Pituitary neuroendocrine tumor: A neuropsychological comparison with intra-axial tumor.

OBJECTIVE: Despite pituitary neuroendocrine tumor (PitNET) being extra-axial tumors without direct damage to brain tissue, patients with PitNET exhibit neuropsychological impairments. However, it remains unclear whether there are neuropsychological differences between PitNET and intra-axial tumors that directly destroy the brain parenchyma. This prospective study aims to clarify this distinction to inform decision-making for intracranial tumors of diverse origins. METHODS: A total of 146 patients with PitNET, 74 patients with glioma representing intra-axial tumors, and 52 age-, sex-, and education-matched healthy controls were recruited. All patients received standard treatment and postoperative rehabilitation. Clinical data were meticulously collected, and neuropsychological tests were administered to all participants both before and 3 months after surgery. RESULTS: Both PitNET and glioma patients experience the dual burden of cognitive and affective deficits. However, the feature of these deficits differs substantially. In PitNET patients, the deficits are relatively mild and focal, whereas in glioma patients, they are severe and extensive. Specifically, PitNET patients exhibit deficits in memory, anxiety, and negative affect. In contrast, glioma patients display deficits in executive function, attention, anxiety, positive/negative affect, and empathy. Notably, except for persistent memory deficits, the majority of neuropsychological scores declines in PitNET patients are restorable and can reach improvement within a short period after standard surgical therapy and perioperative management. Conversely, glioma patients not only fail to show improvements but also demonstrate worsening in terms of general cognition and memory postoperatively. INTERPRETATION: As an extra-axial tumor, PitNET may exhibit distinctive cognitive and affective functioning compared to intra-axial tumors, highlighting the need for specific treatment approaches for PitNET patients.

Development of a High-Field "Brick" Mass Spectrometer with Extended Mass Range and Capable of Characterizing Native Proteins.

One of the main challenges of analyzing intact proteins on an ion trap mass spectrometer is the mass range limitation, especially for miniature mass spectrometers. In this study, a high-field frequency scanning ion trap miniature mass spectrometer, namely the high-field "Brick" mass spectrometer, was developed to analyze intact proteins. A high-voltage broadband radio frequency (rf) amplifier was designed with a maximum output of 900 Vp-p over a frequency range of 130-700 kHz. Compared to the 600 Vp-p rf amplifier equipped in the conventional "Brick" mass spectrometer, the mass range of the instrument could be extended from 2000 to over 8000 Th. Sensitivity and mass resolution for native protein analyses were also evaluated and compared. Various proteins as well as their mixtures were analyzed on the high-field "Brick" mass spectrometer. The noncovalent interaction between protein-ligand complexes, lysozyme with triN-acetylchitotriose, was also analyzed. In addition, a hybrid ion scan mode was explored to further expand the mass range of the instrument at both low- and high-mass ends. In the hybrid ion scan mode, both rf frequency and amplitude were tuned, and a mass range from 100 to 12,000 Th was realized. As a result, both small drugs and proteins could be analyzed in a single mass scan. As proof-of-concept demonstrations, a mixture of atenolol and bovine serum albuminand oligomers of transferrin were analyzed.

Field-Gradient-Focusing Ion Guide for Enhanced Transfer Efficiency of Low-Mass Ions.

Efficient transmission of low-mass ions in a rough vacuum pressure region has always been a challenging issue in mass spectrometry (MS). In this study, a novel ion guide, namely, field-gradient-focusing ion guide (FGF-IG), was proposed to improve the transfer efficiency of ions, especially low-mass ions in a rough vacuum region. The FGF-IG has 12 electrodes whose surfaces gradually narrowed and tilted inward, and its electric field gradually varies from dodecapole (or multipole) to quadrupole along the ion transfer route. The field radius was gradually decreased from 6 to 2 mm in the multipole region (65 mm in length) and finally remained unchanged as 2 mm in the quadrupole region (20 mm in length). By integrating into a miniature mass spectrometer (mini-MS) with a continuous atmospheric pressure interface, this ion guide was optimized in terms of inlet capillary position, radio frequency amplitude, and direct current voltage applied on it. Results showed that a reduced low-mass discrimination effect and improved efficiency of simultaneously transferring mid and low m/z ions were achieved for FGF-IG compared with a conventional ion funnel. Under optimized conditions, a limit of detection of 1 ng/mL was obtained for both reserpine (m/z 609) and arginine (m/z 175) ions by integrating FGF-IG into the mini-MS. The sensitivity of smaller arginine ions using FGF-IG was enhanced by ∼10 times than that obtained using the conventional ion funnel (10 ng/mL) in comparative experiments. The idea of smooth transfer from dodecapole to quadrupole fields could be extended to other multipole fields, as well as in lab-scale MS instruments.

Parallel Pseudo-MRM on the "brick" miniature mass spectrometer for high throughput multi-target screening.

With increasingly improved analytical performances, miniature mass spectrometers are expandingly applied in more application scenarios. The capability of high throughput analysis of multi-targets is a crucial function of a miniature mass spectrometer, especially for in-situ applications. As a powerful method for target screening, multiple reaction monitoring (MRM) was conventionally realized on triple quadrupole (QQQ) mass spectrometers. Previously, pseudo-multiple reaction monitoring (pseudo-MRM) operation mode has been realized on a "brick" mass spectrometer equipped with a single ion trap. However, pseudo-MRM on an ion trap was realized through the tandem-in-time fashion, and the throughput of pseudo-MRM was still limited. As a continuous effort to boost performances of the "brick" miniature mass spectrometer, parallel pseudo-MRM mode was developed, and the throughput could be raised up to 10 times for multi-target screening. To achieve better isolation and collision induced dissociation (CID) efficiencies, the mass range of interest was divided into several segments based on optimized Mathieu q value. The fast screening of 10 different drugs was used as an illustrative example. Furthermore, parallel quantitative analysis was also demonstrated and verified using the internal standard calibration method.

Brainstem tumors may increase the impairment of behavioral emotional cognition in children.

PURPOSE: It remains unclear as to whether patients with brainstem tumor experience complex neuropsychiatric problems. In this cohort study, we specifically investigated behavioral, emotional and cognitive symptoms in pediatric patients with brainstem glioma and healthy individuals. METHODS: A total of 146 patients with pediatric brainstem tumors (aged 4-18 years old) and 46 age-matched healthy children were recruited to assess their behaviors and emotions examined by the Child Behavior Checklist. A variety of clinical factors were also analyzed. RESULTS: There were significant differences in most behavioral and emotional symptoms between pediatric patients and healthy subjects. Moreover, patients with pons tumors exhibited significantly higher scores than patients with medulla oblongata tumors (p = 0.012), particularly in concerning the syndrome categories of Withdrawn (p = 0.043), Anxious/depressed symptoms (p = 0.046), Thought Problems (p = 0.004), Attention deficits (p = 0.008), Externalizing problems (p = 0.013), and Aggressive behavior (p = 0.004). A tumor body located in the pontine (p = 0.01, OR = 4.5, 95% CI = 1.4-14.059) or DIPG in the midbrain (p = 0.002, OR = 3.818, 95% CI = 1.629-8.948) appears to act as a risk factor that is associated with more problems in patients with neuropsychiatric symptoms. CONCLUSIONS: Pediatric patients with brainstem tumors exhibit severe behavioral and emotional problems. Tumor invades the pontine and midbrain act a risk factor with more problems. It suggests that structural and functional abnormalities in the brainstem will cause prolonged behavioral problems and emotional-cognitive dysfunctions in young children.