Subclinical Hypothyroidism: A Review of Neuropsychiatric Aspects (original) (raw)
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Subclinical hypothyroidism: psychiatric disorders and symptoms
Revista Brasileira de …, 2007
In spite of the growing interest in the relation between thyroid dysfunction and neuropsychiatric alterations, no consensus has been reached. We investigated the prevalence of psychiatric disorders and the presence of subsyndromic symptoms of depression and anxiety in patients with SH.
Annals of Neurosciences, 2020
Background: There is a lack of clarity about the cognitive dysfunction in young patients with subclinical hypothyroidism (SCH). This study was done to explore the neuropsychological impairments in young patients with SCH and compare them with euthyroid controls. Methods: Patients between 18 and 45 years of age and diagnosed with SCH were recruited. Controls were euthyroid age, gender, and education matched. All the cases and controls underwent a detailed neuropsychological assessment with a battery of tests validated for use in the age groups of 18 to 65 years. Results: Thirty-nine patients with a mean age of 30.3 ± 7.7 years (female:male ratio 12:1) and 23 controls (female:male ratio 21:2) with a mean age of 33.4 ± 7.1 years ( P = .24) were included in the study. The mean TSH value was 6.36 ± 1.3 mIU/L and 2.49 ± 1.03 mIU/L in cases and controls, respectively ( P < .001). The visual memory delayed recall was impaired, in 48.71% ( n = 19) and 21.7% ( n = 5) cases and controls, re...
Cognitive functions in subclinical hypothyroidism – a systematic review and meta-analysis
Abstract Background: Subclinical hypothyroidism is a highly prevalent condition and there exists no consensus regarding the impairments in the cognitive functions of individuals with subclinical hypothyroidism. In this systematic review and meta-analysis we assessed the pattern and magnitude of the cognitive deficits in subclinical hypothyroidism compared with that of euthyroid individuals. Methods: The review was conducted and reported according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines for systematic reviews and meta-analyses. Studies were identified via PubMed, EMBASE and PsycINFO search for research articles published up to and including December 2013. Search terms included subclinical hypothyroidism, cognitive functions, attention, executive functions and memory. Only the studies which compared cognitive functions of subjects having subclinical hypothyroidism with that of euthyroid individuals were included. Results: Response inhibition and verbal memory could be studied in the meta-analysis. Other cognitive domains including attention, set shifting, decision making, verbal fluency and visual memory were explored but there were insufficient studies to perform the meta-analysis. The individuals with subclinical hypothyroidism did not show significant difference in the performance on tests of response inhibition or verbal memory compared to that of euthyroid individuals. Conclusion: This systematic review and meta-analysis highlights the need for further exploration of the cognitive functions in larger sample prospective cohorts of subclinical hypothyroidism using well validated neuropsychological tasks
Are neuropsychological changes relevant in subclinical hypothyroidism
Arquivos Brasileiros De Endocrinologia E Metabologia, 2007
Introduction: Neuropsychological changes are still controversial in patients with subclinical hypothyroidism (SH). The objective of this study is to assess these changes. Method: Cross-sectional study comparing the results of the neurocognitive evaluation of 65 SH patients and 31 individuals without thyroid disease. Subclinical hypothyroidism was defined as at least two elevated serum TSH levels (> 4 µUI/ml) with normal serum free T 4 levels (0.9-1.8 ng/dl). The participants underwent the following neuropsychological assessment: Buschke's Selective Reminding Procedure, Rey-Osterrieth Complex , Warrington's Recognition Memory Test for Words and Faces, and the Vocabulary subtest of the WAIS-R. Results: The groups were similar in regard to mean age, sex and educational level. No neuropsychological change was found in patients with SH when compared with euthyroid individuals. Conclusion: No difference was observed in the performance of the neuropsychological tests between both groups in regard to the functions studied. (Arq Bras Endocrinol Metab 2007;51/4:606-611) RESUMO Alterações Neuropsicológicas são Relevantes no Hipotireoidismo Subclínico? Introdução: Até o presente momento, não se tem confirmação da presença de alterações neuropsicológicas em pacientes com hipotireoidismo subclínico (HS). O objetivo desta pesquisa foi avaliar essas alterações. Método: Estudo seccional comparando os achados neuropsicológicos de 65 pacientes com HS e 31 indivíduos eutireoidianos. HS foi confirmado por duas dosagens plasmáticas elevadas de TSH (> 4 µUI/ml) associadas com dosagem sérica de T 4 L na faixa da normalidade (0,9-1,8 ng/dl). Para avaliação neuropsicológica, foram utilizados o procedimento de Buschke, a figura de Rey-Osterrieth, o reconhecimento de palavras e faces de Warrington e o subteste Vocabulário do WAIS-R. Resultados: Os grupos foram similares quanto a idade, sexo e nível de escolaridade. Não encontramos alterações neuropsicológicas nos pacientes com HS em comparação ao grupo eutireoidiano. Conclusão: Não foi encontrada nenhuma diferença nos resultados dos testes neuropsicológicos entre os dois grupos em relação às funções estudadas. (Arq Bras Endocrinol Metab 2007;51/4:606-611) Descritores: Hipotireoidismo; Neuropsicologia
