Sardella A, Bellone F, Morabito N, Minisola S, Basile G, Corica F, Catalano A
Department of Clinical and Experimental Medicine, University of Messina, Messina, Italy.
Department of Internal Medicine and Medical Disciplines, "Sapienza" Rome University, Rome, Italy.
J Endocrinol Invest. 2021 May;44(5):905-919. doi: 10.1007/s40618-020-01423-1. Epub 2020 Sep 14.
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.
A systematic selection of the available literature was performed by searching the online databases PubMed, Scopus and Web of Knowledge.
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.
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.
低钙血症和低甲状旁腺激素水平通常被认为是能够诱发中枢神经系统紊乱的因素。然而，关于认知障碍发生的证据有限或被低估。因此，本综述的目的是系统总结关于特发性或继发性甲状旁腺功能减退患者认知障碍发生情况的现有证据。
通过检索在线数据库PubMed、Scopus和Web of Knowledge对现有文献进行系统筛选。
本系统综述纳入了16篇病例报告文章和1项横断面对照研究。病例报告是最具代表性的文献来源，涉及10名女性和7名男性。认知障碍的存在大多与特发性甲状旁腺功能减退症（HPT）相关讨论；5篇文章描述了手术后甲状旁腺功能减退症后认知障碍的发生情况。病例对照研究报告称，与健康对照相比，甲状旁腺功能减退症患者中存在明显的特殊认知缺陷（如抑制控制能力下降、视觉空间功能受损和精神运动迟缓），血清总钙及其与磷的乘积是神经心理功能障碍的独立预测因素。
尽管大多基于单个病例报告，但甲状旁腺功能减退症背景下神经心理功能障碍的存在似乎是一个一致的核心发现。
