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Cognitive dysfunction associated with thyroid disorders

Minh-Ha Tran, Haik Mkhikian, Michael Sy, Ingrid Perez-Alvarez, Michael Demetriou
Hashimoto's encephalopathy (HE) is a presumed autoimmune disorder associated with anti-thyroid autoantibodies and signs and symptoms of encephalopathy. A sub-type of HE is associated with cerebellar dysfunction and ataxia. Immunosuppressive therapy, particularly corticosteroid treatment, is utilized in the majority of cases. Short-term apheresis has been reported with variable patient responses. Here we report the case of a 72 year-old female with an ∼15 year history of cerebellar type HE that had profound improvement in symptoms after long-term apheresis treatment over an ∼2 year period...
June 2018: Transfusion and Apheresis Science
R E Frye, R Wynne, S Rose, J Slattery, L Delhey, M Tippett, S G Kahler, S C Bennuri, S Melnyk, J M Sequeira, E V Quadros
Folate receptor α (FRα) autoantibodies (FRAAs) are prevalent in autism spectrum disorder (ASD). FRAAs disrupt folate transport across the blood-brain barrier by binding to the FRα. Thyroid dysfunction is frequently found in children with ASD. We measured blocking and binding FRAAs and thyroid-stimulating hormone (TSH), free thyroxine (T4) (FT4), total triiodothyronine (T3) (TT3), reverse T3 (rT3), thyroid-releasing hormone (TRH) and other metabolites in 87 children with ASD, 84 of whom also underwent behaviour and cognition testing and in 42 of whom FRAAs, TSH and FT4 were measured at two time points...
March 2017: Journal of Neuroendocrinology
Jennifer Lucarelli, Demetra Pappas, Leah Welchons, Marilyn Augustyn
Kendra is a 4-year-old girl with autism spectrum disorder (ASD) who presents for follow-up of feeding problems to her pediatric clinician. She is an only child in a family where both parents are scientists. Feeding concerns date to infancy, when she was diagnosed with Gastroesophageal Reflux Disease (GERD) associated with persistent bottle refusal and the acceptance of few pureed foods. At 13 months, milk and peanut allergies were diagnosed. Following a feeding clinic evaluation at 24 months, she was prescribed a soy milk supplement and an H2 blocker...
January 2017: Journal of Developmental and Behavioral Pediatrics: JDBP
Simon Stewart, Barbara Riegel, Cynthia Boyd, Yasmin Ahamed, David R Thompson, Louise M Burrell, Melinda J Carrington, Andrew Coats, Bradi B Granger, Julie Hides, William S Weintraub, Debra K Moser, Victoria Vaughan Dickson, Cressida J McDermott, Ashley K Keates, Michael W Rich
BACKGROUND: Multimorbidity in heart failure (HF), defined as HF of any aetiology and multiple concurrent conditions that require active management, represents an emerging problem within the ageing HF patient population worldwide. METHODS: To inform this position paper, we performed: 1) an initial review of the literature identifying the ten most common conditions, other than hypertension and ischaemic heart disease, complicating the management of HF (anaemia, arrhythmias, cognitive dysfunction, depression, diabetes, musculoskeletal disorders, renal dysfunction, respiratory disease, sleep disorders and thyroid disease) and then 2) a review of the published literature describing the association between HF with each of the ten conditions...
June 1, 2016: International Journal of Cardiology
Donna Dunn, Carla Turner
Hypothyroidism, a disease in which the thyroid gland does not make enough thyroid hormone, is the second most common endocrine disorder among women. Symptoms of hypothyroidism include fatigue, weight gain, alteration in cognition, infertility, and menstrual abnormalities. The most common cause of hypothyroidism in the United States is Hashimoto's thyroiditis. The American Thyroid Association recommends an initial screening for thyroid disease at age 35years and every 5years thereafter. Thyroid-stimulating hormone is highly sensitive to thyroid dysfunction and is used to evaluate thyroid disorders...
February 2016: Nursing for Women's Health
Zeeshan Javed, Thozhukat Sathyapalan
Subclinical hypothyroidism (SCH) is defined as elevated thyroid stimulating hormone (TSH) with normal levels of free triiodothyronine (FT3) and free thyroxine (FT4). SCH is further classified into a milder condition with TSH levels between 4.0 and 10.0 milli-international units (mIU)/l (mild-SCH) and a severe form with TSH >10.0 mIU/l (severe-SCH). SCH is a common problem (prevalence is greater in women than men), which increases further with increasing age and TSH levels. Even though the risk of progression to overt hypothyroidism is higher in patients with severe-SCH, the risk is also significant in patients having mild-SCH; it has been suggested that every twofold rise in serum TSH would increase the risk from 1 to 4%, which further increases to 38% if thyroid antibodies are positive...
