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Structural Brain Changes in Graves’ Hyperthyroidism may be of Autoimmune Origin
authors: M. Holmberg, K. Tammelin , P.F. Berglund , L. Bunketorp-Ka¨ll , R. Heckemann, B. Johansson , N. Klasson, A. Lundgren, E. Olsson, S. Skau, H. Malmgren, H. Filipsson Nystromsummary/abstract:
In Graves’ disease (GD), brain-derived symptoms are prevalent. During the hyperthyroid state, the volumes of medial temporal lobe (MTL) structures, e.g. the hippocampi, are reduced. This has been attributed to the high thyroid hormone levels, but we hypothesize that the structural changes and mental symptoms may be due to autoimmunity per se.
Here, autoimmunity directly related to the thyroid as well as other autoimmunity may be important. The aim of the present paper was to determine the relations between non-thyroid autoimmunity and MTL volumes during hyperthyroidism in GD. The CogThy project is a longitudinal observational prospective casecontrol study where 65 premenopausal women were evaluated within 2 weeks after the diagnosis of GD with FT4 > 50 pmol/L (reference 12-22) and after 15 months of anti-thyroid treatment. Thyroidstimulating hormone receptor antibodies (TRAb), thyroid stimulating immunoglobulins (TSI), angiotensin II type 1- (anti-AT1), beta 1 adrenergic- (anti-B1) and M2 muscarinic- (anti-M2) receptor antibodies were measured in the hyperthyroid state. MTL structures were assessed with a 3-Tesla MR scanner to determine hippocampal and amygdala volumes using automatic segmentation with MAPER and normalisation to intracranial volume.organization: University of Gothenburg, Sweden; Karolinska University Hospital, Sweden; Sahlgrenska University Hospital, Senegal; Sahlgrenska University Hospital, Sweden; University of Gothenburg, Sweden
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