Cerebral blood flow abnormalities induced by transient hypothyroidism after thyroidectomy —analysis by Tc-99m-HMPAO and SPM96—

Nagamachi, Shigeki; Jinnouchi, Seishi; Nishii, Ryuichi; Ishida, Yoshiteru; Fujita, Seigo; Futami, Shigemi; Kodama, Takahide; Tamura, Shozo; Kawai, Keiichi

doi:10.1007/bf02984562

Cited by 42 publications

(33 citation statements)

References 23 publications

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“…Indeed, our subjects demonstrated depressive and anxiety symptoms, as well as psychomotor slowing, when markedly hypothyroid. These findings support other studies where depression, anxiety, and psychomotor slowing were found during similar hypothyroid states (Denicoff et al, 1990;Constant et al, 2001;Nagamachi et al, 2004).…”

Section: Discussionsupporting

confidence: 92%

“…These studies included mild hypothyroidism in one study, which might in itself have a different effect on the brain than severe, transient hypothyroidism (Krausz et al, 2004), and marked, transient hypothyroidism (Nagamachi et al, 2004) similar to our subjects. Like us, each of these groups of investigators showed regional decreases in radiotracer activity; and our data do, in fact, corroborate one (but no other) finding by Nagamachi et al (2004) of decreased activity in parts of the occipital lobes. However, unlike our group, neither of these groups of investigators demonstrated areas of increased tracer accumulation.…”

Section: Discussionmentioning

confidence: 91%

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Cerebral Accumulation of TC-99M Ethyl Cysteinate Dimer (ECD) in Severe, Transient Hypothyroidism

Schraml

Beason‐Held

Fletcher

et al. 2006

J Cereb Blood Flow Metab

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Thyroid dysfunction is a well-known contributor to psychiatric morbidity. To investigate the mechanism(s) by which thyroid hormone availability affects cerebral activity, a group of thyroidectomized individuals were studied at two points in time: when markedly hypothyroid in preparation for a thyroid cancer metastatic survey and when clinically and/or biochemically euthyroid. The analysis consisted of single photon emission computed tomography (SPECT) using a lipophilic radiopharmaceutical, technetium-99m (Tc-99m) ethyl cysteinate dimer (ECD), and measurement of mood, anxiety, and psychomotor function, at both points in time. Both increases and decreases in regional cerebral radiotracer activity were found in the hypothyroid condition relative to the euthyroid condition, and the neuropsychological assessment demonstrated significantly greater depression, anxiety, and psychomotor slowing during the hypothyroid state. Increased radiotracer activity was seen in frontal and temporal regions, posterior cingulate gyrus, thalamus, and putamen. Decreased activity was seen in the occipital cortex, and the pre-and postcentral gyri. This distribution pattern is partially consistent with findings in persons with depression and anxiety unrelated to thyroid disease, supporting the link between the symptoms observed in our subjects and their marked hypothyroidism. Finally, these results support the need to consider the effect of the thyroid state on cellular mechanisms of uptake and retention of cerebral blood flow radiopharmaceuticals when studying 'noneuthyroid' individuals.

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Section: Discussionsupporting

confidence: 92%

Section: Discussionmentioning

confidence: 91%

Cerebral Accumulation of TC-99M Ethyl Cysteinate Dimer (ECD) in Severe, Transient Hypothyroidism

Schraml

Beason‐Held

Fletcher

et al. 2006

J Cereb Blood Flow Metab

View full text Add to dashboard Cite

show abstract

“…Thyroid dysfunction-induced mood changes may be partly due to cerebral blood flow (CBF) abnormalities, as demonstrated in patients with transient hypothyroidism studied with 99 mTc-HMPAO SPECT versus normal controls (38). Regional CBF alterations have been detected in the bilateral parietal lobes and in the bilateral occipital lobes, which extended to the prefrontal cortices as hypothyroidism worsened.…”

Section: Effects On Lipidsmentioning

confidence: 98%

Short-term hypothyroidism after Levothyroxine-withdrawal in patients with differentiated thyroid cancer: clinical and quality of life consequences

Duntas¹,

Biondi²

2007

eur j endocrinol

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Acute hypothyroidism induced by thyroid hormone withdrawal in patients with differentiated thyroid cancer during monitoring for remnant or metastatic disease, seriously affects multiple organs and systems, and especially in severe cases can impair quality of life. Indeed, it may induce untoward cardiovascular effects and can be hazardous in patients with underlying cardiovascular disease, particularly in the elderly. Moreover, acute hypothyroidism deranges the lipid profile and exacerbates neuropsychiatric illness. The introduction of recombinant human TSH (rhTSH) as a diagnostic and therapeutic tool in the care of patients with thyroid cancer has widened the scope of disease management. The use of rhTSH prevents derangement of various systems at approximately equivalent societal costs to that of withdrawal and promotes compliance while preserving the patient's normal daily functioning and productivity. Its reliability allied with its safety render this compound a valid alternative in the monitoring of patients with differentiated thyroid carcinoma as well as providing an alternative therapeutic procedure whenever LT4-withdrawal may be hazardous or in cases of patient non-compliance.

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“…However, fluorodeoxyglucose (FDG) and oxygen-15-labeled water studies, in similar patients, showed lower global brain glucose metabolism and flow. Hypothyroidal patients were also significantly more depressed, anxious and psychomotor slowered than euthyroidal subjects (Nagamachi et al, 2004;Constant et al, 2001). …”

Section: Hypothyroidism Depression and Brain Imagingmentioning

confidence: 88%

Depressive Disorders and Thyroid Function

Araya¹,

Massardo²,

Fiedler³

et al. 2012

Thyroid and Parathyroid Diseases - New Insights Into Some Old and Some New Issues

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Cerebral blood flow abnormalities induced by transient hypothyroidism after thyroidectomy —analysis by Tc-99m-HMPAO and SPM96—

Cited by 42 publications

References 23 publications

Cerebral Accumulation of TC-99M Ethyl Cysteinate Dimer (ECD) in Severe, Transient Hypothyroidism

Cerebral Accumulation of TC-99M Ethyl Cysteinate Dimer (ECD) in Severe, Transient Hypothyroidism

Short-term hypothyroidism after Levothyroxine-withdrawal in patients with differentiated thyroid cancer: clinical and quality of life consequences

Depressive Disorders and Thyroid Function

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