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Bazika-Gerasch B, Kumowski N, Enax-Krumova E, Kaisler M, Eitner LB, Maier C, Dietrich JW. Impaired autonomic function and somatosensory disturbance in patients with treated autoimmune thyroiditis. Sci Rep 2024; 14:12358. [PMID: 38811750 PMCID: PMC11137073 DOI: 10.1038/s41598-024-63158-w] [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: 09/08/2023] [Accepted: 05/26/2024] [Indexed: 05/31/2024] Open
Abstract
Despite treatment with levothyroxine, hypothyroidism and autoimmune thyroiditis (AIT) may be associated with reduced quality of life (QoL), an enigmatic condition referred to as "syndrome T". Peripheral neuropathy, described in untreated thyroid disease, could be a contributing mechanism. We analysed autonomic and somatosensory function in 29 patients with AIT and treated hypothyroidism and 27 healthy volunteers. They underwent heart rate variability (HRV) analysis and quantitative sensory testing (n = 28), comprising 13 parameters of small and large nerve fibre function and pain thresholds. Autonomic cardiovascular function was assessed in rest, deep respiration and orthostasis. Additionally, biomarkers for autoimmunity and thyroid function were measured. Anxiety, depression and QoL were assessed using validated questionnaires. 36% of the patients showed at least one sign of somatosensory small or large fibre dysfunction. 57% presented with mild hyperalgesia to at least one stimulus. Several markers of autonomic function and some detection thresholds were related to the antibody titres. Anxiety, depression scores and QoL correlated to antibody titres and HRV measures. Autonomic and somatosensory dysfunction indicate that in treated hypothyroidism and AIT a subgroup of patients suffers from neuropathic symptoms leading to impaired QoL. Additionally, mild hyperalgesia as a possible sensitisation phenomenon should be considered a target for symptomatic treatment.
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Affiliation(s)
- Bojana Bazika-Gerasch
- Diabetes, Endocrinology and Metabolism Section, Department of Internal Medicine I, St. Josef Hospital, Ruhr University Bochum, Gudrunstr. 56, 44791, Bochum, NRW, Germany
- Diabetes Centre Bochum/Hattingen, St. Elisabeth-Hospital Blankenstein, Im Vogelsang 5-11, 45527, Hattingen, NRW, Germany
- Centre for Diabetes Technology, Catholic Hospitals Bochum, Ruhr University Bochum, NRW, Gudrunstr. 56, 44791, Bochum, Germany
- Centre for Rare Endocrine Diseases, Ruhr Centre for Rare Diseases (CeSER), Ruhr University Bochum and Witten/Herdecke University, Alexandrinenstr. 5, 44791, Bochum, NRW, Germany
- Centre for Thyroid Medicine KKB, Catholic Hospitals Bochum, Ruhr University Bochum, Gudrunstr. 56, 44791, Bochum, NRW, Germany
| | - Nina Kumowski
- Department of Internal Medicine 1, University Hospital Aachen, Rheinisch-Westfälische Technische Hochschule (RWTH) Aachen University, Pauwelsstraße 30, 52074, Aachen, NRW, Germany
| | - Elena Enax-Krumova
- Department of Neurology, BG University Hospital Bergmannsheil gGmbH, Ruhr-University Bochum, Bürkle-de-la-Camp-Platz 1, 44789, Bochum, NRW, Germany
| | - Miriam Kaisler
- Department of Neurology, BG University Hospital Bergmannsheil gGmbH, Ruhr-University Bochum, Bürkle-de-la-Camp-Platz 1, 44789, Bochum, NRW, Germany
| | - Lynn Bernadette Eitner
- Pediatrics Department, Catholic Hospitals Bochum, Ruhr University Bochum, Alexandrinenstraße 5, 44791, Bochum, NRW, Germany
- Centre for Thyroid Medicine KKB, Catholic Hospitals Bochum, Ruhr University Bochum, Gudrunstr. 56, 44791, Bochum, NRW, Germany
| | - Christoph Maier
- Pediatrics Department, Catholic Hospitals Bochum, Ruhr University Bochum, Alexandrinenstraße 5, 44791, Bochum, NRW, Germany
| | - Johannes W Dietrich
- Diabetes, Endocrinology and Metabolism Section, Department of Internal Medicine I, St. Josef Hospital, Ruhr University Bochum, Gudrunstr. 56, 44791, Bochum, NRW, Germany.
