A study of cognitive dysfunctions in patients with thyroid disorders
Abstract
Background: Many primary endocrine disorders have notable effects on cognition. Patients with a wide range of thyroid gland abnormalities often present with combined emotional and cognitive symptoms.
Aims and Objectives: To evaluate the cognitive dysfunctions in patients suffering with thyroid disorders. To compare the cognitive dysfunctions in patients with thyroid disorders such as hypothyroidism, hyperthyroidism and subclinical thyroid states.
Materials and Methods: A Purposive sampling was undertaken from the outpatient department of Endocrinology, Narayana Medical College & Hospital, Nellore, Andhra Pradesh. The study included the patients with thyroid disorders and Normal healthy controls. The sample of the study comprised of 60 participants. Out of this 60 participants 30 were diagnosed with thyroid disorders and 30 volunteers who accompanied with patients without evidence of any thyroid disorders who were willing to participate in the study were selected as controls.
Results: The mean SMMSE scores among the cases was 19.4 (± 4.65) and among the controls was 28.1 (± 1.67). The DSST scoring of the cases and controls had shown that the mean 68.1 (± 19.4) and controls was 95.3 (± 3.94). The mean (± SD) TMT - A scores of the cases was 25.8 (± 6.23) and controls was 20.5 (± 2.58). The mean TMT – B scores of the cases was 114.8 (± 51.03) and controls was 68.9 (± 19.2). Summary &
Conclusions: The means of SMMSE, DSST, TMT – A, TMT – B scores have shown statistically significant difference between the patients with thyroid disorders and normal healthy controls.
Downloads
References
Unnikrishnan AG, Menon UV. Thyroid disorders in India: An epidemiological perspective. Indian J Endocrinol Metab. 2011 Jul;15(Suppl 2):S78-81. doi: https://dx.doi.org/10.4103%2F2230-8210.83329.
Ogbera AO, Kuku SF. Epidemiology of thyroid diseases in Africa. Indian J Endocrinol Metab. 2011 Jul;15(Suppl 2):S82-8. doi: https://dx.doi.org/10.4103%2F2230-8210.83331.
Reid JR, Wheeler SF. Hyperthyroidism: diagnosis and treatment. Am Fam Physician. 2005 Aug 15;72(4):623-30.
Dugbartey AT. Neurocognitive aspects of hypothyroidism. Arch Intern Med. 1998 Jul 13;158(13):1413-8.
Silverman JA. Sir William Gull (1819-1890). Limner of anorexia nervosa and myxoedema. An historical essay and encomium. Eat Weight Disord. 1997 Sep;2(3):111-6.
Graves RJ. Newly observed affection of the thyroid gland in females. Lond Med Surg J, 1835; 7:516.
Correia N, Mullally S, Cooke G, Tun TK, Phelan N, Feeney J, Fitzgibbon M, Boran G, O'Mara S, Gibney J. Evidence for a specific defect in hippocampal memory in overt and subclinical hypothyroidism. J Clin Endocrinol Metab. 2009 Oct;94(10):3789-97. https://dx.doi.org/10.4103%2F2230-8210.83331. Epub 2009 Jul 7.
Miller KJ, Parsons TD, Whybrow PC, Van Herle K, Rasgon N, Van Herle A, Martinez D, Silverman DH, Bauer M. Verbal memory retrieval deficits associated with untreated hypothyroidism. J Neuropsychiatry Clin Neurosci. 2007 Spring;19(2):132-6.
Botella-Carretero JI, Galán JM, Caballero C, Sancho J, Escobar-Morreale HF. Quality of life and psychometric functionality in patients with differentiated thyroid carcinoma. Endocr Relat Cancer. 2003 Dec;10(4):601-10.
He XS, Ma N, Pan ZL, Wang ZX, Li N, Zhang XC, Zhou JN, Zhu DF, Zhang DR. Functional magnetic resource imaging assessment of altered brain function in hypothyroidism during working memory processing. Eur J Endocrinol. 2011 Jun;164(6):951-9. doi: http://dx.doi.org/10.1530/EJE-11-0046. Epub 2011 Apr 7.
Davis JD, Tremont G. Neuropsychiatric aspects of hypothyroidism and treatment reversibility. Minerva Endocrinol. 2007 Mar;32(1):49-65.
Constant EL, Adam S, Seron X, Bruyer R, Seghers A, Daumerie C. Anxiety and depression, attention, and executive functions in hypothyroidism. J Int Neuropsychol Soc. 2005 Sep;11(5):535-44.
Correia N, Mullally S, Cooke G, Tun TK, Phelan N, Feeney J, Fitzgibbon M, Boran G, O'Mara S, Gibney J. Evidence for a specific defect in hippocampal memory in overt and subclinical hypothyroidism. J Clin Endocrinol Metab. 2009 Oct;94(10):3789-97. doi: https://doi.org/10.1210/jc.2008-2702. Epub 2009 Jul 7.
