Danielsen ER, Elberling TV, Rasmussen AK, Dock J, Hørding M, Perrild H, Waldemar G, Feldt-Rasmussen U, Thomsen C. Reduced parietooccipital white matter glutamine measured by proton magnetic resonance spectroscopy in treated graves' disease patients.
J Clin Endocrinol Metab 2008;
93:3192-8. [PMID:
18492756 DOI:
10.1210/jc.2007-2161]
[Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/12/2023]
Abstract
CONTEXT
Graves' disease is an autoimmune disease of the thyroid gland. Patients often have affective and cognitive complaints, whether these disappear after treatment remains disputed.
OBJECTIVE
Our objective was to evaluate cerebral biochemistry in acute and treated Graves' disease.
DESIGN
We conducted a prospective study, investigating volunteers once and patients before and 1 yr after treatment.
SETTING
The study was performed at a radiology department, a memory disorder clinic, and two endocrinology clinics.
PATIENTS AND OTHER PARTICIPANTS
Of 53 consecutively referred, newly diagnosed, and untreated patients with Graves' thyrotoxicosis, 27 patients (34 +/- 8 yr) and 33 matched volunteers were included.
INTERVENTIONS
Patients were treated with thionamide.
MAIN OUTCOME MEASURES
We assessed brain metabolite concentrations.
METHODS
Proton magnetic resonance spectroscopy of the brain and a battery of biochemical, affective, and cognitive tests were used.
RESULTS
Previously reported findings of reduced choline and myo-inositol in acute Graves' disease were confirmed and reversibility was demonstrated. Parieto-occipital white matter glutamine was and remained significantly reduced (P < 0.01). Acute phase parieto-occipital white matter total choline correlated significantly (r = -0.57; P < 0.01) with impaired thyroid function. Pretreatment total T(3) predicted posttreatment occipital gray matter glutamine (r = -0.52; P < 0.01). Occipital gray matter total choline (r = -0.53; P < 0.01) and parietooccipital white matter glutamate (r = -0.54; P < 0.01) correlated with initial values of selected attention and concentration cognitive scores and predicted them at follow-up.
CONCLUSIONS
The persistent reduction of glutamine in white matter, the decreasing glutamate in occipital gray matter, and the correlation with severity of the initial disease as well as with attention and concentration cognitive scores indicated that there was a persistent and possibly progressive disturbance of the glutamate glutamine cycling in Graves' disease.
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