Thyroid, Brain and Mood Modulation in Affective Disorder: Insights from Molecular Research and Functional Brain Imaging

M. Bauer; E. D. London; D. H. S. Silverman; N. Rasgon; J. Kirchheiner; P. C. Whybrow

doi:10.1055/s-2003-45133

Pharmacopsychiatry, Table of Contents

Pharmacopsychiatry 2003; 36: 215-221
DOI: 10.1055/s-2003-45133

Original Paper

Thyroid, Brain and Mood Modulation in Affective Disorder: Insights from Molecular Research and Functional Brain Imaging

M. Bauer¹ ^{, 2} , E. D. London² ^{, 3} ^{, 4} , D. H. S. Silverman³ , N. Rasgon⁵ , J. Kirchheiner⁶ , P. C. Whybrow²

¹Department of Psychiatry and Psychotherapy, Charité - University Medicine Berlin, Campus Charité-Mitte (CCM), Berlin, Germany
²Neuropsychiatric Institute & Hospital, and the Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine, University of California at Los Angeles (UCLA), Los Angeles, CA, USA
³Department of Molecular and Medical Pharmacology, Ahmanson Biological Imaging Center, David Geffen School of Medicine, UCLA, Los Angeles, CA, USA
⁴Brain Research Institute, David Geffen School of Medicine, UCLA, Los Angeles, CA, USA
⁵Department of Psychiatry and Behavioral Sciences, Stanford School of Medicine, Palo Alto, CA, USA
⁶Institute of Clinical Pharmacology, Charité - University Medicine Berlin, Campus Charité-Mitte (CCM), Berlin, Germany

Abstract

The efficacy resulting from adjunctive use of supraphysiological doses of levothyroxine has emerged as a promising approach to therapy and prophylaxis for refractory mood disorders. Most patients with mood disorders who receive treatment with supraphysiological doses of levothyroxine have normal peripheral thyroid hormone levels, and also respond differently to the hormone and tolerate it better than healthy individuals and patients with primary thyroid diseases. Progress in molecular and functional brain imaging techniques has provided a new understanding of these phenomena, illuminating the relationship between thyroid function, mood modulation and behavior.

Thyroid hormones are widely distributed in the brain and have a multitude of effects on the central nervous system. Notably many of the limbic system structures where thyroid hormone receptors are prevalent have been implicated in the pathogenesis of mood disorders. The influence of the thyroid system on neurotransmitters (particularly serotonin and norepinephrine), which putatively play a major role in the regulation of mood and behavior, may contribute to the mechanisms of mood modulation. Recent functional brain imaging studies using positron emission tomography (PET) with [¹⁸F]-fluorodeoxyglucose demonstrated that thyroid hormone treatment with levothyroxine affects regional brain metabolism in patients with hypothyroidism and bipolar disorder. Theses studies confirm that thyroid hormones are active in modulating metabolic function in the mature adult brain, and provide intriging neuroanatomic clues that may guide future research.

Key words

Thyroid hormone - levothyroxine - mood disorders - depression - bipolar disorder - positron emission tomography - brain imaging

Full Text

References

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Michael Bauer, M.D., Ph. D.

Department of Psychiatry and Psychotherapy

Charité - University Medicine Berlin

Campus Charité-Mitte (CCM)

Schumannstr. 20/21

10117 Berlin

Germany

Phone: +49-30-450 51 70 70

Fax: +49-30-450-51 79 62

Email: michael.bauer@charite.de