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Genç B, Aslan K, Avcı U, İncesu L, Günbey HP. Opposing effects of thyroid hormones on hypothalamic subunits and limbic structures in hyperthyroidism patients: A comprehensive volumetric study. J Neuroendocrinol 2024; 36:e13369. [PMID: 38326952 DOI: 10.1111/jne.13369] [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: 05/17/2023] [Revised: 12/25/2023] [Accepted: 01/11/2024] [Indexed: 02/09/2024]
Abstract
Thyroid hormones play a critical role in brain development, but paradoxically, patients with hyperthyroidism often exhibit cognitive decline and irritability. This study aims to explore the pattern of atrophy in hyperthyroid patients, changes in specific areas of the brain, including hypothalamic subfields and limbic structures, and their relationships with hormonal levels and psychometric tests. This prospective cross-sectional study involves 19 newly diagnosed, untreated hyperthyroid patients, and 15 age and gender-matched control subjects. The participants underwent psychometric and cognitive tests and volumetric MRI. The hypothalamic subfield (anterior-inferior, anterior-superior, superior-tubular, inferior-tubular, and posterior hypothalamus) and limbic structures (fornix, basal forebrain, nucleus accumbens, and septal nucleus) were segmented using voxel-based morphometry, surface-based morphometry, and deep learning algorithms. The groups were compared using the t-test, and correlation analyses were performed between clinical parameters and volumetric measurements. The correlation between hormonal parameters and volumetric measurements in patient and control groups was assessed with the Meng test. Hyperthyroid patients displayed widespread grey matter loss and sulcal shallowing in the left hemisphere. However, no local gyrification index changes or cortical thickness variations were detected. The limbic structures and hypothalamic subunits did not show any volume discrepancies. Free thyroxine in the patient group negatively correlated with bilateral anterior-inferior and right septal nucleus, but positively correlated with left anterior-inferior in the control group. Thyroid stimulating hormone in the patient group showed a positive correlation with bilateral fornix volume, a correlation absent in the control group. Disease duration negatively correlated with right anterior-inferior, right tubular inferior, and right septal nucleus. Changes in cognitive and psychometric test scores in the patient group correlated with the bilateral septal nucleus volume. Hyperthyroidism primarily leads to a reduction in grey matter volume and sulcal shallowing. Thyroid hormones have differing volumetric effects in limbic structures and hypothalamic subunits under physiological and hyperthyroid conditions.
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Affiliation(s)
- Barış Genç
- Department of Radiology, School of Medicine, Ondokuz Mayis University, Samsun, Turkey
| | - Kerim Aslan
- Department of Neuroradiology, School of Medicine, Ondokuz Mayıs University, Samsun, Turkey
| | - Uğur Avcı
- Department of Endocrinology, School of Medicine, Recep Tayyip Erdoğan University, Rize, Turkey
| | - Lütfi İncesu
- Department of Neuroradiology, School of Medicine, Ondokuz Mayıs University, Samsun, Turkey
| | - Hediye Pınar Günbey
- Department Radiology, University of Health Sciences, Kartal Dr. Lutfi Kirdar City Hospital, Istanbul, Turkey
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Rogge B, Heldmann M, Chatterjee K, Moran C, Göttlich M, Uter J, Wagner-Altendorf TA, Steinhardt J, Brabant G, Münte TF, Cirkel A. Changes in brain structure in subjects with resistance to thyroid hormone due to THRB mutations. Thyroid Res 2023; 16:34. [PMID: 37592301 PMCID: PMC10433577 DOI: 10.1186/s13044-023-00176-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/02/2023] [Accepted: 07/26/2023] [Indexed: 08/19/2023] Open
Abstract
BACKGROUND Being critical for brain development and neurocognitive function thyroid hormones may have an effect on behaviour and brain structure. Our exploratory study aimed to delineate the influence of mutations in the thyroid hormone receptor (TR) ß gene on brain structure. METHODS High-resolution 3D T1-weighted images were acquired in 21 patients with a resistance to thyroid hormone ß (RTHß) in comparison to 21 healthy matched-controls. Changes in grey and white matter, as well as cortical thickness were evaluated using voxel-based morphometry (VBM) and diffusion tensor imaging (DTI). RESULTS RTHß patients showed elevated circulating fT4 & fT3 with normal TSH concentrations, whereas controls showed normal thyroid hormone levels. RTHß patients revealed significantly higher scores in a self-rating questionnaire for attention deficit hyperactivity disorder (ADHD). Imaging revealed alterations of the corticospinal tract, increased cortical thickness in bilateral superior parietal cortex and decreased grey matter volume in bilateral inferior temporal cortex and thalamus. CONCLUSION RTHb patients exhibited structural changes in multiple brain areas. Whether these structural changes are causally linked to the abnormal behavioral profile of RTHß which is similar to ADHD, remains to be determined.
