Autoimmune thyroiditis and a rapidly progressive dementia: Global hypoperfusion on SPECT scanning suggests a possible mechanism

Forchetti, Concetta; Katsamakis, George; Garron, David C.

doi:10.1212/wnl.49.2.623

Cited by 117 publications

(103 citation statements)

References 5 publications

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“…Conversely, depression may be accompanied by various subtle thyroid abnormalities. Relatively few previous functional neuroimaging studies have investigated the neural correlates of mood dysfunction in patients with hypothyroidism (Bauer et al 2009;Constant et al 2001;Nagamachi et al 2004;Schraml et al 2006;Zhu et al 2006), and these studies reported cerebral hypoperfusion as the most consistent finding (Bauer et al 2009;Constant et al 2001;Forchetti et al 1997;Kinuya et al 1999;Krausz et al 2007;Krausz et al 2004;Nagamachi et al 2004;Schraml et al 2006). In a subgroup of patients, this hypoperfusion subsided after thyroid replacement therapy (Bauer et al 2009).…”

Section: Introductionmentioning

confidence: 95%

Neural correlates of free T3 alteration after catecholamine depletion in subjects with remitted major depressive disorder and in controls

2013

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RationaleThyroid hormones and their interactions with catecholamines play a potentially important role in alterations of mood and cognition. ObjectivesThis study aimed to examine the neurobiological effects of catecholamine depletion on thyroid hormones by measuring endocrine and cerebral metabolic function in unmedicated subjects with remitted MDD (RMDD) and in healthy controls. MethodsThis was a randomized, placebo-controlled, and double-blind crossover trial that included 15 unmedicated RMDD subjects and 13 healthy control subjects. The participants underwent two 3-day-long sessions at 1-week intervals; each participant was randomly administered oral α-methyl-para-tyrosine (AMPT) in one session (catecholamine depletion) and an identical capsule containing hydrous lactose (sham depletion) in the other session prior to a [18 F]-fluorodeoxyglucose positron emission tomography scan ( 18 FDG-PET). ResultsSerum concentrations of free T3 (FT3), free T4 (FT4), and TSH were obtained and assessed with respect to their relationship to regional cerebral glucose metabolism. Both serum FT3 (P = 0.002) and FT4 (P = 0.0009) levels were less suppressed after catecholamine depletion compared with placebo treatment in the entire study sample. There was a positive association between both FT3 (P = 0.0005) and FT4 (P = 0.002) and depressive symptoms measured using the MADRS. The relative elevation in FT3 level was correlated with a decrease in regional glucose metabolism in the right dorsolateral prefrontal cortex (rDLPFC; P < 0.05, corrected).Homan et al.2 ConclusionsThis study provided evidence of an association between a thyroid-catecholamine interaction and mood regulation in the rDLPFC.

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Section: Introductionmentioning

confidence: 95%

Neural correlates of free T3 alteration after catecholamine depletion in subjects with remitted major depressive disorder and in controls

2013

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“…Vas kü li tin anji yog ra fik ve bi yop si bul gu la rı, bu has ta lık ta çok net ola rak tes pit edi le me di ği için bu me ka niz ma halen tar tış ma lı ol sa da SPECT (single photon emission computed tomography) ile be yin de dif füz homo jen glo bal hi po per füz yon gös te ril miş ve im mun komp leks ve ya an ti kor bi ri ki mi ile mik ro do la şı mın bo zul du ğu dü şü nül müş tür. 2 Bu bo zul ma, glo bal hipo per füz yo na yol aça rak en se fa lo pa tik de ği şik likle re ne den olur. 1966 yı lın da ta nım lan dı ğın dan be ri bu tab loy la sey re den na dir ol gu lar "Has hi moto En se fa lo pa ti si " ola rak li tera tür de yer al mış tır.…”

Section: Otoimmün Tiroiditle İlişkiliunclassified

“…Ge nel lik le 3-7 gün bo yun ca yük sek doz in tra ve nöz me til pred ni zo lon (1 g/gün) ya da yük sek doz oral pred ni zo lon (50-150 mg/gün) kul la nı lır ve ti pik ola rak kor ti kos te ro id teda vi si nö ro lo jik semp tom lar da be lir gin dü zel me sağ la nır. 2,12 Azat hi op ri ne, sik lo fos fo mid, in tra ve nöz im mung lo bu lin ve plaz ma fe rez de kul la nı lan da ha az sa yı da ol gu da ba şa rı lı so nuç lar ver miş tir. 13 Has himo to en se fa lo pa ti si için öne ri len di ğer te da vi ler, tiro i di et ki le yen ajan lar (ço ğun luk la le vo ti rok sin) ve nö bet olur sa an ti e pi lep tik ilaç la rı içe rir.…”

