Dados do Trabalho

Título

Cognitive Assessment in Pinealectomized Patients: The Impact of Melatonin Deficiency on Cognitive Function

Introdução

Melatonin, a hormone produced by the pineal gland, plays a crucial role in regulating the sleep-wake cycle. However, its mechanisms of action and a possible role in cognitive performance remain not fully understood. Pinealectomized patients, who lack circulating melatonin, provide a valuable model for studying the effe

Objetivo

To define the cognitive profile of pinealectomized hypomelatoninemic patients.

Métodos

This was a bi-centric study project approved by the Ethics Committee of both institutions. Six patients with pineal gland tumor, not age restricted, were evaluated, regardless of histological type. All had previous tumor resection, or radioablation, and total pinealectomy, without anterior hypothalamic involvement. All patients had prior measurement of urinary 6-sulfatoxymelatonin confirming the absence of excretion of this metabolite.
For cognitive screening, were applied: Brief Cognitive Screening Battery (BB), Montreal Cognitive Assessment (MoCA), and Digit Span (DS).

Resultados

The sample (n=6) consisted of individuals aged between 15 and 29 years median 17 [16-20], 83% were male. Half of the patients were attending secondary education, and the other half had incomplete higher education.
In the BB, the median score of the patients was 64[53.5-71.5]. In incidental memory, the median score was 5.5 [5-6], in immediate memory 8 [8-8], learning 8.5 [8.25-9.75], delayed memory 7 [6.25-8.5], and in recognition, all individuals correctly identified the 10 images. In the verbal fluency test, the median was 17 [15-20.5]and in the clock drawing test, the median was 7 [4.5-9.5]
In the MoCa test, the median was 19 [16.5-24.5], values above or equal to 26 are considered normal for this test (1). Only 2 patients (33%) in our sample achieved this score. In the DS test, the median was 7.5 [6.25-12.5].

Conclusões

Age comparison showed that individuals closer to the third quartile (20 years old) and those with higher education levels performed better across evaluated domains.
Although normative values for the instruments used in this specific population are lacking, these findings indicate a decrease in cognitive performance for pinealectomized patients in MoCa test. However, the overall cognitive performance was mainly influenced by age and educational level.
Characterizing the cognitive profile of pinealectomized patients is a first step in understanding the impact of the absence of melatonin, which will be better evaluated by comparing results after melatonin replacement.

Palavras -chave

Melatonin; Pineal; Cognitive