Neuropsychological Alterations in Patients with Congenital Hypothyroidism Treated with Levothyroxine: Linked Factors and Thyroid Hormone Hyposensitivity.

Eighty-five percent of the studies of patients with congenital hypothyroidism (CH) treated with Levothyroxine (L-T4) report neuropsychological sequelae throughout life. In neonates and infants, there is a deficit in sensorimotor skills (impaired balance). In preschool and elementary school children and adolescents, there are alterations in intellectual quotient (low scores), language (delayed phonological acquisition), memory (visual, verbal, visuospatial, visuoconstructive, autobiographical, and semantic), sensorimotor skills (impaired fine and gross motor control), and visuoconstructive-visuospatial domain (low scores in spatial location, block design, and object assembly). These neuropsychological domains are also affected in young adults, except for language (adequate verbal fluency) and visuoconstructive-visuospatial domain (no data). The onset and severity of neuropsychological sequelae in patients with treated CH depend on several factors: extrinsic, related to L-T4 treatment and social aspects, and intrinsic, such as severity and etiology of CH, as well as structural and physiological changes in the brain. In this review, we hypothesized that thyroid hormone hyposensitivity (THH) could also contribute to neuropsychological alterations by reducing the effectiveness of L-T4 treatment in the brain. Thus, further research could approach the THH hypothesis at basic and clinical levels to implement new endocrinological and neuropsychological therapies for CH patients.

Quantitative characterization of proliferative cells subpopulations in the hilus of the hippocampus of adult Wistar rats: an integrative study.

The hilus plays an important role modulating the excitability of the hippocampal dentate gyrus (DG). It also harbors proliferative cells whose proliferation rate is modified during pathological events. However, the characterization of these cells, in terms of cellular identity, lineage, and fate, as well as the morphology and proportion of each cell subpopulation has been poorly studied. Therefore, a deeper investigation of hilar proliferative cells might expand the knowledge not only in the physiology, but in the pathophysiological processes related to the hippocampus too. The aim of this work was to perform an integrative study characterizing the identity of proliferative cells populations harbored in the hilus, along with morphology and proportion. In addition, this study provides comparative evidence of the subgranular zone (SGZ) of the DG. Quantified cells included proliferative, neural precursor, Type 1, oligodendrocyte progenitor (OPCs), neural progenitor (NPCs), and proliferative mature astrocytes in the hilus and SGZ of Wistar adult rats. Our results showed that 84% of the hilar proliferative cells correspond to neural precursor cells, OPCs and NPCs being the most abundant at 54 and 45%, respectively, unlike the SGZ, where OPCs represent only 11%. Proliferative mature astrocytes and Type 1-like cells were rarely observed in the hilus. Together, our results lay the basis for future studies focused on the lineage and fate of hilar proliferative cells and suggest that the hilus could be relevant to the formation of new cells that modulate multiple physiological processes governed by the hippocampus.

Cardiovascular Responses to 5-hydroxytryptamine in Methimazole-induced Hypothyroid Pithed Rats.

BACKGROUND: Patients suffering from hypothyroidism tend to develop diastolic hypertension. 5-Hydroxytryptamine (5-HT) is an amine that contributes to the maintenance of the blood pressure through central and peripheral 5-HT receptors. Curiously, the hypothyroidism alters the density of the 5-HT receptors in rodent brains. AIM OF THE STUDY: Analyze the effect of the methimazole-induced hypothyroidism on the peripheral cardiovascular responses elicited by 5-HT. METHODS: The vasopressor and tachycardic responses to 5-HT (3-300 µg/kg), and the vasodepressor responses to 5-HT, 5-carboxamidotryptamine (5-CT, 0.001-0.1 µg/kg), isoprenaline (0.03-1 µg/kg) and acetylcholine (ACh, 0.03-3 µg/kg), during an infusion of methoxamine, were determined in pithed hypothyroid rats. RESULTS: The tachycardic and vasopressor responses to 5-HT and the vasodepressor responses to 5-CT and ACh remained unaffected, the vasodepressor response to 5-HT reduced, and the vasodepressor response to isoprenaline enhanced and reduced at the lowest and highest dose, respectively. CONCLUSION: These results suggest that hypothyroidism impairs the vasodepressor response to 5-HT, which could contribute to hypothyroidism-induced hypertension.

Moderate exercise prevents the cell atrophy caused by hypothyroidism in rats.

