<p>Reversible Affective Symptoms and Attention Executive Control Network Impairment Following Thyroid Function Normalization in Hyperthyroidism</p>

Abstract

Introduction: Affective symptoms and attention impairments are found in patients with hyperthyroidism. Our previous data have revealed that the patients with hyperthyroidism experience impairments of the attention networks, but it remains unclear whether these disorders persist after the treatment of hyperthyroidism. Methods: Twenty healthy controls and 25 hyperthyroid patients were recruited and performed the attention network test (ANT) which can simultaneously examine the alertness, orientation and execution control components of the participants. The effect of treatment on affective symptom and attention networks impairments were examined in the patient group after 1-year anti-thyroid medication and reaching euthyroidism for at least 3 months. Results: Anxiety and depression scores of patients with hyperthyroidism were significantly higher than those of the healthy control group. The patients with hyperthyroidism had impairments of the alerting and executive control networks. Meanwhile, the score of HAMA correlated significantly with thyroid hormone and TSH levels, and there was a negative significant correlation between the score of HAMD and TSH level in all subjects. There was a positive correlation between the value of the executive control network and thyroid hormones' levels in all subjects and in the hyperthyroidism group. Anxiety and depression symptoms were improved with methimazole treatment after euthyroidism was reached. The value of the executive control network no longer differed from that of healthy controls, but deficits in the alerting network of hyperthyroidism still persisted after treatment. Conclusion: The patients with hyperthyroidism existed affective symptoms and attention networks impairments. Affective symptoms and attention executive control network impairment were improved following thyroid function normalization in hyperthyroidism.

Risk Preferences, Rationality of Choices, and Willingness to Pay for Preventive Medicine in Patients with Graves’ Thyrotoxicosis

“…This time interval might be too short for any difference to be detected, because it has been reported that some patients who achieve euthyroid function after treatment might still have neuropsychological problems. 8 , 23 However, in terms of the quality of informed consent it is important that patients’ decisions would not fluctuate over such a short period. Our results suggest that as long as their mental status is not seriously impaired, informed consent obtained from patients with Graves’ thyrotoxicosis is robust and independent of thyroid function state.…”

“…[3][4][5][6] These mental symptoms usually disappear after reaching euthyroidism. 7,8 Although the biological mechanism for these symptoms remains unknown, recent studies using functional neuroimaging techniques of positron emission tomography (PET) and single photon emission computed tomography (SPECT) have revealed that excessive thyroid hormone induces abnormal metabolism in the limbic system and frontal cortex. [9][10][11] Informed consent for clinical treatment has evolved to become vitally important in modern medical practice.…”

Apathetic hyperthyroidism in an elderly patient presenting with psychomotor retardation

“…The mainstay of treatment in patients with psychomotor retardation, psychiatric features, and hyperthyroidism is the restoration of euthyroid status. Nurse practitioners should reassure the patient and family that the symptoms of confusion, depression, psychomotor retardation, fatigue, and unintentional weight loss should improve and be resolved in a few weeks (Yuan et al, 2019). Additionally, clinicians should encourage adequate hydration, food intake, and the implementation of safety protocol to decrease negative outcomes (Kennedy-Malone, 2020).…”

The relationship between mental fatigue, depression, and cognition in Graves’ disease

“…In GD patients with a previous ability to manage a full-time job, one-third were unable to resume the same work ability after treatment ( 6 , 7 , 8 , 9 , 10 , 11 ). The cognitive problems reported, primarily memory and concentration deficits, are seldom captured with standard neuropsychological tests ( 10 , 12 ), while more demanding tests have shown altered decision-making and attention when suffering from hyperthyroidism compared to controls ( 13 , 14 ). There are contradictory results regarding cognitive tests at follow-up ( 1 , 14 ).…”