Primary Hyperparathyroidism, Cognition, and Health-Related Quality of Life

Coker, Laura H.; Rorie, Kashemi D.; Cantley, Larry K.; Kirkland, Kimberly; Stump, David A.; Burbank, Nicole; Tembreull, Terry; Williamson, Jeff D.; Perrier, Nancy D.

doi:10.1097/01.sla.0000186337.83407.ec

Cited by 144 publications

(96 citation statements)

References 73 publications

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“…The prevalence of these abnormalities is not well defined due to the lack of rigorous evaluation of these symptoms in most studies, a small number of studies, and wide variation in the instruments used to assess the psycho-cognitive manifestations (66).…”

Section: Neuropsychiatric Manifestationsmentioning

confidence: 99%

Diagnosis and management of primary hyperparathyroidism: a scientific statement from the Department of Bone Metabolism, the Brazilian Society for Endocrinology and Metabolism

Bandeira

Griz

Chaves

et al. 2013

Arq Bras Endocrinol Metab

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Objective: To conduct a literature review on the diagnosis and management of primary hyperparathyroidism including the classical hipercalcemic form as well as the normocalcemic variant. Materials and methods: This scientific statement was generated by a request from the Brazilian Medical Association (AMB) to the Brazilian Society for Endocrinology as part of its Clinical Practice Guidelines program. Articles were identified by searching in PubMed and Cochrane databases as well as abstracts presented at the Endocrine Society, Brazilian Society for Endocrinology Annual Meetings and the American Society for Bone and Mineral Research Annual Meeting during the last 5 years. Grading quality of evidence and strength of recommendation were adapted from the first report of the Oxford Centre for Evidence-based Medicine. All grades of recommendation, including "D" , are based on scientific evidence. The differences between A, B, C and D, are due exclusively to the methods employed in generating evidence. Conclusion:We present a scientific statement on primary hyperparathyroidism providing the level of evidence and the degree of recommendation regarding causes, clinical presentation as well as surgical and medical treatment. Arq Bras Endocrinol Metab. 2013;57(6):406-24 KeywordsPrimary hyperparathyroidism; normocalcemic primary hyperparathyroidism; diagnosis; treatment; parathyroidectomy ReSumoObjetivo: Conduzir uma atualização das últimas evidências científicas a respeito da apresentação, do diagnóstico e do manejo clínico e cirúrgico do hiperparatireoidismo primário clássico e normocalcêmico. Materiais e métodos: Este documento foi concebido pelo Departamento de Metabolismo Ósseo da Sociedade Brasileira de Endocrinologia e Metabologia (SBEM) a partir daquele oriundo do Programa de Diretrizes da Associação Médica Brasileira (AMB) da SBEM. Realizamos uma revisão dos artigos mais relevantes obtidos nos bancos de dados PubMed e Cochrane, além de abstracts apresentados nos encontros anuais da Endocrine Society, da Sociedade Brasileira de Endocrinologia e da American Society for Bone and Mineral Research dos últimos cinco anos, e classificamos as evidências em níveis de recomendações de acordo com a força científica por tipo de estudo, adaptando o primeiro relato do "Oxford Centre for Evidence-based Medicine" . Todos os graus de recomendação, incluindo-se o "D" , foram baseados em evidência científica, sendo as diferenças entre o A, B, C e D devidas exclusivamente ao desenho empregado na geração da evidência. Conclusão: Apresentamos uma atualização científica a respeito do hiperparatireoidismo primário, classificando e graduando em níveis de recomendações as principais evidências científicas sobre as suas causas, as variadas formas de apresentação, seu diagnóstico e tratamento. Arq Bras Endocrinol Metab. 2013;57(6):406-24 Descritores Hiperparatireoidismo primário; hiperparatireoidismo primário normocalcêmico; diagnóstico; tratamento; paratireoidectomia

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Section: Neuropsychiatric Manifestationsmentioning

confidence: 99%

Diagnosis and management of primary hyperparathyroidism: a scientific statement from the Department of Bone Metabolism, the Brazilian Society for Endocrinology and Metabolism

