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Zhang T, Zhao L, Chen C, Yang C, Zhang H, Su W, Cao J, Shi Q, Tian L. Structural and Functional Alterations of Hippocampal Subfields in Patients With Adult-Onset Primary Hypothyroidism. J Clin Endocrinol Metab 2024; 109:1707-1717. [PMID: 38324411 DOI: 10.1210/clinem/dgae070] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/19/2023] [Revised: 01/18/2024] [Accepted: 02/02/2024] [Indexed: 02/09/2024]
Abstract
CONTEXT Hypothyroidism is often associated with cognitive and emotional dysregulation; however, the underlying neuropathological mechanisms remain elusive. OBJECTIVE The study aimed to characterize abnormal alterations in hippocampal subfield volumes and functional connectivity (FC) in patients with subclinical hypothyroidism (SCH) and overt hypothyroidism (OH). METHODS This cross-sectional observational study comprised 47 and 40 patients with newly diagnosed adult-onset primary SCH and OH, respectively, and 53 well-matched healthy controls (HCs). The demographics, clinical variables, and neuropsychological scale scores were collected. Next, the hippocampal subfield volumes and seed-based FC were compared between the groups. Finally, correlation analyses were performed. RESULTS SCH and OH exhibited significant alterations in cognitive and emotional scale scores. Specifically, the volumes of the right granule cell molecular layer of the dentate gyrus (GC-ML-DG) head, cornu ammonis (CA) 4, and CA3 head were reduced in the SCH and OH groups. Moreover, the volumes of the right molecular layer head, CA1 body, left GC-ML-DG head, and CA4 head were lower in SCH. In addition, the hippocampal subfield volumes decreased more significantly in SCH than OH. The seed-based FC decreased in SCH but increased in OH compared with HCs. Correlation analyses revealed thyroid hormone was negatively correlated with FC values in hypothyroidism. CONCLUSION Patients with SCH and OH might be at risk of cognitive decline, anxiety, or depression, and exhibited alterations in volume and FC in specific hippocampal subfields. Furthermore, the reduction in volume was more pronounced in SCH. This study provides novel insights into the neuropathological mechanisms of brain impairment in hypothyroidism.
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Affiliation(s)
- Taotao Zhang
- The First School of Clinical Medicine, Lanzhou University, Lanzhou, Gansu 730000, China
- Department of Endocrinology, Gansu Provincial Hospital, Lanzhou, Gansu 730000, China
- Clinical Research Center for Metabolic Diseases, Gansu Province, 204 Donggang West Road, Lanzhou, Gansu 730000, China
| | - Lianping Zhao
- The First School of Clinical Medicine, Lanzhou University, Lanzhou, Gansu 730000, China
- Department of Radiology, Gansu Provincial Hospital, Lanzhou, Gansu 730000, China
| | - Chen Chen
- The First School of Clinical Medicine, Lanzhou University, Lanzhou, Gansu 730000, China
- Department of Radiology, Gansu Provincial Hospital, Lanzhou, Gansu 730000, China
| | - Chen Yang
- Department of Radiology, Gansu Provincial Hospital, Lanzhou, Gansu 730000, China
| | - Huiyan Zhang
- Department of Radiology, Gansu Provincial Hospital, Lanzhou, Gansu 730000, China
| | - Wenxiu Su
- Department of Endocrinology, Gansu Provincial Hospital, Lanzhou, Gansu 730000, China
- Clinical Research Center for Metabolic Diseases, Gansu Province, 204 Donggang West Road, Lanzhou, Gansu 730000, China
| | - Jiancang Cao
- Department of Radiology, Gansu Provincial Hospital, Lanzhou, Gansu 730000, China
| | - Qian Shi
- Department of Radiology, Gansu Provincial Hospital, Lanzhou, Gansu 730000, China
| | - Limin Tian
- The First School of Clinical Medicine, Lanzhou University, Lanzhou, Gansu 730000, China
- Department of Endocrinology, Gansu Provincial Hospital, Lanzhou, Gansu 730000, China
- Clinical Research Center for Metabolic Diseases, Gansu Province, 204 Donggang West Road, Lanzhou, Gansu 730000, China
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Duan Q, Wang Z, Cheung W, Liu J, Zhang H, Qiao W, Zhang Q. Functional decoding and meta-analytic connectivity modeling in thyroid-associated ophthalmopathy. Heliyon 2024; 10:e23749. [PMID: 38226223 PMCID: PMC10788440 DOI: 10.1016/j.heliyon.2023.e23749] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2023] [Revised: 10/24/2023] [Accepted: 12/12/2023] [Indexed: 01/17/2024] Open
Abstract
Background Thyroid-associated ophthalmopathy (TAO) is an orbital disease closely related to thyroid disease with a long-lasting duration that can be blinding and disabling. Recently, structural and functional neuroimaging studies have been performed in TAO patients, but studies have reported inconsistent results. This quantitative meta-analysis was conducted to identify convergent patterns of abnormal brain function among different studies in TAO. Methods We searched PubMed, EMBASE, Cochrane, and Web of Science, performed reference tracking, and retrieved 15 eligible studies. Peak coordinates were extracted from these studies and subsequently tested for convergence using activation likelihood estimation (ALE). Results Compared to healthy subjects, resting-state brain activity in the whole brain of TAO patients was significantly increased in the left superior frontal gyrus (SFG) and decreased in the left cuneus/precuneus. Functional decoding analysis of the BrainMap database revealed that these regions are predominantly associated with cognitive and emotional impairment. In this study, task-related meta-analytic connectivity modeling (MACM) analysis was used to describe the connectivity and function of the two seed regions. Significant coactivation of these regions was found primarily in the bilateral superior parietal lobule, medial frontal gyrus, left fusiform gyrus, left cingulate gyrus, supplementary motor area and thalamus. Conclusion Our findings underscore the role of the SFG and the cuneus/precuneus in the pathophysiology of TAO, highlighting the crucial impact of working memory deficits.
