Neurocognitive performance profile postparathyroidectomy: a pilot study of computerized assessment

Surgery. 2018 Feb;163(2):457-462. doi: 10.1016/j.surg.2017.09.001. Epub 2017 Nov 10.

Abstract

Background: Neurocognitive symptoms attributable to primary hyperparathyroidism are important diagnostic criteria, yet the basic characterization and assessment of neurocognitive deficits in primary hyperparathyroidism are not defined fully.

Methods: In this prospective pilot study, patients with unequivocal biochemical diagnosis of primary hyperparathyroidism were evaluated for neurocognitive performance preoperatively and postparathyroidectomy (2 weeks, 6 months) using a battery of computerized modular tests designed by LUMOSITY. The individual test scores and aggregate scores representing a subject's total neurocognitive performance profile were calculated. Statistical comparisons between groups were performed using univariate analysis and repeated measures of analysis of variance.

Results: In the study, 34 participants were assessed preoperatively; 18 completed all 3 assessments, 2 completed pretest and 6-month assessments, and 30 completed preoperative and 2-week postparathyroidectomy assessments. Primary hyperparathyroidism patients demonstrated significant deficits in memory, attention, mental flexibility, and speed of processing when compared with controls. Total neurocognitive performance profile score was significantly lower at the preoperative (P = .0001) and 2-week postparathyroidectomy (P = .0004) time points when compared with controls; this difference was bridged by 6 months postparathyroidectomy.

Conclusion: Computerized neurocognitive performance profile assessment validated the neurocognitive benefits of parathyroidectomy. Additional study is needed to determine if this novel method provides long-term, objective, quantifiable, and accessible neurocognitive performance profile assessment in primary hyperparathyroidism patients and can serve as a valuable diagnostic and prognostic tool.

Publication types

  • Clinical Trial

MeSH terms

  • Cognitive Dysfunction / diagnosis*
  • Cognitive Dysfunction / etiology
  • Female
  • Humans
  • Hyperparathyroidism, Primary / complications
  • Hyperparathyroidism, Primary / surgery*
  • Male
  • Mental Status and Dementia Tests*
  • Middle Aged
  • Parathyroidectomy / psychology*
  • Pilot Projects
  • Prospective Studies