Spontaneous Brain Activities in Hyperthyroidism Patients Assessed Using Fractional Amplitude of Low-frequency Fluctuation

doi:10.12114/j.issn.1007-9572.2022.0498

Chinese General Practice ›› 2022, Vol. 25 ›› Issue (33): 4173-4178.DOI: 10.12114/j.issn.1007-9572.2022.0498

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Spontaneous Brain Activities in Hyperthyroidism Patients Assessed Using Fractional Amplitude of Low-frequency Fluctuation

1.Department of Radiology, the Second Affiliated Hospital of Xinxiang Medical University/Xinxiang Key Laboratory of Multimodal Brain Imaging/Xinxiang Psychiatric Imaging Engineering Technology Research Center, Xinxiang 453002, China
2.School of Psychology, Xinxiang Medical University, Xinxiang 453003, China

Received:2022-07-03 Revised:2022-08-15 Published:2022-11-20 Online:2022-08-29
Contact: ZHANG Haisan
About author:
WU X R, WANG X Y, GENG Y B, et al. Spontaneous brain activities in hyperthyroidism patients assessed using fractional amplitude of low-frequency fluctuation[J]. Chinese General Practice, 2022, 25 (33) : 4173-4178.

基于比率低频振幅的甲状腺功能亢进症患者脑功能研究

1.453002　河南省新乡市，新乡医学院第二附属医院影像科　新乡市多模态脑影像重点实验室　新乡市精神影像工程技术研究中心
2.453003　河南省新乡市，新乡医学院心理学院

通讯作者: 张海三
作者简介:
武肖然，王晓岳，耿艺博，等.基于比率低频振幅的甲状腺功能亢进症患者脑功能研究[J].中国全科医学，2022，25（33）：4173-4178. [www.chinagp.net] 作者贡献：武肖然负责研究实施、数据统计分析、结果分析与解释、论文撰写及修订；王晓岳、耿艺博负责数据收集、整理及预处理；张红星负责实验设计、研究指导、研究的实施与可行性分析；张海三负责论文修订、质量控制及审校，对文章整体负责、监督管理。
基金资助:
河南省高校科技创新团队(18IRTSTHN025)

Abstract

Abstract:

Background

Hyperthyroidism is a common endocrine psychosomatic disease, which is often accompanied by negative emotions, seriously affecting the prognosis of patients. Moreover, it is associated with more than 5 times more higher risk of committing suicide. Therefore, it has certain clinical and social significance to explore the neuroimaging characteristics of brain damage in patients with hyperthyroidism.

Objective

To analyze the abnormal patterns of spontaneous brain activity measured by resting-state functional magnetic resonance imaging (rs-fMRI) , and the neuroimaging characteristics of brain damage in patients with hyperthyroidism.

Methods

Participants were recruited from December 2014 to June 2016, including 25 hyperthyroidism outpatients with ¹³¹I therapy from Xinxiang Central Hospital, and 28 sex-, age-, and education level-matched healthy volunteers from the same hospital and the community near the hospital. Symptom Checklist-90 (SCL-90) was used to assess the mental health. rs-fMRI was performed to measure the fractional fractional amplitude of low-frequency fluctuation (fALFF) to reflect local spontaneous brain activity. Correlations of the mean fALFF (mfALFF) and with clinical variables and psychological symptoms were analyzed.

Results

Hyperthyroidism patients had higher mean scores of anxiety and anger-hostility than controls (P<0.05) . Hyperthyroidism patients had higher mean mfALFF values in the right cerebellar vermis region 7 (MNI: 3, -75, -27; t=4.381) , left thalamus (MNI: -6, -6, 0; t=3.545) , and right thalamus (MNI: 6, -3, 3; t=4.356) , and lower mean mfALFF values in the left posterior cerebellar lobe (MNI: -39, -81, -27; t=-3.402) , left orbital middle frontal gyrus (MNI: -9, 57, 0; t=-5.253) and left inferior frontal gyrus (MNI: -51, 15, 18; t=-3.747) . Correlation analysis showed that the mfALFF value of right cerebellar vermis region 7 was negatively correlated with the score of anxiety (r=-0.419, P=0.037) or anger-hostility (r=-0.402, P=0.046) .