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Affiliation(s)
- Berenike Rogge
- Department of Neurology, University of Lübeck, Ratzeburger Allee 160, 23538, Lübeck, Germany
| | - Marcus Heldmann
- Department of Neurology, University of Lübeck, Ratzeburger Allee 160, 23538, Lübeck, Germany
- Department of Psychology II, University of Lübeck, Lübeck, Germany
| | - Krishna Chatterjee
- Wellcome-MRC Institute of Metabolic Science, University of Cambridge, Cambridge, UK
| | - Carla Moran
- Beacon Hospital, Dublin, Ireland
- St Vincent's University Hospital, Dublin, Ireland
- School of Medicine, University College Dublin, Dublin, Ireland
| | - Martin Göttlich
- Department of Psychology II, University of Lübeck, Lübeck, Germany
| | - Jan Uter
- Department of Neurology, University of Lübeck, Ratzeburger Allee 160, 23538, Lübeck, Germany
| | | | - Julia Steinhardt
- Department of Neurology, University of Lübeck, Ratzeburger Allee 160, 23538, Lübeck, Germany
| | - Georg Brabant
- Department of Internal Medicine I, University of Lübeck, Lübeck, Germany
| | - Thomas F Münte
- Department of Neurology, University of Lübeck, Ratzeburger Allee 160, 23538, Lübeck, Germany
- Department of Psychology II, University of Lübeck, Lübeck, Germany
| | - Anna Cirkel
- Department of Neurology, University of Lübeck, Ratzeburger Allee 160, 23538, Lübeck, Germany.
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Holmberg M, Malmgren H, Heckemann RA, Johansson B, Klasson N, Olsson E, Skau S, Starck G, Filipsson Nyström H. A Longitudinal Study of Medial Temporal Lobe Volumes in Graves Disease. J Clin Endocrinol Metab 2022; 107:1040-1052. [PMID: 34752624 PMCID: PMC8947220 DOI: 10.1210/clinem/dgab808] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/09/2021] [Indexed: 11/23/2022]
Abstract
CONTEXT Neuropsychiatric symptoms are common features of Graves disease (GD) in hyperthyroidism and after treatment. The mechanism behind these symptoms is unknown, but reduced hippocampal volumes have been observed in association with increased thyroid hormone levels. OBJECTIVE This work aimed at investigating GD influence on regional medial temporal lobe (MTL) volumes. METHODS Sixty-two women with newly diagnosed GD underwent assessment including magnetic resonance (MR) imaging in hyperthyroidism and 48 of them were followed up after a mean of 16.4 ± 4.2 SD months of treatment. Matched thyroid-healthy controls were also assessed twice at a 15-month interval. MR images were automatically segmented using multiatlas propagation with enhanced registration. Regional medial temporal lobe (MTL) volumes for amygdalae and hippocampi were compared with clinical data and data from symptom questionnaires and neuropsychological tests. RESULTS Patients had smaller MTL regions than controls at inclusion. At follow-up, all 4 MTL regions had increased volumes and only the volume of the left amygdala remained reduced compared to controls. There were significant correlations between the level of thyrotropin receptor antibodies (TRAb) and MTL volumes at inclusion and also between the longitudinal difference in the levels of free 3,5,3'-triiodothyronine and TRAb and the difference in MTL volumes. There were no significant correlations between symptoms or test scores and any of the 4 MTL volumes. CONCLUSION Dynamic alterations in the amygdalae and hippocampi in GD reflect a previously unknown level of brain involvement both in the hyperthyroid state of the condition and after treatment. The clinical significance, as well as the mechanisms behind these novel findings, warrant further study of the neurological consequences of GD.
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Affiliation(s)
- Mats Holmberg
- ANOVA, Karolinska University Hospital, Stockholm, Sweden
- Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Göteborg, Sweden
- Correspondence: Mats Holmberg, PhD, ANOVA, Karolinska University Hospital, Norra Stationsgatan 69, SE-17176 Stockholm, Sweden.
| | - Helge Malmgren
- Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Göteborg, Sweden
- MedTech West at University of Gothenburg and Sahlgrenska University Hospital, Göteborg, Sweden
| | - Rolf A Heckemann
- MedTech West at University of Gothenburg and Sahlgrenska University Hospital, Göteborg, Sweden
- Institute of Clinical Sciences, Department of Medical Radiation Sciences, Sahlgrenska Academy, University of Gothenburg, Göteborg, Sweden
| | - Birgitta Johansson
- Institute of Neuroscience and Physiology, Department of Clinical Neuroscience, Sahlgrenska Academy, University of Gothenburg, Göteborg, Sweden
| | - Niklas Klasson
- MedTech West at University of Gothenburg and Sahlgrenska University Hospital, Göteborg, Sweden
- Institute of Neuroscience and Physiology, Department of Clinical Neuroscience, Sahlgrenska Academy, University of Gothenburg, Göteborg, Sweden
| | - Erik Olsson
- Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Göteborg, Sweden
| | - Simon Skau
- MedTech West at University of Gothenburg and Sahlgrenska University Hospital, Göteborg, Sweden
- Institute of Neuroscience and Physiology, Department of Clinical Neuroscience, Sahlgrenska Academy, University of Gothenburg, Göteborg, Sweden
| | - Göran Starck
- Institute of Clinical Sciences, Department of Medical Radiation Sciences, Sahlgrenska Academy, University of Gothenburg, Göteborg, Sweden
- Department of Medical Physics and Biomedical Engineering, Sahlgrenska University Hospital, Göteborg, Sweden
| | - Helena Filipsson Nyström
- Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Göteborg, Sweden
- Department of Endocrinology, Sahlgrenska University Hospital, Göteborg, Sweden