Adult­onset hypothyroidism is associated with an increase in cell atrophy of the hippocampal pyramidal neurons. Physical exercise implies diverse actions on the neural tissue that promote neuron proliferation and survival. The beneficial effects of exercise seem to be inversely linked to its intensity, so that strenuous exercise has reduced protective effects. In this study we evaluated the capacity of a moderate forced­exercise routine to counteract the neurodegenerative effects of a hypothyroid condition induced during adulthood. Simultaneously with a chronic anti­thyroid chemical treatment, a group of rats was forced to walk in a motorized wheel for 30 min daily five times a week. In four weeks of treatment the rats developed a plain hypothyroid condition that in non­exercised rats was accompanied by a marked increase in the number of atrophic cells in all CA regions of the hippocampus. The forced­exercise treatment did not counter the development of hypothyroidism and its signs, but it did prevent almost completely the associated neuronal damage in all CA regions. The forced exercise also improved the cognitive function in a spatial­learning test. These results indicate that moderate exercise has the potential to prevent the structural and functional deficits associated with a hypothyroid condition.

Cerebrolysin enhances the expression of the synaptogenic protein LRRTM4 in the hippocampus and improves learning and memory in senescent rats.

Aging reduces the efficiency of the organs and systems, including the cognitive functions. Brain aging is related to a decrease in the vascularity, neurogenesis, and synaptic plasticity. Cerebrolysin, a peptide and amino acid preparation, has been shown to improve the cognitive performance in animal models of Alzheimer's disease. Similarly, the leucine-rich repeat transmembrane 4 protein exhibits a strong synaptogenic activity in the hippocampal synapses. The aim of this study was to evaluate the effect of the cerebrolysin treatment on the learning and memory abilities, sensorimotor functions, and the leucine-rich repeat transmembrane 4 protein expression in the brain of 15-month-old rats. Cerebrolysin (1076 mg/kg) or vehicle was administered to Wistar rats intraperitoneally for 4 weeks. After the treatments, learning and memory were tested using the Barnes maze test, and the acoustic startle response, and its pre-pulse inhibition and habituation were measured. Finally, the leucine-rich repeat transmembrane 4 expression was measured in the brainstem, striatum, and hippocampus using a Western-blot assay. The 15-month-old vehicle-treated rats showed impairments in the habituation of the acoustic startle response and in learning and memory when compared to 3-month-old rats. These impairments were attenuated by the subchronic cerebrolysin treatment. The leucine-rich repeat transmembrane 4 protein expression was lower in the old vehicle-treated rats than in the young rats; the cerebrolysin treatment attenuated that decrease in the old rats. The leucine-rich repeat transmembrane 4 protein was not expressed in striatum or brainstem. These results suggest that the subchronic cerebrolysin treatment enhances the learning and memory abilities in aging by increasing the expression of the leucine-rich repeat transmembrane 4 protein in the hippocampus.

Neuroprotective effect of Arthrospira (Spirulina) platensis against kainic acid-neuronal death.

Context Arthrospira (Spirulina) platensis (SP) is a cyanobacterium which has attracted attention because of its nutritional value and pharmacological properties. It was previously reported that SP reduces oxidative stress in the hippocampus and protects against damaging neurobehavioural effects of systemic kainic acid (KA). It is widely known that the systemic administration of KA induces neuronal damage, specifically in the CA3 hippocampal region. Objective The present study determines if the SP sub-chronic treatment has neuroprotective properties against KA. Materials and methods Male SW mice were treated with SP during 24 d, at doses of 0, 200, and 800 mg/kg, once daily, and with KA (35 mg/kg, ip) as a single dose on day 14. After the treatment, a histological analysis was performed and the number of atrophic neuronal cells in CA3 hippocampal region was quantified. Results Pretreatment with SP does not protect against seizures induced by KA. However, mortality in the SP 200 and the SP 800 groups was of 20%, while for the KA group, it was of 60%. A single KA ip administration produced a considerable neuronal damage, whereas both doses of SP sub-chronic treatment reduced the number of atrophic neurons in CA3 hippocampal region with respect to the KA group. Discussion The SP neurobehaviour improvement after KA systemic administration correlates with the capacity of SP to reduce KA-neuronal death in CA3 hippocampal cells. This neuroprotection may be related to the antioxidant properties of SP. Conclusion SP reduces KA-neuronal death in CA3 hippocampal cells.

The NMDA receptor antagonist MK-801 abolishes the increase in both p53 and Bax/Bcl2 index induced by adult-onset hypothyroidism in rat.

