An observational study on the association of anti-thyroid autoantibodies with clinical, EEG, MRI, FDG-PET, cerebrospinal fluid and anti-neuronal antibody findings in 530 patients with schizophreniform and affective disorders
| Autor: | Benjamin Pankratz, Dominik Denzel, Kathrin Nickel, Dominique Endres, Ludger Tebartz van Elst, Bernd Feige, Harald Prüss, Simon Maier, Maike Michel, Miriam A. Schiele, Nils Venhoff, Kimon Runge, Katharina Domschke, Sophie Meixensberger |
|---|---|
| Rok vydání: | 2021 |
| Předmět: |
Endocrinology
Diabetes and Metabolism medicine.medical_treatment immunology [Mood Disorders] Gastroenterology metabolism [Cerebrospinal Fluid] 0302 clinical medicine Endocrinology Cerebrospinal fluid Autoantibody immunology [Psychotic Disorders] Cerebrospinal Fluid Thyroid Neurons biology Electroencephalography Magnetic Resonance Imaging Anti-thyroid autoantibodies Hashimoto's encephalopathy Psychiatry and Mental health medicine.anatomical_structure metabolism [Autoantibodies] Antibody endocrine system medicine.medical_specialty Antibodies Autoimmune thyroiditis 03 medical and health sciences Thyroid peroxidase Fluorodeoxyglucose F18 Internal medicine White blood cell medicine Humans ddc:610 Biological Psychiatry Autoantibodies Endocrine and Autonomic Systems business.industry Mood Disorders medicine.disease Autoimmune psychosis 030227 psychiatry metabolism [Mood Disorders] Psychotic Disorders Positron-Emission Tomography biology.protein Thyroglobulin metabolism [Psychotic Disorders] business immunology [Neurons] 030217 neurology & neurosurgery |
| Zdroj: | Psychoneuroendocrinology 131, 105320-(2021). doi:10.1016/j.psyneuen.2021.105320 |
| ISSN: | 1873-3360 |
| Popis: | Introduction Although the link between autoimmune thyroiditis and mental illnesses is well established, the precise underlying pathophysiology and the influence of anti-thyroid antibodies on diagnostic findings require further research. Patients and Methods A total of 530 patients with schizophreniform and affective syndromes were screened for anti-thyroid antibodies against thyroid peroxidase (TPO), thyroglobulin (TG), and thyroid-stimulating hormone receptor (TSH-R). The patient group analyzed here is a patient subgroup of a previously published cohort (Endres et al., 2020, Translational Psychiatry). The anti-thyroid antibody positive (N = 91) and negative (N = 439) patients were compared in terms of various clinical parameters, routine cerebrospinal fluid (CSF) findings, and the number of positive anti-neuronal antibodies in serum and/or CSF, as well as electroencephalography (EEG), magnetic resonance imaging (MRI), and [18 F]fluorodeoxyglucose positron emission tomography (FDG-PET) findings. Results Anti-TPO antibodies were increased in 17%, anti-TG antibodies in 15%, and anti-TSH-R antibodies in 2% of all patients. In CSF, higher protein concentrations (p = 0.018) and albumin quotients (p = 0.008) were found in the anti-thyroid antibody positive patient group. Also, there were more patients with elevated age-corrected albumin quotients in this group (p = 0.031). FDG-PET hypometabolism was significantly more frequent and the number of positive anti-neuronal intracellular antibodies was significantly higher in patients with anti-thyroid antibodies (p = 0.048, N = 29 and p = 0.032, N = 497 respectively). In addition, there was a trend for higher white blood cell (WBC) counts in all patients with anti-thyroid antibodies (p = 0.090). In the patient subgroup with anti-TPO antibodies this difference was statistically significant (p = 0.027). No relevant differences were found in the other CSF routine parameters, the number of anti-neuronal antibodies against cell surface antigens in serum and/or CSF, EEG and MRI findings. Discussion The present study provides evidence of impaired blood CSF barrier (BCSFB) function in patients with anti-TPO and anti-TG antibodies. An influence of anti-TG antibodies on BCSFB structures has been shown in previous laboratory studies, which reported that the antibodies bind to vascular smooth muscle cells. Due to BCSFB breakdown anti-thyroid antibodies might lead to increased autoimmune susceptibility. The alterations in the FDG-PET, WBC count, and anti-neuronal antibody findings against intracellular structures indicate that it could be useful to extend diagnostic investigations in patients with anti-thyroid antibodies. Further studies should investigate whether anti-thyroid antibodies can also act as “drivers of disease”. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|
Full Text from ScienceDirect