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Hashimoto?s Encephalopathy Associated with Autoimmun Thyroiditis: Case Report

Demir¹,

Delibaş²,

Ercan³

et al. 2010

Turkiye Klinikleri J Med Sci

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to im mün ti ro i dit ile bir lik te en se fa lo pa ti ge liş me si na dir gö rü len, ya şa mı teh dit eden ve te da vi edi le bi len bir kli nik du rum dur. Hashi mo to en se fa lo pa ti si, an ti ti ro id yük sek an ti kor tit re le ri ile iliş ki li, otoimmün eti yo lo ji ye bağ lı ol du ğu dü şü nü len ve ste ro id te da vi si ile dü zelen bir tab lo oluş tu rur.1 Kli nik bul gu lar, in me ben ze ri epi zot lar, nö bet, bilinç bo zuk lu ğu gi bi akut bir şekil de ya da de mans, psi koz gi bi tab lo lar la Turkiye Klinikleri J Med Sci 2010;30(3) 1087Otoimmün Tiroiditle İlişkili Hashimoto Ensefalopatisi ÖZET Has hi mo to en se fa lo pa ti si, yük sek an ti ti ro id an ti kor tit re le ri ile iliş ki li, otoimmün eti yo lo jiye bağ lı ol du ğu dü şü nü len ve ste ro id te da vi si ile dü ze len bir tab lo oluş tu rur. Pa to ge ne zi tam olarak an la şı la ma mış tır; otoimmün se reb ral vas kü lit, an ti nö ro nal an ti kor ara cı lı re ak si yon, ti ro id ve san tral si nir sis te mi nin pay laş tı ğı an ti jen le re kar şı otoimmün re ak si yon gi bi me ka niz ma lar öne sü -rül mek te dir. Kli nik gö rü nü mün izo le glo bal am ne zi, sta tus epi lep ti kus ya da psi koz gi bi bul gu lar la or ta ya çı ka bi le ce ği bil di ril miş tir. Ba zı ya yın lar da, bu tab lo ya Gra ves has ta lı ğı ile iliş ki li otoimmün ti ro i di tin de ne den ola bi le ce ği be lir til mek te ve bu isim ile anıl mak ta dır. An ti ti ro id ilaç lar, ste ro id, an ti e pi lep tik ilaç lar ve pa ren te ral sı vı des te ği ile te da vi ye hız lı ve dra ma tik ya nıt alı nır. Da ha ön ce epi lep si ta nı sı ol ma ma sı na rağ men epi lep tik nö bet ge çi ren ve pos tik tal dö nem de bi ze baş vu ran olgu mu zun, kli nik bul gu la rı ve la bo ra tu var de ğer le ri Gra ves has ta lı ğı ile uyum luy du. An ti ti ro id+ an ti e pi lep tik ilaç lar ve des tek te da vi si ile kli nik dü zel me sağ lan dı. Has hi mo to en se fa lo pa ti si tab losu na na di ren Gra ves has ta lı ğı nın da se bep ol ma sı ne de niy le ol gu mu zu sun ma yı uy gun gör dük.Anah tar Ke li me ler: Gra ves has ta lı ğı, has hi mo to has ta lı ğı, oto im mün has ta lık lar ABS TRACT Has hi mo to's en cep ha lo pathy is an au to im mu ne phe no me non as so ci a ted with high anti-thyro id an ti body ti ters and the cli ni cal pic tu re usu ally res ponds to ste ro id tre at ment. Pat ho ge ne sis is not fully un ders to od, ho we ver, se ve ral mec ha nisms we re pos tu la ted as fol lows; au to im mu ne ce reb ral vas cu li tis, an ti-ne u ral an ti body me di a ted re ac ti on and au to im mu ne re ac ti on aga inst common an ti gens sha red with thyro id and cen tral ner vo us system. Va ri o us cli ni cal pre sen ta ti ons were re por ted inc lu ding iso la ted glo bal am ne si a, sta tus epi lep ti cus and psycho sis. Au to im mu ne thyro i di tis as so ci a ted with Gra ves' di se a se may ra rely ca u se this cli ni cal pic tu re. Tre at ment inc ludes an tith yro id drugs, ste ro ids, an ti e pi lep tic agents and hydra ti on and re sults in a ra pid and ...

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“…[7][8][9] Global hypoperfusion on single-photon emission computed tomography (SPECT) studies has also been reported. 10,11 Patients with HE may have nonspecific evidence of inflammation, including an elevated ESR, CRP, and CSF protein. 12 Other laboratory abnormalities may include a mild elevation of liver aminotransferase levels; renal impairment has also been reported in a few cases of HE in the form of glomerulonephritis, and may be related to deposition of immune complexes containing thyroglobulin antigen.…”

Section: Commentarymentioning

confidence: 99%