Objectively Measured Cognitive Dysfunction in Patients with Primary Hyperparathyroidism Improves After Parathyroidectomy

A known relationship between primary hyperparathyroidism (PHPT) and decreased quality of life has been shown using patient-reported outcome measures including Pasieka’s Parathyroid Assessment of Symptoms, SF-36, and PROMIS. Despite this, there remains a paucity of information on objectively measured cognitive dysfunction in PHPT patients. We assessed whether parathyroidectomy resulted in quantifiable cognitive improvement. This is a single-institution study of 59 consecutive patients with PHPT, who underwent parathyroidectomy (2019-2021). We used BrainCheck™ , a clinically validated objective measure of neurocognition, to assess pre and postoperative neurocognitive changes in the cohort. The association between BrainCheck™ scores and parathyroidectomy were evaluated using a Wilcoxon Signed-Ranks Test. A total of 59 PHPT patients underwent parathyroidectomy and the rapid cognitive assessment with BrainCheck™. Most patients were female (72.9%), white (49.2%) or African American (30.5%). A total of 44.1% of patients preoperatively showed neurocognitive dysfunction relative to the general population compared to 22% postoperatively, representing improvement in 53% of the cohort. Postoperative scores for the entire cohort were significantly higher than preoperative scores (Z =2.85, p=0.004). This association remained significant when the cohort was stratified by gender. Males had a significant increase in scores (Z =2.02, p=0.044) as did females (Z =2.09, p=0.037). Domain sub-analysis demonstrated a significant association of parathyroidectomy with improved executive function (p