Skip to main content
Top
Published in: World Journal of Surgery 5/2006

01-05-2006

Neuropsychiatric and Cognitive Changes after Surgery for Primary Hyperparathyroidism

Authors: Cornelia M.E. Dotzenrath, MD, Ana Karena Kaetsch, MD, Henrich Pfingsten, MD, Kenko Cupisti, MD, Norbert Weyerbrock, MD, Alexander Vossough, MD, Pablo E. Verde, MS, Christian Ohmann, MS

Published in: World Journal of Surgery | Issue 5/2006

Login to get access

Abstract

Introduction

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.

Methods

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.

Results

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.

Conclusions

Patients with pHPT often present with neuropsychiatric symptoms and cognitive impairment. A successful parathyroid operation improves cognitive disorders in particular.
Literature
1.
go back to reference Watson KC, Marx CE. New onset of neuropsychiatric symptoms in the elderly. Psychosomatics 2002;43:413–417CrossRefPubMed Watson KC, Marx CE. New onset of neuropsychiatric symptoms in the elderly. Psychosomatics 2002;43:413–417CrossRefPubMed
2.
go back to reference Okamoto T, Kamo T, Obara T. Outcome study of psychological distress and nonspecific symptoms in patients with mild primary hyperparathyroidism. Arch Surg 2002;137:779–783CrossRefPubMed Okamoto T, Kamo T, Obara T. Outcome study of psychological distress and nonspecific symptoms in patients with mild primary hyperparathyroidism. Arch Surg 2002;137:779–783CrossRefPubMed
3.
go back to reference Joburn C, Hetta J, Lind L, et al. Self rated psychiatric symptoms in patients operated on because of primary hyperparathyroidism and in patients with long standing mild hypercalcemia. Surgery 1989;105:72–78 Joburn C, Hetta J, Lind L, et al. Self rated psychiatric symptoms in patients operated on because of primary hyperparathyroidism and in patients with long standing mild hypercalcemia. Surgery 1989;105:72–78
4.
go back to reference Goyal A, Chumber S, Tandon N, et al. Neuropsychiatric manifestations in patients of primary hyperparathyroidism and outcome following surgery. Ind J Med Sci 2001;12:677–686 Goyal A, Chumber S, Tandon N, et al. Neuropsychiatric manifestations in patients of primary hyperparathyroidism and outcome following surgery. Ind J Med Sci 2001;12:677–686
5.
go back to reference Brown RS Jr, Fishman A, Showalter CR. Primary hyperparathyroidism, hypercalcemia, paranoid delusions, homocide, and attempted murder. J Forensic Sci 1987;32:1460–1463PubMed Brown RS Jr, Fishman A, Showalter CR. Primary hyperparathyroidism, hypercalcemia, paranoid delusions, homocide, and attempted murder. J Forensic Sci 1987;32:1460–1463PubMed
6.
go back to reference Rastad J, Joburn C, Akerström G, et al. Incidence, type and severity of psychic symptoms in patients with sporadic primary hyperparathyroidism. J Endocrinol Invest 1992;15:149–156PubMed Rastad J, Joburn C, Akerström G, et al. Incidence, type and severity of psychic symptoms in patients with sporadic primary hyperparathyroidism. J Endocrinol Invest 1992;15:149–156PubMed
8.
go back to reference Hedlund JL, Vieweg BW. The Hamilton rating scale for depression: a comprehensive review. J Operational Psychiatry 1979;10:149–166 Hedlund JL, Vieweg BW. The Hamilton rating scale for depression: a comprehensive review. J Operational Psychiatry 1979;10:149–166
9.
go back to reference Oswald DW, Roth E. Der Zahlenverbindungstest (ZVT). Göttingen, Hogrefe, 1987 Oswald DW, Roth E. Der Zahlenverbindungstest (ZVT). Göttingen, Hogrefe, 1987
10.
go back to reference Orgel SA, McDonald RD. Notes and comments: an evaluation of the Trail Making Test. J Consult Psychol 1967;31:77–79 Orgel SA, McDonald RD. Notes and comments: an evaluation of the Trail Making Test. J Consult Psychol 1967;31:77–79
11.
go back to reference Lehrl S. Der MWT: Ein Intelligenztest für die ärztliche Praxix. Neurol Psychatr 1976;7:488–491 Lehrl S. Der MWT: Ein Intelligenztest für die ärztliche Praxix. Neurol Psychatr 1976;7:488–491
12.
