Impact of parathyroidectomy on neuropsychological disorders and quality of life in primary hyperparathyroidism.

Neuropsychiatric disorders are among the classic manifestations of primary hyperparathyroidism (PHPT), along with bone and renal involvement. They correspond to a broad spectrum of nonspecific neuropsychological symptoms, including depression, anxiety, sleep disturbances, concentration difficulties, memory loss, and even more severe psychiatric syndromes such as psychosis or dementia. These symptoms contribute to a significant deterioration in patients' quality of life compared to the general population. Despite their frequency and functional impact, neuropsychiatric disorders and impaired quality of life are not recognized as formal indications for parathyroidectomy in current French and international guidelines. This position is explained by the heterogeneity of results and the low level of evidence in the available literature. In particular, while some observational studies suggest an improvement in quality of life after surgery, randomized trials published to date have not allowed for a definitive conclusion. The aim of this review is to summarize existing data concerning the effect of parathyroidectomy on neuropsychiatric disorders and on impaired quality of life, and to discuss the remaining questions with the goal of guiding future research.