Abstract
To investigate the brain functional abnormality of hyperthyroid patients before and after treatment for one month using resting-state functional magnetic resonance imaging (rs-fMRI). Amplitude of low-frequency fluctuation (ALFF) and seed-based functional connectivity (FC) analysis were performed in 27 new-onset untreated hyperthyroid patients relative to 30 healthy controls. In addition, follow-up data were available for 19 patients treated with methimazole for one month. Compared with healthy controls, patients exhibited lower ALFF in the right posterior cingulate cortex (PCC); increased FC in the bilateral anterior insula (AI), bilateral posterior insula (PI) and left anterior lobe of the cerebellum (ALC); and decreased FC in the bilateral lateral prefrontal cortex (LPFC), the right medial temporal gyrus (MTG) and the bilateral PCC. Compared with the hyperthyroid status, patients with improved thyroid function showed increased FC in the right LPFC and right dorsolateral prefrontal cortex (DLPFC). Subsequently, Pearson’s correlation analyses were performed between abnormal ALFF, FC, neuropsychological assessment and serum free triiodothyronine (FT3) levels. The results indicated that the alterations in regional and network-level brain functions, which might underlie different psychiatric complications were dynamic and interactional processes in hyperthyroidism. Moreover, the improvement in regional brain FC was correlated with the efficacy of anti-thyroid medication.
Highlights
IntroductionLi15 regarded abnormal degree centrality(DC) in the posterior lobe of the cerebellum (PLC) and medial frontal gyrus (MeFG) as seed regions to explore the aberrant functional connectivity (FC) of patients with hyperthyroidism
Resting-state functional magnetic resonance imaging analysis revealed that hyperthyroid patients showed weaker functional connectivity(FC) from the bilateral hippocampus to both the bilateral anterior cingulate cortex (ACC) and bilateral posterior cingulate cortex (PCC) than the controls, as well as decreased FC between the right hippocampus and right medial orbitofrontal cortex[13]
Compared with the hyperthyroid state, the 19 post-treatment patients showed a significant decrease in FT3, State Anxiety Inventory scores, Beck Depression Inventory (BDI) scores and the values of the alerting network and executive control network, but a significant increase was observed in the accuracy rate of the Stroop and two-back tasks
Summary
Li15 regarded abnormal degree centrality(DC) in the posterior lobe of the cerebellum (PLC) and medial frontal gyrus (MeFG) as seed regions to explore the aberrant FC of patients with hyperthyroidism. They reported that abnormal FC was related to several brain functional networks, such as the default mode network (DMN), attention network and cognitive network. To measure differences in regional cerebral activity, the amplitude of low-frequency fluctuation (ALFF) approach was used to detect alterations of regional brain function in hyperthyroid patients compared with healthy controls. Based on the combination of ALFF and FC analyses, we sought to further investigate the mechanisms underlying emotional and cognitive impairments and their possible reversibility after anti-thyroid therapy over one month. We hypothesized that changes in regional and network-level brain function in specific brain regions of hyperthyroid patients are correlated with neuropsychiatric evaluations, and some of these changes can be reversed with the improvement of thyroid hormones after anti-thyroid therapy
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