- Wallenberg Center for Molecular and Translational Medicine, University of Gothenburg, Göteborg, Sweden
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Chambers T, Anney R, Taylor PN, Teumer A, Peeters RP, Medici M, Caseras X, Rees DA. Effects of Thyroid Status on Regional Brain Volumes: A Diagnostic and Genetic Imaging Study in UK Biobank. J Clin Endocrinol Metab 2021; 106:688-696. [PMID: 33274371 PMCID: PMC7947746 DOI: 10.1210/clinem/dgaa903] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/04/2020] [Indexed: 01/06/2023]
Abstract
BACKGROUND Thyroid hormone is essential for optimal human neurodevelopment and may modify the risk of attention-deficit/hyperactivity disorder (ADHD). However, the brain structures involved are unknown and it is unclear if the adult brain is also susceptible to changes in thyroid status. METHODS We used International Classification of Disease-10 codes, polygenic thyroid scores at different thresholds of association with thyroid traits (PT-values), and image-derived phenotypes in UK Biobank (n = 18 825) to investigate the effects of a recorded diagnosis of thyroid disease and genetic risk for thyroid status on cerebellar and subcortical gray matter volume. Regional genetic pleiotropy between thyroid status and ADHD was explored using the GWAS-pairwise method. RESULTS A recorded diagnosis of hypothyroidism (n = 419) was associated with significant reductions in total cerebellar and pallidum gray matter volumes (β [95% CI] = -0.14[-0.23, -0.06], P = 0.0005 and β [95%CI] = -0.12 [-0.20, -0.04], P = 0.0042, respectively), mediated in part by increases in body mass index. While we found no evidence for total cerebellar volume alterations with increased polygenic scores for any thyroid trait, opposing influences of increased polygenic scores for hypo- and hyperthyroidism were found in the pallidum (PT < 1e-3: β [95% CI] = -0.02 [-0.03, -0.01], P = 0.0003 and PT < 1e-7: β [95% CI] = 0.02 [0.01, 0.03], P = 0.0003, respectively). Neither hypo- nor hyperthyroidism showed evidence of regional genetic pleiotropy with ADHD. CONCLUSIONS Thyroid status affects gray matter volume in adults, particularly at the level of the cerebellum and pallidum, with potential implications for the regulation of motor, cognitive, and affective function.
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Affiliation(s)
- Tom Chambers
- MRC Centre for Neuropsychiatric Genetics and Genomics, Cardiff University, Cardiff, UK
- Cardiff University Brain Research Imaging Centre (CUBRIC), Cardiff University, Cardiff, UK
| | - Richard Anney
- MRC Centre for Neuropsychiatric Genetics and Genomics, Cardiff University, Cardiff, UK
| | - Peter N Taylor
- Systems Immunity Research Institute, School of Medicine, Cardiff University, Cardiff, UK
| | - Alexander Teumer
- Institute for Community Medicine, University Medicine Greifswald, Germany
| | - Robin P Peeters
- Department of Internal Medicine and Academic Center for Thyroid Diseases, Erasmus Medical Center, Rotterdam, The Netherlands
| | - Marco Medici
- Department of Internal Medicine and Academic Center for Thyroid Diseases, Erasmus Medical Center, Rotterdam, The Netherlands
- Department of Epidemiology, Erasmus Medical Center, Rotterdam, The Netherlands
- Department of Internal Medicine, Radboud University Medical Center, HB Nijmegen, The Netherlands
| | - Xavier Caseras
- MRC Centre for Neuropsychiatric Genetics and Genomics, Cardiff University, Cardiff, UK
| | - D Aled Rees
- Neuroscience and Mental Health Research Institute, School of Medicine, Cardiff University, Cardiff, UK
- Correspondence: D. Aled Rees, FRCP, PhD, Neuroscience and Mental Health Research Institute, Hadyn Ellis Building, School of Medicine, Cardiff University, Cardiff CF24 4HQ, United Kingdom.
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Eslami-Amirabadi M, Sajjadi SA. The relation between thyroid dysregulation and impaired cognition/behaviour: An integrative review. J Neuroendocrinol 2021; 33:e12948. [PMID: 33655583 PMCID: PMC8087167 DOI: 10.1111/jne.12948] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/01/2020] [Revised: 12/19/2020] [Accepted: 01/29/2021] [Indexed: 12/20/2022]
Abstract
Despite decades of research on the relation between thyroid diseases and cognition, the nature of this relationship remains elusive. An increasing prevalence of cognitive impairment and thyroid dysfunction has been consistently observed with ageing. Also, there appears to be an association between thyroid disorders and cognitive decline. Given the increasing global burden of dementia, elucidating the relationship between thyroid disorders as a potentially modifiable risk factor of cognitive impairment was the main goal of this review. We summarise the current literature examining the relationship between thyroid hormonal dysregulation and cognition or behaviour. We present the available imaging and pathological findings related to structural and functional brain changes related to thyroid hormonal dysregulation. We also propose potential mechanisms of interaction between thyroid hormones, autoantibodies and cognition/behaviour. Effects of gender, ethnicity and environmental factors are also briefly discussed. This review highlights the need for long-term prospective studies to capture the course of brain functional changes associated with the incidence and progression of thyroid dysregulations along with the confounding effects of non-modifiable risk factors such as gender and ethnicity. Moreover, double-blind controlled clinical trials are necessary to devise appropriate treatment plans to prevent cognitive consequences of over or undertreatment of thyroid disorders.