- Diabetes Centre Bochum/Hattingen, St. Elisabeth-Hospital Blankenstein, Im Vogelsang 5-11, 45527, Hattingen, NRW, Germany.
- Centre for Diabetes Technology, Catholic Hospitals Bochum, Ruhr University Bochum, NRW, Gudrunstr. 56, 44791, Bochum, Germany.
- Centre for Rare Endocrine Diseases, Ruhr Centre for Rare Diseases (CeSER), Ruhr University Bochum and Witten/Herdecke University, Alexandrinenstr. 5, 44791, Bochum, NRW, Germany.
- Centre for Thyroid Medicine KKB, Catholic Hospitals Bochum, Ruhr University Bochum, Gudrunstr. 56, 44791, Bochum, NRW, Germany.
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2
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Tabakoglu NT, Celik M. Evaluation of Health-Related Quality of Life in Patients with Euthyroid Hashimoto's Thyroiditis under Long-Term Levothyroxine Therapy: A Prospective Case-Control Study. J Clin Med 2024; 13:3082. [PMID: 38892793 PMCID: PMC11173285 DOI: 10.3390/jcm13113082] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2024] [Revised: 05/21/2024] [Accepted: 05/22/2024] [Indexed: 06/21/2024] Open
Abstract
Objectives: To investigate quality of life using the SF-12 scale in euthyroid Hashimoto's thyroiditis patients on levothyroxine therapy for at least three years. Methods: This prospective case-control study included 44 euthyroid Hashimoto's thyroiditis patients and 44 matched controls, conducted at a university hospital's endocrinology clinic from 6 November to 30 December 2023. Participants completed the SF-12 questionnaire; data were analyzed using Shapiro-Wilk, Student's t-test, Mann-Whitney U, Yates chi-squared, and Spearman's tests. Results: The study involved 88 participants (Hashimoto's group: 35 females, 9 males; control group: 31 females, 13 males), with average ages of 49.50 and 47.43 years old, respectively. Significant differences were observed in TSH, T4 levels, and family history (p < 0.05). The Hashimoto's thyroiditis group showed higher thyroid peroxidase antibodies (95.69 IU/mL) and lower scores on both physical and mental sub-dimensions of SF-12, with a significant difference in physical scores (p < 0.05). Significant correlations were found between age and Anti-TG; Anti-TPO and Anti-TG; BMI and T3; TSH and T4; HDL and triglycerides; MCS-12 and PCS-12; Anti-TPO and T3; cholesterol and T3; and LDL and cholesterol (p < 0.05). Other variables showed no significant correlations (p > 0.05). Conclusions: Our study shows that effective control of hypothyroidism is not sufficient to reduce the negative effects of Hashimoto's thyroiditis on patients' health-related quality of life. Beyond the normalization of hormone levels, comprehensive therapeutic strategies targeting the autoimmune aspects of the disease are essential for the management of Hashimoto's thyroiditis. This study provides a foundation for developing effective therapies that can enhance quality of life for patients with Hashimoto's thyroiditis.
