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This Article Free to Access Figures Only Full Text Full Text (PDF) All Versions of this Article: ajnr.A2449v1 32/6/1034 most recent Alert me when this article is cited Alert me if a correction is posted Services Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via CrossRef Google Scholar Articles by Miao, Q. Articles by Li, Y. M. PubMed PubMed Citation Articles by Miao, Q. Articles by Li, Y. M. Hotlight (NEW!) What's Hotlight? American Journal of Neuroradiology 32:1034-1042, June-July 2011 © 2011 American Society of Neuroradiology BRAIN Reversible Changes in Brain Glucose Metabolism Following Thyroid Function Normalization in Hyperthyroidism Q. Miao a , S. Zhang a , Y.H. Guan b , H.Y. Ye a , Z.Y. Zhang a , Q.Y. Zhang a , R.D. Xue a , M.F. Zeng a , C.T. Zuo b and Y.M. Li a a From the Division of Endocrinology and Metabolism, Department of Internal Medicine (Q.M., S.Z., H.Y.Y., Z.Y.Z., Q.Y.Z., R.D.X., M.F.Z., Y.M.L.) b PET Center, Department of Radiology (Y.H.G., C.T.Z.), Huashan Hospital, Shanghai Medical College, Fudan University, Shanghai, China. Please address correspondence to Chuan Tao Zuo, MD, PhD, PET Center, Division of Nuclear Medicine, Huashan Hospital, Department of Radiology, Shanghai Medical College, Fudan University, 518 Wuzhong East Rd, Shanghai 200235, China; e-mail: zuoct_cn@hotmail.com ; or Yi Ming Li, MD, PhD, Division of Endocrinology and Metabolism, Huashan Hospital, Department of Internal Medicine, Shanghai Medical College, Fudan University, 12 Wulumuqi Middle Rd, Shanghai 200040, China; e-mail: yimingli@fudan.edu.cn BACKGROUND AND PURPOSE: Patients with hyperthyroidism frequently present with regional cerebral metabolic changes, but the consequences of endocrine-induced brain changes after thyroid function normalization are unclear. We hypothesized that the changes of regional cerebral glucose metabolism are related to thyroid hormone levels in patients with hyperthyroid, and some of these changes can be reversed with antithyroid therapy. MATERIALS AND METHODS: Relative regional cerebral glucose metabolism was compared between 10 new-onset untreated patients with hyperthyroidism and 20 healthy control participants by using brain FDG-PET scans. Levels of emotional distress were evaluated by using the SAS and SDS. Patients were treated with methimazole. A follow-up PET scan was performed to assess metabolic changes of the brain when thyroid functions normalized. RESULTS: Compared with controls, patients exhibited lower activity in the limbic system, frontal lobes, and temporal lobes before antithyroid treatment. There were positive correlations between scores of depression and regional metabolism in the cingulate and paracentral lobule. The severity of depression and anxiety covaried negatively with pretreatment activity in the inferior temporal and inferior parietal gyri respectively. Compared with the hyperthyroid status, patients with normalized thyroid functions showed an increased metabolism in the left parahippocampal, fusiform, and right superior frontal gyri. The decrease in both FT3 and FT4 was associated with increased activity in the left parahippocampal and right superior frontal gyri. CONCLUSIONS: The changes of regional cerebral glucose metabolism are related to thyroid hormone levels in patients with hyperthyroidism, and some cerebral hypometabolism can be improved after antithyroid therapy. Abbreviations: BA, Brodmann area β value, standardized coefficients FDG, fluorodeoxyglucose 18 F-FDG, fluorine 18 fluorodeoxyglucose FDR, false discovery rate FT3, free triiodothyronine FT4, free thyroxine GLUT-1 , glucose transporter protein type 1 MNI, Montreal Neurological Institute MRS, MR spectroscopy PET, positron-emission tomography SAS, Self-Rating Anxiety Scale SDS, Self-Rating Depression Scale SPECT, single-photon emission tomography SPM, statistical parametric mapping SPSS, Statistical Package for the Social Sciences T1, before antithyroid therapy T2, after antithyroid therapy TRAb, anti-thyroid stimulating hormone receptor antibody TSH, thyrotropin VOI, volume of interest Home Subscribe Author Instructions Submit Online Search the AJNR Archives Feedback Help Copyright © 2011 by the American Society of Neuroradiology. Print ISSN: 0195-6108 Online ISSN: 1936-959X
American Journal of Neuroradiology – American Journal of Neuroradiology
Published: Jun 1, 2011
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