Affect. Disord. 90, 209–215 (2006)CrossRefPubMed A. Must, Z. Szabó, N. Bódi, A. Szász, Z. Janka, S. Kéri, Sensitivity to reward and punishment and the prefrontal cortex in major depression. J. Affect. Disord. 90, 209–215 (2006)CrossRefPubMed
23.
Zurück zum Zitat J.A. Suhr, J. Tsanadis, Affect and personality correlates of the Iowa Gambling Task. Pers. Indiv. Diff. 43, 27–36 (2007)CrossRef J.A. Suhr, J. Tsanadis, Affect and personality correlates of the Iowa Gambling Task. Pers. Indiv. Diff. 43, 27–36 (2007)CrossRef
24.
Zurück zum Zitat M.E. Toplak, G.B. Sorge, A. Benoit, R.F. West, K.E. Stanovich, Decision-making and cognitive abilities: a review of associations between Iowa Gambling Task performance, executive functions and intelligence. Clin. Psychol. Rev. 30, 562–581 (2010)CrossRefPubMed M.E. Toplak, G.B. Sorge, A. Benoit, R.F. West, K.E. Stanovich, Decision-making and cognitive abilities: a review of associations between Iowa Gambling Task performance, executive functions and intelligence. Clin. Psychol. Rev. 30, 562–581 (2010)CrossRefPubMed
25.
Zurück zum Zitat V.J. Geraedts, C. Dimopoulou, M. Auer, J. Schopohl, G.K. Stalla, C. Sievers, Health outcomes in acromegaly: depression and anxiety are promising targets for improving reduced quality of life. Front. Endocrinol. 5, 229 (2015)CrossRef V.J. Geraedts, C. Dimopoulou, M. Auer, J. Schopohl, G.K. Stalla, C. Sievers, Health outcomes in acromegaly: depression and anxiety are promising targets for improving reduced quality of life. Front. Endocrinol. 5, 229 (2015)CrossRef
26.
Zurück zum Zitat P. Brummelman, M.G.A. Sattler, L.C. Meiners, M.F. Elderson, R.P.F. Dullaart, G. van den Berg, J. Koerts, O. Tucha, B.H.R. Wolffenbuttel, A.C.M. van den Berg, A.P. van Beek, Cognitive performance after postoperative pituitary radiotherapy: a dosimetric study of the hippocampus and the prefrontal cortex. Euro. J. Endocrinol. 166, 171–179 (2012)CrossRef P. Brummelman, M.G.A. Sattler, L.C. Meiners, M.F. Elderson, R.P.F. Dullaart, G. van den Berg, J. Koerts, O. Tucha, B.H.R. Wolffenbuttel, A.C.M. van den Berg, A.P. van Beek, Cognitive performance after postoperative pituitary radiotherapy: a dosimetric study of the hippocampus and the prefrontal cortex. Euro. J. Endocrinol. 166, 171–179 (2012)CrossRef
27.
Zurück zum Zitat P. Brummelman, J. Koerts, R.P.F. Dullaart, G. van den Berg, O. Tucha, B.H.R. Wolffenbuttel, A.P. van Beek, Effects of previous growth hormone excess and current medical treatment for acromegaly on cognition. Eur. J. Clin. Invest. 42, 1317–1324 (2012)CrossRefPubMed P. Brummelman, J. Koerts, R.P.F. Dullaart, G. van den Berg, O. Tucha, B.H.R. Wolffenbuttel, A.P. van Beek, Effects of previous growth hormone excess and current medical treatment for acromegaly on cognition. Eur. J. Clin. Invest. 42, 1317–1324 (2012)CrossRefPubMed
Metadaten
Titel
Impaired decision making and delayed memory are related with anxiety and depressive symptoms in acromegaly
verfasst von
Iris Crespo
Alicia Santos
Elena Valassi
Patricia Pires
Susan M. Webb
Eugenia Resmini
Publikationsdatum
01.12.2015
Verlag
Springer US
Erschienen in
Endocrine / Ausgabe 3/2015
Print ISSN: 1355-008X
Elektronische ISSN: 1559-0100
DOI
https://doi.org/10.1007/s12020-015-0634-6

Weitere Artikel der Ausgabe 3/2015

Endocrine 3/2015 Zur Ausgabe

Leitlinien kompakt für die Innere Medizin

Mit medbee Pocketcards sicher entscheiden.

Seit 2022 gehört die medbee GmbH zum Springer Medizin Verlag

Notfall-TEP der Hüfte ist auch bei 90-Jährigen machbar

26.04.2024 Hüft-TEP Nachrichten

Ob bei einer Notfalloperation nach Schenkelhalsfraktur eine Hemiarthroplastik oder eine totale Endoprothese (TEP) eingebaut wird, sollte nicht allein vom Alter der Patientinnen und Patienten abhängen. Auch über 90-Jährige können von der TEP profitieren.

Niedriger diastolischer Blutdruck erhöht Risiko für schwere kardiovaskuläre Komplikationen

25.04.2024 Hypotonie Nachrichten

Wenn unter einer medikamentösen Hochdrucktherapie der diastolische Blutdruck in den Keller geht, steigt das Risiko für schwere kardiovaskuläre Ereignisse: Darauf deutet eine Sekundäranalyse der SPRINT-Studie hin.

Bei schweren Reaktionen auf Insektenstiche empfiehlt sich eine spezifische Immuntherapie

Insektenstiche sind bei Erwachsenen die häufigsten Auslöser einer Anaphylaxie. Einen wirksamen Schutz vor schweren anaphylaktischen Reaktionen bietet die allergenspezifische Immuntherapie. Jedoch kommt sie noch viel zu selten zum Einsatz.

Therapiestart mit Blutdrucksenkern erhöht Frakturrisiko

25.04.2024 Hypertonie Nachrichten

Beginnen ältere Männer im Pflegeheim eine Antihypertensiva-Therapie, dann ist die Frakturrate in den folgenden 30 Tagen mehr als verdoppelt. Besonders häufig stürzen Demenzkranke und Männer, die erstmals Blutdrucksenker nehmen. Dafür spricht eine Analyse unter US-Veteranen.

Update Innere Medizin

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.