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Purpose <p>Neuropsychological manifestations are common in chronic hypoparathyroidism (cHypoPT). Here, we report the change in cognitive and neuropsychiatric functions in cHypoPT during long-term follow-up.</p> Design <p>Observational-cohort study.</p> Methods <p>Fifty-four patients with non-surgical idiopathic cHypoPT (M: F = 24:30, age = 47.8 ± 14.0 years, duration of hypoparathyroidism = 24.5 ± 7.7 years), who were evaluated for cognitive, neuropsychiatric function, and quality of life in 2011–12, were re-evaluated in 2023–24 using the same battery of tests. Change in intracranial calcification was compared with previous computed tomography scans. Multivariable regression was used to assess association of change in cognitive and neuropsychiatric function with sex, age, body mass index (BMI), sites of intracranial calcification, and time weighted estimated glomerular filtration rate (eGFR), serum total calcium, phosphate, their product, and ratio.</p> Results <p>The mean global cognitive dysfunction score increased during follow-up (4.04 ± 2.56 to 5.69 ± 2.10, <i>p</i> &lt; 0.001). Motor speed and fine control, memory, trail-making test, Bender-Gestalt test, and quality of life showed significant deterioration. Deterioration in cognition was associated with increased age (<i>p</i> &lt; 0.001). Neuropsychiatric assessment showed significant improvement in somatic concerns, anxiety, tension, and hostility. Male patient, increasing age, and higher BMI showed significant association with improvement in neuropsychiatric function. However, duration of illness and lower eGFR were associated with neuropsychiatric deterioration (<i>p</i> = 0.003 and 0.035). Changes in intracranial-calcification and biochemical control showed no significant association with cognitive and neuropsychiatric functions.</p> Conclusions <p>Hypoparathyroid patients showed a significant decline in cognitive function during follow-up. However, neuropsychiatric function improved during follow-up, more so in males, in older individuals and in those with a higher BMI. Deteriorating cognition could affect the earning and compliance with treatment. Further studies assessing the role of behavioral/drug therapy would be helpful in cHypoPT.</p>

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Natural Course of Neuropsychological Functions in Chronic Non-Surgical Hypoparathyroidism on Conventional Therapy: 12 Years of Follow-Up

  • 期刊论文

  • 发表日期：

    2026年3月24日

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  • Preeti Namjoshi,
  • Snehaa Seetharaman,
  • Soma Saha,
  • Mani Kalaivani,
  • Manjari Tripathi,
  • Devasenathipathy Kandasamy,
  • Sameer Aggarwal,
  • Rajesh Sagar,
  • Ravinder Goswami

摘要

Purpose

Neuropsychological manifestations are common in chronic hypoparathyroidism (cHypoPT). Here, we report the change in cognitive and neuropsychiatric functions in cHypoPT during long-term follow-up.

Design

Observational-cohort study.

Methods

Fifty-four patients with non-surgical idiopathic cHypoPT (M: F = 24:30, age = 47.8 ± 14.0 years, duration of hypoparathyroidism = 24.5 ± 7.7 years), who were evaluated for cognitive, neuropsychiatric function, and quality of life in 2011–12, were re-evaluated in 2023–24 using the same battery of tests. Change in intracranial calcification was compared with previous computed tomography scans. Multivariable regression was used to assess association of change in cognitive and neuropsychiatric function with sex, age, body mass index (BMI), sites of intracranial calcification, and time weighted estimated glomerular filtration rate (eGFR), serum total calcium, phosphate, their product, and ratio.

Results

The mean global cognitive dysfunction score increased during follow-up (4.04 ± 2.56 to 5.69 ± 2.10, p < 0.001). Motor speed and fine control, memory, trail-making test, Bender-Gestalt test, and quality of life showed significant deterioration. Deterioration in cognition was associated with increased age (p < 0.001). Neuropsychiatric assessment showed significant improvement in somatic concerns, anxiety, tension, and hostility. Male patient, increasing age, and higher BMI showed significant association with improvement in neuropsychiatric function. However, duration of illness and lower eGFR were associated with neuropsychiatric deterioration (p = 0.003 and 0.035). Changes in intracranial-calcification and biochemical control showed no significant association with cognitive and neuropsychiatric functions.

Conclusions

Hypoparathyroid patients showed a significant decline in cognitive function during follow-up. However, neuropsychiatric function improved during follow-up, more so in males, in older individuals and in those with a higher BMI. Deteriorating cognition could affect the earning and compliance with treatment. Further studies assessing the role of behavioral/drug therapy would be helpful in cHypoPT.