Objective: To describe the evolution of neurobehavioral and cognitive symptoms in patients with primary hyperparathyroidism as measured by mini-mental state (MMS), Hamiltons 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.
30 Apr - 04 May 2011
European Society of Endocrinology