Structural and functional MRI study of the brain, cognition and mood in long-term adequately treated Hashimoto's thyroiditis
Structural and functional MRI study of the brain, cognition and mood in long-term adequately treated Hashimoto's thyroiditis
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DOI：
10.1016/j.psyneuen.2014.01.015
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发表时间：
2014-04-01
影响因子：
3.7
通讯作者：
Villringer, Arno
中科院分区：
文献类型：
--
作者：
Quinque, Eva M.;Karger, Stefan;Villringer, Arno
目前的研究调查了长期接受充分治疗的桥本甲状腺炎患者的神经心理和潜在的结构和功能变化，以检查与潜在的自身免疫过程特别感兴趣的可能的长期神经变化有关的患者中经常讨论的残余主诉。18名桥本甲状腺炎致甲状腺功能减退的患者(平均年龄32岁，范围18-54岁；两名男性，平均治疗时间4.4年)和18名健康的匹配对照组受试者接受了3-特斯拉磁共振成像(MRI)。基于体素的形态计量学用于研究灰质密度，静息状态功能磁共振用于分析甲状腺功能减退已知改变区域的大脑连接性，事件相关功能磁共振用于检测联想记忆编码过程中的大脑活动。神经心理学评估包括记忆、工作记忆、精神运动速度和注意力。我们之前报告了这一研究人群中亚临床情绪下降的情况，并在这里调查了其神经相关性。检测血清促甲状腺激素、游离三碘甲状腺原氨酸、游离甲状腺激素和甲状腺过氧化物酶抗体。与对照组相比，我们没有发现认知障碍或灰质密度、功能连接性或联想记忆相关脑活动的改变，患者组的认知与甲状腺血清指标无关。患者组中的甲状腺过氧化物酶抗体与右侧杏仁核灰质密度的增加以及穹隆下和海马区之间的连通性增强相关。治疗时间与额叶和枕叶皮质的脑结构以及左侧杏仁核和额叶皮质之间的连通性有关。情绪与与不同功能网络相关的大脑区域相关，但与抑郁症最显著的影响区域无关。总而言之，与健康对照组相比，在这群年轻且其他方面健康的患者中没有检测到认知或神经变化，目前的情绪状态与抑郁症相关网络无关。然而，自身免疫活性和治疗时间与抑郁和甲状腺功能减退相关的脑结构和功能有关。因此，尽管对桥本甲状腺炎患者进行了适当的生化治疗，但它们仍有望成为进一步调查残留症状的因素。考虑到样本量很小，所有的发现都需要重复。(C)爱思唯尔有限公司出版的2014年。
The current study investigated neuropsychological and underlying structural and functional brain alterations in long-term adequately treated patients with Hashimoto's thyroiditis in order to examine much discussed residual complaints in patients in relation to possible long-term neural alterations with a specific interest in the underlying autoimmune process.Eighteen patients with treated hypothyroidism due to Hashimoto's thyroiditis (mean age 32, range 18-54 years; two males; mean treatment duration 4.4 years) and 18 healthy matched control subjects underwent 3-Tesla magnetic resonance imaging (MRI). Voxel-based morphometry was used to investigate grey matter density, resting-state functional MRI to analyse the brain connectivity of areas known to be altered in hypothyroidism and event-related functional MRI to examine brain activity during associative memory encoding. Neuropsychological assessment included memory, working memory, psychomotor speed and attention. We previously reported subclinically reduced mood in this study population and investigated its neural correlates here. Thyroid stimulating hormone, free triiodthyronine, free thyroxine and thyroid peroxidase antibodies were measured in serum.We did not find cognitive deficits or alterations in grey matter density, functional connectivity or associative memory-related brain activity in comparison to the control group and cognition was unrelated to thyroid serum measures in the patient group. Thyroid peroxidase antibodies in the patient group correlated with increased grey matter density in right amygdala and enhanced connectivity between subcallosal and parahippocampal areas. Treatment duration was associated with brain structure in frontal and occipital cortex and connectivity between left amygdala and frontal cortex. Mood correlated with brain areas associated with distinct functional networks, but not with those most prominently affected in depression.In conclusion, no cognitive or neural alterations were detected in this young and otherwise healthy cohort of patients in comparison to a healthy control group and current mood status could not be related to depression-related networks. However, autoimmune activity and treatment duration showed a relationship with depression and hypothyroidism-related brain structure and function. They are thus promising factors to further investigate residual complaints despite biochemically adequate treatment in patients with Hashimoto's thyroiditis. Given the small sample size, all findings require replication. (C) 2014 Published by Elsevier Ltd.