I hope some who have had Grave's read this and add some comments.
A Longitudinal Study of Medial Temporal Lobe Volumes in Graves Disease
Mats Holmberg, Helge Malmgren, Rolf A Heckemann, Birgitta Johansson, Niklas Klasson, Erik Olsson, Simon Skau, Göran Starck, Helena Filipsson Nyström
The Journal of Clinical Endocrinology & Metabolism, dgab808, doi.org/10.1210/clinem/dgab808
Published:
09 November 2021
Abstract
Context
Neuropsychiatric symptoms are common features of Graves disease (GD) in hyperthyroidism and after treatment. The mechanism behind these symptoms is unknown, but reduced hippocampal volumes have been observed in association with increased thyroid hormone levels.
Objective
This work aimed at investigating GD influence on regional medial temporal lobe (MTL) volumes.
Methods
Sixty-two women with newly diagnosed GD underwent assessment including magnetic resonance (MR) imaging in hyperthyroidism and 48 of them were followed up after a mean of 16.4 ± 4.2 SD months of treatment. Matched thyroid-healthy controls were also assessed twice at a 15-month interval. MR images were automatically segmented using multiatlas propagation with enhanced registration. Regional medial temporal lobe (MTL) volumes for amygdalae and hippocampi were compared with clinical data and data from symptom questionnaires and neuropsychological tests.
Results
Patients had smaller MTL regions than controls at inclusion. At follow-up, all 4 MTL regions had increased volumes and only the volume of the left amygdala remained reduced compared to controls. There were significant correlations between the level of thyrotropin receptor antibodies (TRAb) and MTL volumes at inclusion and also between the longitudinal difference in the levels of free 3,5,3′-triiodothyronine and TRAb and the difference in MTL volumes. There were no significant correlations between symptoms or test scores and any of the 4 MTL volumes.
Conclusion
Dynamic alterations in the amygdalae and hippocampi in GD reflect a previously unknown level of brain involvement both in the hyperthyroid state of the condition and after treatment. The clinical significance, as well as the mechanisms behind these novel findings, warrant further study of the neurological consequences of GD.
Graves disease, hippocampus, amygdala, longitudinal, cognition, depression
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