左旋甲状腺素对甲状腺功能减退症患者脑默认网络静息态功能连接的影响

The effect of levothyroxine treatment on resting-state brain functional connectivity of default network in patients with hypothyroidism

目的研究甲状腺功能减退症(简称甲减)患者在左旋甲状腺激素(L-T4)替代治疗前后,默认网络脑区静息态脑功能连接的改变。方法运用静息态功能磁共振(rsf MRI)技术检测14例初诊成人原发性甲减患者在左旋甲状腺素替代治疗前后及15例健康对照的静息态脑功能连接强度。结果利用基于种子的分析方法显示,健康对照组前后两次扫描双侧丘脑与后扣带回/楔前叶的功能连接强度差异无统计学意义;甲减组治疗后扫描时,双侧丘脑的丘脑枕区域与后扣带回/楔前叶之间的功能连接强度较治疗前出现显著性下降(左侧:P=0.007,右侧:P=0.001)。结论甲减患者双侧丘脑与后扣带回/楔前叶之间静息态脑功能连接强度在左旋甲状腺素替代治疗后较治疗前显著降低。

Objective To study the state of resting-state brain functional connectivity of default network in patients with hypothyroidism, and the value of levothyroxine replacement treatment. Method The strength of the restingstate brain functional connectivity of default network in 14 patients with newly diagnosed adult hypothyroidism and 15 healthy controls before and after the treatment of levothyroxine was detected using resting-state functional magnetic resonance（rsfMRI）. Results Using the method based on the seed analysis, there was no significant differences between the two scans in the normal control group, but there was a significant decrease of the strength of the brain functional connectivity of default network between the bilateral thalamic pulvinar region and the posterior cingulate / precuneus after the treatment of levothyroxine （ the left ： P = 0. 007, the right ： P = 0. 001 ）. Conclusion The resting-state functional connectivity strength between the bilateral thalamic and the posterior cingulate / precuneus are significantly lower after the treatment of the levothyroxine in patients with hypothyroidism.