A Pilot Study of Cognition Among Hypoparathyroid Adults

Abstract

Purpose Hypoparathyroid patients describe cognitive deficits, yet data regarding objective assessment of cognitive function are limited. We assessed cognition in a pilot study of hypoparathyroid patients using the NIH Toolbox® Adult Cognitive Battery (NIHTB-CB). We also sought to determine whether cognition relates to emotion, quality of life (QoL) and hypoparathyroidism-related biochemistries. Methods Nineteen hypoparathyroid patients were studied. Objective cognition was assessed with NIHTB-CB. Impairment was defined as fully demographically adjusted T-score < 1.5 SD in at least 1 cognitive domain or < 1 SD in 2 or more domains. Results Of the 19 participants (17 women; median age 49; 18 postsurgical), impaired demographically adjusted NIHTB-CB cognition scores were observed in 13 subjects (68%). Cognition scores correlated with self-reported perception of general health. Processing speed was the most commonly impaired cognitive domain, with T-scores that were ≤ 2 SD in 6 subjects (32%). Processing speed correlated with serum calcium (r=0.53, p=0.023) and inversely with serum phosphate (r=-0.48, p=0.042) levels. Conclusions Impaired cognition using the NIHTB-CB was common in this small pilot cohort of hypoparathyroid patients. Slower processing speed was present and associated with lower serum calcium and higher serum phosphate levels. Larger controlled studies with additional neuropsychological testing are needed to investigate cognitive function in hypoparathyroidism.

Parathyroid Hormone (PTH)-Related Peptides Family: An Intriguing Role in the Central Nervous System

“…Moreover, a novel neuropsychological approach, using expert neuropsychologist-devised tests, has allowed the analysis of cognitive, executive, and attentive functions in patients with Hypoparathyroidism. Patients with both idiopathic and post-surgical Hypoparathyroidism present neuropsychological impairment, with a worse performance in these tests for the former and for patients with longer follow-up and lower calcium levels, as evaluated in studies by our group and others [9,10,81].…”

Introductory Chapter: A Brief Statement about Parathyroid Glands

“…Considering its psychological effects, hypoparathyroidism, which affects the quality of life, is evaluated from a broader perspective with current studies. In a pilot study, it was even shown that the cognitive functions of hypoparathyroidism patients were weakened Introductory Chapter: A Brief Statement about Parathyroid Glands DOI: http://dx.doi.org/10.5772/intechopen.110125 [18]. More studies are urgently needed to prevent hypoparathyroidism from the very beginning.…”

The Role of the Patient Partnership in Designing Research on Neuropsychiatric Issues in Hypoparathyroidism

“…Limited reports have documented impaired cognitive function in nonsurgical hypoparathyroid patients, including reduced inhibitory control or an inability to suppress a thought, action, or feeling or a lack of “self-control,” impairment in visuo-spatial functioning, and psychomotor retardation [ 6 ]. In postsurgical hypoparathyroidism, the scant available data are variable, with one small study of predominantly White women showing impaired cognition, particularly slowed processing speed [ 7 ], and another report not finding a difference from controls but demonstrating that lower serum calcium levels were associated with worse visuo-spatial attention, executive function, and semantic memory scores [ 8 ]. Integrating hypoparathyroid patients' points of view is necessary to ascertain whether more studies are needed with formally administered cognitive testing by trained neuropsychologists.…”