Bandeira

Griz

Chaves

et al. 2013

Arq Bras Endocrinol Metab

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“…The impact of asymptomatic PHPT on neurocognitive function/QOL Neurological and neuropsychiatric symptoms have been described in classical PHPT [Coker et al 2005;Fitz and Hallman, 1952], but it remains unclear to what extent they are present in the mild form of PHPT seen commonly today. Neurological and neuropsychiatric symptoms are especially difficult to define and investigate in mild PHPT.…”

Section: Consequences Of Untreated Asymptomatic Phptmentioning

confidence: 99%

Review: New perspectives in the management of primary hyperparathyroidism

Ayuk

Cooper

Gittoes

2010

Therapeutic Advances in Endocrinology

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Primary hyperparathyroidism (PHPT) is a biochemical syndrome caused by the inappropriate or unregulated overproduction of parathyroid hormone, leading to hypercalcaemia. It was previously considered a relatively rare disorder, with clinical manifestations dominated by renal and/or bone disease. However, in modern times the diagnosis is most frequently recognized coincidentally on biochemical testing in patients evaluated for unrelated complaints. Parathyroidectomy is the only curative treatment for PHPT, with improved outcomes in symptomatic patients following this procedure. However, surgical intervention in patients with no clear clinical features remains controversial. The National Institutes for Health (NIH) have developed consensus guidelines giving specific indications for when surgery is recommended in patients with asymptomatic PHPT. This article examines the impact of treatment on asymptomatic PHPT, focusing on bone disease, neurocognitive function, quality of life, cardiovascular disease and mortality. Medical treatment options, including bisphosphonates and cinacalcet, are also discussed.

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“…Some studies showed that a successful PTx can have positive effects on different domains of quality of life such as increased energy levels and improved physical as well as emotional well-being (26,27,28). However, other studies found no evidence of a positive change in depression scales when comparing PTx patients with patients who underwent orthopedic surgery (29).…”

Section: Introductionmentioning

confidence: 99%

Perioperative changes in cortical excitability, mood, and quality of life in patients with primary hyperparathyroidism: a pilot study using transcranial magnetic stimulation

Hermsen

Eienbröker

Haag

et al. 2014

European Journal of Endocrinology

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Objective: Serum calcium (Ca 2C ) and parathyroid hormone (PTH), amongst others, modify cortical excitability. Alterations in cortical excitability were shown in patients with epilepsy as well as hyper-or hypoparathyroidism. In patients with primary hyperparathyroidism (pHPT), preoperative elevated serum calcium and parathyroidectomy (PTx) may affect mood and quality of life. We hypothesized that perioperative changes in Ca 2C and PTH in pHPT will affect cortical excitability and improve subjective health. Design and methods: Transcranial magnetic stimulation (TMS) was performed before and after surgery in 15 pHPT patients. We measured resting motor threshold, cortical silent period (CSP), short intracortical inhibition, and intracortical facilitation. Health questionnaires were administered before, 1 day and 6 months after PTx, along with the disease-specific Pasieka's parathyroid assessment of symptoms (PAS), which was, to our knowledge, its first use in German.Results: Surgery was successful in all patients. TMS-measurements remained unchanged when analyzing all patients in this pilot study. Postoperatively, depression declined (PZ0.05) and quality of life improved significantly (PZ0.001) in the SF-36-subscales: vitality, social functioning, mental health and subjective health transition (post-hoc analysis). The PAS proved early relief of disease-specific symptoms (P!0.001). Conclusions: We found unchanged cortical excitability comparing pre-and post-PTx in this pilot study. Mood and quality of life improved postoperatively. The German PAS is valuable in detecting disease-specific changes early after PTx.

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Primary Hyperparathyroidism, Cognition, and Health-Related Quality of Life

Cited by 144 publications

References 73 publications

Diagnosis and management of primary hyperparathyroidism: a scientific statement from the Department of Bone Metabolism, the Brazilian Society for Endocrinology and Metabolism

Diagnosis and management of primary hyperparathyroidism: a scientific statement from the Department of Bone Metabolism, the Brazilian Society for Endocrinology and Metabolism

Review: New perspectives in the management of primary hyperparathyroidism

Perioperative changes in cortical excitability, mood, and quality of life in patients with primary hyperparathyroidism: a pilot study using transcranial magnetic stimulation

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