Souvislost mezi hladinou volného trijodtyroninu v séru a skóre Mini-Mental State Examination po prodělané akutní ischemické CMP

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Autoři: S. Taroza; J. Burkauskas; A. Podlipskyté; N. Mickuviené
Působiště autorů: Neuroscience Institute, Lithuanian University of Health Sciences, Kaunas, Lithuania
Vyšlo v časopise: Cesk Slov Neurol N 2023; 86(1): 74-81
Kategorie: Původní práce
doi: https://doi.org/10.48095/cccsnn202374

Souhrn

Cíl: Cílem této studie bylo určit souvislost mezi hormony produkovanými hypotalamo-hypofyzárně-tyroidní (tyroidní) osou (thyroid axis produced hormones; TAPH) a kognitivním stavem po prodělané akutni ischemické CMP (acute ischemic stroke; AIS). Materiál a metody: U jedinců s AIS z tří různých výzkumných a klinických center byla stanovena hladina TAPH v séru, vč. tyreostimulačního hormonu, volného tyroxinu a volného trijodtyroninu (FT3), a to po přijetí pacienta a před jeho propuštěním. Kognitivní funkce byly hodnoceny během akutní ubakutní fáze AIS pomocí Mini-Mental State Examination (MMSE). Výsledky: Byla získána data týkající se 194 jedinců s AIS v akutní fázi a 89 jedinců s AIS v subakutní fázi. Během akutní fáze AIS byla nezávislou determinantou kognitivního stavu hladina FT3 (R2 = 0,016; p = 0,017). Během subakutní fáze AIS nebyly zjištěny žádné nezávislé asociace mezi změřenými hladinami hormonů v séru a MMSE. Závěr: Hladina FT3 v séru změřená při přijetí pacienta s AIS v akutní fázi může predikovat jeho kognitivní stav hodnocený pomocí MMSE.

Klíčová slova:

ischemická cévní mozková příhoda – tyreostimulační hormon – volný trijodotyronin – volný tyroxin – kognitivní stav

Zdroje

1. Barbay M, Diouf M, Roussel M et al. Systematic review and meta-analysis of prevalence in post-stroke neurocognitive disorders in hospital-based studies. Dement Geriatr Cogn Disord 2018; 46 (5–6): 322–334. doi: 10.1159/000492920.

2. Gallucci L, Umarova RM. Kognitive Defizite und Demenz nach Schlaganfall. Therapeutische Umschau 2021; 78 (6): 305–311. doi: 10.1024/0040-5930/a001278.

3. Mijajlović MD, Pavlović A, Brainin M et al. Post-stroke dementia – a comprehensive review. BMC Med 2017; 15 (1): 11. doi: 10.1186/s12916-017-0779-7.

4. Stolwyk RJ, Mihaljcic T, Wong DK et al. Poststroke cognitive impairment negatively impacts activity and participation outcomes: a systematic review and meta-analysis. Stroke 2021; 52 (2): 748–760. doi: 10.1161/strokeaha.120.032215.

5. Saposnik G, Cote R, Rochon PA et al. Care and outcomes in patients with ischemic stroke with and without preexisting dementia. Neurology 2011; 77 (18): 1664–1673. doi: 10.1212/WNL.0b013e31823648f1.

6. Das J, Rajanikant GK. Post stroke depression: the sequelae of cerebral stroke. Neurosci Biobehav Rev 2018; 90: 104–114. doi: 10.1016/j.neubiorev.2018.04.005.

7. Lee M, Saver JL, Hong KS et al. Cognitive impairment and risk of future stroke: a systematic review and meta-analysis. CMAJ 2014; 186 (14): E536–546. doi: 10.1503/cmaj. 140147.

8. Milinavičienė E, Rastenytė D, Kriščiūnas A. Effectiveness of the second-stage rehabilitation in stroke patients with cognitive impairment. Medicina 2011; 47 (9): 486–493.

9. Zietemann V, Georgakis MK, Dondaine T et al. Early MoCA predicts long-term cognitive and functional outcome and mortality after stroke. Neurology 2018; 91 (20): e1838–e1850. doi: 10.1212/wnl.0000000000006 506.

10. Anstey KJ, Mack HA, von Sanden C. The relationship between cognition and mortality in patients with stroke, coronary heart disease, or cancer. Eur Psychol 2006; 11 (3): 182–195. doi: 10.1027/1016-9040.11.3.182.

11. Saa JP, Tse T, Baum C. Longitudinal evaluation of cognition after stroke – a systematic scoping review. PLoS One 2019; 14 (8): e0221735. doi: 10.1371/journal.pone. 0221735.

12. Pendlebury ST, Rothwell PM. Prevalence, incidence, and factors associated with pre-stroke and post-stroke dementia: a systematic review and meta-analysis. Lancet Neurol 2009; 8 (11): 1006–1018. doi: 10.1016/s1474-4422 (09) 70236-4.

