, Volume 65, Issue 3, pp 524–530 | Cite as

Early detection of cognitive impairment in patients with insulinoma

  • Hongmei Dai
  • Hao Chen
  • Xiafei Hong
  • Xianlin Han
  • Qiang Xu
  • Haiyu Pang
  • Jing Yuan
  • Xianze Wang
  • Peiran Xu
  • Jialin Jiang
  • Rui Jiang
  • Zhe Zhuang
  • Yupei ZhaoEmail author
  • Wenming WuEmail author
Original Article



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.


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.


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.


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.


Cognitive impairment Insulinoma MoCA Hypoglycemia 



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).

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

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

Informed consent

The authors declare that they have no conflict of interest.

Supplementary material

12020_2019_1994_MOESM1_ESM.docx (58 kb)
Supplementary Information


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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2019

Authors and Affiliations

  • Hongmei Dai
    • 1
  • Hao Chen
    • 1
  • Xiafei Hong
    • 1
  • Xianlin Han
    • 1
  • Qiang Xu
    • 1
  • Haiyu Pang
    • 2
  • Jing Yuan
    • 3
  • Xianze Wang
    • 1
  • Peiran Xu
    • 1
  • Jialin Jiang
    • 1
  • Rui Jiang
    • 1
  • Zhe Zhuang
    • 4
  • Yupei Zhao
    • 1
    Email author
  • Wenming Wu
    • 1
    Email author
  1. 1.Department of General Surgery, Peking Union Medical College HospitalChinese Academy of Medical Sciences and Peking Union Medical CollegeBeijingChina
  2. 2.Medical Research Center, Peking Union Medical College HospitalChinese Academy of Medical Sciences and Peking Union Medical CollegeBeijingChina
  3. 3.Department of Neurology, Peking Union Medical College HospitalChinese Academy of Medical Sciences and Peking Union Medical CollegeBeijingChina
  4. 4.School of MedicineTsinghua UniversityBeijingChina

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