Jennifer Duncan Davis, Robert A. Stern and Laura A. Flashman. Cognitive and neuropsychiatric aspects of subclinical hypothyroidism: significance in the elderly. Current psychiatry reports, 2003; 5:384-390.
Miller KJ, Parsons TD, Whybrow PC, Van Herle K, Rasgon N, Van Herle A, Martinez D, Silverman DH, Bauer M. Verbal memory retrieval deficits associated with untreated hypothyroidism. J Neuropsychiatry Clin Neurosci. 2007 Spring;19(2):132-6.
Bégin ME, Langlois MF, Lorrain D, Cunnane SC. Thyroid Function and Cognition during Aging. Curr Gerontol Geriatr Res. 2008:474868. doi: https://doi.org/10.1155/2008/474868. Epub 2008 Sep 1.
Vogel A, Elberling TV, Hørding M, Dock J, Rasmussen AK, Feldt-Rasmussen U, Perrild H, Waldemar G. Affective symptoms and cognitive functions in the acute phase of Graves' thyrotoxicosis. Psychoneuroendocrinology. 2007 Jan;32(1):36-43. Epub 2006 Nov 13.
Hollowell JG, Staehling NW, Flanders WD, Hannon WH, Gunter EW, Spencer CA, Braverman LE. Serum TSH, T(4), and thyroid antibodies in the United States population (1988 to 1994): National Health and Nutrition Examination Survey (NHANES III). J Clin Endocrinol Metab. 2002 Feb;87(2):489-99.
Molloy DW, Alemayehu E, Roberts R. Reliability of a Standardized Mini-Mental State Examination compared with the traditional Mini-Mental State Examination. Am J Psychiatry. 1991 Jan;148(1):102-5.
Wechsler, David. The Measurement and Appraisal of Adult Intelligence. American psychologist, 1958; 30:123-34.
Parkington JE, Leiter RG. Partington’s Pathway Test. The Psychological Service Center Bulletin, 1949;1:9–20.
Osterweil D, Syndulko K, Cohen SN, Pettler-Jennings PD, Hershman JM, Cummings JL, Tourtellotte WW, Solomon DH. Cognitive function in non-demented older adults with hypothyroidism. J Am Geriatr Soc. 1992 Apr;40(4):325-35.
Mennemeier M, Garner RD, Heilman KM. Memory, mood and measurement in hypothyroidism. J Clin Exp Neuropsychol. 1993 Sep;15(5):822-31.
Manciet G, Dartigues F, Decamps A, et al. The PAUID survey and correlates of subclinical hypothyroidism in elderly community residents in the southwest of France. Age Ageing, 1995;24:235–41.
Bono G, Fancellu R, Blandini F, Santoro G, Mauri M. Cognitive and affective status in mild hypothyroidism and interactions with L-thyroxine treatment. Acta Neurol Scand. 2004 Jul;110(1):59-66.
Hu Y, Wang ZC, Guo QH, Cheng W, Chen YW. Is thyroid status associated with cognitive impairment in elderly patients in China? BMC Endocr Disord. 2016 Feb 20;16:11. doi: https://doi.org/10.1186/s12902-016-0092-z.
Wijsman LW, de Craen AJ, Trompet S, Gussekloo J, Stott DJ, Rodondi N, Welsh P, Jukema JW, Westendorp RG, Mooijaart SP. Subclinical thyroid dysfunction and cognitive decline in old age. PLoS One. 2013;8(3):e59199. doi: https://dx.doi.org/10.1371%2Fjournal.pone.0059199. Epub 2013 Mar 12.
del Ser Quijano T, Delgado C, Martínez Espinosa S, Vázquez C. [Cognitive deficiency in mild hypothyroidism]. Neurologia. 2000 May;15(5):193-8.
Cook SE,Nebes RD, Halligan EM, et al. Memory impairment in elderly individuals with a mildly elevated serum TSH: the role of processing resources, depression and cerebrovascular disease, Aging. Neuropsychology and Cognition, 2002; 9: 3: 175–183.
Jaeschke R, Guyatt G, Gerstein H, Patterson C, Molloy W, Cook D, Harper S, Griffith L, Carbotte R. Does treatment with L-thyroxine influence health status in middle-aged and older adults with subclinical hypothyroidism? J Gen Intern Med. 1996 Dec;11(12):744-9.
Bono G, Fancellu R, Blandini F, Santoro G, Mauri M. Cognitive and affective status in mild hypothyroidism and interactions with L-thyroxine treatment. Acta Neurol Scand. 2004 Jul;110(1):59-66.