title: Neuropsychological dysfunction in idiopathic hypoparathyroidism and its relationship with intracranial calcification and serum total calcium.
abstract: BACKGROUND
  There is limited information on neuropsychological and neurological dysfunctions in patients with idiopathic hypoparathyroidism (IH).
  
  
  OBJECTIVE
  To assess neuropsychological and neurological dysfunctions in IH and its associated factors in a cross-sectional design.
  
  
  METHODS
  Neuropsychological functions were assessed in 62 patients with IH and 70 controls using a battery of cognitive tests. Neurological assessment included extrapyramidal and cerebellar signs. Assessment of intracranial calcification and volume of basal ganglia calcification (BGC) were made on computed tomography and of calcium control by averaging serum total calcium values available during the follow-up.
  
  
  RESULTS
  A significantly higher proportion of patients with IH showed neuropsychological dysfunctions than controls (32.3 (95% CI: 20.9-45.3) vs 5.7% (95% CI: 1.6-14.0), P<0.001). Neurological signs were present in 35.5% patients (extrapyramidal: 16.1%; cerebellar: 20.9%). Volume of BGC and number of sites with intracranial calcifications including cerebellum/dentate were comparable in patients with and without neuropsychological, extrapyramidal or cerebellar dysfunctions. Cognitive dysfunction score was lower by 1.7 points in males than in females (P=0.02) and increased by 0.21 and 5.5 for each year increase in the duration of illness (P=0.001) and one unit increase in serum calcium-phosphorus product (P=0.01) respectively. The scores improved by 0.27 for every mg% increase in serum calcium (P=0.001).
  
  
  CONCLUSIONS
  Neuropsychological dysfunctions are present in up to one-third of patients with IH and correlate with duration of illness, female gender, serum calcium and calcium-phosphorus product during follow-up but not with intracranial calcification. These dysfunctions may affect their daily functions, safety and drug compliance.
authors.affiliation: Department of Endocrinology and Metabolism, All India Institute of Medical Sciences, New Delhi 110029, India.
authors.forename: Sameer
authors.initials: S
authors.lastname: Aggarwal
authors.forename: Suparna
authors.initials: S
authors.lastname: Kailash
authors.forename: Rajesh
authors.initials: R
authors.lastname: Sagar
authors.forename: Manjari
authors.initials: M
authors.lastname: Tripathi
authors.forename: Vishnubhatla
authors.initials: V
authors.lastname: Sreenivas
authors.forename: Raju
authors.initials: R
authors.lastname: Sharma
authors.forename: Nandita
authors.initials: N
authors.lastname: Gupta
authors.forename: Ravinder
authors.initials: R
authors.lastname: Goswami
mesh_terms: D002114:Calcinosis / Q000503:physiopathology*; D002118:Calcium / Q000097:blood*; D003072:Cognition Disorders / Q000097:blood / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000523:psychology; D006801:Humans; D007011:Hypoparathyroidism / Q000097:blood / Q000473:pathology / Q000503:physiopathology* / Q000523:psychology*; D009483:Neuropsychological Tests; D011859:Radiography; D012737:Sex Factors
chemical_list: D002118:Calcium