Table 3 shows a comparison between the studied groups as regards HTN. None of the control subjects was hypertensive, while According to HPT, there was a significant difference between patients and controls, and P is 0.
Table 4 shows that serum TSH was significantly high in patients than in the control group. Serum FT3 was significantly low in patients in comparison to the control. There was no statistically significant difference regarding FT4 between patients and the control group. Table 5 shows a comparison between thyroid dysfunction in the studied groups.
Table 7 compares the degree of dementia according to the history of DM. In patients with MCI, There was a statistically significant difference between the degree of dementia and DM, when comparing between MCI and mild dementia, MCI, and moderate dementia.
Table 8 compares the degree of dementia according to the history of HTN. Table 9 shows the relation between thyroid dysfunction and degree of dementia. There was a statistically significant difference in thyroid dysfunction with the degree of dementia especially when comparing subclinical hypothyroidism with MCI and mild dementia, MCI, and moderate dementia.
Table 10 compares the degree of dementia according to sex. There was a statistically significant difference when comparing the degree of dementia with sex. P is less than 0. Figure 2 compares the MMSE score according to age there is a highly significant correlation. In our study, we investigate the relationship between thyroid status, cognitive status, and severity of dementia. Besides, it imposes a major burden on the health care system.
Therefore, it would be of great advantage if modifiable risk factors for dementia could be identified [ 2 ]. Thyroid hormones have been demonstrated to play central roles in the development of the central neural system. Both subclinical hyper- and hypothyroidism have been established as risk factors for cognitive impairment [ 2 ]. Both clinical and subclinical hypothyroidism have been shown by several although not all studies to affect cardiovascular risk.
Hyperthyroidism is associated with an increase in vascular basement membrane thickness and capillary destruction. In parallel, vascular risk factors have been correlated with an increase in the risk for AD. Thus, through an increase in vascular risk factors, thyroid function may indirectly affect AD risk Tan et al.
In our study, we found that there is a strong link between high thyroid dysfunction and risk Tables 5 and 6 and the degree of dementia Table 9. One of the biological mechanisms underlying the relationship between thyroid dysfunction and dementia is suggested to be associated with cardiac vascular disease, which can contribute to cognitive impairment in later life. Our results were in agreement with Davis et al.
Subclinical hypothyroidism with T4 and elevated TSH has been identified as a common predisposing factor of depression, cognitive impairment, and dementia [ 4 ]. Also, this was concordant with Carole Rieben et al. Also, this was concordant with Scherr et al. Also, this was in agreement with Shindo et al. It is likely that T3 deficiency may lead to the onset of mitochondrial dysfunctions, thus affecting brain metabolic activity and intracellular signal transduction and contributing to the cerebral ischemia [ 8 ].
Also, this was concordant with Chen et al. This was in agreement with Hogervorst et al. Also, this was not concordant with Hofman and his colleagues who, in the Rotterdam Study , after adjustment for variables including age, sex, and cardiovascular disease risk factors, showed that those with higher thyroid-stimulating hormone TSH levels—typically a sign of an underactive thyroid—had a lower risk of dementia [ 12 ]. This was not concordant with Jorde et al.
This was not concordant with Roberts et al. This was concordant with Zongsheng Chen who found that a close correlation between thyroid status and cognitive dysfunction in SIVD was observed. Also, thyroid function and thyroid hormone level could be a risk factor in the development of SIVD. Also, this was concordant with Johe who found a linear relationship between thyroid hormone and MMSE scores was conducted.
A central role of T3 in neuronal differentiation has been uncovered, which directed stem cells to generate clones of neuro-oligodendrocytes from the central nervous system [ 16 ].
Also, this was concordant with [ 17 ]. The cognitive performance of VD patients was significantly declined, as indicated by the significantly altered scores of several neuropsychological tests, for example MMSE as measurements of global cognitive function. Also, this was in agreement with Roman et al. But this was not concordant with Jorde et al. In our study, we found that dementia increases in the presence of DM Table 2. There was a relationship between impaired glucose tolerance and stroke-related dementia as DM is one of many other risk factors of vascular disease.
During follow-up mean 8. This was not concordant with J. Curb et al. In our study, we found that dementia increases in the presence of hypertension which is one of the many risk factors of vascular disease. This was in agreement with Nelson et al. To what extent the decline in blood pressure before dementia onset is a consequence or a cause of the brain disease remains to be elucidated [ 21 ]. This was not concordant with Luchsinger et al.
A history of hypertension may be an antecedent to VD, particularly in the presence of heart disease or diabetes [ 22 ]. In our study, we found that the degree of dementia increases with FT3 decrease and TSH increase hypothyroidism but with no relation with the FT4 level. This was concordant with Francesco et al.
But this was not in agreement with Hogervorst et al. It is unclear why high normal FT4 levels were independently associated with accelerated cognitive decline in those without overt thyroid disease [ 11 ]. In our study, we found an increase severity of dementia with age. Patients with mild dementia and those with moderate dementia are older than those with MCI.
People are living longer, and dementia is becoming more common in the population as a whole. This was in agreement with Constantine et al. Also, this was in agreement with [ 25 ] who found the same results. This was not in agreement with Holland et al. In our study, we found that the dementia degree increases more in females. The relationship between sex and AD has been inconsistent across studies although in many studies women are reported to have higher rates of AD than men even after adjusting for differential survival.
Associations between rCBFs and thyroid hormones in the Normal group. Table 4. Table 5. Discussion The present study investigated the effects of fluctuations in thyroid hormone levels within the normal range on cerebral blood flow in MCI and AD patients. Supporting information. S1 Table. Patient characteristics and all their relevant data.
Acknowledgments The authors would like to thank the participants in this study and all of the staff in the Division of Neurology, Department of Medicine, Showa University School of Medicine for their cooperation during the study. References 1. Clinical review: The thyroid in mind: cognitive function and low thyrotropin in older people. J Clin Endocrinol Metab. Low thyroid-stimulating hormone as an independent risk factor for Alzheimer disease. Acta Neurol Scand. Relationship between thyroid hormone levels and regional cerebral blood flow in Alzheimer disease.
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Neurol Med Chir Tokyo. Friston KJ. Spatial registration and normalization of images. Human Brain Mapping. View Article Google Scholar Takeuchi R. Nihon Hoshasen Gijutsu Gakkai Zasshi. J Neurol Sci. Jack CR Jr. Hypothetical model of dynamic biomarkers of the Alzheimer's pathological cascade. Lancet Neurol. Thyrotropin releasing hormone TRH in the hippocampus of Alzheimer patients. Thyroid hormone levels in the prefrontal cortex of post-mortem brains of Alzheimer's disease patients.
Curr Aging Sci. Serum thyroid-stimulating hormone and cognition in older people. Humans have two hippocampi, one in each side of the brain. MRI Magnetic Resonance Imaging : a medical imaging technique used to investigate the anatomy and function of the. MRI scanners use strong magnetic fields and radiowaves to form images of the body. The technique is widely used in hospitals for medical diagnosis, staging of disease and for follow-up without exposure to ionizing radiation.
TSH: thyroid stimulating hormone — produced by the pituitary gland that regulates thyroid function; also the best screening test to determine if the thyroid is functioning normally. Thyroxine T 4 : the major hormone produced by the thyroid gland. T 4 gets converted to the active hormone T 3 in various tissues in the body.
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