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Microstructural white matter abnormalities in hypothyroidism evaluation with diffusion tensor imaging tract-based

Hediye Pınar Gunbey1, Arzu Ceylan Has2, Kerim Aslan3

  • 1Department of Radiology, University of Health Sciences Kartal Lutfi Kırdar Training and Research Hospital, 34890, Kartal/Istanbul, Turkey. hpgunbey@hotmail.com.

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Summary

Hypothyroidism impacts white matter integrity, showing reduced fractional anisotropy and increased radial diffusivity in key brain tracts. These changes correlate with cognitive and mood disturbances, suggesting demyelination.

Keywords:
BrainDTIHypothyroidismMRITBSS

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Area of Science:

  • Neuroimaging
  • Neurology
  • Endocrinology

Background:

  • Hypothyroidism presents with diverse neuropsychiatric symptoms, including cognitive deficits and depression.
  • Brain white matter (WM) integrity is crucial for cognitive function and motor control.
  • Morphological, functional, and molecular brain changes occur in hypothyroidism.

Purpose of the Study:

  • To investigate the effects of hypothyroidism on white matter (WM) integrity.
  • Utilize tract-based spatial statistics (TBSS) for detailed WM analysis.

Main Methods:

  • Diffusion tensor imaging (DTI) was performed on 18 hypothyroidism patients and 14 controls.
  • Tract-based spatial statistics (TBSS) enabled whole-brain, voxel-wise analysis of WM metrics.
  • Analyzed fractional anisotropy (FA), mean diffusivity (MD), axial diffusivity (AD), and radial diffusivity (RD).

Main Results:

  • TBSS revealed widespread reductions in FA across supratentorial WM, including the corticospinal tract and posterior limb of the internal capsule.
  • ROI analyses showed increased RD in the superior longitudinal fasciculus and decreased AD in the cingulum, external capsule, PLIC, and corpus callosum.
  • Significant differences in WM metrics were observed between autoimmune and non-autoimmune hypothyroidism subgroups, with cingulum FA negatively correlating with depression scores.

Conclusions:

  • Preliminary TBSS findings indicate FA and AD decrement, alongside RD increment, in multiple WM tracts in hypothyroidism.
  • These observed WM alterations suggest a demyelination process contributing to the clinical manifestations of hypothyroidism.
  • WM integrity changes may underlie the neuropsychiatric symptoms associated with hypothyroidism.