The change of cerebral blood flow in depression of hypothyroidism in induced by post-thyroidectomy

本研究采用99 mTc-HMPAO SPECT和统计参数图（SPM 96）研究了甲状腺切除术后短暂性甲状腺功能减退症患者局部脑血流（rCBF）分布的变化。甲状腺素治疗对rCBF变化的影响也进行了研究。在131 I治疗前和甲状腺激素（甲状腺素）治疗后进行测量。我们使用调整后的rCBF图像在相对流量再分布，比较这些数据与正常对照组使用SPM 96。我们还分析了rCBF与患者抑郁严重程度之间的关系。通过甲状腺功能减退状态和甲状腺功能正常状态之间的组比较试验来研究甲状腺激素替代的效果。为了进行统计学分析，进行了组比较检验和Jack-Knife检验。组间比较研究显示，在甲状腺功能减退状态下，双侧顶叶校正rCBF显著降低，包括 ...更多信息 楔前叶和部分双侧枕叶，包括楔叶。随着抑郁程度的加重，脑灌注显著降低的区域逐渐扩展到双侧前额叶。在Jack-Knife试验中，66.7%的患者显示rCBF降低。56.3%的患者在甲状腺素治疗后进行的Jack-Knife试验显示改善。43.7%的基线研究时rCBF异常者在随访研究时未显示任何变化。在组间比较研究中，所有rCBF降低的区域在甲状腺素替代治疗后均未显示出显著变化。目前的研究表明，甲状腺切除术后和131 I治疗前短暂性甲状腺功能减退症的rCBF显着下降。在这个rCBF减少的区域，包括顶叶，枕叶的一部分，并进展到前额叶皮质，可能是重要的理解认知功能障碍和抑郁症患者短暂性甲状腺功能减退症。基于甲状腺素治疗后rCBF的变化不显著，在诱导的甲状腺功能减退症条件下，rCBF的降低被认为是长期的或不可逆的，在短期随访。少

The study investigated alterations in regional cerebral blood flow (rCBF) distribution in patients with transient hypothyroidism, post-thyroidectomy, using 99mTc-HMPAO SPECT and statistical parametric mapping (SPM96). The effect of thyroxine treatment on rCBF change was also studied. The measurements were done both before 131I therapy and after thyroid hormone (thyroxin) therapy. We used the adjusted rCBF images in relative flow redistribution to compare these data with normal control groups using SPM96. We also analyzed the association between rCBF and the severity of the patients' depression. The effect of thyroid hormone replacement was investigated by a group comparison test between the hypothyroidic state and the euthyroidic state. For statistical analysis, both a group comparison test and the Jack-Knife test were done. The group comparison study showed that in the hypothyroidic state, there was a significant decrease in adjusted rCBF in the bilateral parietal lobe, including the … More precuneus and in part of the bilateral occipital lobe, including the cuneus. The areas of significantly low perfusion extended to the bilateral prefrontal cortex in accordance with the progression of the severity of depression. On the Jack-Knife test, 66.7% showed rCBF reduction. The Jack-Knife test given after thyroxine administration showed improvement in 56.3% patients. 43.7% with abnormal rCBF at the baseline study did not show any change at the follow-up study. In group comparison studies, all those areas with decreased rCBF did not show significant changes after thyroxin replacement treatment. The current study demonstrated a significant rCBF decrease in transient hypothyroidic condition after thyroidectomy and before 131I therapy. Abnormalities in this rCBF-reduced area, including the parietal lobe, part of the occipital lobe, and progressing to the prefrontal cortex, may be important in understanding cognitive dysfunction and depression in patients with transient hypothyroidism. Based on the insignificant change in rCBF after thyroxin therapy, the reduction of rCBF under the induced hypothyroidic condition was thought to be prolonged or irreversible during short-term follow up. Less