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Brain functional connectivity may be increased in acute hypothyroid state
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During the acute hypothyroid state after total thyroidectomy, local brain functional connectivity is increased, according to study findings published in Thyroid.
Poorer mental quality of life and increased depression in the hypothyroid state is associated with higher brain functional connectivity, researchers said.
Won Bae Kim, MD, PhD, of the department of internal medicine at Asan Medical Center and the University of Ulsan College of Medicine in South Korea, and colleagues evaluated 21 patients who underwent total thyroidectomy for thyroid cancer to determine whether thyroid hormone withdrawal affects resting state functional connectivity and whether changes in functional connectivity are linked to mood or quality of life.
Before and 2 weeks after thyroid hormone withdrawal, resting state functional MRI scans of the brain and thyroid function tests were performed on all patients; participants also completed the 12-Item Short Form Health Survey and Patient Health Questionnaire-9.
Mean serum thyroid-stimulating hormone increased and mean serum free thyroxine decreased after 2 weeks of thyroid hormone withdrawal. The mental component summary decreased (P < .05) and the total score of the Patient Health Questionnaire-9 increased (P = .06) after thyroid hormone withdrawal.
Before and after thyroid hormone withdrawal, several brain regions, including the precuneus and medial prefrontal gyrus, exhibited higher regional homogeneity values than other areas of the brain.
Researchers noted higher regional homogeneity after thyroid hormone withdrawal in spatially distributed brain regions, including the superior frontal gyrus bilaterally, the left medial frontal gyrus, the pre- and postcentral gyri bilaterally, the middle temporo-occipital gyrus bilaterally, and the left precuneus, the left lingual gyrus, the left inferior parietal gyrus and the right putamen.
Positive correlations were found between TSH levels and mean regional homogeneity values after thyroid hormone withdrawal in the pre- and postcentral gyri bilaterally, middle temporo-occipital gyri bilaterally, left precuneus and left lingual gyrus (P < .005 for all).
“We have shown that local brain [functional connectivity] evaluated by resting functional MRI is higher in multiple brain areas in the acute hypothyroid state and that higher brain [functional connectivity] correlates with poorer psychological [quality of life] measures and increased depression in patients in the hypothyroid state,” the researchers wrote. “In future studies, utilization of comprehensive neurocognitive assessments in conjunction with [quality of life] and depressive symptoms could yield valuable insights into the impact of adult hypothyroidism on cognitive performance and mood, the relationship of these functional measures to neural changes measured by [functional connectivity], and the degree to which these disturbances are reversible with [thyroid hormone] replacement.” – by Amber Cox
Disclosure: The researchers report no relevant financial disclosures.
“Higher brain [functional connectivity] correlates with poorer psychological [quality of life] measures and increased depression in patients in the hypothyroid state.”
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