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Abstract
BackgroundThis study aims to evaluate relationship between three different clinical conditions: Major Depressive Disorders (MDD), Hashimoto Thyroiditis (HT) and reduction in regional Cerebral Blood Flow (rCBF) in order to explore the possibility that patients with HT and MDD have specific pattern(s) of cerebral perfusion.MethodsDesign: Analysis of data derived from two separate data banks.Sample: 54 subjects, 32 with HT (29 women, mean age 38.8 ± 13.9); 22 without HT (19 women, mean age 36.5 ± 12.25).Assessment: Psychiatric diagnosis was carried out by Simplified Composite International Diagnostic Interview (CIDIS) using DSM-IV categories; cerebral perfusion was measured by 99 mTc-ECD SPECT. Statistical analysis was done through logistic regression.ResultsMDD appears to be associated with left frontal hypoperfusion, left temporal hypoperfusion, diffuse hypoperfusion and parietal perfusion asymmetry. A statistically significant association between parietal perfusion asymmetry and MDD was found only in the HT group.ConclusionIn HT, MDD is characterized by a parietal flow asymmetry. However, the specificity of rCBF in MDD with HT should be confirmed in a control sample with consideration for other health conditions. Moreover, this should be investigated with a longitudinally designed study in order to determine a possible pathogenic cause. Future studies with a much larger sample size should clarify whether a particular perfusion pattern is associated with a specific course or symptom cluster of MDD.
Highlights
This study aims to evaluate relationship between three different clinical conditions: Major Depressive Disorders (MDD), Hashimoto Thyroiditis (HT) and reduction in regional Cerebral Blood Flow in order to explore the possibility that patients with HT and MDD have specific pattern(s) of cerebral perfusion
In two-way interactions between all possible risk factors, only the interaction between left temporal hypoperfusion and HT reached a statistical significance (p = 0.16; O.R. = 0.07): the presence of HT decreased the significance of left temporal hypoperfusion on MDD
Our study indicates that MDD is associated with asymmetry in cerebral diffuse hypoperfusion, right and left Frontal hypoperfusion, right Temporal hypoperfusion and Parietal perfusion
Summary
This study aims to evaluate relationship between three different clinical conditions: Major Depressive Disorders (MDD), Hashimoto Thyroiditis (HT) and reduction in regional Cerebral Blood Flow (rCBF) in order to explore the possibility that patients with HT and MDD have specific pattern(s) of cerebral perfusion. In patients with HT, a form of encephalopathy known as Hashimoto Encephalopathy (HE) has been described as a severe but rare syndrome with different clinical presentations and course [4]. The aetiopathogenesis of HE is not yet well defined This form of encephalopathy is understood to be independent from thyroid function since patients can present with variable clinical pictures from frank hypothyroidism to hyperthyroidism, but subclinical hypothyroidism is more frequent [7]. Independent of these rare cases of HE, several observations indicate that there is a frequent decrease in cerebral perfusion in patients with autoimmune thyroiditis. This suggests cerebral vasculitis as a possible pathogenic model or cause [8,9]
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