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Affiliation(s)
- Qidang Duan
- School of Basic Medicine and Life Science, Hainan Medical University, Haikou, 571199, China
| | - Zhihong Wang
- The first people's hospital of lanzhou city, Lanzhou, 730000, China
| | | | - Jing Liu
- Department of Endocrinology and Gerontology, Gansu Provincial Hospital, Lanzhou, 730000, China
| | - Huiyan Zhang
- School of Clinical Medicine, Ningxia Medical University, Yinchuan, 750000, China
| | - Wenjun Qiao
- School of Clinical Medicine, Ningxia Medical University, Yinchuan, 750000, China
| | - Qi Zhang
- Department of Endocrinology and Gerontology, Gansu Provincial Hospital, Lanzhou, 730000, China
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Su W, Zhao L, Bao S, Qin R, Cao J, Tian J, Han Y, Zhang T, Chen C, Shi Q, Guo Q, Shao F, Tian L. Alterations in gray matter morphology and functional connectivity in adult patients with newly diagnosed, untreated hypothyroidism. Thyroid 2023. [PMID: 37130043 DOI: 10.1089/thy.2022.0476] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/03/2023]
Abstract
BACKGROUND Untreated adult hypothyroidism may be associated with cognitive and emotional impairment, but the precise underlying neuropathological mechanism is unknown. We investigated the brain morphological and functional abnormalities associated with cognition and emotion in hypothyroidism. METHODS This is a cross-sectional observational study. Forty-four newly diagnosed adult hypothyroid patients and 54 well-matched healthy controls (HC) were enrolled. All participants underwent 3D T1WI and resting-state functional brain MRI. Morphological and seed-based functional connectivity (FC) analyses were performed to compare the inter-group differences. Neuropsychological tests, including the Montreal Cognitive Assessment Scale (MoCA), 24-item Hamilton Depression Rating Scale (HAMD-24), and Hamilton Anxiety Rating Scale (HAMA) were administered. Thyroid function test and blood lipid levels were measured. Correlations were computed between neuropsychological and biochemical measures with neuroimaging indices. Sensitive morphological or functional neuroimaging indicators were identified using ROC analysis. RESULTS Compared with HC, hypothyroid patients demonstrated lower total and subdomain scores on the MoCA and higher HAMD-24 and HAMA scores. Morphological analysis revealed the hypothyroid patients had significantly reduced gray matter (GM) volumes in the right superior frontal gyrus, superior temporal gyrus, left dorsolateral superior frontal gyrus, middle frontal gyrus, and supplementary motor area as well as significantly increased GM volumes in the bilateral cerebellar CrusⅠand left precentral gyrus. Furthermore, MRIs of hypothyroid patients showed increased FC between the right cerebellar CrusⅠand left precentral gyrus, triangular part of the inferior frontal gyrus, and angular gyrus of the inferior parietal lobe. The language scores of the MoCA were positively correlated with Jacobian values of the left supplementary motor area (r = 0.391, P = 0.046) and precentral gyrus (r = 0.401, P = 0.039). ROC analysis revealed FC value between cerebellar CrusⅠand angular gyrus could differentiate groups with relatively high accuracy (sensitivity: 75%, specificity: 77.8%, AUC: 0.794, 95% CI: 0.701-0.888, P < 0.001). CONCLUSION Untreated adult-onset hypothyroidism may be associated with impaired cognition and anxiety or depression. GM morphological alterations and FC of the cerebellum with subregions of the frontal and parietal lobes may represent key neuropathological mechanisms underlying the cognitive deterioration and mood dysregulation observed in hypothyroid adults.
