Neuropsychiatric and cognitive changes after surgery for primary hyperparathyroidism

Neuropsychiatric symptoms and cognitive impairment are mental manifestations of primary hyperparathyroidism (pHPT). The aim of our study was to determine if surgical treatment results in a long-lasting full recovery from these symptoms.

In a prospective case-control study with matching pairs, mental changes were examined preoperatively and 6 months postoperatively in 30 patients with primary hyperparathyroidism and 30 patients with nontoxic nodular goiter using the Hamilton depression score and four cognitive tests: DEM Tect, MWT (multiple word test), ZVT, and Benton test.

Patients with pHPT demonstrated significantly more cognitive changes (P < 0.0001) with significant improvement 6 months postoperatively (P < 0.0001). Patients with pHPT presented more psychopathologic symptoms than patients of the control group (P = NS), and there was a tendency towards recovery in the pHPT group postoperatively. There was no correlation between biochemistry and psychopathologic or cognitive changes in the pHPT group.

Patients with pHPT often present with neuropsychiatric symptoms and cognitive impairment. A successful parathyroid operation improves cognitive disorders in particular.