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Changes in brain size with treatment in patients with hyper- or hypothyroidism
Angela Oatridge1, Maria L Barnard, Basant K Puri
1Robert Steiner Magnetic Resonance Unit, Imaging Sciences Department, Faculty of Medicine, Imperial College, Hammersmith Hospital Campus, London W12 0HS, England, UK.
AJNR. American Journal of Neuroradiology
|October 10, 2002
Summary
Thyroid disease significantly alters brain and ventricle size, with changes correlating to hormone levels. Treatment normalizes these dimensions, suggesting a link between thyroid function and brain structure.
Area of Science:
- Neurology
- Endocrinology
- Radiology
Background:
- Neuropsychological symptoms are common in thyroid disease, but their underlying organic basis remains unclear.
- Thyroid dysfunction, including hyperthyroidism and hypothyroidism, can impact brain structure and function.
Purpose of the Study:
- To investigate the organic substrate of neuropsychological symptoms in thyroid disease.
- To assess changes in brain and ventricular size in patients with hyperthyroidism and hypothyroidism before and after treatment.
- To correlate these volumetric changes with hormonal markers.
Main Methods:
- Brain MR imaging was performed on eight hyperthyroid and three hypothyroid patients.
- Brain and ventricular volumes were measured using semiautomated techniques.
- Changes in volume were correlated with serum levels of total thyroxine (T4), free triiodothyronine (free T3), and thyroid-stimulating hormone (TSH).
Main Results:
- Hyperthyroid patients showed decreased brain size and increased ventricular size after treatment, correlating with reduced T4 and free T3 levels.
- Hypothyroid patients exhibited increased brain size and decreased ventricular size post-treatment, correlating with TSH levels.
- Significant correlations were found between brain/ventricular volume changes and T4, free T3, and TSH levels.
Conclusions:
- Thyroid hormone levels significantly influence brain and ventricular size in patients with thyroid disease.
- Treatment of thyroid dysfunction leads to reversible changes in brain and ventricular volumes.
- Potential mechanisms include alterations in osmolyte regulation, sodium/water balance, and cerebral hemodynamics.