Hypothyroidism affects neuron population dynamics in the hippocampus of the adult rat, with neuronal damage as the main feature of its effect. This effect is prevented by the blockade of NMDA receptors, which suggests that glutamatergic activity mediates cell death in this condition. Glutamate can also stimulate cell proliferation and survival of newborn neurons, indicating that it can affect different stages of the cell cycle. In this work we measured the expression of specific proteins that control cell proliferation (cycline-D1), cell arrest (p21), damage (p53) or apoptosis (Bax and Bcl2) in the hippocampus of hypothyroid rats treated with the NMDA receptor (NMDAR) blocker MK-801 during the induction of hypothyroidism. The results show that hypothyroidism increases the expression of markers of DNA damage, cell arrest, and apoptosis, but does not affect the marker of cell proliferation. NMDAR blockade prevents the increase on markers of DNA damage and apoptosis, but does not influence cell arrest or cell proliferation. This suggests that hypothyroidism promotes cell death mainly by an excitotoxic effect of glutamate.

The long-term regulation of food intake and body weight depends on the availability of thyroid hormones in the brain.

OBJECTIVES: We evaluated the contribution of the thyroid hormones to the long-term maintenance of feeding behavior and body weight, while distinguishing their direct central effects from those resulting from the metabolic rate in the peripheral tissues. METHODS: We assessed the effect of hypothyroidism on the long-term (6 months) regulation of food intake, body weight, and energy expenditure in rats. We then generated the recovery of a euthyroid condition in the brain while maintaining a low T3 availability for the peripheral organs, i.e. a combined condition of central euthyroidism with peripheral hypothyroidism, with the aid of a pharmacological combination. RESULTS: Hypothyroidism caused a decrease in the daily food intake, body weight, and body temperature. The food intake and body temperature stabilized at a lower value, whereas body weight kept decreasing at a constant rate. The administration of exogenous T4 increased food intake and body-weight gain, but had no effect on body temperature. CONCLUSIONS: The thyroid hormones are necessary for the long-term regulation of energy intake, storage, and expenditure by different mechanisms. The feeding behavior seems to be partially dependent on a direct action of the thyroid hormones on the brain and this effect is independent of the energy expenditure in the peripheral organs. The body weight is closely dependent on the thyroid status and its maintenance seems to involve thyroid action on mechanisms other than feeding and metabolic rate.

Participation of NMDA-glutamatergic receptors in hippocampal neuronal damage caused by adult-onset hypothyroidism.

We analyzed the participation of N-methyl-d-aspartate (NMDA) receptors in the neuronal damage caused by adult-onset hypothyroidism. Wistar rats were randomly assigned into four groups. The euthyroid group received tap water. The hypothyroid group received methimazole (60 mg/kg) in their drinking water to induce hypothyroidism. Two more groups of rats received the antithyroid treatment and were injected daily with the NMDA antagonist ketamine (15 mg/kg, sc) or MK-801 (0.5mg/kg, ip). Treatments were administered during 4 weeks. At the end of the respective treatments rats were deeply anaesthetized and perfused intracardially with 0.9% NaCl followed by 4% paraformaldehyde. The brains were removed from the skull, and coronal brain sections (7microm thick) were obtained. Neurons were counted in the CA1, CA2, CA3, and CA4 hippocampal regions differentiating between normal and atrophic cells by an experimenter blind to the treatment. The percentage of neuronal damage found in the MMI group was significantly greater in the hippocampal regions compared to the euthyroid group. In contrast, both NMDA antagonists were able to prevent the neuronal damage secondary to hypothyroidism in all hippocampal regions. Our results suggest that the neuronal damage caused in the hippocampus of adult-onset hypothyroid rats requires activation of NMDA channels.

The maintenance of hippocampal pyramidal neuron populations is dependent on the modulation of specific cell cycle regulators by thyroid hormones.

The onset of adult hypothyroidism causes neuronal damage in the CA3 hippocampal region, which is attenuated by T(4) administration. We analyzed the expression of molecular proliferation markers (Cyclin D1 and PCNA), cellular damage-arrest (p53 and p21), and apoptosis (Bax/Bcl-2 index) in the hippocampus of hypothyroid (methimazole; 60 mg/kg) or thyroid replaced (T(4), 20 microg/kg; MMI+T(4) or T(3), 20 microg/kg; MMI+T(3)) adult male rats. Histological analysis showed that hypothyroid animals exhibit significant neuronal damage in all regions of the hippocampus accompanied by the triggering of the apoptotic pathway (increases in p53, p21 and the Bax/Bcl-2 index) and no changes in proliferation (Cyclin D1 and PCNA). MMI+T(4) replaced animals were completely protected with no changes in molecular markers. In contrast, MMI+T(3) replaced animals showed partial protection in which, although pro-apoptotic effects remained (increase in the Bax/Bcl-2), proliferative mechanisms were triggered (increase in p53, Cyclin D1 and PCNA expression). Our results indicate that thyroid hormones participate in the maintenance of the hippocampal neuronal population even in adulthood, suggesting that THs have different physiological roles as neuronal survival factors: T(4) prevents the activation of apoptotic pathways, whereas T(3) activates cell differentiation and proliferation mechanisms.

