Brain Glucose Metabolism in Hypothyroidism: A Positron Emission Tomography Study before and after Thyroid Hormone Replacement Therapy

被引：113

作者：

Bauer, M. ^{[1
,2
]}

Silverman, D. H. S. ^{[4
]}

Schlagenhauf, F. ^{[6
]}

London, E. D. ^{[4
]}

Geist, C. L. ^{[4
]}

van Herle, K. ^{[3
]}

Rasgon, N. ^{[5
]}

Martinez, D. ^{[3
]}

Miller, K. ^{[2
]}

van Herle, A. ^{[3
]}

Berman, S. M. ^{[2
]}

Phelps, M. E. ^{[4
]}

Whybrow, P. C. ^{[2
]}

机构：

[1] Tech Univ Dresden, Univ Hosp Carl Gustav Carus Dresden, Dept Psychiat & Psychotherapy, D-01307 Dresden, Germany

[2] Univ Calif Los Angeles, David Geffen Sch Med, Dept Psychiat & Biobehav Sci, Semel Inst Neurosci & Human Behav, Los Angeles, CA 90095 USA

[3] Univ Calif Los Angeles, David Geffen Sch Med, Dept Med, Div Endocrinol, Los Angeles, CA 90095 USA

[4] Univ Calif Los Angeles, David Geffen Sch Med, Dept Mol & Med Pharmacol, Los Angeles, CA 90095 USA

[5] Stanford Sch Med, Dept Psychiat & Behav Sci, Palo Alto, CA 94305 USA

[6] Charite Univ Med Berlin, Dept Psychiat & Psychotherapy, D-10117 Berlin, Germany

来源：

JOURNAL OF CLINICAL ENDOCRINOLOGY & METABOLISM | 2009年 / 94卷 / 08期

关键词：

CEREBRAL-BLOOD-FLOW; TRANSIENT HYPOTHYROIDISM; DEPRESSION; MOOD; LOCALIZATION; VALIDATION; T3;

D O I：

10.1210/jc.2008-2235

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

Context: Hypothyroidism is frequently associated with subtle behavioral and psychiatric symptoms. The consequences of inadequate thyroid hormone availability to brain metabolism are poorly understood. Objective: This study assessed the relationships between neuropsychiatric symptoms and changes in relative regional cerebral glucose metabolism in hypothyroid patients undergoing thyroid hormone replacement therapy. Design, Setting, and Outcome Measure: Relative regional cerebral glucose metabolism was compared in 13 previously untreated hypothyroid patients and 10 healthy control participants. Effects of thyroid hormone replacement therapy (levothyroxine, 3 months) were assessed using neuropsychiatric measures and positron emission tomography with [(18)F] fluorodeoxyglucose. Results: Before treatment, hypothyroid patients exhibited lower regional activity than control subjects in the bilateral amygdala, hippocampus, and perigenual anterior cingulate cortex (ACC), left subgenual ACC, and right posterior cingulate cortex. Severity of depressive symptoms covaried negatively with pretreatment activity in the bilateral middle frontal gyrus and right subgenual and dorsal ACC. Thyroid hormone replacement therapy abolished pretreatment group differences in regional activity, robustly increased activity in the ventral ACC, and significantly reduced both clinician-rated and self-rated behavioral and psychiatric symptoms. Increased activity within the ventral ACC was associated with reduced somatic complaints, whereas increased activity within the dorsal ACC was associated with reduced depressive symptoms. Conclusions: Reduction of the behavioral complaints during thyroid hormone therapy is associated with a restoration of metabolic activity in brain areas that are integral to the regulation of affect and cognition. The findings suggest that thyroid hormone modulates regional glucose metabolism and psychiatric symptoms in the mature brain. (J Clin Endocrinol Metab 94: 2922-2929, 2009)

引用

页码：2922 / 2929

页数：8

共 29 条

[1] Supraphysiological doses of levothyroxine alter regional cerebral metabolism and improve mood in bipolar depression [J].