Structural and Functional Brain Changes After Glucocorticoid Therapy in Thyroid-Associated Ophthalmopathy

Area of Science:

• Neuroimaging
• Endocrinology
• Ophthalmology

Background:

• Thyroid-associated ophthalmopathy (TAO) is an autoimmune condition affecting the eyes and potentially the brain.
• Understanding TAO's neurological impact is crucial for comprehensive patient care.

Purpose of the Study:

• To investigate brain structural and functional changes in TAO patients before and after glucocorticoid therapy.
• To utilize voxel-based morphometry (VBM) and resting-state functional MRI (ALFF, ReHo) for detailed analysis.

Main Methods:

• 32 TAO patients and 23 healthy controls underwent baseline MRI scans.
• Patients received intravenous glucocorticoid therapy.
• 26 patients were rescanned 3 months post-therapy to assess treatment effects using VBM, ALFF, and ReHo.

Main Results:

• Pre-therapy TAO patients showed reduced gray matter volume (GMV) in frontal regions and altered brain activity (ALFF, ReHo) in visual and emotional processing areas compared to controls.
• Post-therapy, TAO patients exhibited increased GMV in the anterior cingulate and medial superior frontal gyrus, and improved activity in the cuneus and superior occipital gyrus.
• Despite improvements, some GMV deficits in the left orbital superior frontal gyrus persisted post-treatment.

Conclusions:

• TAO is associated with structural and functional brain deficits, particularly impacting visual and emotional brain regions.
• Glucocorticoid therapy demonstrates efficacy in partially restoring brain function and structure in TAO patients.
• These findings enhance understanding of TAO's complex pathophysiology and treatment outcomes.