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Affiliation(s)
- Wenxiu Su
- Gansu Provincial Hospital, 91589, Department of Endocrinology, Lanzhou, Gansu, China
- Gansu Province, 118136, Gansu Clinical Research Center for Metabolic Diseases, Lanzhou, Gansu, China
- Ningxia Medical University, 105002, School of Clinical Medicine, Yinchuan, Ningxia, China;
| | - Lianping Zhao
- Gansu Provincial Hospital, 91589, Department of Radiology, Lanzhou, Gansu, China;
| | - Shisan Bao
- The University of Sydney, 4334, School of Medical Sciences, Sydney, New South Wales, Australia;
| | - Rui Qin
- Gansu Provincial Hospital, 91589, Department of Endocrinology, Lanzhou, Gansu, China
- Gansu Province, 118136, Gansu Clinical Research Center for Metabolic Diseases, Lanzhou, Gansu, China;
| | - Jiancang Cao
- Gansu Provincial Hospital, 91589, Department of Radiology, Lanzhou, Gansu, China;
| | - Jing Tian
- Gansu Provincial Hospital, 91589, Department of Radiology, Lanzhou, Gansu, China;
| | - Yalan Han
- Gansu Provincial Hospital, 91589, Department of Radiology, Lanzhou, Gansu, China;
| | - Taotao Zhang
- Gansu Provincial Hospital, 91589, Department of Endocrinology, Lanzhou, Gansu, China
- Gansu Province, 118136, Gansu Clinical Research Center for Metabolic Diseases, Lanzhou, Gansu, China;
| | - Chen Chen
- Gansu Provincial Hospital, 91589, Department of Radiology, Lanzhou, Gansu, China;
| | - Qian Shi
- Gansu Provincial Hospital, 91589, Department of Radiology, Lanzhou, Gansu, China;
| | - Qian Guo
- Gansu Provincial Hospital, 91589, Department of Endocrinology, Lanzhou, Gansu, China
- Gansu Province, 118136, Gansu Clinical Research Center for Metabolic Diseases, Lanzhou, Gansu, China;
| | - Feifei Shao
- Gansu Provincial Hospital, 91589, Department of Endocrinology, Lanzhou, Gansu, China
- Gansu Province, 118136, Gansu Clinical Research Center for Metabolic Diseases, Lanzhou, Gansu, China;
| | - Limin Tian
- Gansu Provincial Hospital, 91589, Department of Endocrinology, Lanzhou, China
- Gansu Province, 118136, Gansu Clinical Research Center for Metabolic Diseases, Lanzhou, Gansu, China;
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Tissink E, Werme J, de Lange SC, Savage JE, Wei Y, de Leeuw CA, Nagel M, Posthuma D, van den Heuvel MP. The Genetic Architectures of Functional and Structural Connectivity Properties within Cerebral Resting-State Networks. eNeuro 2023; 10:ENEURO.0242-22.2023. [PMID: 36882310 PMCID: PMC10089056 DOI: 10.1523/eneuro.0242-22.2023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2022] [Revised: 12/12/2022] [Accepted: 01/08/2023] [Indexed: 03/09/2023] Open
Abstract
Functional connectivity within resting-state networks (RSN-FC) is vital for cognitive functioning. RSN-FC is heritable and partially translates to the anatomic architecture of white matter, but the genetic component of structural connections of RSNs (RSN-SC) and their potential genetic overlap with RSN-FC remain unknown. Here, we perform genome-wide association studies (N discovery = 24,336; N replication = 3412) and annotation on RSN-SC and RSN-FC. We identify genes for visual network-SC that are involved in axon guidance and synaptic functioning. Genetic variation in RSN-FC impacts biological processes relevant to brain disorders that previously were only phenotypically associated with RSN-FC alterations. Correlations of the genetic components of RSNs are mostly observed within the functional domain, whereas less overlap is observed within the structural domain and between the functional and structural domains. This study advances the understanding of the complex functional organization of the brain and its structural underpinnings from a genetics viewpoint.
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Affiliation(s)
- Elleke Tissink
- Department of Complex Trait Genetics, Center for Neurogenomics and Cognitive Research, Vrije Universiteit Amsterdam, Amsterdam Neuroscience, Amsterdam 1081 HV, The Netherlands
| | - Josefin Werme
- Department of Complex Trait Genetics, Center for Neurogenomics and Cognitive Research, Vrije Universiteit Amsterdam, Amsterdam Neuroscience, Amsterdam 1081 HV, The Netherlands
| | - Siemon C de Lange
- Department of Complex Trait Genetics, Center for Neurogenomics and Cognitive Research, Vrije Universiteit Amsterdam, Amsterdam Neuroscience, Amsterdam 1081 HV, The Netherlands
- Department of Sleep and Cognition, Netherlands Institute for Neuroscience, Amsterdam 1105 BA, The Netherlands
| | - Jeanne E Savage
- Department of Complex Trait Genetics, Center for Neurogenomics and Cognitive Research, Vrije Universiteit Amsterdam, Amsterdam Neuroscience, Amsterdam 1081 HV, The Netherlands
| | - Yongbin Wei
- Department of Complex Trait Genetics, Center for Neurogenomics and Cognitive Research, Vrije Universiteit Amsterdam, Amsterdam Neuroscience, Amsterdam 1081 HV, The Netherlands
- School of Artificial Intelligence, Beijing University of Posts and Telecommunications, Beijing 100876, China
| | - Christiaan A de Leeuw
- Department of Complex Trait Genetics, Center for Neurogenomics and Cognitive Research, Vrije Universiteit Amsterdam, Amsterdam Neuroscience, Amsterdam 1081 HV, The Netherlands
| | - Mats Nagel
- Department of Complex Trait Genetics, Center for Neurogenomics and Cognitive Research, Vrije Universiteit Amsterdam, Amsterdam Neuroscience, Amsterdam 1081 HV, The Netherlands
| | - Danielle Posthuma
- Department of Complex Trait Genetics, Center for Neurogenomics and Cognitive Research, Vrije Universiteit Amsterdam, Amsterdam Neuroscience, Amsterdam 1081 HV, The Netherlands
- Department of Clinical Genetics, Section Complex Trait Genetics, Amsterdam Neuroscience, Vrije Universiteit Medical Center, Amsterdam University Medical Centre, Amsterdam 1081 HZ, The Netherlands
| | - Martijn P van den Heuvel
- Department of Complex Trait Genetics, Center for Neurogenomics and Cognitive Research, Vrije Universiteit Amsterdam, Amsterdam Neuroscience, Amsterdam 1081 HV, The Netherlands
- Department of Clinical Genetics, Section Complex Trait Genetics, Amsterdam Neuroscience, Vrije Universiteit Medical Center, Amsterdam University Medical Centre, Amsterdam 1081 HZ, The Netherlands
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Chen Y, Zhou Z, Liang Y, Tan X, Li Y, Qin C, Feng Y, Ma X, Mo Z, Xia J, Zhang H, Qiu S, Shen D. Classification of type 2 diabetes mellitus with or without cognitive impairment from healthy controls using high-order functional connectivity. Hum Brain Mapp 2021; 42:4671-4684. [PMID: 34213081 PMCID: PMC8410559 DOI: 10.1002/hbm.25575] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2021] [Revised: 06/03/2021] [Accepted: 06/08/2021] [Indexed: 12/12/2022] Open
