Cognitive and affective status in mild hypothyroidism and interactions with L-thyroxine treatment
Cognitive and affective status in mild hypothyroidism and interactions with L-thyroxine treatment
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DOI：
10.1111/j.1600-0404.2004.00262.x
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发表时间：
2004-07-01
影响因子：
3.5
通讯作者：
Mauri, M
中科院分区：
文献类型：
--
作者：
Bono, G;Fancellu, R;Mauri, M
目的 - 虽然临床甲状腺功能减退症与明显的神经心理学和情感改变相关，并被认为是可逆性痴呆的原因之一，但这些改变的发生及其在轻度甲状腺功能减退症 (MH) 中的治疗仍然是一个有争议的问题。因此，我们的目的是评估最近诊断的具有轻微主观症状的 MH 患者的认知和心理功能。材料和方法 - 在仔细评估排除患有神经、精神和/或躯体疾病或混杂病症的受试者后，对 36 名 MH 女性（平均年龄 51.9 +/- 13.5 岁）进行观察。在基础条件下和 L-甲状腺素治疗 6 个月后，对受试者的甲状腺功能进行了评估，并进行了广泛的神经心理学测试和心理评定量表测试。结果 - 基线神经心理学表现在正常范围内，而注意力功能则出现年龄依赖性下降。 L-甲状腺素治疗后，检测到血清 fT4 增加，同时促甲状腺激素 (TSH) 减少。言语流畅性和抑郁评分略有改善。 TSH 降低与情绪评分改善之间存在正相关关系。结论 - 从结果分析来看，为了重新设定激素水平，特别是在老年受试者中，治疗无症状 MH 似乎是可取的，可以保护大脑免受认知和情感功能障碍的潜在风险。
Objectives - While clinical hypothyroidism is associated with frank neuropsychological and affective alterations and is considered one of the causes of reversible dementia, the occurrence of these alterations and their treatment in mild hypothyroidism (MH) remains a controversial issue. Our aim was therefore to evaluate cognitive and psychological functions in a selected population of recently-diagnosed MH patients with minor subjective symptoms. Materials and methods - Thirty-six MH women (mean age 51.9 +/- 13.5 years) were observed after a careful assessment had excluded subjects with neurological, psychiatric and/or somatic disorders, or confounding conditions. The subjects were evaluated for thyroid function and tested with an extensive battery of neuropsychological tests and psychological rating scales, in basal conditions and after 6 months of L-thyroxine treatment. Results - Baseline neuropsychological performance was within the normal range, while an age-dependent reduction was found in attentive function. After L-thyroxine treatment, an increase in serum fT4 was detected in parallel with thyroid stimulating hormone (TSH) reduction. Verbal fluency and depression scores showed a slight improvement. A positive correlation was found between TSH reduction and improved mood scores. Conclusion - From the analysis of the results, treatment of asymptomatic MH would seem advisable in order to re-set hormonal levels and, particularly in older subjects, to protect the brain against the potential risk of cognitive and affective dysfunctions.