February 2016: Therapeutic Advances in Endocrinology and Metabolism
Giacomo Montagna, Mauro Imperiali, Pamela Agazzi, Federica D'Aurizio, Renato Tozzoli, Ulla Feldt-Rasmussen, Luca Giovanella
Hashimoto's encephalopathy (HE) is a rare not well understood, progressive and relapsing multiform disease, characterized by seizures, movement disorders, subacute cognitive dysfunction, psychiatric symptoms and responsiveness to steroid therapy. The disorder is generally associated with thyroid diseases and the most common feature is the presence of anti-thyroperoxidase antibodies (TPOAb). Patients are usually euthyroid or mildly hypothyroid at presentation. All age groups can be affected. The pathophysiology is still unclear, especially the link between elevated serum TPOAb and the encephalopathy...
May 2016: Autoimmunity Reviews
Lili Yuan, Yanghua Tian, Fangfang Zhang, Huijuan Ma, Xingui Chen, Fang Dai, Kai Wang
INTRODUCTION: Cognitive and behavioral impairments are common in patients with abnormal thyroid function; these impairments cause a reduction in their quality of life. The current study investigates the decision making performance in patients with hyperthyroidism to explore the possible mechanism of their cognitive and behavioral impairments. METHODS: Thirty-eight patients with hyperthyroidism and forty healthy control subjects were recruited to perform the Iowa Gambling Task (IGT), which assessed decision making under ambiguous conditions...
2015: PloS One
Noriaki Manabe, Hideaki Tsutsui, Hiroaki Kusunoki, Jiro Hata, Ken Haruma
"Globus sensation" is often described as the sensation of a lump in the throat associated with dry swallowing or the need for dry swallowing, which disappears completely during eating or drinking and for which no organic cause can be established. Due to the uncertain etiology of "globus sensation", it remains difficult to establish standard treatment strategies for affected patients. Lately most attention has been focused on gastroesophageal reflux disease and several reports have indicated that there is a close relationship between esophageal acid reflux and globus sensation...
2014: Journal of Smooth Muscle Research
M A Angulo, M G Butler, M E Cataletto
INTRODUCTION: Prader-Willi syndrome (PWS) is a multisystemic complex genetic disorder caused by lack of expression of genes on the paternally inherited chromosome 15q11.2-q13 region. There are three main genetic subtypes in PWS: paternal 15q11-q13 deletion (65-75 % of cases), maternal uniparental disomy 15 (20-30 % of cases), and imprinting defect (1-3 %). DNA methylation analysis is the only technique that will diagnose PWS in all three molecular genetic classes and differentiate PWS from Angelman syndrome...
December 2015: Journal of Endocrinological Investigation
Amanda K Tilot, Thomas W Frazier, Charis Eng
Germline mutations in PTEN, which encodes a widely expressed phosphatase, was mapped to 10q23 and identified as the susceptibility gene for Cowden syndrome, characterized by macrocephaly and high risks of breast, thyroid, and other cancers. The phenotypic spectrum of PTEN mutations expanded to include autism with macrocephaly only 10 years ago. Neurological studies of patients with PTEN-associated autism spectrum disorder (ASD) show increases in cortical white matter and a distinctive cognitive profile, including delayed language development with poor working memory and processing speed...
July 2015: Neurotherapeutics: the Journal of the American Society for Experimental NeuroTherapeutics
Meg Ritchie, Bu B Yeap
The association of thyroid dysfunction with alterations in mood and cognition has been recognised since some of the earliest descriptions of thyroid disease. Over the years, researchers have aimed to further define these effects throughout the spectrum of thyroid disorders, to better understand the underlying condition and refine indications for treatment. More recently, attention has turned towards examining the impact of differences in thyroid hormones within the normal reference range, particularly in older adults, providing new insights into the association of thyroid hormone with cognitive decline...
June 2015: Maturitas
Debika Nandi-Munshi, Craig E Taplin
BACKGROUND: Thyroid hormones exert critical roles throughout the body and play an important and permissive role in neuroendocrine, neurological, and neuromuscular function. METHODS: We performed a PubMed search through June 2014 with search terms including "hypothyroidism," "hyperthyroidism," "neurological complications," "neuropathy," "myopathy," "congenital hypothyroidism," and "encephalopathy." Relevant publications reviewed included case series, individual case reports, systematic reviews, retrospective analyses, and randomized controlled trials...
