Liu Xinxin, Bai Zhilan, Liu Feng, Li Min, Zhang Qiujuan, Song Guangyi, Xu Jing
Department of Radiology, Second Affiliated Hospital of Xi'an Jiaotong University College of Medicine, Xi'an, China.
Neuro Endocrinol Lett. 2012;33(6):626-30.
Patients with hyperthyroidism frequently have neuropsychiatric complaints such as lack of concentration, poor performance in memory, depression, anxiety and mania. These symptoms suggest the dysfunction of brain. However, the underlying process of this dysfunction is not well understood. At the same time, glutamatergic system has been considered important in neuropsychiatric process by recent studies. Thus, this study is to investigate the change of glutamate concentration in patients with hyperthyroidism using proton magnetic resonance spectroscopy.
Fifteen untreated patients with hyperthyroidism and fifteen age- and gender- matched controls participated in the study. The region of the posterior cingulate cortex was examined by magnetic resonance spectroscopy with a technique referred as TE-averaged PRESS at 3T field strength. The concentrations of N-Acetylaspartate, creatine, choline and glutamate were assessed using jMRUI v4.0 software.
Hyperthyroid patients, compared with controls, showed a decrease of glutamate concentration (P<0.047) and glutamate/creatine ratios (P<0.009) in the posterior cingulate cortex. The decrease of choline concentration (P<0.004) and choline/creatine ratios (P<0.012) were also discovered. No significant difference was found in the concentrations of N-Acetylaspartate or creatine between patients and controls.
Concentration of glutamate decreased in the region of posterior cingulate cortex in patients with hyperthyroidism. This reduction indicated a possible involvement of glutamate in the brain dysfunction in hyperthyroidism.
甲状腺功能亢进症患者经常出现神经精神方面的主诉，如注意力不集中、记忆力差、抑郁、焦虑和躁狂。这些症状提示大脑功能障碍。然而，这种功能障碍的潜在机制尚不清楚。同时，近期研究认为谷氨酸能系统在神经精神过程中很重要。因此，本研究旨在使用质子磁共振波谱法研究甲状腺功能亢进症患者谷氨酸浓度的变化。
15名未经治疗的甲状腺功能亢进症患者和15名年龄及性别匹配的对照者参与了本研究。在3T场强下，采用一种称为TE平均PRESS的技术，通过磁共振波谱对后扣带回皮质区域进行检查。使用jMRUI v4.0软件评估N-乙酰天门冬氨酸、肌酸、胆碱和谷氨酸的浓度。
与对照组相比，甲状腺功能亢进症患者后扣带回皮质中的谷氨酸浓度（P<0.047）和谷氨酸/肌酸比值（P<0.009）降低。还发现胆碱浓度（P<0.004）和胆碱/肌酸比值（P<0.012）降低。患者与对照组之间的N-乙酰天门冬氨酸或肌酸浓度无显著差异。
甲状腺功能亢进症患者后扣带回皮质区域的谷氨酸浓度降低。这种降低表明谷氨酸可能参与了甲状腺功能亢进症患者的脑功能障碍。
