Correlation Between Brain Function And Psychological Symptoms In Patients With Hyperthyroidism

BackgroundHyperthyroidism is a common clinical endocrine psychosomatic disease,mainly due to the excessive circulation of thyroid hormone.Excessive thyroid hormone secretion not only leads to the occurrence of physical symptoms,also leads to psychological and emotional changes,which affects the quality of life seriously.The combination of neuroimaging and psychology provides more possibilities for studying the neural mechanisms of mental disorders in vivo.Recent studies have found that psychological and emotional abnormalities in patients with hyperthyroidism are closely related to brain function changes,but the results are not consistent.In this study,fractional amplitude of low-frequency fluctuation（f ALFF）was used in combination with functional connectivity（FC）was used to study the changes of resting brain function in patients with hyperthyroidism,and to analyze the relationship between the changes and psychological symptoms,so as to explore the potential neural mechanism of the occurrence of psychological symptoms of hyperthyroidism.ObjectiveIn this study,resting-state functional magnetic resonance imaging（rs-f MRI）and symptom checklist 90（SCL-90）were used to explore the brain function changes and the neural mechanism related to psychological symptoms in patients with hyperthyroidism MethodA total of 25 patients with hyperthyroidism were enrolled as the hyperthyroidism group and 28 healthy volunteers with no significant difference in gender,age and education level were enrolled as the control group.All subjects were examined by rs-f MRI,which reflected local spontaneous brain activity by measuring global f ALFF,and the brain regions with different spontaneous brain activity between the two groups were used as seed points for functional connectivity analysis based on seed points.The SCL-90 scale was used to evaluate the psychological symptoms of all subjects.Correlation methods were used to analyze the relationship between mean f ALFF（mf ALFF）value,FC value and psychological symptoms in different brain regions between the two groups.Results1.Compared with the control group,the scores of anxiety,hostility and other factors in the hyperthyroidism group increased,and the difference was statistically significant（P<0.05）;2.In the resting state,compared with the control group,increased mf ALFF were found in the right cerebellar vermis region 7（MNI:3,-75,-27;t=4.3807）,left thalamus（MNI:-6,-6,0;t=3.5448）and right thalamus（MNI:6,-3,3;t=4.3559）.Decreased mf ALFF were found in the left cerebellum Crus1 region（MNI:-39,-81,-27;t=-3.4015）,left orbital middle frontal gyrus（MNI:-9,57,0;t=-5.2534）and left inferior frontal gyrus（MNI:-51,15,18;t=-3.7407）in the hyperthyroidism group.3.Compared with the control group,increased FC were observed between the right cerebellar vermis region 7 and left thalamus（MNI:-12,-3,3;t=4.3761）,right inferior temporal gyrus（MNI:54,-51,-3;t=4.0553）,right precuneus（MNI:3,-75,24;t=4.5981）in the hyperthyroidism group.Increased FC were also observed between left thalamus and left cerebellum Crus2 region（MNI:-48,-72,-45;t=4.7308）,Crus1 region of the left cerebellum（MNI:-42,-66,-21;t=4.3454）right middle temporal gyrus（MNI:54,-48,-3;t=4.5543）,right precuneus（MNI:27,-81,39;t=4.0033）.4.Compared with the control group,the mf ALFF value of the right cerebellar vermis region 7 in hyperthyroidism group negatively correlated with anxiety（P=0.037,r=-0.419）,hostile（P=0.046,r=-0.402）factor score,positive correlation with TSH（P=0.049,r=-0.398）.The FC values between the left thalamus and the left cerebellum Crus2 region positively correlated with psychosis（P=0.022,r=0.455）,depression（P=0.035,r=0.422）,compulsion（P=0.027,r=0.442）and others（P=0.044,r=0.406）.The FC value between right cerebellar vermicular region 7 and right precuneus was negatively correlated with FT3（P=0.004,r=-0.554）,FT4（P=0.001,r=-0.602）.The FC value between left thalamus and left cerebellum Crus1 region was positively correlated with TSH（P=0.020,r=0.462）.Conclusions1.In hyperthyroidism patients,there were abnormal spontaneous brain activity in cerebellar,thalamus,frontal lobe and abnormal functional connection between cerebellum and brain circuits.2.Spontaneous brain activity in the right cerebellum vermis and abnormal functional connection between the left posterior cerebellum and left thalamus may be involved in the neural mechanism of psychological symptoms in patients with hyperthyroidism.