Subclinical Hypothyroidism: behavioral and psychophysiological characteristics.A pilot study
Background: Clinical hypothyroidism affects various aspects of cognitive and affective brain function. The most severe hypothyroidism may also mimic a picture of melancholic depression and dementia. Subclinical hypothyroidism (SHT) is characterized by elevated TSH levels despite normal thyroid hormone concentrations. The aim of this research is to verify the presence of a typical psychophysiological pattern in SHT patients. Methods: Since 1998 fifty patients who underwent surgeries at the Department of Endocrinology, University of Pisa, diagnosed with SHT, were subsequently recruited. Subjects underwent an inspection of the reported symptoms using the Crown & Crisp Experiential Index, and a psychophysiological assessment with a simultaneous recording of the parameters Skin Conductance Level/ Response (SCL/SCR), Surface Frontal Electromyogram (EMG), Peripheral Temperature (PT), Heart Rate (HR). As a control group, fifty subjects without endocrine disorders were subsequently recruited. Results: Data shows little difference in levels in hormonal assays except for TSH. There is also a significant elevation of some of the CCEI subscales: Anxiety, Depression, and Somatic Complaints. At the autonomic level, there is a general pattern of excessive arousal with significant differences in SCL/SCR, HR, and PT. Conclusions: A first data interpretation is that in sub-clinical hypothyroidism, the body tries to support and integrate the general lack of energy with an acceleration of the autonomic activity. This condition of initial arousal could be a useful indicator in order to monitor the treatment course and its effectiveness on the pathological evolution.
Cognitive function in subclinical hypothyroidism in elderly
Indian Journal of Endocrinology and Metabolism, 2014
To study the association of cognitive function with subclinical hypothyroidism in elderly. Materials and Methods: It's a cross-sectional, case-control study of 103 patients (≥65 years) who met the criteria for subclinical hypothyroidism. Similarly 103 age, sex and education-matched healthy controls were taken. Serum TSH, free T3 and free T4 were measured. Cognitive functions were assessed by using Folstein Mini Mental Examination (MMSE) and clock drawing test. Results: Out of the 103 diagnosed subclinical hypothyroidism cases, cognitive impairment (by MMSE) was found in 33 (30.9%) while it was present in only 15 (14.54%) out of 103 controls (P = 0.003), cognitive impairment (by CDT) was present in 32 patients (31.06%) out of 103 cases while it was present in 26 patients (25.24%) out of 103 controls (P > 0.05, insignificant). Mean TSH of subclinical hypothyroidism with cognitive impairment was 7.67 ± 1.22 mIU/liter and without cognitive impairment was 6.47 ± 0.98 mIU/liter (P value = 0.0001, significant) Conclusions: Prevalence of cognitive impairment was significantly higher in subclinical hypothyroidism as compared to controls. Presence of cognitive impairment correlated with the level of TSH; as TSH increased cognitive function declined.
Prevalence of depression in patients affected by subclinical hypothyroidism
Panminerva medica, 2010
AIM The aim of this study was to estimate the prevalence of depressive symptoms in patients affected by subclinical hypothyroidism by means of Hamilton Rating Scale for Depression (HAM-D) and Montgomery-Asberg Depression Rating Scale (MADRS); to assess which depressive symptoms are prevalent in our population, with references to the factorialization of HAM-D by Cleary and Guy (1977); to verify whether levothyroxine replacement therapy alone can induce total remission of depressive symptoms. METHODS The study enrolled 63 patients affected by subclinical hypothyroidism undergoing follow-up at the endocrinology service of San Paolo Hospital in Milan. All patients underwent an evaluation by means of HAM-D and MADRS scales and serum TSH, free T4, free T3, TPO-Ab and Tg-Ab levels were measured. RESULTS We estimated a prevalence of depressive symptoms in our population of 63.5%. Concerning the qualitative assessment of psychiatric disturbances in the population we considered, our results s...