Abstract
Type 2 diabetes mellitus (T2DM) is associated with cognitive impairment and may progress to dementia. However, the brain functional mechanism of T2DM-related dementia is still less understood. Recent resting-state functional magnetic resonance imaging functional connectivity (FC) studies have proved its potential value in the study of T2DM with cognitive impairment (T2DM-CI). However, they mainly used a mass-univariate statistical analysis that was not suitable to reveal the altered FC "pattern" in T2DM-CI, due to lower sensitivity. In this study, we proposed to use high-order FC to reveal the abnormal connectomics pattern in T2DM-CI with a multivariate, machine learning-based strategy. We also investigated whether such patterns were different between T2DM-CI and T2DM without cognitive impairment (T2DM-noCI) to better understand T2DM-induced cognitive impairment, on 23 T2DM-CI and 27 T2DM-noCI patients, as well as 50 healthy controls (HCs). We first built the large-scale high-order brain networks based on temporal synchronization of the dynamic FC time series among multiple brain region pairs and then used this information to classify the T2DM-CI (as well as T2DM-noCI) from the matched HC based on support vector machine. Our model achieved an accuracy of 79.17% in T2DM-CI versus HC differentiation, but only 59.62% in T2DM-noCI versus HC classification. We found abnormal high-order FC patterns in T2DM-CI compared to HC, which was different from that in T2DM-noCI. Our study indicates that there could be widespread connectivity alterations underlying the T2DM-induced cognitive impairment. The results help to better understand the changes in the central neural system due to T2DM.
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Affiliation(s)
- Yuna Chen
- The First School of Clinical MedicineGuangzhou University of Chinese MedicineGuangzhouGuangdongChina
- Department of Radiology and BRICUniversity of North Carolina at Chapel HillChapel HillNorth CarolinaUSA
| | - Zhen Zhou
- Department of Radiology and BRICUniversity of North Carolina at Chapel HillChapel HillNorth CarolinaUSA
| | - Yi Liang
- Department of RadiologyThe First Affiliated Hospital of Guangzhou University of Chinese MedicineGuangzhouGuangdongChina
| | - Xin Tan
- Department of RadiologyThe First Affiliated Hospital of Guangzhou University of Chinese MedicineGuangzhouGuangdongChina
| | - Yifan Li
- The First School of Clinical MedicineGuangzhou University of Chinese MedicineGuangzhouGuangdongChina
| | - Chunhong Qin
- Department of RadiologyThe First Affiliated Hospital of Guangzhou University of Chinese MedicineGuangzhouGuangdongChina
| | - Yue Feng
- The First School of Clinical MedicineGuangzhou University of Chinese MedicineGuangzhouGuangdongChina
| | - Xiaomeng Ma
- The First School of Clinical MedicineGuangzhou University of Chinese MedicineGuangzhouGuangdongChina
| | - Zhanhao Mo
- Department of Radiology and BRICUniversity of North Carolina at Chapel HillChapel HillNorth CarolinaUSA
- Department of RadiologyChina‐Japan Union Hospital of Jilin UniversityChangchunJilinChina
| | - Jing Xia
- Institute of Brain‐Intelligence Technology, Zhangjiang LabShanghaiChina
| | - Han Zhang
- Institute of Brain‐Intelligence Technology, Zhangjiang LabShanghaiChina
| | - Shijun Qiu
- Department of RadiologyThe First Affiliated Hospital of Guangzhou University of Chinese MedicineGuangzhouGuangdongChina
| | - Dinggang Shen
- School of Biomedical EngineeringShanghaiTech UniversityShanghaiChina
- Shanghai United Imaging Intelligence Co., Ltd.ShanghaiChina
- Department of Artificial IntelligenceKorea UniversitySeoulRepublic of Korea
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Tu Y, Huang P, Mao C, Liu X, Gao J. Abnormal functional connectivity density in patients with dysthyroid optic neuropathy. Ophthalmic Res 2020; 65:171-179. [PMID: 33142292 DOI: 10.1159/000512755] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2020] [Accepted: 11/02/2020] [Indexed: 11/19/2022]
Abstract
[Objective] Functional connectivity density (FCD) mapping was used to investigate abnormalities and factors related to brain functional connectivity (F.C.) in cortical regions of patients with dysthyroid optic neuropathy (DON) and to analyze the pathogenesis of DON further. [Methods] Patients diagnosed with thyroid-associated ophthalmopathy (TAO) in the Eye Hospital were enrolled. All patients underwent comprehensive eye examinations and best-corrected visual acuity, visual field(V.F.) test. MRI data collection and analysis were completed in the 2nd Affiliated Hospital of Wenzhou Medical University. The patients were divided into two groups: the DON group, with an average visual field, mean deviation (M.D.) of both eyes < -5 dB, and the non-DON group (nDON group), with an average visual field M.D. of both eyes ≥ -2 dB. [Results] A total of 30 TAO patients (14 men, 16 women) with complete data who met the experimental requirements were enrolled. The average age was 48.79 (40~ 57) years. There were 16 patients in the DON group and 14 patients in the nDON group. No significant differences in age, gender, education level, and the maximum horizontal diameter of either medial rectus muscle were found between the two groups. The difference of brain FCD between the two groups showed significant abnormal connectivity in the right orbital gyri of the frontal lobe (Frontal_Inf_Orb_R) and the left precuneus in the DON group compared with the nDON group. As demonstrated by decreased FCD values in the right inferior frontal gyrus/orbital part, the relevant brain regions were the left middle temporal gyrus, left precuneus, left middle frontal gyrus, right postcentral gyrus, and brain gyri (excluding the supramarginal gyrus and angular gyrus) below the left parietal bone. The FCD associated with the left precuneus was increased, and the relevant brain areas were the left middle temporal gyrus, right cuneus, superior occipital gyrus, and right fusiform gyrus. A significant correlation was identified between the MD. of the binocular visual field and brain FCD. [Conclusion] The abnormal FCD in the cortex of DON patients suggests that a central nervous system mechanism may be related to the pathogenesis of the DON.
