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Related Experiment Video

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Neuropsychological Changes in Primary Hyperparathyroidism after Parathyroidectomy.

Jessica Y Liu1, Neil D Saunders, Aaron Chen

  • 1Division of General Surgery, Department of Surgery, Emory University, Atlanta, Georgia, USA.

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|September 28, 2016
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Parathyroidectomy significantly improves neuropsychiatric symptoms like depression and anxiety in primary hyperparathyroidism patients. These symptoms are more common in PHPT patients and surgery offers substantial relief.

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Area of Science:

  • Endocrinology
  • Neurosurgery
  • Psychiatry

Background:

  • Neuropsychiatric symptoms (NPSs) in sporadic primary hyperparathyroidism (PHPT) are often subtle.
  • The impact of parathyroidectomy (PTX) on these NPSs is not well understood.

Purpose of the Study:

  • To evaluate the effects of PTX on NPSs in patients diagnosed with PHPT.
  • To compare NPSs in PHPT patients undergoing PTX versus a control group undergoing thyroidectomy (TX).

Main Methods:

  • Prospective questionnaire study including validated scales: Patient Health Questionnaire-9 (PHQ-9) for depression and Generalized Anxiety Disorder-7 (GAD-7) for anxiety.
  • Modified Pasieka's Parathyroid Assessment of Symptoms (M-PAS) scale was also used.
  • Data collected from 58 patients undergoing PTX and 41 patients undergoing TX.

Main Results:

  • PHPT patients undergoing PTX had significantly higher preoperative scores for total symptoms, depression, anxiety, and M-PAS compared to the TX group (P < 0.05).
  • Post-PTX, patients showed significant reductions in total score, PHQ-9, GAD-7, and M-PAS scores (P < 0.05), unlike the TX group.
  • Post-PTX, symptom-free rates increased, with 69.0% showing no depression and 82.8% no anxiety, while severe symptoms decreased to 0%.

Conclusions:

  • NPSs are more prevalent in PHPT patients compared to those undergoing TX.
  • Parathyroidectomy leads to significant improvements in neuropsychiatric symptoms for PHPT patients.
  • NPS scoring should be standard for PHPT patients, with symptom severity considered a potential indication for PTX.