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Affiliation(s)
- Nilgun Tan Tabakoglu
- Hospital Health Research and Development Center, Faculty of Medicine, Trakya University, Edirne 22030, Turkey
| | - Mehmet Celik
- Department of Internal Medicine—Endocrinology and Metabolism, Trakya University, Edirne 22030, Turkey;
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Bablis P, Day RR, Bablis S, Pollard H. Treatment of Hypothyroidism and Stress Using Neuro-Emotional Technique (NET): A Case Study. Cureus 2024; 16:e58231. [PMID: 38745794 PMCID: PMC11092426 DOI: 10.7759/cureus.58231] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/14/2024] [Indexed: 05/16/2024] Open
Abstract
Hypothyroidism is generally considered an autoimmune condition, and typical medical management involves taking levothyroxine (synthetic thyroid hormone) for life. This case report details the results of a mind-body intervention (MBI) called the Neuro-Emotional Technique (NET) used to treat a 28-year-old Caucasian female presenting with symptoms and bloodwork markers associated with two years of hypothyroidism and a long history of stress. The patient's medical doctor provided a diagnosis of hypothyroidism after blood tests showed that thyroid-stimulating hormone (TSH) levels were high at 6.87 mIU/L (where the acceptable range is 0.40-3.50 mIU/L) and free T4 (FT4) levels were low at 8.6 pmol/L (where the acceptable range is 9.0-19.0 pmol/L). Psychometric tests were completed at baseline and after 12 weeks of treatment to evaluate changes in mental health and emotional well-being. The Adverse Childhood Experiences Questionnaire (ACE-Q) revealed a high degree of childhood trauma that may have predisposed to the underlying autoimmune thyroid dysfunction. At the conclusion of the treatment period, serum thyroid-stimulating hormone (TSH) and free T4 were within normal ranges and psychometric indicators normalized. We hypothesize that these changes may be due to the stress-reducing mechanism of NET and outline possible mechanisms via the Psycho-Immune-Neuroendocrine (PINE) network. The PINE network model asserts that chronic stress acts as a potential driver of pathophysiology that can lead to one or more medical and mental health conditions. While further studies with larger sample sizes are required to establish whether these results could be extrapolated to a wider population, the results of this case suggest that it may be pertinent to consider co-management of subclinical hypothyroidism with a relatively quick and cost-effective MBI such as NET.
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Affiliation(s)
- Peter Bablis
- Department of Maternal and Child Health and Precision Medicine, University Research Institute, Athens, GRC
- Department of Integrative and Complementary Medicine, Universal Health, Sydney, AUS
| | - Ryan R Day
- Department of Chiropractic, Universal Health, Sydney, AUS
| | - Sophia Bablis
- Department of Psychology, Universal Health, Sydney, AUS
| | - Henry Pollard
- Faculty of Health Sciences, Durban University of Technology, Durban, ZAF
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Tunç S, Altuntaş ŞL, Atmaca M, Çakıcı Ç, Yiğitbaşı T, Liou YC, Chang WA. The effect of low-level laser therapy on the oxidative stress level and quality of life in patients with Hashimoto's thyroiditis. Free Radic Res 2024; 58:249-260. [PMID: 38628043 DOI: 10.1080/10715762.2024.2339892] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2023] [Accepted: 03/15/2024] [Indexed: 05/23/2024]
Abstract
This study aimed to examine the effects of low-level laser therapy (LLLT) combined with levothyroxine replacement therapy on thyroid function, oxidative stress (OS), and quality of life in patients with Hashimoto's thyroiditis (HT). Forty-six patients diagnosed with HT were randomized to receive active LLLT (n = 23) and sham LLLT (n = 23) twice a week for three weeks. Clinical and laboratory evaluations of the participants were performed before treatment and three months after treatment. Biochemical parameters were taken from the patient file requested by the physician as a routine examination. Malondialdehyde and nitricoxide indicating oxidant stress and superoxide dismutase, catalase, and glutathione, which indicate antioxidant capacity, were used in OS evaluation. The Oxidative Stress Index was calculated by measuring the Total Antioxidant Status and the Total Oxidant Status. At the end of our study, a significant improvement in oxidant and antioxidant biomarker levels showing OS and quality of life was observed in the treatment groups (p < 0.05). There was no change in thyroid function and autoimmunity at the end of the treatment between the two groups (p > 0.05). Improvements in glutathione levels and quality of life were significantly higher in the active treatment group than in the sham-controlled group. LLLT was found to be more effective on OS and quality of life in patients with HT than in patients in the sham-controlled group. It was concluded that LLLT is a safe and effective method that can be used in the treatment of patients with HT.
