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Early detection of cognitive impairment in patients with insulinoma

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Abstract

Purpose

Long-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.

Methods

A 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.

Results

Eighteen 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.

Conclusions

Cognitive 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.

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Acknowledgements

This work was supported by the National Natural Science Foundation of China (81573009, 81773292, 81603157) and Chinese Academy of Medical Sciences Initiative for Innovative Medicine (CAMS-I2M 2017-I2M-1-001).

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Author notes

  1. These authors jointly supervised this work: Hongmei Dai, Hao Chen

  2. These authors contributed equally: Yupei Zhao, Wenming Wu

Authors and Affiliations

  1. Department of General Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China

    Hongmei Dai, Hao Chen, Xiafei Hong, Xianlin Han, Qiang Xu, Xianze Wang, Peiran Xu, Jialin Jiang, Rui Jiang, Yupei Zhao & Wenming Wu

  2. Medical Research Center, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China

    Haiyu Pang

  3. Department of Neurology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China

    Jing Yuan

  4. School of Medicine, Tsinghua University, Beijing, China

    Zhe Zhuang

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  1. Hongmei Dai
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  2. Hao Chen
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Corresponding authors

Correspondence to Yupei Zhao or Wenming Wu.

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The authors declare that they have no conflict of interest.

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The study protocol (S-K654) was approved by the Institutional Ethics Committee of PUMCH, Chinese Academy of Medical Sciences.

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Dai, H., Chen, H., Hong, X. et al. Early detection of cognitive impairment in patients with insulinoma. Endocrine 65, 524–530 (2019). https://doi.org/10.1007/s12020-019-01994-x

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  • DOI: https://doi.org/10.1007/s12020-019-01994-x

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