title: Effect of thyroid hormone replacement therapy on cognition in long-term survivors of aneurysmal subarachnoid hemorrhage.
abstract: Aneurysmal subarachnoid hemorrhage (aSAH) is a recently identified risk factor for chronic hypothyroidism. Patients with hypothyroidism often exhibit cognitive dysfunction. The aim of the present study was to determine the effects of thyroid hormone replacement therapy on cognition in aSAH survivors with hypothyroidism. A study population of 135 patients was recruited and subjected to the Montreal Cognitive Assessment (MoCA) and Beck Depression Inventory. Among the study population, 52 patients exhibited cognitive dysfunction. Thyroid hormone levels were measured in these patients using an electrochemiluminescence immunoassay in order to elucidate possible deficits in the thyrotrophic hormonal axes, and hypothyroidism was confirmed in 31 patients. Among these 31 patients, 22 patients consented to be randomized into groups and were administered levothyroxine replacement or a placebo treatment for 3 months. The MoCA and Wechsler Adult Intelligence Scale-Chinese version (WAIS-RC) testing were performed prior to and following the replacement therapy or placebo treatments. All subjects completed the study with no negative side effects. After 8-12 weeks of oral levothyroxine administration, it was observed that the serum concentration of thyroid-stimulating hormone was restored to normal levels. Furthermore, neuropsychological test results improved following the replacement therapy. A significant improvement was observed in the MoCA scores of the replacement group following therapy, with the exception of the score for abstraction. Additionally, significant improvements in the WAIS-RC were observed in the replacement group, with the exceptions of the information comprehension and letter-number sequencing scores. Thus, the present study has demonstrated the partial normalization of cognitive impairments in patients with hypothyroidism following aSAH as a result of appropriate levothyroxine replacement therapy.
authors.affiliation: Department of Interventional Neuroradiology, Beijing Neurosurgical Institute and Beijing Tiantan Hospital, Capital Medical University, Beijing 100050, P.R. China ; Department of Neurosurgery, Guizhou Provincial People's Hospital, Guiyang, Guizhou 550002, P.R. China.
authors.forename: Jun
authors.initials: J
authors.lastname: Ma
authors.affiliation: Department of Interventional Neuroradiology, Beijing Neurosurgical Institute and Beijing Tiantan Hospital, Capital Medical University, Beijing 100050, P.R. China.
authors.forename: Xinjian
authors.initials: X
authors.lastname: Yang
authors.affiliation: Department of Neurosurgery, Guizhou Provincial People's Hospital, Guiyang, Guizhou 550002, P.R. China.
authors.forename: Hao
authors.initials: H
authors.lastname: Yin
authors.affiliation: Department of Interventional Neuroradiology, Beijing Neurosurgical Institute and Beijing Tiantan Hospital, Capital Medical University, Beijing 100050, P.R. China.
authors.forename: Yang
authors.initials: Y
authors.lastname: Wang
authors.affiliation: Department of Neurosurgery, Guizhou Provincial People's Hospital, Guiyang, Guizhou 550002, P.R. China.
authors.forename: Hongbin
authors.initials: H
authors.lastname: Chen
authors.affiliation: Department of Neurosurgery, Guizhou Provincial People's Hospital, Guiyang, Guizhou 550002, P.R. China.
authors.forename: Chuangxi
authors.initials: C
authors.lastname: Liu
authors.affiliation: Department of Neurosurgery, Guizhou Provincial People's Hospital, Guiyang, Guizhou 550002, P.R. China.
authors.forename: Guoqiang
authors.initials: G
authors.lastname: Han
authors.affiliation: Department of Neurosurgery, Guizhou Provincial People's Hospital, Guiyang, Guizhou 550002, P.R. China.
authors.forename: Fangyou
authors.initials: F
authors.lastname: Gao
keywords: Beck Depression Inventory; Montreal Cognitive Assessment; Wechsler Adult Intelligence Scale; aneurysmal; hypothyroidism; subarachnoid hemorrhage