[1]李艳捧 杜晓猛 郎晓燕等.基于核磁共振成像技术的甲状腺功能减退伴焦虑患者的脑功能区研究[J].卒中与神经疾病杂志,2021,28(02):197-201.[doi:10.3969/j.issn.1007-0478.2021.02.014]
 Li Yanpeng*,Du Xiaomeng,Lang Xiaoyan*,et al.MRI-based study of brain functional areas in patients with hypothyroidism and anxiety[J].Stroke and Nervous Diseases,2021,28(02):197-201.[doi:10.3969/j.issn.1007-0478.2021.02.014]
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基于核磁共振成像技术的甲状腺功能减退伴焦虑患者的脑功能区研究()
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《卒中与神经疾病》杂志[ISSN:1007-0478/CN:42-1402/R]

卷:
第28卷
期数:
2021年02期
页码:
197-201
栏目:
论 著
出版日期:
2021-04-20

文章信息/Info

Title:
MRI-based study of brain functional areas in patients with hypothyroidism and anxiety
文章编号:
1007-0478(2021)02-0197-05
作者:
李艳捧 杜晓猛 郎晓燕等
075000 张家口,河北北方学院附属第一医院医学影像科(李艳捧 郎晓燕 张斌 刘迪 陈静 李晓东 李娇娇),放疗科(杜晓猛)
Author(s):
Li Yanpeng* Du Xiaomeng Lang Xiaoyan* et al.
*Department of Medical Imaging, the First Affiliated Hospital of Hebei North University, Zhangjiakou Hebei 075000
关键词:
甲状腺功能减退 焦虑 脑功能区 核磁共振成像
Keywords:
Hypothyroidism Anxiety disorder Brain functional area MRI
分类号:
R747.9
DOI:
10.3969/j.issn.1007-0478.2021.02.014
文献标志码:
A
摘要:
目的 探讨甲状腺功能减退伴焦虑患者脑功能区核磁共振成像(Magnetic resonance imaging,MRI)表现。方法 选取本院2018年5月-2019年8月收治的甲状腺功能减退伴焦虑患者30例为观察组,并选取同期体检健康者30例为对照组; 收集2组研究对象的一般资料,并对脑功能区进行功能磁共振成像(Functional magnetic resonance imaging,fMRI)扫描,采用局部一致性(Regional homogeneity,ReHo)值找出基础状态下自发异常脑功能活动区,Speaeman分析异常脑功能区与甲状腺激素水平、神经精神症状的相关性。结果 fMRI扫描显示甲状腺功能减退患者右海马旁回、左侧颞下回、左右前扣带回脑功能区的ReHo值明显高于对照组(0.81±0.02 vs. 0.78±0.04、0.73±0.07 vs. 0.69±0.05、0.89±0.12 vs.0.84±0.09、0.87±0.11 vs. 0.83±0.07)(P<0.05),左侧内额上回ReHo值明显低于对照组(0.77±0.13 vs. 0.72±0.11)(P<0.05); 不同焦虑程度的右海马旁回、左侧颞下回、左前扣带回、右前扣带回、左侧内侧额上回5个异常脑功能区ReHo值相近(P>0.05); 左、右前扣带回ReHo值与游离甲状腺素(Free thyroxine,FT4)水平显著相关(r=-0.398,P=0.023; r=-0.424,P=0.031); 左、右前扣带回ReHo值与焦虑等级显著相关(r=0.425,P=0.533; r=0.027,P=0.017)。结论 海马旁回、颞下回、前扣带回、内侧额上回4个脑功能区可能参与甲状腺功能减退患者引发焦虑症状的脑部生理机制,甲状腺功能减退患者焦虑症状的脑神经反常活动与前扣带回自发异常活动密切相关,可为甲状腺功能减退伴焦虑患者的临床诊疗提供新思路。
Abstract:
ObjectiveTo explore the magnetic resonance imaging(MRI)manifestations of brain functional areas in patients with hypothyroidism and anxiety.Methods Between May 2018 and August 2019, we enrolled 30 patients with hypothyroidism and anxiety and 30 healthy subjects. The demographic data of the two groups were collected. Brain functional MRI(fMRI)was performed. The spontaneous abnormal brain function areas under the basic state were identified by regional homogeneity(ReHo)value. The correlation between abnormal brain function areas and neuropsychiatric symptoms and thyroid hormone was analyzed by Spearman’s correlation coefficient.Results fMRI scanning showed that the ReHo values of the functional areas of the right hippocampus, left temporal inferior gyrus, and left and right anterior cingulgyrgyrus were higher than those in the control group(0.81±0.02 vs. 0.78±0.04, 0.73±0.07 vs. 0.69±0.05, 0.89±0.12 vs. 0.84±0.09, 0.87±0.11 vs. 0.83±0.07, respectively)(P<0.05). ReHo value in the left lateral frontal superior gyrus is significantly lower than that of normal subjects(0.77±0.13 vs. 0.72±0.11)(P<0.05). The ReHo values of the five brain functional areas including the right parahippocampal gyrus, left inferior temporal gyrus, left anterior cingulate gyrus, right anterior cingulate gyrus, and left medial superior frontal gyrus were similar in patients with different degrees of anxiety(P>0.05). The ReHo values in the left and right anterior cingulate gyrus were correlated with free thyroxine(FT4)(r=-0.398, P=0.023; r=-0.424, P=0.031). The ReHo values in the left and right anterior cingulate gyrus were correlated with anxiety level(r=0.425, P=0.533; r=0.027, P=0.017).Conclusion Parahippocampal gyrus, inferior temporal gyrus, anterior cingulate gyrus, and medial superior frontal gyrus may participate in the pathogenesis of anxiety in patients with hypothyroidism. The abnormal activities of the brain in patients with hypothyroidism are closely related to the spontaneous abnormal activities of the anterior cingulate cortex. Our results provide new evidence for clinical diagnosis and treatment of patients with hypothyroidism and anxiety.

