Choi Seong-Min, Kim Byeong C, Choi Kang-Ho, Nam Tai-Seung, Kim Joon-Tae, Lee Seung-Han, Park Man-Seok, Kim Myeong-Kyu, Cho Ki-Hyun
Department of Neurology, Chonnam National University Hwasun Hospital, Gwangju, South Korea.
Dement Geriatr Cogn Disord. 2014;38(3-4):178-85. doi: 10.1159/000359966. Epub 2014 Apr 8.
Alterations in thyroid hormone (TH) levels may be related to the pathogenesis of mild cognitive impairment (MCI) and dementia. Cognitive deficits are common in Parkinson's disease (PD) patients. The aim of this study was to investigate whether variations within the normal ranges of thyroid function are related to cognitive function in early PD without dementia.
Eighty-four euthyroid patients with early PD underwent evaluation of their thyroid status, including measures of thyroid-stimulating hormone (TSH), total triiodothyronine (tT3) and free thyroxine (fT4), and comprehensive neuropsychological tests.
The 46 patients of the PD-MCI group did not differ in the serum levels of TH compared to the 38 patients of the PD-normal cognition group. fT4 levels were inversely associated with the Mini-Mental State Examination (MMSE) score and neuropsychological tests of attention and visuospatial and executive function. TSH and tT3 levels were not related to cognitive performances. After controlling for demographic and clinical variables, multiple regression analyses indicated statistically significant associations between fT4 concentrations and MMSE score and neuropsychological tests of executive function.
This study supports a relationship between the thyroid status and cognitive function in euthyroid early PD patients, with higher concentrations of fT4 being associated with a poor performance of executive function.
甲状腺激素（TH）水平的改变可能与轻度认知障碍（MCI）和痴呆的发病机制有关。认知缺陷在帕金森病（PD）患者中很常见。本研究的目的是调查甲状腺功能正常范围内的变化是否与无痴呆的早期PD患者的认知功能有关。
84例甲状腺功能正常的早期PD患者接受了甲状腺状态评估，包括促甲状腺激素（TSH）、总三碘甲状腺原氨酸（tT3）和游离甲状腺素（fT4）的检测，以及全面的神经心理学测试。
与38例认知正常的PD患者相比，46例PD-MCI组患者的TH血清水平无差异。fT4水平与简易精神状态检查表（MMSE）评分以及注意力、视觉空间和执行功能的神经心理学测试呈负相关。TSH和tT3水平与认知表现无关。在控制了人口统计学和临床变量后，多元回归分析表明fT4浓度与MMSE评分以及执行功能的神经心理学测试之间存在统计学上的显著关联。
本研究支持甲状腺功能正常的早期PD患者的甲状腺状态与认知功能之间存在关联，fT4浓度较高与执行功能较差有关。
