The association between hypoparathyroidism and cognitive impairment: a systematic review
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REVIEW
The association between hypoparathyroidism and cognitive impairment: a systematic review A. Sardella1 · F. Bellone1 · N. Morabito1 · S. Minisola2 · G. Basile1 · F. Corica1 · A. Catalano1 Received: 15 August 2020 / Accepted: 8 September 2020 © Italian Society of Endocrinology (SIE) 2020
Abstract Context and purpose Hypocalcemia and low parathyroid hormone levels have been commonly suggested as factors able to induce central nervous system disturbances. However, evidences on the occurrence of cognitive impairment are limited or underestimated. The aim of this review is, therefore, to systematically summarize the available evidence concerning the occurrence of cognitive impairment among subjects suffering from idiopathic or secondary hypoparathyroidism. Methods A systematic selection of the available literature was performed by searching the online databases PubMed, Scopus and Web of Knowledge. Results The present systematic review included sixteen case report articles and one cross-sectional controlled study. Case reports were the most representative literature sources and involved ten women and seven men. The presence of cognitive impairment was mostly discussed in association with idiopathic hypoparathyroidism (HPT); five articles described the occurrence of cognitive impairment following postsurgical HPT. The case-controlled study reported a significant presence of peculiar cognitive deficits (e.g. reduced inhibitory control, impairment in visuo-spatial functioning among, and psychomotor retardation) among HPT subjects compared to healthy controls, with serum total calcium and its product with phosphorus as independent predictors of neuropsychological dysfunctions. Conclusion Even though mostly based on single case reports, the presence of neuropsychological dysfunctions in the context of HPT appears to be a consistent core finding. Keywords Hypoparathyroidism · Parathyroid · Hypocalcaemia · Cognitive functions · Cognitive impairment Abbreviations SCD Subjective cognitive decline MCI Mild cognitive impairment PTH Parathyroid hormone BBB Blood brain barrier HPT Hypoparathyroidism MMSE Mini Mental State Examination MoCA Montreal Cognitive Assessment WAIS Wechsler Adult Intelligence Scale Electronic supplementary material The online version of this article (https://doi.org/10.1007/s40618-020-01423-1) contains supplementary material, which is available to authorized users. * A. Catalano [email protected] 1
Department of Clinical and Experimental Medicine, University of Messina, Messina, Italy
Department of Internal Medicine and Medical Disciplines, “Sapienza” Rome University, Rome, Italy
2
PTH2R PTH 2 receptor GPCRs G protein-coupled receptors TIP39 Tuber infundibular peptide of 39 residues
Introduction The term cognitive functioning refers to a wide range of multiple mental abilities, which commonly include learning, memory, reasoning, problem-solving, decision-making, and attention processes [1]. Cognitive functioning follows different and heterogeneous trajectories along th
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