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Affiliation(s)
- Sümeyye Tunç
- Physiotherapy Programme, Department of Therapy and Rehabilitation, IMU Vocational School, Istanbul Medipol University, Istanbul, Turkey
| | - Şükriye Leyla Altuntaş
- Department of Obstetrics and Gynecology, Faculty of Medicine, Istanbul Medipol University, Istanbul, Turkey
| | - Murat Atmaca
- Department of Endocrinology and Metabolism, Faculty of Medicine, Istanbul Medipol University, Istanbul, Turkey
| | - Çağrı Çakıcı
- Department of Biochemistry, Faculty of Medicine, Istanbul Medipol University, Kavacık, Istanbul, Turkey
| | - Türkan Yiğitbaşı
- Department of Biochemistry, Faculty of Medicine, Istanbul Medipol University, Istanbul, Turkey
| | - Yeong-Cheng Liou
- Department of Healthcare Administration and Medical Informatics, and Research Center of Nonlinear Analysis and Optimization, Kaohsiung Medical University, Kaohsiung, Taiwan
- Department of Medical Research, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
| | - Wei-An Chang
- Graduate Institute of Clinical Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
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Kollerits E, Zsila Á, Matuszka B. Quality of life, social support, and adherence in female patients with thyroid disorders. BMC Womens Health 2023; 23:567. [PMID: 37919706 PMCID: PMC10623692 DOI: 10.1186/s12905-023-02718-0] [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: 11/16/2022] [Accepted: 10/17/2023] [Indexed: 11/04/2023] Open
Abstract
BACKGROUND According to the 2010 European Health Interview Survey, 51% of women in Hungary have a chronic disease, and is among the poorest quartile in the EU countries. Thyroid diseases affected more than 650,000 women in 2021 based on a recent report by the Hungarian Central Statistical Office. Despite the high prevalence rates, quality of life in these patients is scarcely researched in Hungary. To fill this gap, this study aims to explore the associations of the quality of life of thyroid patients in Hungary with social support and adherence. METHODS A cross-sectional study was conducted via an online questionnaire. Data from 885 female Hungarian thyroid patients with pharmacological treatment (M = 35.6 years, SD = 10.7, age range: 18-73 years) were analyzed. Participants were divided into two patient groups based on the type of thyroid disorder: hypothyroidism (n = 824; 93.1%) and hyperthyroidism (n = 61; 6.9%). Group comparisons, correlations, and a mediation model were performed to explore differences between thyroid patients. RESULTS No differences were found between patients with different types of thyroid disorders in quality of life, adherence, and social support. Consistent, weak associations were found between quality of life and social support in both patient groups. Higher perceived social support partially explained the relationship between adherence and life quality in thyroid patients. CONCLUSIONS: No substantial differences were found between patients with different types of thyroid disease in mental well-being indicators. These patients are psychologically more vulnerable and need a socially supportive environment to recover, because higher adherence is associated with a better quality of life, and social support can facilitate this process.
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Affiliation(s)
- Eliza Kollerits
- ELTE Doctoral School of Psychology, Kazinczy u. 23-27, Budapest, 1075, Hungary.
- ELTE Institute of Psychology, Kazinczy u. 23-27, Budapest, 1075, Hungary.
- Institute of Psychology, Pázmány Péter Catholic University, Mikszáth Kálmán tér 1., Budapest, 1088, Hungary.
