[Autoimmune thyroid disease and brain]

Area of Science:

• Neuroendocrinology
• Immunology
• Cognitive Neuroscience

Context:

• Thyroid gland dysfunction, encompassing hypothyroidism and hyperthyroidism, is frequently linked to alterations in affective and cognitive states.
• Autoimmune thyroid diseases, such as Hashimoto's thyroiditis, can precipitate these changes directly through hormonal imbalances or indirectly via antithyroid antibodies.
• Cognitive function is sensitive to even minor fluctuations in thyroid hormone levels, impacting various cognitive domains.

Purpose:

• To explore the intricate relationship between thyroid function, autoimmune thyroid disease, and neurological/cognitive manifestations.
• To investigate the role of thyroid hormones, antithyroid antibodies, and specific autoantibodies in cognitive dysfunction and encephalopathy.
• To elucidate the mechanisms underlying brain dysfunction in conditions like Hashimoto's encephalopathy.

Summary:

• Thyroid hormone variations correlate with cognitive function, affecting intelligence test scores and mental status assessments.
• Hypothyroidism, even mild forms, induces reversible cognitive dysfunction and is associated with reduced brain blood flow and glucose metabolism.
• Hashimoto's encephalopathy presents with reversible neurological and psychiatric symptoms, linked to antithyroid and antineuronal antibodies, including those against alpha-enolase.

Impact:

• Highlights the critical role of thyroid health in maintaining cognitive and affective well-being.
• Suggests potential diagnostic utility of autoantibodies in identifying neurological complications associated with autoimmune thyroid disease.
• Underscores the reversibility of cognitive deficits with appropriate thyroid hormone management and potential immunomodulatory treatments.