Postoperative changes in circulating brain injury biomarkers in relation to long-term fatigue and cognitive outcomes after surgery for nonfunctioning pituitary adenomas
Authors' conclusion
Endoscopic transsphenoidal surgery for NFPAs is associated with transient increases in circulating brain injury biomarkers, particularly in patients with hypothalamic compression. Our findings revealed that these elevations were not related to long-term fatigue or cognitive decline
Study context
- Population
- Patients with nonfunctioning pituitary adenomas (NFPAs) undergoing endoscopic transsphenoidal surgery
- Participants
- 68 patients
- Outcome
- Association of postoperative changes in plasma GFAP, NfL and tau with fatigue (Multidimensional Fatigue Inventory) and cognitive performance (RBANS)
- Follow-up
- 12 months postsurgery
Main finding
As reported in the abstract
Association of increased postoperative biomarker levels with changes in fatigue or cognitive performance · 12 months
- No significant associations between increased postoperative biomarker levels and changes in fatigue or cognitive performance
Observational data: associations, not effects.
Further findings
Postoperative biomarker levels
- All biomarkers increased significantly after surgery; tau peaked immediately, glial fibrillary acidic protein (GFAP) on day 1, NfL on day 5
- all p < 0.01
- Preoperative hypothalamic compression: greater postoperative increases in GFAP and NfL
Fatigue and cognitive performance at group level · 12 months
- Fatigue improved at the group level; cognitive performance remained stable
Clinically meaningful worsening (≥ 0.5 SD from baseline) · 12 months
- Worsening of fatigue
- 8/58 patients (14%)
- Worsening of cognitive performance
- 6/31 patients (19%)
Original publication
Postoperative changes in circulating brain injury biomarkers in relation to long-term fatigue and cognitive outcomes after surgery for nonfunctioning pituitary adenomas. Pituitary. Published 1 July 2026. doi:10.
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