Functional correlates of TSH, fT3 and fT4 in Alzheimer disease: a F-18 FDG PET/CT study

Abstract

The present study was aimed to investigate the relationships between thyroid stimulating hormone (TSH), freeT3 (fT3) and freeT4 (fT4) and brain glucose consumption as detectable by means of 2-deoxy-2-(F-18) fluoro-D-glucose (F-18 FDG) Positron Emission Tomography/Computed Tomography (PET/CT) in a selected population with Alzheimer disease (AD). We evaluated 87 subjects (37 males and 50 females, mean age 70 (±6) years old) with AD. All of them were subjected to TSH, fT3 and fT4 assay and to cerebrospinal fluid amyloid (Aβ1-42) and tau [phosphorylated-tau (p-tau) and total-tau (t-tau)] assay prior PET/CT examination. Values for TSH, fT3 and fT4 were in the normal range. The relationships were evaluated by means of statistical parametric mapping (SPM8) using age, sex, MMSE, scholarship and CSF values of amyloid and tau as covariates. We found a significant positive correlation between TSH values and cortical glucose consumption in a wide portion of the anterior cingulate cortex bilaterally (BA32) and left frontal lobe (BA25) (p FWE-corr <0.001; p FDRcorr <0.000; cluster extent 66950). No significant relationships were found between cortical F-18 FDG uptake and T3 and T4 serum levels. The results of our study suggest that a cortical dysfunction in anterior cingulate and frontal lobes may affect serum values of TSH in AD patients.

Figure 1

3D rendering of data presented in Table 3 in (a) showing the positive correlation between TSH and brain glucose consumption in left anterior cingulate cortex (<) and medial frontal gyrus (*) and in the right anterior cingulate cortex (b, >). Threshold P < 0.01 corrected for multiple comparisons with false discovery rate at the voxel level. Coordinate and other regional details are presented in Table 3.

Figure 2

T1 magnetic resonance imaging superimposition showing the significant (positive) relationship between cortical activity in BA25 and that of the region corresponding to the hypothalamus. Since cluster was large as compared to the anatomical region here represented, for illustrative purposes a mask with WFU pickatlas was generated. Coordinates are shown in Table 4.