Regional cerebral blood flow in patients with primary hyperparathyroidism before and after successful parathyroidectomy

Abstract

The finding of reduced regional cerebral blood flow in patients with primary hyperparathyroidism followed by significant improvement after operation might influence the case for surgical treatment.

Asymptomatic primary hyperparathyroidism: a surgical perspective

“…Following parathyroidectomy, regional blood flow returned to normal in all but 1 patient. Furthermore, 8 patients had high depression scores (Montgomery and Asberg Depression Rating Scale) preoperatively, with improved scores in 6 of the 8 patients following surgery [30]. One potential caveat to this study is that most of the patients had classical symptoms, and no similar study to date has been undertaken addressing patients with pHPT who suffer few symptoms of the disease.…”

“…Although this study is mainly observational, calcium is involved in neurotransmitter synthesis/release, and lowered CSF monoamine metabolites have been associated with depressive symptoms [29]. A study investigating regional cerebral blood flow and metabolism found reduced values compared with normal subjects in 14 of 16 patients with pHPT [30]. Reduced blood flow has also been demonstrated in depression [31].…”

Parathyroidectomy, Elevated Depression Scores, and Suicidal Ideation in Patients With Primary Hyperparathyroidism

“…8,10 Cerebral blood flow may also be an explanatory factor. Mjåland et al 23 showed with single-photon emission computerized tomography that cerebral blood flow was pathologically reduced in 14 of 16 females with pHPT preoperatively and normalized after parathyroidectomy in almost all cases (13/14).…”

The Spectrum of Clinical Benefits Following Parathyroidectomy for Primary Hyperparathyroidism

“…While this study is mainly observational, calcium is involved in neurotransmitter synthesis/release, and lowered CSF monoamine metabolites have been associated with depressive symptoms [29]. A study investigating regional cerebral blood flow and metabolism found reduced values compared to normal subjects in 14 of 16 patients with pHPT [30]. Reduced blood flow has also been demonstrated in depression [31].…”

“…Following parathyroidectomy, regional blood flow returned to normal in all but one patient. Furthermore, eight patients had high depression scores (Montgomery and Asberg Depression Rating Scale) preoperatively with improved scores in six of the eight patients following surgery [30]. One potential caveat is that most of the patients in this study had classical symptoms and no similar study to date has been undertaken addressing patients with pHPT that suffer with a mild form of the disease.…”