13. Zhang X, Bi X. Post-stroke cognitive impairment: a review focusing on molecular biomarkers. J Mol Neurosci 2020; 70 (8): 1244–1254. doi: 10.1007/s12031-020-01 533-8.

14. Simpkins AN, Janowski M, Oz HS et al. Biomarker application for precision medicine in stroke. Transl Stroke Res 2020; 11 (4): 615–627. doi: 10.1007/s12975-019-00762-3.

15. Jickling GC, Sharp FR. Biomarker panels in ischemic stroke. Stroke 2015; 46 (3): 915–920. doi: 10.1161/ strokeaha.114.005604.

16. Burkauskas J, Bunevicius A, Brozaitiene J et al. Cognitive functioning in coronary artery disease patients: associations with thyroid hormones, N-terminal pro-B-type natriuretic peptide and high-sensitivity C-reactive protein. Arch Clin Neuropsychol 2017; 32 (2): 245–251. doi: 10.1093/arclin/acx004.

17. Burkauskas J, Lang P, Bunevičius A et al. Cognitive function in patients with coronary artery disease: a literature review. J Int Med Res 2018; 46 (10): 4019–4031. doi: 10.1177/0300060517751452.

18. Balch MHH, Nimjee SM, Rink C et al. Beyond the brain: the systemic pathophysiological response to acute ischemic stroke. J Stroke 2020; 22 (2): 159–172. doi: 10.5853/jos.2019.02978.

19. Lamba N, Liu C, Zaidi H et al. A prognostic role for low tri-iodothyronine syndrome in acute stroke patients: a systematic review and meta-analysis. Clin Neurol Neurosurg 2018; 169: 55–63. doi: 10.1016/j.clineuro.2018.03.025.

20. Wang F, Luo MY, Zhou L et al. Endocrine dysfunction following stroke. J Neuroimmune Pharmacol 2021; 16 (2): 425–436. doi: 10.1007/s11481-020-09935-6.

21. Taroza S, Rastenyte D, Burkauskas J et al. Lower serum free triiodothyronine levels are associated with symptoms of depression after ischemic stroke. J Psychosom Res 2019; 122: 29–35. doi: 10.1016/j.jpsychores. 2019.04.018.

22. Taroza S, Rastenytė D, Podlipskytė A et al. Nonthyroidal illness syndrome in ischaemic stroke patients is associated with increased mortality. Exp Clin Endocrinol Diabetes 2020; 128 (12): 811–818. doi: 10.1055/ a-0915-2015.

23. Giannocco G, Kizys MML, Maciel RM et al. Thyroid hormone, gene expression, and central nervous system: where we are. Semin Cell Dev Biol 2021; 114: 47–56. doi: 10.1016/j.semcdb.2020.09.007.

24. Papaefthymiou O, N‘Guyen S, Smith C et al. Dysfonction thyroïdienne et fonctions cognitives: mythe ou réalité? Praxis (Bern 1994) 2016; 105 (20): 1205–1212. doi: 10.1024/1661-8157/a002485.

26. Irimie CA, Vârciu M, Irimie M et al. C-reactive protein and T3: new prognostic factors in acute ischemic stroke. J Stroke Cerebrovasc Dis 2018; 27 (10): 2731–2737. doi: 10.1016/j.jstrokecerebrovasdis.2018.05.047.

27. Chen H, Wu Y, Huang G et al. Low tri-iodothyronine syndrome is associated with cognitive impairment in patients with acute ischemic stroke: a prospective cohort study. Am J Geriatr Psychiatry 2018; 26 (12): 1222–1230. doi: 10.1016/j.jagp.2018.07.007.

28. Bunevicius A, Kazlauskas H, Raskauskiene N et al. Ischemic stroke functional outcomes are independently associated with C-reactive protein concentrations and cognitive outcomes with triiodothyronine concentrations: a pilot study. Endocrine 2014; 45 (2): 213–220. doi: 10.1007/s12020-013-9958-2.

29. Burkauskas J, Brozaitiene J, Staniute M et al. Gene-environment interactions connecting low triiodothyronine syndrome and outcomes of cardiovascular disease (GET-VASC): study protocol. Biol Psychiatr Psychopharmacol 2014; 16 (2): 66–73.

30. Kazukauskiene N, Skiriute D, Gustiene O et al. Importance of thyroid hormone level and genetic variations in deiodinases for patients after acute myocardial infarction: a longitudinal observational study. Sci Rep 2020; 10 (1): 9169. doi: 10.1038/s41598-020-66006-9.

31. Aho K, Harmsen P, Hatano S et al. Cerebrovascular disease in the community: results of a WHO collaborative study. Bull World Health Organ 1980; 58 (1): 113–130.