go back to reference Kalbe E, Kessler J, Calabrese P, et al. DEM test: a new, sensitive cognitive screening test to support the diagnosis of mild cognitive impairment and early dementia. Int J Geriatr Psychiatry 2004;19:136–143CrossRefPubMed Kalbe E, Kessler J, Calabrese P, et al. DEM test: a new, sensitive cognitive screening test to support the diagnosis of mild cognitive impairment and early dementia. Int J Geriatr Psychiatry 2004;19:136–143CrossRefPubMed
13.
go back to reference Sivan Benton A, Spreen O. Der Benton Test. Bern, Verlag Hand Huber, 1996 Sivan Benton A, Spreen O. Der Benton Test. Bern, Verlag Hand Huber, 1996
14.
go back to reference Prager G, Kalaschek A, Kaczirek K, et al. Parathyroidectomy improves concentration and retentiveness in patients with primary hyperparathyroidism. Surgery 2002;132:930–936CrossRefPubMed Prager G, Kalaschek A, Kaczirek K, et al. Parathyroidectomy improves concentration and retentiveness in patients with primary hyperparathyroidism. Surgery 2002;132:930–936CrossRefPubMed
15.
go back to reference Quiros RM, Alef MJ, Wilhelm SM, et al. Health related quality of life in hyperparathyroidism measurably improves after parathyroidectomy. Surgery 2003;134:675–681CrossRefPubMed Quiros RM, Alef MJ, Wilhelm SM, et al. Health related quality of life in hyperparathyroidism measurably improves after parathyroidectomy. Surgery 2003;134:675–681CrossRefPubMed
16.
go back to reference Sheldon DG, Lee FT, Neil NJ, et al. Surgical treatment of hyperparathyroidism improves health related quality of life. Arch Surg 2002;137:1022–1028CrossRefPubMed Sheldon DG, Lee FT, Neil NJ, et al. Surgical treatment of hyperparathyroidism improves health related quality of life. Arch Surg 2002;137:1022–1028CrossRefPubMed
17.
go back to reference Pasieka JL, Parson LL, Demeure MJ, et al. Patient-based surgical outcome tool demonstrating alleviation of symptoms following parathyroidectomy in patients with primary hyperparathyroidism. World J Surg 2002;26:942–949CrossRefPubMed Pasieka JL, Parson LL, Demeure MJ, et al. Patient-based surgical outcome tool demonstrating alleviation of symptoms following parathyroidectomy in patients with primary hyperparathyroidism. World J Surg 2002;26:942–949CrossRefPubMed
18.
go back to reference Prete C, Foppiani L, Trasciatti S, et al. Primary hyperparathyroidism and neuropsychiatric alterations in a nonagenarian woman. Aging Clin Exp Res 2005;17:67–70PubMed Prete C, Foppiani L, Trasciatti S, et al. Primary hyperparathyroidism and neuropsychiatric alterations in a nonagenarian woman. Aging Clin Exp Res 2005;17:67–70PubMed
19.
go back to reference NIH Consensus Development Conference Panel. Diagnosis and management of asymptomatic primary hyperparathyroidism: consensus development conference statement. Ann Intern Med 1991;114:593–597 NIH Consensus Development Conference Panel. Diagnosis and management of asymptomatic primary hyperparathyroidism: consensus development conference statement. Ann Intern Med 1991;114:593–597
20.
go back to reference Eigelberger MS, Cheah WK, Ituarte PH, et al. The NIH criteria for parathyroidectomy in asymptomatic primary hyperparathyroidism: are they too limited? Ann Surg 2004;239:381–382 Eigelberger MS, Cheah WK, Ituarte PH, et al. The NIH criteria for parathyroidectomy in asymptomatic primary hyperparathyroidism: are they too limited? Ann Surg 2004;239:381–382
21.
go back to reference Solomon BL, Schaaf M, Smallridge RC. Psychologic symptoms before and after parathyroid surgery. JAMA 1994;96:101–106 Solomon BL, Schaaf M, Smallridge RC. Psychologic symptoms before and after parathyroid surgery. JAMA 1994;96:101–106
Metadata
Title
Neuropsychiatric and Cognitive Changes after Surgery for Primary Hyperparathyroidism
Authors
Cornelia M.E. Dotzenrath, MD
Ana Karena Kaetsch, MD
Henrich Pfingsten, MD
Kenko Cupisti, MD
Norbert Weyerbrock, MD
Alexander Vossough, MD
Pablo E. Verde, MS
Christian Ohmann, MS
Publication date
01-05-2006
Publisher
Springer-Verlag
Published in
World Journal of Surgery / Issue 5/2006
Print ISSN: 0364-2313
Electronic ISSN: 1432-2323
DOI
https://doi.org/10.1007/s00268-005-0444-8

Other articles of this Issue 5/2006

World Journal of Surgery 5/2006 Go to the issue