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Affiliation(s)
- Yunhai Tu
- Liaocheng People's Hospital, Cheeloo College of Medicine Shandong University, Liaocheng, China
| | - Pingping Huang
- The Eye Hospital, Wenzhou Medical University, Wenzhou, China
| | - Chuanwan Mao
- Department of Radiology, Yuying Children's Hospital, The Second Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
| | - Xiaozheng Liu
- Department of Radiology, Yuying Children's Hospital, The Second Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
| | - Jianlu Gao
- Liaocheng People's Hospital, Cheeloo College of Medicine Shandong University, Liaocheng, China
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Liu B, Wang Z, Lin L, Yang H, Gao F, Gong T, Edden RAE, Wang G. Brain GABA+ changes in primary hypothyroidism patients before and after levothyroxine treatment: A longitudinal magnetic resonance spectroscopy study. Neuroimage Clin 2020; 28:102473. [PMID: 33395967 PMCID: PMC7663215 DOI: 10.1016/j.nicl.2020.102473] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2020] [Revised: 10/15/2020] [Accepted: 10/17/2020] [Indexed: 11/26/2022]
Abstract
OBJECTIVE Increasing evidence indicates the involvement of the GABAergic system in the pathophysiology of hypothyroidism. We aimed to investigate longitudinal changes of brain GABA in primary hypothyroidism before and after levothyroxine (L-T4) treatment. MATERIAL AND METHODS In 18 patients with hypothyroidism, we used the MEGA-PRESS (Mescher-Garwood point-resolved spectroscopy) editing sequence to measure brain GABA levels from medial prefrontal cortex (mPFC) and posterior cingulate cortex (PCC) at baseline and after 6-months of L-T4 treatment. Sex- and age-matched healthy controls (n = 18) were scanned at baseline. Thyroid function and neuropsychological tests were also performed. RESULTS GABA signals were successfully quantified from all participants with fitting errors lower than 15%. GABA signal was labeled as GABA+ due to contamination from co-edited macromoleculars and homocarnosine. In hypothyroid patients, mean GABA+ was significantly lower in the mPFC region compared with controls (p = 0.031), and the mPFC GABA+ measurements were significantly correlated with depressive symptoms and memory function (r = -0.558, p = 0.016; r = 0.522, p = 0.026, respectively). After adequate L-T4 treatment, the mPFC GABA+ in hypothyroid patients increased to normal level, along with relieved neuropsychological impairments. CONCLUSION The study suggested the decrease of GABA+ may be an important neurobiological factor in the pathophysiology of hypothyroidism. Treatment of L-T4 may reverse the abnormal GABA+ and hypothyroidism-induced neuropsychiatric impairments, indicating the action mode of L-T4 in adjunctive treatment of affective disorders.
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Affiliation(s)
- Bo Liu
- Department of Radiology, Qilu Hospital of Shandong University, Jinan, China
| | - Zhensong Wang
- Second Affiliated Hospital of Shandong University of Traditional Chinese Medicine, Jinan, Shandong, China
| | - Liangjie Lin
- MSC Clinical & Technical Solutions, Philips Healthcare, Beijing, China
| | - Huan Yang
- Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, China
| | - Fei Gao
- Shandong Medical Imaging Research Institute, Shandong University, Jinan, China
| | - Tao Gong
- Shandong Medical Imaging Research Institute, Shandong University, Jinan, China
| | - Richard A E Edden
- Russell H. Morgan Department of Radiology and Radiological Science, The Johns Hopkins University School of Medicine, Baltimore, MD, USA; FM Kirby Center for Functional Brain Imaging, Kennedy Krieger Institute, Baltimore, MD, USA
| | - Guangbin Wang
- Shandong Medical Imaging Research Institute, Shandong University, Jinan, China.