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Aslan K, Gunbey HP, Cortcu S, Ozyurt O, Avci U, Incesu L. Diffusion tensor imaging in hyperthyroidism: assessment of microstructural white matter abnormality with a tract-based spatial statistical analysis. Acta Radiol 2020; 61:1677-1683. [PMID: 32202136 DOI: 10.1177/0284185120909960] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
BACKGROUND Metabolic, morphological, and functional brain changes associated with a neurological deficit in hyperthyroidism have been observed. However, changes in microstructural white matter (WM), which can explain the underlying pathophysiology of brain dysfunctions, have not been researched. PURPOSE To assess microstructural WM abnormality in patients with untreated or newly diagnosed hyperthyroidism using tract-based spatial statistics (TBSS). MATERIAL AND METHODS Eighteen patients with hyperthyroidism and 14 age- and sex-matched healthy controls were included in this study. TBSS were used in this diffusion tensor imaging study for a whole-brain voxel-wise analysis of fractional anisotropy, mean diffusivity, axial diffusivity (AD), and radial diffusivity (RD) of WM. RESULTS When compared to the control group, TBSS showed a significant increase in the RD of the corpus callosum, anterior and posterior corona radiata, posterior thalamic radiation, cingulum, superior longitudinal fasciculus, and the retrolenticular region of the internal capsule in patients with hyperthyroidism (P < 0.05), as well as a significant decrease in AD in the anterior corona radiata and the genu of corpus callosum (P < 0.05). CONCLUSION This study showed that more regions are affected by the RD increase than the AD decrease in the WM tracts of patients with hyperthyroidism. These preliminary results suggest that demyelination is the main mechanism of microstructural alterations in the WM of hyperthyroid patients.
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Affiliation(s)
- Kerim Aslan
- Department of Radiology, Ondokuz Mayis University Faculty of Medicine, Samsun, Turkey
| | - Hediye Pinar Gunbey
- Department of Radiology, Health Sciences University Kartal Lütfi Kırdar Training and Research Hospital, Istanbul, Turkey
| | - Sumeyra Cortcu
- Department of Radiology, Kastamonu State Hospital, Kastamonu, Turkey
| | - Onur Ozyurt
- Telemed Solutions Teknopark, Bogazici University, İstanbul, Turkey
| | - Ugur Avci
- Department of Endocrinology and Metabolism, Recep Tayyip Erdogan University Faculty of Medicine, Rize, Turkey
| | - Lutfi Incesu
- Department of Radiology, Ondokuz Mayis University Faculty of Medicine, Samsun, Turkey
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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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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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Fetene DM, Betts KS, Alati R. The role of maternal prenatal thyroid function on offspring depression: Findings from the ALSPAC cohort. Dev Psychopathol 2020; 32:189-196. [PMID: 30688193 DOI: 10.1017/s0954579418001657] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Maternal thyroid dysfunction during pregnancy may contribute to offspring neurobehavioral disorders. In this paper, we investigate the relationship between maternal thyroid function during pregnancy and offspring depression and anxiety. Data were taken from the Avon Longitudinal Study of Parents and Children. A total of 2,920 mother-child pairs were included. Thyroid-stimulating hormone levels, free thyroxine (FT4), and thyroid peroxidase antibodies were assessed during the first trimester of pregnancy because maternal supply is the only source of thyroid hormone for the fetus during the first 12 weeks of gestation. Child symptoms of depression and anxiety were assessed using the Development and Well-Being Assessment at ages 7.5 and 15 years. The odds of presenting with depression and anxiety were estimated using the generalized estimating equation. The level of FT4 during the first trimester of pregnancy was associated with child depression combined at ages 7.5 and 15 (odds ratio = 1.21, 95% confidence interval [1.00, 1.14]. An increase of 1 standard deviation of FT4 during pregnancy increased the odds of child depression by 28% after adjustment made for potential confounders. No association was found among maternal levels of thyroid-stimulating hormone, FT4, and thyroid peroxidase antibodies and childhood anxiety. In conclusion, increased levels of FT4 during the first trimester of pregnancy appear be linked to greater risk of offspring depression.
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Affiliation(s)
- Dagnachew Muluye Fetene
- Institute for Social Science Research, University of Queensland, Brisbane, Australia
- College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
- School of Public Health, University of Queensland, Brisbane, Australia
| | - Kim S Betts
- Institute for Social Science Research, University of Queensland, Brisbane, Australia
| | - Rosa Alati
- Institute for Social Science Research, University of Queensland, Brisbane, Australia
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Hippocampal Up-Regulation of Apolipoprotein D in a Rat Model of Maternal Hypo- and Hyperthyroidism: Implication of Oxidative Stress. Neurochem Res 2019; 44:2190-2201. [DOI: 10.1007/s11064-019-02859-5] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2019] [Revised: 07/08/2019] [Accepted: 08/09/2019] [Indexed: 01/19/2023]
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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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Liu WF, Shu YQ, Zhu PW, Li B, Shi WQ, Lin Q, Liu YX, Zhang MY, Min YL, Yuan Q, Shao Y. The Cerebellum Posterior Lobe Associates with the Exophthalmos of Primary Hyperthyroidism: A Resting-State fMRI Study. Int J Endocrinol 2019; 2019:8135671. [PMID: 31885561 PMCID: PMC6914989 DOI: 10.1155/2019/8135671] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/20/2019] [Revised: 08/22/2019] [Accepted: 10/04/2019] [Indexed: 01/19/2023] Open
Abstract
BACKGROUND Exophthalmos occurs in patients with primary hyperthyroidism. There were few studies about the changes of brain functional networks of patients with exophthalmos of primary hyperthyroidism (EOPH). However, differences in spontaneous brain activity in patients with EOPH remain unclear. OBJECTIVE This study explored alterations in the brain functional networks of patients with EOPH using a voxel-wise degree centrality (DC) method. METHODS A total of 20 patients with EOPH (8 men and 12 women) were enrolled. In addition, 20 patients with primary hyperthyroidism without exophthalmos, matched in age, sex, and education status, were enrolled as a control group. The Hospital Anxiety and Depression Scale was used to assess the anxiety and depression status of participants. All participants were examined using resting-state functional MRI. Changes in spontaneous brain activity were investigated using the DC method. To distinguish between the DC values of the patients with EOPH and those of the control group, we analyzed the receiver operating characteristic (ROC) curve. The interrelationships between the DC values and clinical variables in the patients with EOPH were evaluated using Pearson's correlation coefficient. RESULTS Patients with EOPH exhibited notably lower DC values in the cerebellum posterior lobe than the control group. In addition, there were negative correlations between the anxiety scores (AS) and the depression scores (DS) and DC values of the cerebellum posterior lobe. The ROC curve analysis of the cerebellum posterior lobe demonstrated that the area under the curve method had a high diagnostic accuracy. CONCLUSIONS Our study was the first, to our knowledge, to explore changes in the brains of patients with EOPH using the DC method. The DC value was significantly different in the cerebellum posterior lobe in patients with EOPH, indicating that the cerebellum posterior lobe is associated with EOPH.