参考文献/References:

[1] Buller LT, Rosas S, Sabeh KG, et al. Hypothyroidism increases 90-Day complications and costs following primary total knee arthroplasty[J]. J Arthroplasty, 2018, 33(4): 1003-1007.
[2] Blagoi Marinov, Boyan Nonchev, Miroslava Todorova, et al. Reversibility of diffusion capacity abnormalities in patients with clinical hypothyroidism with establishment of euthyroid state[J]. Encyclopedia of Sleep, 2013, 42(57):482-485.
[3] Kim JS, Zhang Y, Chang Y, et al. Subclinical hypothyroidism and incident depression in young and Middle-Age adults[J]. J Clin Endocrinol Metab, 2018, 103(5): 1827-1833.
[4] Wiles K. Management for women with subclinical hypothyroidism in pregnancy[J]. Drug Ther Bull, 2019, 57(2): 22-26.
[5] Lee Y, Lim YH, Shin JH, et al. Impact of subclinical hypothyroidism on clinical outcomes following percutaneous coronary intervention[J]. Int J Cardiol, 2018, 253(7): 155-160.
[6] Ge JF, Xu YY, Qin G, et al. Resveratrol ameliorates the anxiety- and Depression-Like behavior of subclinical hypothyroidism rat: possible involvement of the HPT axis, HPA axis, and Wnt/β-Catenin pathway[J]. Front Endocrinol(Lausanne), 2016, 7(4): 44.
[7] 王宜文,赵雨,王泉泉.基于fMRI技术的电影学与认知神经科学交叉研究进展[J].当代电影,2018,263(2):37-42.
[8] Bilous II, Korda MM, Krynytska IY, et al. Nerve impulse transmission pathway-focused genes expression analysis in patients with primary hypothyroidism and autoimmune thyroiditis[J]. Endocr Regul, 2020, 54(2): 109-118.
[9] 俞淼,袁鹰,迟松,等.原发性甲状腺功能减退症患者认知功能障碍的特点[J].中华行为医学与脑科学杂志,2013,22(4):332-334.
[10] Han L, Zhao WJ, Yang HL, et al. Subclinical hypothyroidism would not lead to female sexual dysfunction in Chinese women[J]. BMC Womens Health, 2018, 18(1): 26.
[11] Prof. Dr.T.J.visser.Regulation of thyroid hormone production and metabolism[J]. Magnetic Resonance in Medicine, 2016, 75(1): 137-149.
[12] 程千鹏,洛佩,吕肖锋.甲状腺功能减退症的病因和对机体影响的研究进展[J].医学综述,2018,24(9):1766-1770.
[13] Sindoni A, Rodolico C, Pappalardo MA, et al. Hypothyroid myopathy: A peculiar clinical presentation of thyroid failure. Review of the literature[J]. Rev Endocr Metab Disord, 2016, 17(4): 499-519.
[14] Lang X, Hou X, Shangguan F, et al. Prevalence and clinical correlates of subclinical hypothyroidism in first-episode drug-naive patients with major depressive disorder in a large sample of Chinese[J]. J Affect Disord, 2020, 263(263): 507-515.
[15] Zhao T, Chen BM, Zhao XM, et al. Subclinical hypothyroidism and depression: a meta-analysis[J]. Transl Psychiatry, 2018, 8(1): 239.
[16] Ramos-Leví AM, Marazuela M. Pathogenesis of thyroid autoimmune disease: the role of cellular mechanisms[J]. Endocrinol Nutr, 2016, 63(8): 421-429.
