Early detection of cognitive impairment in patients with insulinoma
Early detection of cognitive impairment in patients with insulinoma
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早期发现胰岛素瘤患者的认知障碍
DOI：
10.1007/s12020-019-01994-x
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发表时间：
2019-09-01
期刊：
影响因子：
3.7
通讯作者：
Wu, Wenming
中科院分区：
文献类型：
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作者：
Dai, Hongmei;Chen, Hao;Wu, Wenming
目的长期低血糖可导致认知功能障碍，而反复发生的严重低血糖是否会影响胰岛素瘤患者的认知功能，目前尚无研究。本研究旨在探讨胰岛素瘤患者的认知功能。方法于2016年1月至2017年7月采用蒙特利尔认知评估(MoCA)问卷对胰岛素瘤患者的认知功能进行前瞻性研究，并于术后1年对认知障碍患者进行随访。结果34例胰岛素瘤患者中有18例(53%)存在MoCA评分阳性的认知功能障碍，以MoCA评分和26分为标准。认知障碍患者在某些认知领域的表现明显更差，包括视觉空间和执行功能、延迟记忆、注意力、语言和抽象。多因素分析显示，MoCA评分与肿瘤分级和文化程度显著相关。有8名认知障碍患者失去了随访。其余10例患者术后1年认知功能改善，7例患者认知功能恢复正常。结论胰岛素瘤患者术后1年存在认知功能障碍，部分患者认知功能障碍是可逆的。需要更多的研究来探索胰岛素瘤患者认知障碍存在和可逆性的潜在机制。
PurposeLong-standing hypoglycemia can cause cognitive impairment, and whether recurrent severe hypoglycemia impacts cognitive function in patients with insulinoma has not been studied. This study focused on exploring the cognitive function in patients with insulinoma.MethodsA prospective study was conducted to assess cognitive function in patients with insulinoma by administering the Montreal Cognitive Assessment (MoCA) questionnaire between January 2016 and July 2017, and patients with cognitive impairment were followed up to undergo the MoCA test 1 year after surgery. The MoCA scores after surgery were compared with the scores before surgery, and the associations between cognitive impairment and relevant factors were further evaluated by multiple linear regression analysis.ResultsEighteen out of thirty-four patients (53%) with insulinoma were screened positive for cognitive impairment as defined by a MoCA score <26. Performance in certain cognitive domains, including visuospatial and executive functions, delayed memory, attention, language, and abstraction, was significantly worse in patients with cognitive impairment. Multivariate analysis indicated that MoCA scores correlated significantly with tumor grade and years of education. Eight patients with cognitive impairment were lost to follow-up. The remaining ten patients with cognitive impairment showed improvements 1 year postoperatively, and seven patients recovered to normal cognitive function.ConclusionsCognitive impairment was found in patients with insulinoma and was reversible in some patients 1 year after surgery. More studies are needed to explore the underlying mechanisms of the existence and reversibility of cognitive impairment in patients with insulinoma.