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Gunbey HP, Has AC, Aslan K, Saglam D, Avcı U, Sayıt AT, Incesu L. Microstructural white matter abnormalities in hypothyroidism evaluation with diffusion tensor imaging tract-based spatial statistical analysis. Radiol Med 2020; 126:283-290. [PMID: 32524282 DOI: 10.1007/s11547-020-01234-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2019] [Accepted: 05/25/2020] [Indexed: 12/12/2022]
Abstract
PURPOSE Hypothyroidism is presented in a wide range from neuropsychiatric problems including depression, memory and cognitive disorders to poor motor coordination. Against the background of morphologic, functional and molecular changes on the white and grey matter of the brain, we aimed to investigate the effects of hypothyroidism on white matter (WM) integrity using tract-based spatial statistics (TBSS). METHODS Eighteen patients with hyperthyroidism and 14 age-sex-matched healthy control subjects were included in this study. TBSS was used in the diffusion tensor imaging study for whole-brain voxel wise analysis of fractional anisotropy (FA), mean diffusivity (MD), axial diffusivity (AD) and radial diffusivity (RD) of WM. RESULTS When compared to the control group, the whole brain TBSS revealed extensive reductions of FA in the supratentorial WM including corticospinal tract, posterior limb of the internal capsule (PLIC), uncinate fasciculus, inferior longitudinal fasciculus (p < 0.005). The ROI analyses showed RD increment of superior longitudinal fasciculus, AD decrement of cingulum (CIN), external capsule, PLIC and corpus callosum (CC) in patients with hypothyroidism (p < 0.005). Autoimmune and non-autoimmune hypothyroidism patient subgroups showed a significant difference in terms of hippocampus FA, CIN MD, CC MD, CC AD, CIN RD, SLF RD, CC RD (p < 0.005). CIN FA values showed a negative correlation with the Beck Depression Inventory (p = 0.007, r = - 852). CONCLUSIONS These preliminary results of TBSS analyses represented FA and AD decrement, and RD increment in several WM tracts and indicates the demyelination process underlying pathophysiology of clinical aspects of hypothyroidism.
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Affiliation(s)
- Hediye Pınar Gunbey
- Department of Radiology, University of Health Sciences Kartal Lutfi Kırdar Training and Research Hospital, 34890, Kartal/Istanbul, Turkey.
| | - Arzu Ceylan Has
- Institute of Neuroimmunology and Multiple Sclerosis, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Kerim Aslan
- Department of Radiology, Ondokuz Mayıs University Faculty of Medicine, Samsun, Turkey
| | - Dilek Saglam
- Departmant of Radiology, University of Health Sciences Malatya Training and Research Hospital, Malatya, Turkey
| | - Ugur Avcı
- Department of Endocrinology, Recep Tayyip Erdogan University, Rize, Turkey
| | | | - Lutfi Incesu
- Department of Radiology, Ondokuz Mayıs University Faculty of Medicine, Samsun, Turkey
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Göbel A, Göttlich M, Reinwald J, Rogge B, Uter JC, Heldmann M, Sartorius A, Brabant G, Münte TF. The Influence of Thyroid Hormones on Brain Structure and Function in Humans. Exp Clin Endocrinol Diabetes 2020; 128:432-436. [PMID: 32040963 DOI: 10.1055/a-1101-9090] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
The pleiotropic function of thyroid hormones (TH) is mediated by an organ specific expression of thyroid hormone transporters, deiodinases and TH receptors. In a series of studies we used the model of an experimentally induced hyper- or hypothyroidism in human volunteers to delineate TH action on the brain. A battery of neuropsychological testing paradigms was employed and complemented by structural and functional multimodal neuroimaging. Experimentally induced mild thyrotoxicosis for 6 weeks was associated with changes in brain structure (determined with voxel-based morphometry), resting state functional connectivity, and task-related functional activation in a working memory paradigm. Partial withdrawal of TH replacement in patients without thyroid (subclinical hypothyroidism) likewise lead to changes on multiple functional and structural brain measures. Importantly, the series of studies reviewed here identified the cerebellum as one crucial site of action.
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Affiliation(s)
- Anna Göbel
- Department of Neurology, University of Lübeck, Lübeck, Germany
| | - Martin Göttlich
- Department of Neurology, University of Lübeck, Lübeck, Germany
| | | | - Berenike Rogge
- Department of Neurology, University of Lübeck, Lübeck, Germany
| | | | - Marcus Heldmann
- Department of Neurology, University of Lübeck, Lübeck, Germany.,Department of Psychology II, University of Lübeck, Lübeck, Germany
| | | | - Georg Brabant
- Department of Internal Medicine I, University of Lübeck, Lübeck, Germany
| | - Thomas F Münte
- Department of Neurology, University of Lübeck, Lübeck, Germany.,Department of Psychology II, University of Lübeck, Lübeck, Germany
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Göbel A, Göttlich M, Heldmann M, Georges R, Nieberding R, Rogge B, Sartorius A, Brabant G, Münte TF. Experimentally induced subclinical hypothyroidism causes decreased functional connectivity of the cuneus: A resting state fMRI study. Psychoneuroendocrinology 2019; 102:158-163. [PMID: 30557763 DOI: 10.1016/j.psyneuen.2018.12.012] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/31/2018] [Revised: 12/10/2018] [Accepted: 12/11/2018] [Indexed: 10/27/2022]
Abstract
OBJECTIVE The aim of this study was to experimentally evaluate the effects of subclinical mild hypothyroidism on brain network connectivity as determined by resting state fMRI (rsfMRI) which serves as a proxy for global changes in brain function. METHODS Fifteen otherwise healthy patients with complete hypothyroidism under stable, long term levothyroxine substitution volunteered for the study. They reduced their pretest levothyroxine dosage by 30% for 52-56 days. Basally and after partial levothyroxine withdrawal, rsfMRI along with a neuropsychological analysis was performed. RsfMRI was subjected to graph-theory-based analysis to investigate whole-brain intrinsic functional connectivity. RESULTS The desired subclinical hypothyroidism was achieved in all subjects. This was associated with a significant decrease in resting-state functional connectivity specifically in the cuneus (0.05 FWE corrected at cluster level) which was mainly caused by a weaker functional connectivity to the cerebellum and regions of the default mode network, i.e. the medial prefrontal cortex, the precuneus and the bilateral angular gyri. The decrease in cuneus connectivity was correlated to the increase in TSH serum levels. A working memory task showed a slightly longer reaction time and less accuracy after partial levothyroxine withdrawal. CONCLUSION Even short-term partial levothyroxine partial withdrawal leads to deficits in working memory tasks and to a weaker integration of the cuneus within the default mode network.
