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

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.

The dopamine-somatostatin chimeric compound BIM-23A760 exerts antiproliferative and cytotoxic effects in human non-functioning pituitary tumors by activating ERK1/2 and p38 pathways.

The study investigated the effects of the dopamine-somatostatin chimeric compound BIM-23A760 on cell proliferation and apoptosis in cultured cells from human non-functioning pituitary tumors (NFPTs). Both BIM-23A760 and the dopaminergic agonist BIM-53097 induced a significant inhibition of cell proliferation associated with increased p27 expression, together with a significant increase in caspase-3 activity. Conversely, null or marginal effects were elicited by somatostatin analogs. Moreover, BIM-23A760 and BIM-53097 induced ERK1/2 and p38 phosphorylation and the blockade of these pathways prevented both the antiproliferative and the pro-apoptotic effects of these drugs. In conclusions the chimeric compound BIM-23A760 is able to exert cytostatic and cytotoxic effects in NFPTs, these phenomena being mainly mediated by DR2D and involving ERK1/2 and p38 pathways activation.