背景:据报道,成人发病的甲状腺功能减退症患者的call体(CC)中存在磁共振成像(MRI)脑异常。然而,尚无研究直接比较亚临床甲状腺功能减退症(SCH)中CC特异性形态学或功能改变,明显的甲状腺功能减退症(OH),和健康对照(HC)。此外,CC改变与认知和情绪的关系尚不清楚。
方法:人口统计数据,临床变量,神经心理学评分,和152名参与者的MRI数据(60SCH,37OH,和55HC)被收集。这项研究调查了临床表现,三组CC亚区的形态和功能变化。此外,我们进行了相关分析,以探索这些因素之间的潜在关系.
结果:与HC相比,SCH和OH组表现出较低的认知评分和较高的抑郁/焦虑评分。值得注意的是,SCH组CC的柱体和柱体体积较大。头端体之间的功能连接,SCH组的前中体和右中央和背外侧额上回增加。相比之下,SCH和OH基团在脾和右角回之间的功能连通性下降。在SCH组中,讲台体积与蒙特利尔认知评估和视觉空间/执行分数呈负相关,同时显示与24项汉密尔顿抑郁量表评分呈正相关。在OH基团中,头端体体积与血清促甲状腺激素水平呈负相关,而与血清总甲状腺素和游离甲状腺素水平呈正相关。
结论:本研究提示不同阶段的成人发病甲状腺功能减退患者可能表现出不同的CC异常模式。这些发现为甲状腺功能减退症的神经病理生理机制提供了新的见解。
BACKGROUND: Magnetic resonance imaging (MRI) brain abnormalities have been reported in the corpus callosum (CC) of patients with adult-onset hypothyroidism. However, no study has directly compared CC-specific morphological or functional alterations among subclinical hypothyroidism (SCH), overt hypothyroidism (OH), and healthy controls (HC). Moreover, the association of CC alterations with cognition and emotion is not well understood.
METHODS: Demographic data, clinical variables, neuropsychological scores, and MRI data of 152 participants (60 SCH, 37 OH, and 55 HC) were collected. This study investigated the clinical performance, morphological and functional changes of CC subregions across three groups. Moreover, a correlation analysis was performed to explore potential relationships between these factors.
RESULTS: Compared to HC, SCH and OH groups exhibited lower cognitive scores and higher depressive/anxious scores. Notably, rostrum and rostral body volume of CC was larger in the SCH group. Functional connectivity between rostral body, anterior midbody and the right precentral and dorsolateral superior frontal gyrus were increased in the SCH group. In contrast, the SCH and OH groups exhibited a decline in functional connectivity between splenium and the right angular gyrus. Within the SCH group, rostrum volume demonstrated a negative correlation with Montreal Cognitive Assessment and visuospatial/executive scores, while displaying a positive correlation with 24-item Hamilton Depression Rating Scale scores. In the OH group, rostral body volume exhibited a negative correlation with serum thyroid stimulating hormone levels, while a positive correlation with serum total thyroxine and free thyroxine levels.
CONCLUSIONS: This study suggests that patients with different stages of adult-onset hypothyroidism may exhibit different patterns of CC abnormalities. These findings offer new insights into the neuropathophysiological mechanisms in hypothyroidism.