| | - Ágnes Zsila
- ELTE Institute of Psychology, Kazinczy u. 23-27, Budapest, 1075, Hungary
- Institute of Psychology, Pázmány Péter Catholic University, Mikszáth Kálmán tér 1., Budapest, 1088, Hungary
| | - Balázs Matuszka
- Institute of Psychology, Pázmány Péter Catholic University, Mikszáth Kálmán tér 1., Budapest, 1088, Hungary
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Martin M, Subramaniyan R, Naik D, Ramamoorthy L, Lalthanthuami HT. Health-related quality of life and its association with the symptom score and the thyroid function status of patients with primary hypothyroidism on replacement therapy. J Family Community Med 2023; 30:280-286. [PMID: 38044967 PMCID: PMC10688588 DOI: 10.4103/jfcm.jfcm_103_23] [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: 04/22/2023] [Revised: 07/14/2023] [Accepted: 08/09/2023] [Indexed: 12/05/2023] Open
Abstract
BACKGROUND A number of patients with primary hypothyroidism have reduced health-related quality of life (HR-QoL), even with optimum thyroid hormone replacement therapy. This study aimed to assess the HR-QoL of patients with hypothyroidism under replacement therapy and identify its relationship with the symptom score and thyroid function status. MATERIALS AND METHODS Using a cross-sectional study design, 175 hypothyroid patients under replacement therapy who visited the Endocrinology Outpatient Department of a tertiary care center were selected by convenient sampling technique. Data was collected using a structured data collection tool comprising, HR-QoL Short Form-36 questionnaire, and Zulewski's clinical score. Inferential statistical analyses were performed using Mann-Whitney U, Kruskal-Wallis, and Karl-Pearson Correlation tests. RESULTS The overall mean quality of life score was 44.22 ± 12.14, with a substantial decline in role functioning because of physical health. A significant negative correlation (P < 0.05) was found between HR-QoL and hypothyroidism symptom score. A significant association was observed between participants' HR-QoL and their dosage of thyroxine supplement (P < 0.05,) but no association was found with thyroid function status. CONCLUSION There was a substantial reduction in the quality of life of the patients despite being on thyroid replacement therapy and achieving euthyroid status. This underlines the importance of symptom reduction and hormone optimization to enhance the quality of life.
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Affiliation(s)
- Merina Martin
- Medical Surgical Nursing, College of Nursing, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India
| | - Rani Subramaniyan
- Medical Surgical Nursing, College of Nursing, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India
| | - Dhukhabandu Naik
- Department of Endocrinology, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India
| | - Lakshmi Ramamoorthy
- Medical Surgical Nursing, College of Nursing, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India
| | - Hmar T. Lalthanthuami
- Medical Surgical Nursing, College of Nursing, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India
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Ramezani M, Reisian M, Sajadi Hezaveh Z. The effect of synbiotic supplementation on hypothyroidism: A randomized double-blind placebo controlled clinical trial. PLoS One 2023; 18:e0277213. [PMID: 36745650 PMCID: PMC9901790 DOI: 10.1371/journal.pone.0277213] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2022] [Accepted: 10/20/2022] [Indexed: 02/07/2023] Open
Abstract
OBJECTIVE We hypothesize that synbiotic supplementation could modulate the intestinal microbiota and subsequently, improve the condition of hypothyroid patients. METHODS Fifty-six adult hypothyroid patients were recruited to this double-blind, placebo-controlled, randomized clinical trial. The intervention was 10 weeks of synbiotic (500 mg of 109 CFU/g probiotics plus fructo-oligosaccharide, n = 28) compared to placebo (lactose, magnesium stearate, talc, and silicon dioxide, n = 28). Randomization and allocation to trial groups were carried out using random number sequences drawn from https://sealedenvelope.com/. Primary outcomes were serum thyroid stimulating hormone (TSH) and free thyroxine (FT4), and secondary outcomes were depression, quality of life, and blood pressure (BP). P-values< 0.05 were considered statistically significant. RESULTS Analysis on 51 patients who completed the trial showed that TSH and depression (p> 0.05) did not change significantly, while serum FT4 significantly increased in both groups (p = 0.03 and p = 0.02 in symbiotic and placebo respectively). A significant decrease in systolic BP occurred only in the synbiotic group (p = 0.05). Significant improvements occurred regarding different domains and areas of quality of life in the crude and adjusted analysis, including perceived mental health (p = 0.02), bodily pain (p = 0.02), general health perception (p = 0.002), and wellbeing (p = 0.002), which were significantly higher in the synbiotic group. CONCLUSIONS Ten-week supplementation with synbiotic had no favorable effect on depression and TSH, but it improved blood pressure and quality of life in patients with hypothyroidism. More trials are needed to support or reject these findings. TRIAL REGISTRATION IRCT20210926052583N1, Iranian Registry of Clinical Trials (IRCT), registered October 1st, 2021.