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Affiliation(s)
- Anna Göbel
- Department of Neurology, University of Lübeck, Lübeck, Germany.
| | - Martin Göttlich
- Department of Neurology, University of Lübeck, Lübeck, Germany
| | - Marcus Heldmann
- Department of Neurology, University of Lübeck, Lübeck, Germany; Department of Psychology II, University of Lübeck, Lübeck, Germany
| | - René Georges
- Department of Internal Medicine I, University of Lübeck, Lübeck, Germany
| | - Relana Nieberding
- Department of Internal Medicine I, University of Lübeck, Lübeck, Germany
| | - Berenike Rogge
- Department of Neurology, University of Lübeck, Lübeck, Germany
| | | | - Georg Brabant
- Department of Internal Medicine I, University of Lübeck, Lübeck, Germany
| | - Thomas F Münte
- Department of Neurology, University of Lübeck, Lübeck, Germany; Department of Psychology II, University of Lübeck, Lübeck, Germany
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Kumar M, Rana P, Modi S, Tyagi R, Kaur P, Kanwar R, Sekhri T, D'souza M, Khushu S. Aberrant intra and inter network resting state functional connectivity in thyrotoxicosis. J Neuroendocrinol 2019; 31:e12683. [PMID: 30600576 DOI: 10.1111/jne.12683] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/04/2018] [Revised: 12/02/2018] [Accepted: 12/28/2018] [Indexed: 11/28/2022]
Abstract
Thyroid hormones epigenetically play an important role in the regularisation of neural networks and in neural differentiation during brain development. The present study aimed to explore the intra and inter network resting state functional connectivity changes underlying the neurobehavioural symptoms in thyrotoxicosis. To understand the pathophysiological changes, we investigated the correlation between functional connectivity and clinical and behavioural measures. Twenty-eight freshly diagnosed thyrotoxicosis patients suffering with symptoms such as palpitation, loss of weight, trembling and heat intolerance from days to weeks and 28 healthy controls were recruited for the study. Thyrotoxicosis patients showed significantly decreased functional connectivity in sensorimotor network, fronto-temporal network, default mode network, right fronto-parietal network, left fronto-parietal network and salience network. Inter network functional connectivity was significantly reduced between the basal ganglia network and sensorimotor network and increased between the salience network and fronto-temporal network in thyrotoxicosis. Cognitive functions such as visual retention, recognition of objects, mental balance and performance on neuropsychological tests (ie, the Bender Gestalt test, Nahar-Benson test and Mini Mental State Examination) also showed significant decline in thyrotoxicosis patients. The altered intrinsic resting state functional connectivity might underlie these cognitive deficits. The increased functional connectivity between the salience network and fronto-temporal network suggests the recruitment of additional neuronal circuitry needed to compensate for the neuropathology in the primary neural network in thyrotoxicosis.
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Affiliation(s)
- Mukesh Kumar
- NMR Research Centre, Institute of Nuclear Medicine and Allied Sciences (INMAS), DRDO, New Delhi, India
| | - Poonam Rana
- NMR Research Centre, Institute of Nuclear Medicine and Allied Sciences (INMAS), DRDO, New Delhi, India
| | - Shilpi Modi
- NMR Research Centre, Institute of Nuclear Medicine and Allied Sciences (INMAS), DRDO, New Delhi, India
| | - Ritu Tyagi
- NMR Research Centre, Institute of Nuclear Medicine and Allied Sciences (INMAS), DRDO, New Delhi, India
| | - Prabhjot Kaur
- NMR Research Centre, Institute of Nuclear Medicine and Allied Sciences (INMAS), DRDO, New Delhi, India
| | | | - Tarun Sekhri
- Thyroid Research Centre, INMAS, DRDO, New Delhi, India
| | - Maria D'souza
- NMR Research Centre, Institute of Nuclear Medicine and Allied Sciences (INMAS), DRDO, New Delhi, India
| | - Subash Khushu
- NMR Research Centre, Institute of Nuclear Medicine and Allied Sciences (INMAS), DRDO, New Delhi, India
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Wang H, Tan Z, Zheng Q, Yu J. Metabolic Brain Network Analysis of Hypothyroidism Symptom Based on [18F]FDG-PET of Rats. Mol Imaging Biol 2018. [DOI: 10.1007/s11307-018-1182-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
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Kumar M, Modi S, Rana P, Kumar P, Kanwar R, Sekhri T, D'souza M, Khushu S. Alteration in intrinsic and extrinsic functional connectivity of resting state networks associated with subclinical hypothyroid. J Neuroendocrinol 2018; 30. [PMID: 29504670 DOI: 10.1111/jne.12587] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/08/2017] [Accepted: 02/27/2018] [Indexed: 11/28/2022]
Abstract
Subclinical hypothyroidism (SCH) is characterized by mild elevation of thyroid stimulating hormone (TSH) (range 5-10 μIU/ml) and normal free triiodothyronine (FT3) and free thyroxine (FT4). The cognitive function impairment is well known in thyroid disorders such as hypothyroidism and hyperthyroidism, but little is known about deficits in brain functions in SCH subjects. Also, whether hormone-replacement treatment is necessary or not in SCH subjects is still debatable. In order to have an insight into the cognition of SCH subjects, intrinsic and extrinsic functional connectivity (FC) of the resting state networks (RSNs) was studied. For resting state data analysis we used an unbiased, data-driven approach based on Independent Component Analysis (ICA) and dual-regression that can emphasize widespread changes in FC without restricting to a set of predefined seeds. 28 SCH subjects and 28 matched healthy controls (HC) participated in the study. RSN analysis showed significantly decreased intrinsic FC in somato-motor network (SMN) and right fronto-parietal attention network (RAN) and increased intrinsic FC in default mode network (DMN) in SCH subjects as compared to control subjects. The reduced intrinsic FC in the SMN and RAN suggests neuro-cognitive alterations in SCH subjects in the corresponding functions which were also evident from the deficit in the neuropsychological performance of the SCH subjects on behavioural tests such as digit span, delayed recall, visual retention, recognition, Bender Gestalt and Mini-Mental State Examination (MMSE). We also found a significant reduction in extrinsic network FC between DMN and RAN; SMN and posterior default mode network (PDMN); and increased extrinsic FC between SMN and anterior default mode network (ADMN) in SCH subjects as compared to controls. An altered extrinsic FC in SCH suggests functional reorganization in response to neurological disruption. The partial correlation analysis between intrinsic and extrinsic RSNs FC and neuropsychological performances as well as clinical indices give interesting insights into brain-behavior relationship in SCH subjects. This article is protected by copyright. All rights reserved.
