Cognitive impairment and intracranial calcification in chronic hypoparathyroidism

Background: Intracranial calcification is associated with chronic hypoparat hyroidism. The relationship between intracranial calcification, neurologica l abnormalities and cognitive deficits in this disorder is unknown, The pur pose of this study was to determine whether chronic hypoparathyroidism is a ssociated with cognitive impairment. Methods: We studied 11 hypoparathyroid patients and compared them with a se x- age-, and education-matched control group. The hypoparathyroidism was po stsurgical in nine and idiopathic in two, All patients underwent nonenhance d head computed tomography, detailed neurological examinations, and a batte ry of cognitive tests. These tests were performed separately and individual examiners were blinded to the results of the other components of the study . Results: The mean age of the patients was 55 years; the duration of hypopar athyroidism was at least 9 years. Neuropsychological testing revealed cogni tive impairment in 65% of hypoparathyroid subjects, and the presence of sig nificant differences between the hypoparathyroid and control groups, Comput ed tomography showed intracranial calcification in 6 of 10 hypoparathyroid subjects tested, and neurological (motor) examination revealed 5 of 11 with abnormal findings, There were positive correlations between the presence o f cognitive deficits and cerebral calcification (r = 0.59, P = 0.07), betwe en abnormal motor findings and cerebral calcification (r = 0.77, P < 0.01) and between abnormal motor findings and the degree of cognitive deficit (r = 0.83, P < 0.01), Conclusions: We conclude that cognitive and neurological deficits commonly occur in patients with chronic hypoparathyroidism and ma y be pathophysiologically related to the presence of intracranical calcific ation.