An Analysis Of Serum Thyroid Hormones And Cortisol Abnormalities In Depression Patients With Asymptomatic Cerebral Infarction

Objective: Major depression is a serious and disabling illness, estimated by the World Health Organization to be the second most important world-wide cause of loss in disability adjusted life years by 2020. At 1997Alexopoulos and Krishnan coined the term "vascular depression" to describe associated with cerebrovascular disease. As a subtype of depression, vascular depression has its particularity in clinical manifestation, neuroimaging neuroimaging characteristics,and treatment outcome .The relationship between the interest in the brain and the thyroid function was established long time ago. After many years of research ,the precise relationship between the HPT axis HPA axis and depressive disorders remains obscure, and the mechanism underlying the thyroid, cortiso abnormalities in depressive patients remains indeterminate. Thus, considerable further investigati -on will be necessary to understand the role of the HPT axis ,HPA axis in the pathogenesis and treatment of depression disorders. To investigated the changes of serum T3 T4 TSH and cortisol in depressed patients with asymptomatic cerebral infarction. Methods: We classified 66 depression patients into two groups-those withACI(+)(N=31) and ACI(-)(N=35),after the age of 50 underwent the brain CT. The two group patients were compared on serum T3 T4 TSH and cortisol. T3 T4 TSH assays were conducted by time resolved fluoroimmunoassay. Cortisol conducted by PEG. Hamilton Depression Scale (HAMD) was used to assess the depressive symptoms before and after treatment. Results: 1.No differenced was founded between patients group and normal controlsbefore treatment in serum T3 T4 TSH, but serum cortisol was higher than normal controls. 2. No significant differenced was founded after paroxetine was taken 2 weeks between the ACI(+) group and ACI(-) group in serum T3 T4 TSH and cortisol. 3. Serum T3 increased, sernuT4 and cortisol decreased after trentment in ACI(+)group, TSH changed slightly .4.SerumT3increased T4 and cortisol decreased , TSH changed slightly in ACI(-) group after treatment .5. The ACI(+) group HAMD Scores was higher than ACI(-) before and after trentment, the effective rate was lower than ACI(-) after6weeks 6. serum T3 T4 TSH and cortisol had no correlation with HAMD.7.There may be no correlation between thyroid and cortisol in patients with depression. Conclusion: 1 depression with asymptomatic cerebral infarction has been associated with changes in the hypothalamus-pituitary-thyroid (HPT) axis and the hypothalamus -pituitary-adrenal(HPA) axis as well as noasymptomatic cerebral infarction.2. HAMD score was higher and the effective rate was lower in depression with asymptomatic cerebral infarction as compared with noasymptomatic cerebral infarction. 3.Paroxetine may influence the serum levels of thyroid hormones and cortisol.