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Effects of successful parathyroidectomy on neuropsychological and cognitive status in patients with asymptomatic primary hyperparathyroidism

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Abstract

Purpose

Besides typical clinical symptoms, primary hyperparathyroidism (pHPT) is associated with impaired quality of life and cognitive status. The aim of this study was to evaluate the quality of life and cognitive impairment in patients with pHPT, before and after parathyroidectomy.

Methods

We conducted a panel study, which included asymptomatic pHPT patients scheduled for parathyroidectomy. Besides demographic and clinical data, patients’ quality of life and cognitive capacity were recorded before, 1 month, and 6 months following parathyroidectomy using the Short Form 36 questionnaire (RAND-36), Beck Depression Inventory (BDI), Depression Anxiety Stress Scales (DASS), Mini-Mental State Examination (MMSE), and Symptom Check List 90—revised version (SCL90R).

Results

During a 2-year follow-up, 101 patients entered the study (88 women), with an average age of 60.7 years. The Global score of RAND-36 test ameliorated by almost 50% 6 months after parathyroidectomy. The most sustained subscores of the RAND-36 test were role functioning/physical and health change, with an improvement of more than 125%. According to the BDI, DASS depression subscore, and SCL90R depression subscore, the extent of depressive symptoms reduction was approximately 60% 6 months postoperatively. The level of anxiety was reduced by 62.4%, measured by both the DASS and SCL90R anxiety subscores. The stress level was almost halved according to the DASS stress subscore (from 10.7 to 5.6 points). The results of the MMSE test showed a significant improvement postoperatively, for 1.2 points (4.4%). A worse preoperative score of each tool was related to the higher magnitude of improvement 6 months after parathyroidectomy.

Conclusion

A considerable number of pHPT patients, even without other typical symptoms, show signs of impaired quality of life and neurocognitive status preoperatively. After a successful parathyroidectomy, there is an improvement in quality of life, declined levels of depression, anxiety, and stress, as well as amelioration of cognitive status. Patients with more impaired quality of life and pronounced neurocognitive symptoms may expect more benefits from the surgery.

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Funding

The study was supported by the Ministry of the Education and Science of the Republic of Serbia (grant No 175042).

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Authors and Affiliations

  1. Clinic for Endocrine Surgery, University Clinical Center of Serbia, Belgrade, Serbia

    Milan Jovanovic, Vladan Zivaljevic, Katarina Tausanovic, Nikola Slijepcevic, Branislav Rovcanin, Bozidar Odalovic, Matija Buzejic & Ivan Paunovic

  2. Faculty of Medicine, University of Belgrade, Belgrade, Serbia

    Milan Jovanovic, Vladan Zivaljevic, Katarina Tausanovic, Nikola Slijepcevic, Branislav Rovcanin, Ksenija Jovanovic & Ivan Paunovic

  3. Institute of Epidemiology, Faculty of Medicine, University of Belgrade, Belgrade, Serbia

    Sandra Sipetic Grujicic

  4. Center for Anesthesiology and Resuscitation, University Clinical Center of Serbia, Belgrade, Serbia

    Ksenija Jovanovic

  5. Faculty of Medicine Pristina/K. Mitrovica, University of Pristina/K. Mitrovica, K. Mitrovica, Serbia

    Bozidar Odalovic

  6. Institute of Medical Statistics and Informatics, Faculty of Medicine, University of Belgrade, Belgrade, Serbia

    Zoran Bukumiric

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  1. Milan Jovanovic
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Jovanovic, M., Zivaljevic, V., Sipetic Grujicic, S. et al. Effects of successful parathyroidectomy on neuropsychological and cognitive status in patients with asymptomatic primary hyperparathyroidism. Endocrine 81, 592–601 (2023). https://doi.org/10.1007/s12020-023-03426-3

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