[17] Cannizzaro M, Buffone A, Lo Bianco S, et al. The thyroid disease in the elderly: Our experience[J]. Int J Surg, 2016, 33(Suppl 1): S85-S87.
[18] Chen J, Liu ML, Sun D, et al. Effectiveness and neural mechanisms of home-based telerehabilitation in patients with stroke based on fMRI and DTI: A study protocol for a randomized controlled trial[J]. Medicine, 2018, 97(3): e9605.
[19] 金亚玲,冒雷明,虞莹.首发精神分裂症患者甲状腺激素水平与精神症状的相关性研究[J].交通医学,2019,33(1):28-29, 32.
[20] Zhang Q, Bai ZL, Gong Y, et al. Monitoring glutamate levels in the posterior cingulate cortex of thyroid dysfunction patients with TE-averaged PRESS at 3T[J]. Magn Reson Imaging, 2015, 33(6): 774-778.
[21] Wang Q, Zhu GP, Yi L, et al. A review of functional Near-Infrared spectroscopy studies of motor and cognitive function in preterm infants[J]. Neurosci Bull, 2020, 36(3): 321-329.
[22] 申延蕊,李中林,武肖玲,等.静息态fMRI观察基于中国人脑模板的慢性失眠患者岛叶功能连接[J].中国医学影像技术,2019,35(1):15-19.
[23] 郭志伟,陈华平,母其文,等.轻度认知功能障碍弥散参数定量范围及与认知损伤程度的关系[J].西部医学,2018,30(4):594-598.
[24] Li Q, Zhu P, Shao Y. Research progresses of brain remodeling in visual deprivation based on fMRI[J]. Chinese Journal of Medical Imaging Technology, 2018, 34(12): 1893-1896.
[25] 韩子亮,于东升,吕东升,等.首发抑郁障碍患者静息态脑局部一致性研究[J].世界最新医学信息文摘,2019,19(12):25-28.
[26] Rolls ET. The cingulate cortex and limbic systems for emotion, action, and memory[J]. Brain Struct Funct, 2019, 224(9): 3001-3018.
[27] 王薇薇,吴逊.扣带回的解剖、生理及扣带回癫(痫)[J].中国现代神经疾病杂志,2018,18(5):315-323.
[28] 陆颖.中扣带回-后岛叶通路调控痛觉超敏反应[J].中国疼痛医学杂志,2018,24(9):653-655.
[29] Wickham J, Corna A, Schwarz N, et al. Human cerebrospinal fluid induces neuronal excitability changes in resected human neocortical and hippocampal brain slices[J]. Front Neurosci, 2020, 14(21): 283-297.
[30] 孙娜,姚建,王宝,等.动脉自旋标记在评估甲状腺功能亢进患者脑血流灌注情况中的应用研究[J].医学影像学杂志,2018,28(4):550-553, 578.
[31] 曾宪忠,何晓松,王芬,等.左旋甲状腺素对甲状腺功能减退症患者脑默认网络静息态功能连接的影响[J].中国临床保健杂志,2017,20(1):14-16.
[32] Wei YY, Wang JJ, Yan C, et al. Correlation between brain activation changes and cognitive improvement following cognitive remediation therapy in schizophrenia: an activation likelihood estimation meta-analysis[J]. Chinese medical journal, 2016, 129(5): 578-585.
[33] 张利红.甲状腺激素异常伴神经精神症状患者脑功能区研究[D].重庆:第三军医大学,2014.
[34] 史飞,周艳秋,干伟,等.8氧化鸟嘌呤在快速老化小鼠大脑颞叶与额叶表达研究的比较[J].中华老年医学杂志,2019,38(8):934-938.
[35] Singh S, Rana P, Kumar P, et al. Hippocampal neurometabolite changes in hypothyroidism:An in-vivo(1)HMRS Study before and after thyroxine treatment[J]. J Neuroendocrinol, 2016, 28(9): 147-149.

备注/Memo

备注/Memo:
基金项目:河北省医学科学研究重点课题计划项目(20180837)
更新日期/Last Update: 2021-04-20