April 2015: Pediatric Neurology
Adriana G Ioachimescu, Benjamin M Hampstead, Anna Moore, Elizabeth Burgess, Lawrence S Phillips
OBJECTIVE: Traumatic brain injury (TBI) has been recognized as a cause of growth hormone deficiency (GHD) in civilians. However, comparable data are sparse in veterans who incurred TBI during combat. Our objective was to determine the prevalence of GHD in veterans with a history of combat-related TBI, and its association with cognitive and psychosocial dysfunction. DESIGN: Single center prospective study. PATIENTS: Twenty male veterans with mild TBI incurred during combat 8-72 months prior to enrollment...
August 2015: Pituitary
Mary H Samuels
PURPOSE OF REVIEW: Overt hypothyroidism has major effects on neuropsychiatric function, but patients with mild hypothyroidism may attribute unrelated neuropsychiatric symptoms to their thyroid condition. This review will summarize data on neuropsychiatric effects of hypothyroidism, and provide guidelines regarding the relationship between hypothyroidism and neuropsychiatric issues, and treatment indications. RECENT FINDINGS: Clinical investigations and functional imaging studies confirm that overt hypothyroidism is associated with affective and cognitive decrements, largely reversible with treatment...
October 2014: Current Opinion in Endocrinology, Diabetes, and Obesity
Johannes M Hilberath, Heinrich Schmidt, Gerhard K Wolf
UNLABELLED: Steroid-responsive encephalopathy associated with autoimmune thyroiditis (SREAT), also termed Hashimoto's encephalopathy (HE), is a rare immune-mediated disorder and is also affecting children and adolescents. It is characterized by altered mental status, seizures, and cognitive dysfunction. Therapeutic options include steroid treatment and prognosis range from complete recovery, a relapsing course to long-term cognitive sequelae. We describe a previously healthy 13-year-old girl presenting to the emergency room with coma and refractory status epilepticus...
October 2014: European Journal of Pediatrics
Sara Tognini, Giuseppe Pasqualetti, Valeria Calsolaro, Antonio Polini, Fabio Monzani
Subclinical hypothyroidism (sHT) is very common in general population, especially in women and older people. sHT individuals may experience symptoms that resemble those observed in overt hypothyroidism, resulting in impaired quality of life (QOL). Asymptomatic patients may suffer a reduction in perceived health status due to the awareness of disease. Cognitive function represents one of the most important domains of the QOL questionnaires. Given the intrinsic relationship between cognitive status and QOL it is worth to address these topics together, in a systematic review of the literature...
2014: Recent Patents on Endocrine, Metabolic & Immune Drug Discovery
Akihiro Mouri, Yuta Hoshino, Shiho Narusawa, Keisuke Ikegami, Hiroyuki Mizoguchi, Yoshiharu Murata, Takashi Yoshimura, Toshitaka Nabeshima
Attention deficit/hyperactivity disorder (ADHD) has been reported in association with resistance to thyroid hormone, a disease caused by a mutation in the thyroid hormone receptor β (TRβ) gene. TRβ is a key protein mediating down-regulation of thyrotropin (TSH) expression by 3,3',5-tri-iodothyronine (T3), an active form of thyroid hormone. Dysregulation of TSH and its receptor (TSHR) is implicated in the pathophysiology of ADHD but the role of TSHR remains elusive. Here, we clarified a novel role for TSHR in emotional and cognitive functions related to monoaminergic nervous systems...
October 2014: Psychoneuroendocrinology
Mary H Samuels
Overt hypothyroidism and thyrotoxicosis are associated with significant decrements in mood and cognitive function, and therapy usually leads to improvement in these symptoms. In contrast, major affective or cognitive dysfunction is not typical of subclinical thyroid disease. Subtle deficits in specific cognitive domains (primarily working memory and executive function) likely exist in subclinical hypothyroidism and thyrotoxicosis, but these are unlikely to cause major problems in most patients. Patients with mild thyroid disease and significant distress related to mood or cognition most likely have independent diagnoses that should be evaluated and treated separately...
June 2014: Endocrinology and Metabolism Clinics of North America
Gustavo B Mendes, Rosangela S Kalil, Carolina Rosadas, Marcos R G de Freitas, Marzia Puccioni-Sohler
Human T-lymphotropic virus type 1 (HTLV-1)-associated myelopathy/tropical spastic paraparesis (HAM/TSP) is a chronic inflammatory disease of the spinal cord, characterized by spastic paraparesis, back pain, and sphincter disorders. Involvement of multiple organs and encephalopathy are uncommon in HAM/TSP. Nonspecific small white matter lesions of unknown etiology, mainly in the periventricular and subcortical regions, have been found on brain magnetic resonance imaging of HAM/TSP patients. Bitemporal lesions have rarely been described...
August 2014: International Journal of Infectious Diseases: IJID
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