Neuropsychological profile in acromegaly: a single center cross sectional analysis and preliminary prospective long-term study

Background: Psychological and cognitive disorders have been reported in acromegaly, yet with limited and heterogeneous data, especially concerning long-term cognitive functioning. Methods: We conducted a cross-sectional study enrolling 44 acromegalic patients and 40 healthy controls. We systematically assessed anxiety and depressive symptoms through the State-trait Anxiety Inventory and the Beck Depression Inventory, respectively. We investigated their cognitive functioning thorough a wide battery of 16 tests addressing verbal and visuo-spatial memory, attention, verbal fluencies, executive functions and constructional praxis. Moreover, we performed a prospective evaluation in a 10-year time-span of a small subgroup of patients. Results: Clinically significant depressive and anxiety symptoms were registered in 23 and 35% of patients respectively, mostly in the group with active disease at evaluation. Concerning cognition, patients scored worse than controls in all cognitive domains explored, with a significant difference registered in almost all tests administered. Moreover, hypopituitarism and IGF-1 levels seem to be related to a worse cognitive performance, especially in the group of tests exploring the memory domain. In the prospective group, with the limitation of a really small sample size, we observed a global improvement over time in all domains evaluated. Conclusion: Acromegaly is characterized by higher levels of psychological distress and poorer neurocognitive functioning, with a possible association with activity of disease.