Reduced posterior cingulate glutamate measured by magnetic resonance spectroscopy in hyperthyroidism.

OBJECTIVES: Patients with hyperthyroidism frequently have neuropsychiatric complaints such as lack of concentration, poor performance in memory, depression, anxiety and mania. These symptoms suggest the dysfunction of brain. However, the underlying process of this dysfunction is not well understood. At the same time, glutamatergic system has been considered important in neuropsychiatric process by recent studies. Thus, this study is to investigate the change of glutamate concentration in patients with hyperthyroidism using proton magnetic resonance spectroscopy.

METHODS: Fifteen untreated patients with hyperthyroidism and fifteen age- and gender- matched controls participated in the study. The region of the posterior cingulate cortex was examined by magnetic resonance spectroscopy with a technique referred as TE-averaged PRESS at 3T field strength. The concentrations of N-Acetylaspartate, creatine, choline and glutamate were assessed using jMRUI v4.0 software.

RESULTS: Hyperthyroid patients, compared with controls, showed a decrease of glutamate concentration (P<0.047) and glutamate/creatine ratios (P<0.009) in the posterior cingulate cortex. The decrease of choline concentration (P<0.004) and choline/creatine ratios (P<0.012) were also discovered. No significant difference was found in the concentrations of N-Acetylaspartate or creatine between patients and controls.

CONCLUSION: Concentration of glutamate decreased in the region of posterior cingulate cortex in patients with hyperthyroidism. This reduction indicated a possible involvement of glutamate in the brain dysfunction in hyperthyroidism.

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