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Affiliation(s)
- Wen-Feng Liu
- Department of Ophthalmology, The First Affiliated Hospital of Nanchang University, Nanchang 330006, Jiangxi, China
| | - Yong-Qiang Shu
- Department of Radiology, The First Affiliated Hospital of Nanchang University, Nanchang 330006, Jiangxi, China
| | - Pei-Wen Zhu
- Department of Ophthalmology, The First Affiliated Hospital of Nanchang University, Nanchang 330006, Jiangxi, China
| | - Biao Li
- Department of Ophthalmology, The First Affiliated Hospital of Nanchang University, Nanchang 330006, Jiangxi, China
| | - Wen-Qing Shi
- Department of Ophthalmology, The First Affiliated Hospital of Nanchang University, Nanchang 330006, Jiangxi, China
| | - Qi Lin
- Department of Ophthalmology, The First Affiliated Hospital of Nanchang University, Nanchang 330006, Jiangxi, China
| | - Yu-Xin Liu
- Department of Ophthalmology, The First Affiliated Hospital of Nanchang University, Nanchang 330006, Jiangxi, China
| | - Meng-Yao Zhang
- Department of Ophthalmology, The First Affiliated Hospital of Nanchang University, Nanchang 330006, Jiangxi, China
| | - You-Lan Min
- Department of Ophthalmology, The First Affiliated Hospital of Nanchang University, Nanchang 330006, Jiangxi, China
| | - Qing Yuan
- Department of Ophthalmology, The First Affiliated Hospital of Nanchang University, Nanchang 330006, Jiangxi, China
| | - Yi Shao
- Department of Ophthalmology, The First Affiliated Hospital of Nanchang University, Nanchang 330006, Jiangxi, China
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Cognitive Deficit-Related Interhemispheric Asynchrony within the Medial Hub of the Default Mode Network Aids in Classifying the Hyperthyroid Patients. Neural Plast 2018; 2018:9023604. [PMID: 30532774 PMCID: PMC6250039 DOI: 10.1155/2018/9023604] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2018] [Accepted: 09/30/2018] [Indexed: 12/28/2022] Open
Abstract
Background and Purpose Recent studies suggest that abnormal structure and function in the brain network were related to cognitive and emotional impairment in hyperthyroid patients (HPs). The association between altered voxel-mirrored homotopic connectivity (VMHC) and neuropsychological impairment in HPs remains unclear. This study is aimed at investigating the association between the disrupted functional coordination and psychological dysfunction in hyperthyroidism. Method Thirty-three hyperthyroid patients and thirty-three matched healthy controls (HCs) were recruited, and they received resting-state functional magnetic resonance imaging (fMRI) scans and neuropsychological evaluation. The VMHC value was computed to reveal the functional coordination between homotopic regions in both groups. The neurobehavioral relevancy method was employed to explore the relationship between the altered VMHC and emotional, cognition measures. Further receiver operating characteristic (ROC) curve analysis was adopted to examine the power of changed regional VMHC in classifying the patients with hyperthyroidism. Results Compared with the HCs, the HPs exhibited significantly declined VMHC values in the bilateral medial frontal gyrus (MeFG). The interhemispheric asynchrony in the MeFG was positively correlated with Z scores of episodic memory. The ROC analysis further determined that abnormal VMHC in the MeFG could efficiently distinguish the HPs from the HCs (area under the curve (AUC) = 0.808, P < 0.001). Conclusion The altered interhemispheric coordination in the hub of the default mode network may implicated in the modulation of episodic memory in HPs patients and the distinct feature of the interhemispheric asynchrony may be treated as a potential target for the early recognition and intervention for the HPs with cognitive impairments. Clinical Trial Registration This is a study of the neurological basis for dysfunction of mood and cognition in hyperthyroid patients: a resting-state fMRI study (registration number: ChiCTR-OOC-16008607).