Conclusion

The abnormal spontaneous activity in the right cerebellar vermis may be an important imaging marker of brain damage in hyperthyroidism, and may be imaging evidence for the studying of neuropathological mechanism of negative emotion in hyperthyroidism.

Key words: Hyperthyroidism, Brain injuries, Magnetic resonance imaging, Fractional amplitude of low-frequency, Mental health status, Symptom Checklist 90

摘要：

背景

甲状腺功能亢进症（以下简称甲亢）是临床常见的内分泌心身疾病，常伴发负性情绪，严重影响患者预后，且甲亢患者自杀可能性为未患病者的5倍多。因此探讨甲亢患者脑损害的神经影像学特征有一定的临床价值和社会意义。

目的

通过静息态功能磁共振成像（rs-fMRI）分析甲亢患者脑自发活动异常模式，并探讨甲亢患者脑损害的神经影像学特征。

方法

选取2014年12月至2016年6月在新乡市中心医院门诊拟行¹³¹I治疗的甲亢患者25例纳入甲亢组，同时选取医院和临近社区招募的性别、年龄、受教育程度与甲亢组无显著差异的健康志愿者28例作为对照组。使用症状自评量表（SCL-90）评估研究对象的心理健康状况。研究对象均接受rs-fMRI检查，通过测量全脑比率低频振幅（fALFF）反映局部脑自发活动。应用Pearson相关分析探讨平均比率低频振幅（mfALFF）值与临床变量及心理健康状况之间的关系。

结果

甲亢组SCL-90焦虑、敌对评分高于对照组（P<0.05）。与对照组相比，甲亢组右侧小脑蚓部7区〔蒙特利尔神经研究所（MNI）坐标：3、-75、-27，t=4.381〕、左侧丘脑（MNI坐标：-6、-6、0，t=3.545）、右侧丘脑（MNI坐标：6、-3、3，t=4.356）的mfALFF值升高，左侧小脑后叶（MNI坐标：-39、-81、-27，t=-3.402）、左侧眶部额中回（MNI坐标：-9、57、0，t=-5.253）、左侧额下回（MNI坐标：-42、33、18，t=-3.747）的mfALFF值降低。相关性分析结果显示，右侧小脑蚓部7区的mfALFF值与SCL-90焦虑（r=-0.419，P=0.037）、敌对（r=-0.402，P=0.046）评分呈负相关。

结论

右侧小脑蚓部脑自发活动异常可能是甲亢患者脑损害的重要影像学标志，可为甲亢患者负性情绪产生的神经病理机制提供影像学参考依据。

关键词: 甲状腺功能亢进症, 脑损伤, 磁共振成像, 比率低频振幅, 心理健康状况, 症状自评量表

WU Xiaoran,WANG Xiaoyue,GENG Yibo, et al. Spontaneous Brain Activities in Hyperthyroidism Patients Assessed Using Fractional Amplitude of Low-frequency Fluctuation[J]. Chinese General Practice, 2022, 25(33): 4173-4178. DOI: 10.12114/j.issn.1007-9572.2022.0498.
武肖然,王晓岳,耿艺博等. 基于比率低频振幅的甲状腺功能亢进症患者脑功能研究[J]. 中国全科医学, 2022, 25(33): 4173-4178. DOI: 10.12114/j.issn.1007-9572.2022.0498.