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Affiliation(s)
- Majid Ramezani
- Department of Internal Medicine, School of Medicine, Baqiyatallah University of Medical Sciences, Tehran, Iran
| | - Mahnaz Reisian
- Department of Nutrition, School of Public Health, Iran University of Medical Sciences, Tehran, Iran
| | - Zohreh Sajadi Hezaveh
- Department of Nutrition, School of Public Health, Iran University of Medical Sciences, Tehran, Iran
- * E-mail:
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Ghamri R, Babaker R, Ezzat S, Alsaedi H, Alkhamisi M, Arbaein R, Alyahya R, Fayraq S, Alamri S. Assessment of Quality of Life Among Patients With Primary Hypothyroidism: A Case-Control Study. Cureus 2022; 14:e29947. [PMID: 36348860 PMCID: PMC9635404 DOI: 10.7759/cureus.29947] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/05/2022] [Indexed: 05/29/2023] Open
Abstract
Introduction Hypothyroidism is a globally prevalent condition with a huge impact on health. It has been demonstrated that hypothyroidism is associated with negative health outcomes that have a significant impact on quality of life. The aim of this study is to assess the relative significance of various parts of quality of life satisfaction in adult patients with hypothyroidism. This study has never been done in Saudi Arabia. No previous research was conducted in our region to highlight the quality of life of these patients. From this, it is very important to acknowledge the impact of hypothyroidism on quality of life, to help improve their lives and reduce the burden of the disease. Method This is a case-control study conducted on patients with hypothyroidism presented to the family medicine clinic at King Abdulaziz University Hospital. The participants were divided into two groups: patients with primary hypothyroidism (cases) and euthyroid subjects of the same age without chronic illnesses (control group). We used the Short Form-12 questionnaire (SF-12) and a sociodemographic questionnaire as a tool to assess the quality of life. Results Compared to healthy euthyroid controls, patients with hypothyroidism had a significantly reduced quality of life regarding their physical (p<0.001) aspect, with mental health not being affected. Smoking, female gender, and BMI showed significant associations with their mental health status (p=0.021, p=0.001, and p=0.045) respectively. Conclusions Regarding the results of the current study, there is a reduced level of physical health in patients with hypothyroidism than in healthy controls, which adversely affects their QoL. Smoking, gender, and BMI were associated with lower mental health among patients with hypothyroidism, which adversely affected their quality of life. Health practices should include assessment of the quality of life, monitoring by specialized physicians, and educational programs for these patients.
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Affiliation(s)
- Ranya Ghamri
- Family Medicine, King Abdulaziz University, Jeddah, SAU
| | | | - Salwan Ezzat
- Medical School, King Abdulaziz University, Jeddah, SAU
| | - Haya Alsaedi
- Medical School, King Abdulaziz University, Jeddah, SAU
| | | | - Ragad Arbaein
- Medical School, King Abdulaziz University, Jeddah, SAU
| | - Rahaf Alyahya
- Medical School, King Abdulaziz University, Jeddah, SAU
| | - Shahad Fayraq
- Medical School, King Abdulaziz University, Jeddah, SAU
| | - Sultan Alamri
- Family Medicine, King Abdulaziz University, Jeddah, SAU
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Xu YX, Wang C, Li XD, Guo WL, Liu GY, Zhang HB, Sun Y, Zhu DF, Xu Q. Activation of cholinergic basal forebrain neurons improved cognitive functions in adult-onset hypothyroid mice. Biomed Pharmacother 2022; 153:113495. [DOI: 10.1016/j.biopha.2022.113495] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2022] [Revised: 07/21/2022] [Accepted: 07/27/2022] [Indexed: 11/24/2022] Open
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