Technetium-99m ethyl cysteinate dimer (ECD) cerebral accumulation and symptom and sign severity during hypothyroidism.
OBJECTIVE
The purpose of this study was to correlate hypothyroid-related symptomatology with regional cerebral blood flow (rCBF) during hypothyroidism.


METHODS
Nine thyroidectomized patients underwent neuropsychological testing and single photon emission computed tomography (SPECT) of their brains with technetium-99m (Tc-99m) ethyl cysteinate dimer (ECD), a lipophilic cerebral blood flow radiotracer, while hypothyroid, and again following thyroid hormone replacement. Neuropsychological test scores and TSH levels while hypothyroid were correlated with rCBF in hypothyroid-affected areas of the brain.


RESULTS
Correlations were found during hypothyroidism between the noted parameters and ECD radiotracer accumulation in the following respective regions, all of which demonstrated hypothyroid-related cerebral blood flow (CBF) aberrations: TSH and left middle occipital gyrus; psychomotor performance speed and left precentral gyrus; and depression and right middle frontal gyrus, left middle frontal gyrus, right insula, and left thalamus.


CONCLUSIONS
Severity of psychomotor impairment and depression, and TSH level during hypothyroidism appeared to correlate with CBF to brain regions associated with motor activity, mood and vision, respectively; and previously shown to manifest significantly altered rCBF during hypothyroidism.
Department of Radiology, Saint Joseph's Hospital and Medical Center and The Barrow Neurologic Institute; 350 West Thomas Rd., Phoenix, Arizona, USA. fvschraml@yahoo.com
Frank V
FV
Schraml
Lori L
LL
Beason-Held
D000328:Adult; D001931:Brain Mapping / Q000379:methods; D002540:Cerebral Cortex / Q000378:metabolism* / Q000473:pathology; D003553:Cystine / Q000031:analogs & derivatives* / Q000737:chemistry / Q000493:pharmacokinetics; D015914:Estrogen Replacement Therapy; D005260:Female; D006801:Humans; D007037:Hypothyroidism / Q000175:diagnosis* / Q000188:drug therapy / Q000378:metabolism / Q000473:pathology; D008297:Male; D009483:Neuropsychological Tests; D011379:Prognosis; D012720:Severity of Illness Index; D013667:Technetium / Q000737:chemistry / Q000493:pharmacokinetics*; D013974:Thyroxine / Q000627:therapeutic use; D055815:Young Adult
C541351:ethyl cysteinate dimer; D003553:Cystine; D013667:Technetium; D013974:Thyroxine