32. Mancia G, Fagard R, Narkiewicz K et al. 2013 ESH/ESC practice guidelines for the management of arterial hypertension. Blood Press 2014; 23 (1): 3–16. doi: 10.3109/08037051.2014.868629.

33. Camm AJ, Kirchhof P, Lip GY et al. Guidelines for the management of atrial fibrillation: the task force for the management of atrial fibrillation of the European Society of Cardiology (ESC). Eur Heart J 2010; 31 (19): 2369–2429. doi: 10.1093/eurheartj/ehq278.

34. World Health Organization. Definition and diagnosis of diabetes mellitus and intermediate hyperglycaemia: report of a WHO/IDF consultation. [online]. Dostupné z: https: //apps.who.int/iris/handle/10665/43588.

35. Bunevicius R. Protinės būklės mini tyrimas. Biol Psychiatr Psychopharmacol 2000; 2 (1): 13.

36. Folstein MF, Folstein SE, McHugh PR. “Mini-mental state”. A practical method for grading the cognitive state of patients for the clinician. J Psychiatr Res 1975; 12 (3): 189–198. doi: 10.1016/0022-3956 (75) 90026-6.

37. Bikle DD. The free hormone hypothesis: when, why, and how to measure the free hormone levels to assess vitamin D, thyroid, sex hormone, and cortisol status. JBMR Plus 2021; 5 (1): e10418. doi: 10.1002/jbm4.10418.

38. Fliers E, Boelen A. An update on non-thyroidal illness syndrome. J Endocrinol Invest 2021; 44 (8): 1597–1607. doi: 10.1007/s40618-020-01482-4.

39. Maiden MJ, Torpy DJ. Thyroid hormones in critical illness. Crit Care Clin 2019; 35 (2): 375–388. doi: 10.1016/ j.ccc.2018.11.012.

40. Grefkes C, Fink GR. Recovery from stroke: current concepts and future perspectives. Neurol Res Pract 2020; 2: 17. doi: 10.1186/s42466-020-00060-6.

41. Xie F, Liu H, Liu Y. Adult neurogenesis following ischemic stroke and implications for cell-based therapeutic approaches. World Neurosurg 2020; 138: 474–480. doi: 10.1016/j.wneu.2020.02.010.

42. Samuels MH. Thyroid disease and cognition. Endocrinol Metab Clin North Am 2014; 43 (2): 529–543. doi: 10.1016/j.ecl.2014.02.006.

43. Fernández-Lamo I, Montero-Pedrazuela A, Delgado--García JM et al. Effects of thyroid hormone replacement on associative learning and hippocampal synaptic plasticity in adult hypothyroid rats. Eur J Neurosci 2009; 30 (4): 679–692. doi: 10.1111/j.1460-9568.2009.06862.x.

44. Talhada D, Santos CRA, Goncalves I et al. Thyroid hormones in the brain and their impact in recovery mechanisms after stroke. Front Neurol 2019; 10: 1103. doi: 10.3389/fneur.2019.01103.

45. Talhada D, Feiteiro J, Costa AR et al. Triiodothyronine modulates neuronal plasticity mechanisms to enhance functional outcome after stroke. Acta Neuropathol Commun 2019; 7 (1): 216. doi: 10.1186/s40478-019-0866-4.

46. Sadana P, Coughlin L, Burke J et al. Anti-edema action of thyroid hormone in MCAO model of ischemic brain stroke: possible association with AQP4 modulation. J Neurol Sci 2015; 354 (1–2): 37–45. doi: 10.1016/ j.jns.2015.04.042.

47. Mayerl S, Heuer H, Ffrench-Constant C. Hippocampal neurogenesis requires cell-autonomous thyroid hormone signaling. Stem Cell Reports 2020; 14 (5): 845–860. doi: 10.1016/j.stemcr.2020.03.014.

48. Remaud S, Demeneix B. Thyroid hormones regulate neural stem cell fate. Biol Aujourdhui 2019; 213 (1–2): 7–16. doi: 10.1051/jbio/2019007.

49. Mok VC, Lam BY, Wong A et al. Early-onset and delayed-onset poststroke dementia – revisiting the mechanisms. Nat Rev Neurol 2017; 13 (3): 148–159. doi: 10.1038/nrneurol.2017.16.

50. Shi Q, Presutti R, Selchen D et al. Delirium in acute stroke: a systematic review and meta-analysis. Stroke 2012; 43 (3): 645–649. doi: 10.1161/strokeaha.111.643726.

51. Mitchell AJ. A meta-analysis of the accuracy of the mini-mental state examination in the detection of dementia and mild cognitive impairment. J Psychiatr Res 2009; 43 (4): 411–431. doi: 10.1016/j.jpsychires.2008.04.014.

52. Morris CJ, Aeschbach D, Scheer FA. Circadian system, sleep and endocrinology. Mol Cell Endocrinol 2012; 349 (1): 91–104. doi: 10.1016/j.mce.2011.09.003.