Figures/Tables 6

References 33

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组别	例数	年龄（±s，岁）	性别（男/女）	受教育程度（初中及以下/高中及以上）	FT₃ （±s，pmol/L）	FT₄ （±s，pmol/L）	TSH （±s，μU/ml）
对照组	28	29.6±10.1	11/17	11/17	5.01±0.92	14.92±2.94	3.45±1.00
甲亢组	25	31.7±7.7	7/18	14/11	36.07±15.73	65.95±21.63	0.01±0.004
t（χ²）值		0.854	0.750^a	1.481^a	10.438	12.371	-17.139
P值		0.402	0.386	0.224	<0.001	<0.001	<0.001

组别	例数	年龄（±s，岁）	性别（男/女）	受教育程度（初中及以下/高中及以上）	FT₃ （±s，pmol/L）	FT₄ （±s，pmol/L）	TSH （±s，μU/ml）
对照组	28	29.6±10.1	11/17	11/17	5.01±0.92	14.92±2.94	3.45±1.00
甲亢组	25	31.7±7.7	7/18	14/11	36.07±15.73	65.95±21.63	0.01±0.004
t（χ²）值		0.854	0.750^a	1.481^a	10.438	12.371	-17.139
P值		0.402	0.386	0.224	<0.001	<0.001	<0.001

组别	例数	躯体化	强迫症状	人际关系敏感	抑郁	焦虑
对照组	28	1.40（1.20，1.60）	1.16（1.00，1.50）	1.16（1.11，1.44）	1.19（1.07，1.44）	1.33（1.04，1.50）
甲亢组	25	1.70（1.20，2.10）	1.16（1.00，1.75）	1.22（1.11，2.00）	1.30（1.11，1.92）	1.50（1.16，2.08）
Z值		-1.754	-0.831	-0.896	-1.221	-3.011
P值		0.079	0.406	0.370	0.222	0.003
组别	敌对	恐怖	偏执	精神病性	总分
对照组	1.33（1.04，1.50）	1.14（1.00，1.28）	1.16（1.00，1.50）	1.10（1.00，1.30）	1.33（1.15，1.82）
甲亢组	1.50（1.16，2.08）	1.14（1.00，1.28）	1.16（1.00，1.75）	1.20（1.05，1.40）	1.20（1.12，1.40）
Z值	-2.023	-1.279	-0.831	-1.339	-0.825
P值	0.043	0.201	0.406	0.181	0.307

组别	例数	躯体化	强迫症状	人际关系敏感	抑郁	焦虑
对照组	28	1.40（1.20，1.60）	1.16（1.00，1.50）	1.16（1.11，1.44）	1.19（1.07，1.44）	1.33（1.04，1.50）
甲亢组	25	1.70（1.20，2.10）	1.16（1.00，1.75）	1.22（1.11，2.00）	1.30（1.11，1.92）	1.50（1.16，2.08）
Z值		-1.754	-0.831	-0.896	-1.221	-3.011
P值		0.079	0.406	0.370	0.222	0.003
组别	敌对	恐怖	偏执	精神病性	总分
对照组	1.33（1.04，1.50）	1.14（1.00，1.28）	1.16（1.00，1.50）	1.10（1.00，1.30）	1.33（1.15，1.82）
甲亢组	1.50（1.16，2.08）	1.14（1.00，1.28）	1.16（1.00，1.75）	1.20（1.05，1.40）	1.20（1.12，1.40）
Z值	-2.023	-1.279	-0.831	-1.339	-0.825
P值	0.043	0.201	0.406	0.181	0.307

Spontaneous Brain Activities in Hyperthyroidism Patients Assessed Using Fractional Amplitude of Low-frequency Fluctuation

基于比率低频振幅的甲状腺功能亢进症患者脑功能研究

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差异脑区	体素数量	MNI坐标			t值
差异脑区	体素数量	X	Y	Z	t值
右侧小脑蚓部7区	42	3	-75	-27	4.381
左侧丘脑	27	-6	-6	0	3.545
右侧丘脑	20	6	-3	3	4.356
左侧小脑Crus1区	20	-39	-81	-27	-3.402
左侧眶部额中回	72	-9	57	0	-5.253
左侧额下回	21	-42	33	18	-3.747

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