Functional magnetic resource imaging assessment of altered brain function in hypothyroidism during working memory processing.

CONTEXT Hypothyroidism is related to multiple cognitive deficits including working memory dysfunction, of which the underlying neural correlates were rarely studied. In this study, the impact of hypothyroidism on neural circuits involved in working memory processing was explored by functional magnetic resource imaging (fMRI). DESIGN Using fMRI, we conducted a longitudinal study investigating alterations of brain function during a working memory task, the four-digit backward recall (BR) and forward recall (FR), in hypothyroid patients and controls. METHODS fMRI scan was used in 13 female patients at two time points: before and after having been treated with levothyroxine (L-T(4)) for ∼6 months, and 12 matched euthyroid controls were also scanned. Wechsler Memory Scale-Chinese Revision was used to assess the memory states of each participant. RESULTS The hypothyroid patients showed poorer memory states than that in controls. Furthermore, significant differences of task-induced deactivation (TID, task-dependent decreases in neural activity relative to rest) between patients and controls were found in the bilateral medial prefrontal cortices, posterior cingulate cortices, and left inferior partial lobule (P<0.05). These regions were considered as parts of a task-negative network, namely the default mode network (DMN). Concretely, relative to controls, patients showed diminished TID during BR in contrast to FR. After the L-T(4) treatment, neither the poor memory states nor the alteration of TID was detectable in patients. CONCLUSION Hypothyroidism is related to alterations of TID within DMN regions during working memory processing. These exploratory findings may imply potential neural correlates in hypothyroidism-related cognitive deficits and their recoveries.