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Affiliation(s)
- Mukesh Kumar
- NMR Research Centre, Institute of Nuclear Medicine and Allied Sciences (INMAS)
| | - Shilpi Modi
- NMR Research Centre, Institute of Nuclear Medicine and Allied Sciences (INMAS)
| | - Poonam Rana
- NMR Research Centre, Institute of Nuclear Medicine and Allied Sciences (INMAS)
| | - Pawan Kumar
- NMR Research Centre, Institute of Nuclear Medicine and Allied Sciences (INMAS)
| | - Ratnesh Kanwar
- Thyroid Research Centre, (INMAS), Brig. SK Mazumdar Marg, Timarpur, Delhi, India, 110054
| | - Tarun Sekhri
- Thyroid Research Centre, (INMAS), Brig. SK Mazumdar Marg, Timarpur, Delhi, India, 110054
| | - Maria D'souza
- NMR Research Centre, Institute of Nuclear Medicine and Allied Sciences (INMAS)
| | - Subash Khushu
- NMR Research Centre, Institute of Nuclear Medicine and Allied Sciences (INMAS)
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Liu B, Yang H, Gao F, Wang Q, Zhao B, Gong T, Wang Z, Chen W, Wang G, Edden RA. Investigation of brain GABA+ in primary hypothyroidism using edited proton MR spectroscopy. Clin Endocrinol (Oxf) 2017; 86:256-262. [PMID: 27581339 PMCID: PMC5512100 DOI: 10.1111/cen.13177] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/21/2016] [Revised: 07/17/2016] [Accepted: 08/30/2016] [Indexed: 12/11/2022]
Abstract
OBJECTIVE Evidence indicates that thyroid hormones have effects on the inhibitory GABAergic system. The aim of this study was to investigate whether brain GABA levels are altered in patients with hypothyroidism compared with healthy controls. DESIGN/METHODS Fifteen patients with primary hypothyroidism and 15 matched healthy controls underwent single-voxel MEGA-PRESS magnetic resonance spectroscopy at 3T, to quantify GABA levels in the median prefrontal cortex (mPFC) and posterior cingulate cortex (PCC). All participants underwent thyroid function test. Neuropsychological performances were evaluated by administration of the Montreal Cognitive Assessment (MoCA) and the 21-item Beck Depression Inventory-II (BDI-II). RESULTS The patients with hypothyroidism had significantly lower GABA+ levels in the mPFC compared with healthy controls (P = 0·016), whereas no significant difference (P = 0·214) was observed in the PCC. Exploratory analyses revealed that mPFC GABA+ levels were negatively correlated with the BDI-II scores in patient group (r = -0·60, P = 0·018). No correlations were found between GABA+ levels and TSH or fT3 or fT4 levels in either region (all P > 0·05). CONCLUSION This study suggests that alteration of GABAergic neurotransmission may play an important role in the pathophysiology of primary hypothyroidism, providing intriguing neurochemical clues to understand thyroid-brain interactions.
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Affiliation(s)
- Bo Liu
- Department of Radiology, Qilu Hospital of Shandong University, Jinan, China
| | - Huan Yang
- Shandong Medical Imaging Research Institute affiliated to Shandong University, Jinan, China
| | - Fei Gao
- Shandong Medical Imaging Research Institute affiliated to Shandong University, Jinan, China
| | - Qing Wang
- Department of Radiology, Qilu Hospital of Shandong University, Jinan, China
| | - Bin Zhao
- Shandong Medical Imaging Research Institute affiliated to Shandong University, Jinan, China
| | - Tao Gong
- Shandong Medical Imaging Research Institute affiliated to Shandong University, Jinan, China
| | - Zhensong Wang
- Second Affiliated Hospital of Shandong University of Traditional Chinese Medicine, Jinan, China
| | | | - Guangbin Wang
- Shandong Medical Imaging Research Institute affiliated to Shandong University, Jinan, China
| | - Richard A.E. Edden
- Russell H. Morgan Department of Radiology and Radiological Science, The Johns Hopkins University School of Medicine, Baltimore, MD, USA
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