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Ittermann T, Wittfeld K, Nauck M, Bülow R, Hosten N, Völzke H, Grabe HJ. High Thyrotropin Is Associated with Reduced Hippocampal Volume in a Population-Based Study from Germany. Thyroid 2018; 28:1434-1442. [PMID: 30259797 DOI: 10.1089/thy.2017.0561] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
BACKGROUND Previous patient studies suggest that thyroid dysfunction affects volumes of particular regions of the brain. So far, population-based data related to this topic are lacking. The aim of this study was to investigate associations of serum levels of thyrotropin (TSH), free triiodothyronine, and free thyroxine (fT4) with total brain volume, gray matter volume, white matter volume (WMV), and hippocampal volume (HV) in a population-based study. METHODS Data on 2557 individuals were pooled from two independent population-based surveys of the Study of Health in Pomerania conducted in Northeast Germany. Brain volumes were determined from images derived from 1.5 T magnetic resonance imaging. Low and high TSH were defined using the cutoffs 0.40 and 3.29 mIU/L, respectively. Associations between thyroid hormone levels and segmented brain volumes were analyzed by linear regression models. Further, voxel-based morphometry was conducted to search for associations with thyroid hormone levels in a hypothesis-free way throughout the whole brain. All models were adjusted for confounders. RESULTS Only 9/70 individuals with high TSH had low free triiodothyronine or fT4 levels. Individuals with high TSH had significantly lower total brain volume (β = -26.9 [confidence interval (CI) -49.0 to -4.8]; p = 0.017), WMV (β = -16.1 [CI -29.4 to -2.7]; p = 0.018), and HV (β = -223 [CI -395 to -50]; p = 0.011) than individuals with TSH within the reference range, while low TSH was not significantly associated with any of the brain volumes. Voxel-based morphometry analyses revealed a significant positive association with serum fT4 levels in the left middle frontal gyrus. CONCLUSIONS In conclusion, the results of this study indicate that the subclinical hypothyroid state may lead to a reduced brain volume affecting particularly HV in younger subjects and WMV, which might correspond to subtle microstructural changes in white matter fiber tracts or myelination of the axones. Gray matter seems not to be affected by subclinical hypothyroid states.
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Affiliation(s)
- Till Ittermann
- 1 Institute for Community Medicine , Site Rostock/Greifswald, Greifswald, Germany
| | - Katharina Wittfeld
- 2 Institute for Psychiatry and Psychotherapy , Site Rostock/Greifswald, Greifswald, Germany
- 3 German Center for Neurodegenerative Diseases (DZNE) , Site Rostock/Greifswald, Greifswald, Germany
| | - Matthias Nauck
- 4 Institute for Clinical Chemistry and Laboratory Medicine, University Medicine Greifswald , Greifswald, Germany
- 5 DZHK (German Centre for Cardiovascular Research), Partner Site Greifswald, University Medicine Greifswald , Greifswald, Germany
| | - Robin Bülow
- 6 Institute of Diagnostic Radiology and Neuroradiology, University Medicine Greifswald , Greifswald, Germany
| | - Norbert Hosten
- 6 Institute of Diagnostic Radiology and Neuroradiology, University Medicine Greifswald , Greifswald, Germany
| | - Henry Völzke
- 1 Institute for Community Medicine , Site Rostock/Greifswald, Greifswald, Germany
| | - Hans J Grabe
- 2 Institute for Psychiatry and Psychotherapy , Site Rostock/Greifswald, Greifswald, Germany
- 3 German Center for Neurodegenerative Diseases (DZNE) , Site Rostock/Greifswald, Greifswald, Germany
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16
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Zhi M, Hou Z, We Q, Zhang Y, Li L, Yuan Y. Abnormal spontaneous brain activity is associated with impaired emotion and cognition in hyperthyroidism: A rs-fMRI study. Behav Brain Res 2018; 351:188-194. [DOI: 10.1016/j.bbr.2018.05.020] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2017] [Revised: 05/02/2018] [Accepted: 05/22/2018] [Indexed: 12/13/2022]
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17
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Liu B, Wen L, Ran Q, Zhang S, Hu J, Gong M, Zhang D. Dysregulation within the salience network and default mode network in hyperthyroid patients: a follow-up resting-state functional MRI study. Brain Imaging Behav 2018; 14:30-41. [PMID: 30259292 DOI: 10.1007/s11682-018-9961-6] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
This study investigated the aberrant connectivity of the salience network (SN) and default mode network (DMN) and the relevance between these abnormalities and symptom improvement in hyperthyroid patients using resting-state functional magnetic resonance imaging (rs-fMRI). Seed-based functional connectivity (FC) analyses were performed on state fMRI data to reveal possible differences in critical node connectivity in the SN and DMN between 41 new-onset, untreated hyperthyroid patients and 41 healthy controls. Subsequently, follow-up data were available for 25 patients treated with methimazole for one month. Compared with the healthy controls, the patients exhibited abnormal internetwork FC from the SN to the DMN and the executive control network (ECN) and decreased intra-network FC within the SN. Relative to the hyperthyroid state, the antithyroid therapy induced reversible connectivity of the left insula to the dorsal anterior cingulate cortex(dACC)and ECN, and persistently increased connectivity between the SN and DMN in patients with improved thyroid function. Finally, Pearson's correlation analyses were performed among the abnormal FC, neuropsychological assessment and serum free triiodothyronine(FT3)level data. The results indicated that aberrant intra- and internetwork FC in the SN and DMN might underlie the pathogenesis of hyperthyroidism, and antithyroid treatment could regulate the FC of certain key brain regions within the SN and DMN in hyperthyroid patients.
