ECE2011 Oral Communications Bone/Reproduction (6 abstracts)
Evolution of neurobehavioral and cognitive symptoms in patients with primary hyperparathyroidism belonging to the Swiss primary hyperparathyroidism cohort
A Trombetti 1 , C Meier 2 , G Gold 1 , C Torriani 1 , C Henzen 3 , F R Herrmann 1 , E R Christ 5 , M Braendle 4 , M E Kraenzlin 2 & R Rizzoli 1
1University Hospital, Geneva, Switzerland; 2University Hospital, Basel, Switzerland; 3Kantonspital, Luzern, Switzerland; 4Kantonspital, St Gallen, Switzerland; 5University Hospital, Bern, Switzerland.
Objective: To describe the evolution of neurobehavioral and cognitive symptoms in patients with primary hyperparathyroidism as measured by mini-mental state (MMS), Hamilton’s anxiety and depression scale (HADS) and Clock tests. Scores were also compared with biochemical data.
Methods: The Swiss primary hyperparathyroidism (PHPT) Cohort Study is an ongoing, prospective, non-interventional national project collecting clinical, biochemical and outcome data in patients with PHPT. Newly diagnosed patients were enrolled. All three tests applied were interpreted centrally. Thereafter, follow-up data were recorded every 6 months as recommended by the NIH guidelines at the time of study onset. The tests were re-administered on a yearly basis. Patients with parathyroidectomy had one follow-up visit 3 to 6 months after surgery. We applied a multiple regression model comparing test results with serum calcium, serum parathyroid hormone (PTH) and serum 25-hydroxyvitamin D, adjusting for age and gender.
Results: From June 2007 to December 2010, 253 patients (mean age 68.8±14.5 years; 77.5% female) were included. To avoid the effect of age, we limited our analysis to the 100 subjects aged 65 years old and less. Fifty-one had completed at least one of the neuropsychological tests. We found a positive correlation between PTH levels and the HADS anxiety scores (r=0.23, P=0.01) and a negative one with MMS scores (r=−0.13, P=0.03). A Wilcoxon matched-pairs signed-rank test showed an improvement in MMS (P=0.04), anxiety (P=0.01) and depression (P=0.02) scores in the 16 operated patients.
Conclusion: The severity of PHPT as evaluated by serum markers is correlated with impaired cognitive functions, increased anxiety and depression. These alterations may be reversible upon treatment by parathyroidectomy.
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Endocrine Abstracts
ISSN 1470-3947 (print) | ISSN 1479-6848 (online)
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