Neuropsychiatric and cognitive changes after surgery for primary hyperparathyroidism.

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.