Yin Jingjing, Xie Lei, Luo DongXue, Huang Jinzhuang, Guo Ruiwei, Zheng Yanmin, Xu Wencan, Duan Shouxing, Lin Zhirong, Ma Shuhua
Department of Radiology, The First Affiliated Hospital of Shantou University Medical College, Shantou, China.
Department of Medical Imaging and Nuclear Medicine, Shantou University Medical College, Shantou, China.
Front Behav Neurosci. 2021 Oct 29;15:725908. doi: 10.3389/fnbeh.2021.725908. eCollection 2021.
This study aimed to explore the structural changes in patients with subclinical hypothyroidism (SCH) using voxel-based morphometry (VBM) and to investigate the altered attentional control networks using functional MRI (fMRI) during the performance of a modified Stroop task with Chinese characters. High-resolution three-dimensional (3D) T1-weighted images and an fMRI scan were taken from 18 patients with SCH and 18 matched control subjects. The Montreal Cognitive Assessment Chinese-revised (MoCA-CR) and the Stroop task were used to evaluate the cognitive and attention control of the participants. Compared to controls, the VBM results showed decreased gray matter volumes (GMVs) in bilateral prefrontal cortices (PFCs, including middle, medial, and inferior frontal gyri), cingulate gyrus, precuneus, left middle temporal gyrus, and insula in patients with SCH. The fMRI results showed a distributed network of brain regions in both groups, consisting of PFCs (including superior and middle and inferior frontal cortices), anterior cingulate cortex (ACC), posterior cingulate cortex, and precuneus, as well as the insula and caudate nucleus. Compared to controls, the SCH group had lower activation of the above brain areas, especially during the color-naming task. In addition, the normalized GMV (nGMV) was negatively correlated with thyroid-stimulating hormone (TSH) level ( = -0.722, < 0.001). Results indicate that patients with SCH exhibit reduced GMVs, altered BOLD signals, and activation in regions associated with attention control, which further suggest that patients with SCH may have attentional control deficiency, and the weakened PFC-ACC-precuneus brain network might be one of the neural mechanisms. Negative correlations between nGMV and TSH suggest that TSH elevation may induce abnormalities in the cortex.
本研究旨在使用基于体素的形态学测量（VBM）方法探索亚临床甲状腺功能减退症（SCH）患者的结构变化，并通过功能磁共振成像（fMRI）研究在执行改良汉字Stroop任务期间注意力控制网络的改变。对18例SCH患者和18名匹配的对照受试者进行了高分辨率三维（3D）T1加权成像和fMRI扫描。使用蒙特利尔认知评估中文版修订版（MoCA-CR）和Stroop任务来评估参与者的认知和注意力控制。与对照组相比，VBM结果显示SCH患者双侧前额叶皮质（PFC，包括额中回、额内侧回和额下回）、扣带回、楔前叶、左侧颞中回和脑岛的灰质体积（GMV）减少。fMRI结果显示两组均有一个分布式脑区网络，包括PFC（包括额上回、额中回和额下回）、前扣带回皮质（ACC）、后扣带回皮质和楔前叶，以及脑岛和尾状核。与对照组相比，SCH组上述脑区的激活较低，尤其是在颜色命名任务期间。此外，标准化GMV（nGMV）与促甲状腺激素（TSH）水平呈负相关（r = -0.722，P < 0.001）。结果表明，SCH患者表现出GMV减少、血氧水平依赖（BOLD）信号改变以及与注意力控制相关区域的激活，这进一步提示SCH患者可能存在注意力控制缺陷，而PFC-ACC-楔前叶脑网络减弱可能是神经机制之一。nGMV与TSH之间的负相关表明TSH升高可能诱发皮质异常。
