Correlation between hypo-pituitarism and poor cognitive function using neuropsychological tests after aneurysmal subarachnoid haemorrhage: A pilot study

Clin Neurol Neurosurg. 2022 Mar:214:107167. doi: 10.1016/j.clineuro.2022.107167. Epub 2022 Feb 9.

Abstract

Background: Hypopituitarism seems to be rather common following aneurysmal subarachnoid haemorrhage (aSAH), even though its real prevalence remains unclear and the effects on six-month patient functional outcomes are debatable. This study correlated hypopituitarism after aSAH and cognitive performances using neuropsychological tests.

Methods: In a prospective cohort of patients with aSAH, basal pituitary hormone testing was undergone and two neuropsychological tests, Montreal Cognitive Assessment (MoCA) and Mini Mental Status Examination (MMSE), were administered in three phases: in the subacute phase (2 weeks), the chronic phase (3-6 months) and the follow-up phase (6-12 months) post aSAH.

Results: Twenty-five patients were enrolled in the study. Considering the median values of MMSE and MoCA in the subacute phase there was an association with hypo-free triiodothyronine (fT3) (p = 0.03, p = 0.03), hypo-luteinizing hormone (LH) (p = 0.002, p = 0.0002), hypo-follicle stimulating hormone (FSH) (p = 0.002, p = 0.002) and hypo-testosterone (p = 0.02, p = 0.05) respectively. Similarly, in the chronic phase we found an association of median values of MMSE and MoCA with hypo-free thyroxine (fT4) (p = 0.03, p = 0.03), hypo-LH (p = 0.03, p = 0.03) and hypo-FSH (p = 0.03, p = 0.03), respectively. Finally, in the follow-up phase, MMSE and MoCA correlated with hypo-fT4 (p = 0.03, p = 0.03), hypo-LH (p = 0.05, p = 0.05) and hypo-FSH (p = 0.05, p = 0.05), respectively.

Conclusions: For aSAH patients in the post-acute phase, neuropsychological tests can represent an inexpensive tool to confirm cognitive impairment, which can be associated with neuroendocrine dysfunction.

Keywords: Hypopituitarism; MMSE; MoCA; Neurological outcome; Subarachnoid haemorrhage.

MeSH terms

  • Cognition
  • Cognitive Dysfunction* / complications
  • Cognitive Dysfunction* / etiology
  • Follicle Stimulating Hormone
  • Humans
  • Hypopituitarism* / complications
  • Hypopituitarism* / etiology
  • Luteinizing Hormone
  • Neuropsychological Tests
  • Pilot Projects
  • Prospective Studies
  • Subarachnoid Hemorrhage* / complications
  • Subarachnoid Hemorrhage* / diagnosis
  • Subarachnoid Hemorrhage* / epidemiology

Substances

  • Luteinizing Hormone
  • Follicle Stimulating Hormone