Hashimoto's encephalopathy: A rare proteiform disorder

Montagna, Giacomo; Imperiali, Mauro; Agazzi, P.; D’Aurizio, Federica; Tozzoli, Renato; Feldt‐Rasmussen, Ulla; Giovanella, Luca

doi:10.1016/j.autrev.2016.01.014

Cited by 76 publications

(41 citation statements)

References 106 publications

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“…Yu et al [51] yielded a study showing that high serum TPOAb level in subclinical hypothyroidism after I-treatment of Graves’ disease was an independent risk factor for depression. And TPOAb was also proved to be associated with abnormal neuropsychiatric symptoms in autoimmune thyroid diseases, including Hashimoto's thyroiditis [52] and Hashimoto's encephalopathy [53–55]. The possible mechanisms proposed included autoimmune central nervous system (CNS) vasculitis with or without immune complex deposits, and autoimmune reaction to antigens shared by the thyroid gland and the CNS [56].…”

Section: Discussionmentioning

confidence: 99%

Abnormal brain functional connectivity leads to impaired mood and cognition in hyperthyroidism: a resting-state functional MRI study

et al. 2016

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Patients with hyperthyroidism frequently have neuropsychiatric complaints such as lack of concentration, poor memory, depression, anxiety, nervousness, and irritability, suggesting brain dysfunction. However, the underlying process of these symptoms remains unclear. Using resting-state functional magnetic resonance imaging (rs-fMRI), we depicted the altered graph theoretical metric degree centrality (DC) and seed-based resting-state functional connectivity (FC) in 33 hyperthyroid patients relative to 33 healthy controls. The peak points of significantly altered DC between the two groups were defined as the seed regions to calculate FC to the whole brain. Then, partial correlation analyses were performed between abnormal DC, FC and neuropsychological performances, as well as some clinical indexes. The decreased intrinsic functional connectivity in the posterior lobe of cerebellum (PLC) and medial frontal gyrus (MeFG), as well as the abnormal seed-based FC anchored in default mode network (DMN), attention network, visual network and cognitive network in this study, possibly constitutes the latent mechanism for emotional and cognitive changes in hyperthyroidism, including anxiety and impaired processing speed.

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Section: Discussionmentioning

confidence: 99%

Abnormal brain functional connectivity leads to impaired mood and cognition in hyperthyroidism: a resting-state functional MRI study

et al. 2016

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“…Recently, some diagnostic algorisms were proposed . We reviewed the literature including our previous reports, with the aim of developing a practical diagnostic approach to HE.…”

Section: Diagnosismentioning

confidence: 99%

“…25 Recently, some diagnostic algorisms were proposed. 33,48 We reviewed the literature including our previous reports, with the aim of developing a practical diagnostic approach to HE. When we encounter patients with encephalopathy of unknown origin, we carefully exclude other possible etiologies of encephalopathy, including infectious, paraneoplastic, vascular, metabolic and nutritional causes, by blood and urine tests, neuroimaging, and CSF examination ( Table 2).…”

Section: Single-photon Emission Computed Tomography and Positron Emismentioning

confidence: 99%

Hashimoto encephalopathy

Matsunaga

Ikawa

Yoneda

2019

Clinical & Exp Neuroim

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Hashimoto encephalopathy (HE) is an autoimmune encephalopathy associated with autoimmune chronic thyroiditis. The clinical entity and nosology of HE have long been debated. Recently, new autoantibodies associated with autoimmune encephalitis have been discovered. With accumulated reported cases, and our discovery of serum autoantibody against NH2‐terminal of alpha‐enolase as a specific diagnostic marker, HE has been recognized as a distinct clinical entity. The condition appears dominant in females. The clinical features of HE are characterized by various neuropsychiatric symptoms, such as altered consciousness, psychosis and seizures, the presence of serum anti‐thyroid antibodies, normal or non‐specific changes in brain magnetic resonance imaging, diffuse slow wave activities in electroencephalogram and responsiveness to immunotherapy. A few pathological studies showed a lymphocytic infiltration of the small and medium‐sized vessels of the brain, which suggested vasculitis. Non‐specific neurological symptoms, laboratory findings and neuroimaging of HE make its diagnosis an oversight and difficult, whereas antibodies against NH2‐terminal of alpha‐enolase can be useful as a diagnostic biomarker for HE. In this review, we describe the current state of knowledge about HE and discuss progress in the diagnosis of HE.

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“…HE is a rare entity, described in 1966 by Brain et al, characterized by unspecific neurological and/or psychiatric symptoms associated with increased TPOAb in serum and sometimes in CSF, nonspecific EEG abnormalities and MRI features, and responsiveness to corticosteroids . Current diagnostic criteria include corticosteroid responsiveness, but that occurs in only 50% of HE .…”

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confidence: 99%