Hypothyroidism induces selective oxidative stress in amygdala and hippocampus of rat.

The effects of hypothyroidism on lipid peroxidation (LP), reactive oxygen species (ROS), and nitric oxide synthase (NOS), levels and expression, in rat brain were examined. Hypothyroidism was induced by administering methimazole in drinking water (60 mg/kg/day). In striatum, motor cortex and cerebellum of hypothyroid rats LP was not modified, whereas LP and ROS increased in amygdala and hippocampus of hypothyroid rats at the third week of treatment with methimazole as compared to euthyroid group values. Regarding NOS participation, only hippocampal constitutive-NOS activity was increased, accompanied by an augmentation in nNOS expression. Results show that hypothyroidism induces selective oxidative stress in both the hippocampus and amygdala, where the nitrergic system is involved.

Selective decrease of Na+/k+ -ATPase activity in the brain of hypothyroid rats.

The present work was performed in order to know if mild hypothyroidism in rats modifies the activity of the Na+/K+ -ATPase in different regions of the brain. Male Wistar rats (300-350 g) were randomly divided into three groups: (1) control group (n=8) drank tap water. (2) hypothyroid group (n=8) treated with 60 mg/kg of methimazole in drinking water; and (3) replaced group (n=8) treated with 60 mg/kg of methimazole plus 35 microg/kg of thyroid hormone (T3) in drinking water. After four weeks of treatment, the rats of all groups were sacrificed by decapitation. The cortex, amygdala, hippocampus and cerebellum were dissected and frozen at -70 degrees C until assay. For enzymatic assay, the tissues were homogenized. The Na+/K+ -ATPase activity was determined by quantifying inorganic phosphate after the samples were incubated with ATP in the presence and absence of 1 mM ouabain. The Na+/K+ -ATPase activity is expressed as pmoles Pi/hr/mg protein. The results showed that the Na+/K+ -ATPase activity in the cortex, amygdala and hippocampus, but not in cerebellum, was lower in hypothyroid group than in control group (p<0.05). The co-administration of methimazole and T3 avoided the decrease of Na+/K+ -ATPase activity, except in amygdala. According to the results obtained we concluded that methimazole treatment decreased the Na+/K+- ATPase activity in the brain's regions which are related to seizures onset. That decrement in enzyme activity was avoided with the coadministration of thyroid hormone.

Perinatal hypothyroidism increases the susceptibility to lidocaine-kindling in adult rats.

The present study was developed to ascertain whether or not susceptibility to lidocaine-kindling persists into adulthood in perinatal hypothyroid rats. Pregnant Wistar rats were randomly divided into two groups: the first one, a control group, that drank tap water; and a second one, a hypothyroid group, were treated with 0.02% propylthiouracil in their drinking water from the 14th gestational day to the 10th postpartum day. The pups of both groups were maintained with food and tap water ad libitum until the experiment was over. The pups of each group were divided to test the susceptibility to lidocaine-kindling at 30 and 100 days old, for this, lidocaine (50 mg/kg, i.p.) was administered daily. The seizures were usually present in the form of tonic attacks of fore and hind limbs, followed by intermittent clonic movements. An animal was considered kindled when it showed clonic movements for two consecutive days. We observed that the number of stimuli necessary to produce lidocaine-kindling seizures in hypothyroid rats was significantly lower than in the control group for both ages. Also, the percentage of kindled rats aged 30 days (73% and 89%) was greater than aged of 100 days (26% and 59%) in both control and hypothyroid groups, respectively. In conclusion, the perinatal hypothyroidism increases the susceptibility to lidocaine-kindling in adult rats.

Kainic acid does not affect CA3 hippocampal region pyramidal cells in hypothyroid rats.

Thyroid hormones exert a crucial role on trophic events of the central nervous system during development, adulthood, and ageing. The deficiency of thyroid hormones could also produce a deficiency in neurotransmission in the hippocampal region. Kainic acid (KA) has become an important tool for studying functions related to excitatory amino acid transmission in mammals. Its neurotoxic effects on the pyramidal neurons of the CA3 hippocampal region are well known. We have examined the neurotoxicity of KA on these cells in hypothyroid rats. The hypothyroid state was induced by administration of methimazole. After 4 weeks of treatment, KA was administered once intraperitoneally at doses of 0, 1, 2.5, and 5mg/kg to the hypothyroid group, and 0 and 5mg/kg to the euthyroid group. In the euthyroid group, KA reduced the neuronal density in the CA3 hippocampal region, and in the hypothyroid rats with no administration of KA, the neuronal density of the CA3 hippocampal region is reduced also. Administering KA in hypothyroid rats did not reduce the number of CA3 pyramidal cells.