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Affiliation(s)
- Bo Liu
- Department of Radiology, XinQiao Hosptial, Third Military Medical University, ChongQing, 400037, People's Republic of China
| | - Li Wen
- Department of Radiology, XinQiao Hosptial, Third Military Medical University, ChongQing, 400037, People's Republic of China
| | - Qian Ran
- Department of Radiology, XinQiao Hosptial, Third Military Medical University, ChongQing, 400037, People's Republic of China
| | - Si Zhang
- Department of Radiology, XinQiao Hosptial, Third Military Medical University, ChongQing, 400037, People's Republic of China
| | - Junhao Hu
- Department of Radiology, XinQiao Hosptial, Third Military Medical University, ChongQing, 400037, People's Republic of China
| | - Mingfu Gong
- Department of Radiology, XinQiao Hosptial, Third Military Medical University, ChongQing, 400037, People's Republic of China
| | - Dong Zhang
- Department of Radiology, XinQiao Hosptial, Third Military Medical University, ChongQing, 400037, People's Republic of China.
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18
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Li L, Zhi M, Hou Z, Zhang Y, Yue Y, Yuan Y. Abnormal brain functional connectivity leads to impaired mood and cognition in hyperthyroidism: a resting-state functional MRI study. Oncotarget 2018; 8:6283-6294. [PMID: 28009983 PMCID: PMC5351631 DOI: 10.18632/oncotarget.14060] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2016] [Accepted: 12/13/2016] [Indexed: 12/18/2022] Open
Abstract
Patients with hyperthyroidism frequently have neuropsychiatric complaints such as lack of concentration, poor memory, depression, anxiety, nervousness, and irritability, suggesting brain dysfunction. However, the underlying process of these symptoms remains unclear. Using resting-state functional magnetic resonance imaging (rs-fMRI), we depicted the altered graph theoretical metric degree centrality (DC) and seed-based resting-state functional connectivity (FC) in 33 hyperthyroid patients relative to 33 healthy controls. The peak points of significantly altered DC between the two groups were defined as the seed regions to calculate FC to the whole brain. Then, partial correlation analyses were performed between abnormal DC, FC and neuropsychological performances, as well as some clinical indexes. The decreased intrinsic functional connectivity in the posterior lobe of cerebellum (PLC) and medial frontal gyrus (MeFG), as well as the abnormal seed-based FC anchored in default mode network (DMN), attention network, visual network and cognitive network in this study, possibly constitutes the latent mechanism for emotional and cognitive changes in hyperthyroidism, including anxiety and impaired processing speed.
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Affiliation(s)
- Ling Li
- Department of Endocrinology, Affiliated ZhongDa Hospital, School of Medicine, Southeast University, Nanjing, Jiangsu, 210009, China
| | - Mengmeng Zhi
- Department of Endocrinology, Affiliated ZhongDa Hospital, School of Medicine, Southeast University, Nanjing, Jiangsu, 210009, China
| | - Zhenghua Hou
- Department of Psychosomatics and Psychiatry, Affiliated ZhongDa Hospital, School of Medicine, Southeast University, Nanjing, Jiangsu, 210009, China
| | - Yuqun Zhang
- Department of Psychosomatics and Psychiatry, Affiliated ZhongDa Hospital, School of Medicine, Southeast University, Nanjing, Jiangsu, 210009, China
| | - Yingying Yue
- Department of Psychosomatics and Psychiatry, Affiliated ZhongDa Hospital, School of Medicine, Southeast University, Nanjing, Jiangsu, 210009, China
| | - Yonggui Yuan
- Department of Psychosomatics and Psychiatry, Affiliated ZhongDa Hospital, School of Medicine, Southeast University, Nanjing, Jiangsu, 210009, China.,Neuropsychiatric Institute, Affiliated ZhongDa Hospital, Southeast University, Nanjing, Jiangsu, 210009, China
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Manto M, Hampe CS. Endocrine disorders and the cerebellum: from neurodevelopmental injury to late-onset ataxia. HANDBOOK OF CLINICAL NEUROLOGY 2018; 155:353-368. [PMID: 29891071 DOI: 10.1016/b978-0-444-64189-2.00023-8] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
Hormonal disorders are a source of cerebellar ataxia in both children and adults. Normal development of the cerebellum is critically dependent on thyroid hormone, which crosses both the blood-brain barrier and the blood-cerebrospinal fluid barrier thanks to specific transporters, including monocarboxylate transporter 8 and the organic anion-transporting polypeptide 1C1. In particular, growth and dendritic arborization of Purkinje neurons, synaptogenesis, and myelination are dependent on thyroid hormone. Disturbances of thyroid hormone may also impact on cerebellar ataxias of other origin, decompensating or aggravating the pre-existing ataxia manifesting with motor ataxia, oculomotor ataxia, and/or Schmahmann syndrome. Parathyroid disorders are associated with a genuine cerebellar syndrome, but symptoms may be subtle. The main conditions combining diabetes and cerebellar ataxia are Friedreich ataxia, ataxia associated with anti-GAD antibodies, autoimmune polyglandular syndromes, aceruloplasminemia, and cerebellar ataxia associated with hypogonadism (especially Holmes ataxia/Boucher-Neuhäuser syndrome). The general workup of cerebellar disorders should include the evaluation of hormonal status, including thyroid-stimulating hormone and free thyroxine levels, and hormonal replacement should be considered depending on the laboratory results. Cerebellar deficits may be reversible in some cases.
