Brain Diffusion Tensor Imaging Findings in Hashimoto's Thyroiditis

Abstract

BACKGROUND AND PURPOSE Hashimoto's thyroiditis (HT) is a type of autoimmune thyroid disease. Diffusion tensor imaging (DTI) can evaluate microstructural brain involvement in various diseases. We aimed to investigate whether there were any DTI differences in patients with HT, and the relationship between DTI values and disease duration time and thyroid peroxidase antibodies (TPOAb) levels. METHODS We prospectively included 36 patients with HT (mean age 41.6 ± 13.8 years, range 18‐64 years) and 18 age and sex‐matched healthy control subjects (mean age 41.6 ± 13.1 years, range 18‐63 years). All patients were euthyroid at the time of imaging. Fractional anisotropy (FA), mean diffusivity (MD), axial diffusivity (AD), and radial diffusivity (RD) values of 15 distinct neuroanatomical locations were measured and compared. RESULTS FA values of the patients with HT were lower in cingulum, globus pallidus (GP), cerebellar white matter (CWM) than the control (P = .019, .002, and <.001, respectively). MD values of the CWM in patients were higher than the control (P = .008). AD values of patients with HT were lower in the cingulum, posterior limbs of the internal capsule, GP, and putamen (P = .038, .038, .030, and .045, respectively). RD values of cingulum and CWM in HT were higher than controls (P <.001 and P = .011, respectively). There was a negative relationship between the FA values of PLIC and a positive relationship between the MD values of the corona radiata and TPOAb levels were detected. CONCLUSIONS The current DTI study presented microstructural changes in the neurocognitive‐related areas that may be related to accompanying neurological findings in HT.

Utility of Magnetic Resonance Spectroscopy and Diffusion Tensor Imaging of the Brain in Patients with Hashimoto’s Thyroiditis with Normal Appearing Conventional Brain MRI

“…Contrary to previous studies (26)(27)(28)(29)(30) ; in this study, all participating patients were euthyroid and had normal thyroid hormone levels to examine and highlight the autoimmune effects and rule out the effects of thyroid hormone abnormalities in HT patients. This current study's observations are matched and consistent with those of Mehmet A. G. et al (17) that FA values in globus pallidus (GP) and cerebellar white matter (CWM) patients were lower in HT patients compared to controls. The mean diffusivity (MD) and radial diffusivity (RD) in CWM were higher in patients compared to controls, meanwhile, lower axial diffusivity (AD) was recorded in basal ganglia in studied patients.…”

“…Few studies are concerned about the presence of cognitive disorders in patients who have HT and who are euthyroid, in whom there are memory, focusing, and attention difficulties (4)(5)(6)(7)(8) . In clinical practice; cognitive event-related potentials (ERP) represent the way to assess both cognitive and intellectual functions in an objective way (9)(10)(11)(12)(13) , this clinical assessment needs the active contribution of the examined patient and represents an indicator of functional activity and integrity at the cortical and subcortical neural networks levels of the brain (11)(12)(13)(14)(15)(16)(17) . The conventional brain MRI displays normal brain features in the majority of patients, the remaining patients were manifested by many patterns that are non-specific as the presence of vasogenic edema, features suggesting demyelinating, ischemic-like processes, or even brain atrophic changes (3,(6)(7)(8) .…”

“…Magnetic resonance spectroscopy (MRS) enabled the detection of any metabolic abnormalities or changes, even when the brain appeared structurally normal on conventional MRI (10) . A newly developed promising technique; diffusion tensor imaging (DTI) can detect and evaluate the brain structural changes or abnormalities in many various diseases, and expressed through objective measurable values known as fractional anisotropy (FA), and axial diffusivity (AD), mean diffusivity (MD), radial diffusivity (RD) (11)(12)(13)(14)(15)(16)(17) . These previously mentioned advanced MR techniques can provide potentially unique data and new insight and give clearer data about the pathophysiology of HT-induced CNS changes.…”

Microstructural alterations in hypoxia‐related BRAIN centers after COVID‐19 by using DTI: A preliminary study

“…An increase in FA is associated with increased brain fiber integrity, while the decrease in FA is probably caused by the loss of regular anisotropic structures due to the disruption of cytoarchitecture. 2,4,19 Diffusion tensor imaging has also demonstrated evidence of demyelination with abnormal FA values in the CNS of patients who develop chronic neurological symptoms in the subacute phase after CO intoxication. 20 Yiping Lu et al 1 analyzed DTI changes and measured gray matter volume in the cingulate gyrus, hippocampus, Heschl's gyrus, olfactory center, rolandic operculum and white matter tracts after a 3-month follow-up of patients with COVID-19 infection.…”

“…Fractional anisotropy values can display myelination abnormalities and microstructural stability of the brain. An increase in FA is associated with increased brain fiber integrity, while the decrease in FA is probably caused by the loss of regular anisotropic structures due to the disruption of cytoarchitecture 2,4,19 …”