{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,4]],"date-time":"2026-11-04T21:50:45Z","timestamp":1793829045242,"version":"4.6.1"},"reference-count":49,"publisher":"Oxford University Press (OUP)","issue":"7","license":[{"start":{"date-parts":[[2024,4,22]],"date-time":"2024-04-22T00:00:00Z","timestamp":1713744000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"funder":[{"name":"Investigator Initiated Research"},{"DOI":"10.13039\/100016469","name":"Takeda Pharmaceuticals International","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100016469","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100007723","name":"Takeda","doi-asserted-by":"publisher","award":["IISR-2016-104119"],"award-info":[{"award-number":["IISR-2016-104119"]}],"id":[{"id":"10.13039\/100007723","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2024,8,5]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:p>Hypoparathyroidism (HypoPT) is a disease with no\/or inadequate production\/secretion of parathyroid hormone (PTH) from the parathyroid glands. Low levels of PTH result in hypocalcemia, which is often treated with calcium supplementation and active vitamin-D analogs. However, increasing evidence suggests that HypoPT has a profound impact on several organ systems. Quality of life (QOL) is reduced in patients with HypoPT, partly due to symptoms related to the central nervous system\u2014including subjective feelings of confusion, a reduced ability to focus and think clearly (ie, \u201cbrain fog\u201d). However, the extent to which these complex symptoms relate to quantifiable changes in patients\u2019 cognitive performance as determined by neuropsychological tests remains unclear. The brains of HypoPT patients may reveal tissue calcifications, but the extent to which long-term brain exposure to low PTH levels and\/or changing calcium levels affects brain structure is unknown. In a cross-sectional study, we investigated PTH levels, QOL, cognitive impairment, and brain structure in well-treated post-surgical and non-surgical hypoparathyroid patients compared with healthy controls. QOL was quantified by the SF36v2, WHO-5 wellbeing Index, and two disease-specific questionnaires\u2014the HPQ28 and Hypoparathyroidism Symptom Diary. Cognitive functions were tested using comprehensive neuropsychological. Brain structure was quantified by morphological analyses of magnetic resonance imaging images. We found reduced QOL and cognitive functioning in terms of processing speed, executive functions, visual memory, and auditory memory in HypoPT. Furthermore, HypoPT revealed a reduced volume of the hippocampus\u2014and the size of the thalamus in postsurgical patients was associated with the disease duration. Importantly, patients reporting severe brain fog had a smaller hippocampus than those with less brainfog. HypoPT is associated with quantifiable cognitive deficits and changes in brain structure that align with patient symptoms. Our exploratory study warrants further studies of the neurobiological impact of PTH and of the impact of PTH replacements therapy on patients\u2019 cognitive functioning.<\/jats:p>","DOI":"10.1093\/jbmr\/zjae063","type":"journal-article","created":{"date-parts":[[2024,4,22]],"date-time":"2024-04-22T17:54:45Z","timestamp":1713808485000},"page":"855-866","source":"Crossref","is-referenced-by-count":27,"title":["Hypoparathyroidism: changes in brain structure, cognitive impairment, and reduced quality of life"],"prefix":"10.1093","volume":"39","author":[{"given":"Tanja","family":"Sikjaer","sequence":"first","affiliation":[{"name":"Department of Internal Medicine, Horsens Regional Hospital , 8700 Horsens , Denmark"},{"name":"Department of Endocrinology and Internal Medicine, Aarhus University Hospital , 8000 Aarhus , Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Simon Fristed","family":"Eskildsen","sequence":"additional","affiliation":[{"name":"Center of 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