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Affiliation(s)
- Mario Manto
- Neurology Service, CHU-Charleroi, Charleroi, Belgium; Neuroscience Service, Université de Mons, Mons, Belgium.
| | - Christiane S Hampe
- Department of Medicine, University of Washington, Seattle, United States
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20
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Liu B, Ran Q, Liu D, Zhang S, Zhang D. Changes in Resting-State Cerebral Activity in Patients with Hyperthyroidism: A Short-Term Follow-Up Functional MR Imaging Study. Sci Rep 2017; 7:10627. [PMID: 28878279 PMCID: PMC5587688 DOI: 10.1038/s41598-017-10747-7] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2017] [Accepted: 08/14/2017] [Indexed: 12/20/2022] Open
Abstract
To investigate the brain functional abnormality of hyperthyroid patients before and after treatment for one month using resting-state functional magnetic resonance imaging (rs-fMRI). Amplitude of low-frequency fluctuation (ALFF) and seed-based functional connectivity (FC) analysis were performed in 27 new-onset untreated hyperthyroid patients relative to 30 healthy controls. In addition, follow-up data were available for 19 patients treated with methimazole for one month. Compared with healthy controls, patients exhibited lower ALFF in the right posterior cingulate cortex (PCC); increased FC in the bilateral anterior insula (AI), bilateral posterior insula (PI) and left anterior lobe of the cerebellum (ALC); and decreased FC in the bilateral lateral prefrontal cortex (LPFC), the right medial temporal gyrus (MTG) and the bilateral PCC. Compared with the hyperthyroid status, patients with improved thyroid function showed increased FC in the right LPFC and right dorsolateral prefrontal cortex (DLPFC). Subsequently, Pearson’s correlation analyses were performed between abnormal ALFF, FC, neuropsychological assessment and serum free triiodothyronine (FT3) levels. The results indicated that the alterations in regional and network-level brain functions, which might underlie different psychiatric complications were dynamic and interactional processes in hyperthyroidism. Moreover, the improvement in regional brain FC was correlated with the efficacy of anti-thyroid medication.
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Affiliation(s)
- Bo Liu
- Department of Radiology, XinQiao Hosptial, Third Military Medical University, ChongQing, 400037, P.R. China
| | - Qian Ran
- Department of Radiology, XinQiao Hosptial, Third Military Medical University, ChongQing, 400037, P.R. China
| | - Daihong Liu
- Department of Radiology, Southwest Hosptial, Third Military Medical University, ChongQing, 400038, P.R. China
| | - Si Zhang
- Department of Radiology, XinQiao Hosptial, Third Military Medical University, ChongQing, 400037, P.R. China
| | - Dong Zhang
- Department of Radiology, XinQiao Hosptial, Third Military Medical University, ChongQing, 400037, P.R. China.
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Göbel A, Heldmann M, Sartorius A, Göttlich M, Dirk AL, Brabant G, Münte TF. Mild Thyrotoxicosis Leads to Brain Perfusion Changes: An Arterial Spin Labelling Study. J Neuroendocrinol 2017; 29. [PMID: 27859916 DOI: 10.1111/jne.12446] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/11/2016] [Revised: 10/12/2016] [Accepted: 11/05/2016] [Indexed: 11/29/2022]
Abstract
Hypo- and hyperthyroidism have effects on brain structure and function, as well as cognitive processes, including memory. However, little is known about the influence of thyroid hormones on brain perfusion and the relationship of such perfusion changes with cognition. The present study aimed to demonstrate the effect of short-term experimental hyperthyroidism on brain perfusion in healthy volunteers and to assess whether perfusion changes, if present, are related to cognitive performance. It is known that an interaction exists between brain perfusion and cerebral oxygen consumption rate and it is considered that neural activation increases cerebral regional perfusion rate in brain areas associated with memory. Measuring cerebral blood flow may therefore represent a proxy for neural activity. Therefore, arterial spin labelling (ASL) measurements were conducted and later analysed to evaluate brain perfusion in 29 healthy men before and after ingesting thyroid hormones for 8 weeks. Psychological tests concerning memory were performed at the same time-points and the results were correlated with the imaging results. In the hyperthyroid condition, perfusion was increased in the posterior cerebellum in regions connected with cerebral networks associated with cognitive control and the visual cortex compared to the euthyroid condition. In addition, these perfusion changes were positively correlated with changes of performance in the German version of the Auditory Verbal Learning Task [AVLT, Verbaler Lern-und-Merkfähigkeits-Test (VLMT)]. Cerebellar perfusion and function therefore appears to be modulated by thyroid hormones, likely because the cerebellum hosts a high number of thyroid hormone receptors.
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Affiliation(s)
- A Göbel
- Department of Neurology, University of Lübeck, Lübeck, Germany
| | - M Heldmann
- Department of Neurology, University of Lübeck, Lübeck, Germany
- Institute of Psychology II, University of Lübeck, Lübeck, Germany
| | - A Sartorius
- Central Institute of Mental Health, Mannheim, Germany
| | - M Göttlich
- Department of Neurology, University of Lübeck, Lübeck, Germany
| | - A-L Dirk
- Department of Internal Medicine I, University of Lübeck, Lübeck, Germany
| | - G Brabant
- Department of Internal Medicine I, University of Lübeck, Lübeck, Germany
| | - T F Münte
- Department of Neurology, University of Lübeck, Lübeck, Germany
- Institute of Psychology II, University of Lübeck, Lübeck, Germany
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