Tütüncü Neslihan Başçil, Karataş Metin, Sözay Seyhan
Department of Endocrinology and Metabolism, Başkent University Faculty of Medicine, Ankara, Turkey. tt04-k@tr-net
Thyroid. 2004 Aug;14(8):622-7. doi: 10.1089/1050725041692837.
This study was performed to analyze quantitatively the cognitive functions of patients with mild and severe hypothyroidism by measuring P300 event-related evoked potentials before and after euthyroidism was established. Patients diagnosed as having Hashimato's thyroiditis with thyroid stimulating hormone (TSH) levels between 5 and 10 mU/L (mild thyroid failure; n = 24) and those with severe hypothyroidism (n = 13) were enrolled randomly to the study protocol. P300-event related potentials were recorded during thyroid insufficiency, and in the first and sixth month of euthyroidism. P300 latencies were prolonged in both the mild and severe hypothyroid patients compared to controls (p = 0.042, p < 0.001, respectively). The overt hypothyroid patients showed significant decrease in their P300 latencies after the first month of euthyroidism (p = 0.001). These P300 latency values did not differ in the subsequent 6-month period. The mild hypothyroid group, however, displayed no improvement of P300 latency in the first month but normalized at the sixth month of euthyroidism. In conclusion, both the overt and the mild hypothyroid patients revealed prolonged P300 latencies. Unexpectedly, P300 latencies in the patients with mild thyroid failure required more time to recover compared to the overt hypothyroid patients. This finding indicates different clinical outcomes of various thyroid insufficiency states on the brain.
本研究旨在通过测量甲状腺功能正常化前后的P300事件相关诱发电位,对轻度和重度甲状腺功能减退患者的认知功能进行定量分析。诊断为桥本甲状腺炎且促甲状腺激素(TSH)水平在5至10 mU/L之间的患者(轻度甲状腺功能减退;n = 24)和重度甲状腺功能减退患者(n = 13)被随机纳入研究方案。在甲状腺功能不全期间以及甲状腺功能正常化的第一个月和第六个月记录P300事件相关电位。与对照组相比,轻度和重度甲状腺功能减退患者的P300潜伏期均延长(分别为p = 0.042,p < 0.001)。明显甲状腺功能减退的患者在甲状腺功能正常化第一个月后P300潜伏期显著缩短(p = 0.001)。在随后的6个月期间,这些P300潜伏期值没有差异。然而,轻度甲状腺功能减退组在第一个月P300潜伏期没有改善,但在甲状腺功能正常化的第六个月恢复正常。总之,明显和轻度甲状腺功能减退患者均表现出P300潜伏期延长。出乎意料的是,与明显甲状腺功能减退患者相比,轻度甲状腺功能减退患者的P300潜伏期恢复所需时间更长。这一发现表明不同程度的甲状腺功能不全状态对大脑有不同的临床影响。