Parkinson Hastalığında Motor Semptomların Tiroid Hormon Seviyeleri ile İlişkisi

Yıl 2022, Cilt: 24 Sayı: 2, 142 - 146, 30.08.2022

Özgül Ocak , Erkan Melih Şahin , Mustafa Çam

https://doi.org/10.18678/dtfd.1068664

Öz

Amaç: Bu çalışmanın amacı Parkinson hastalarının tiroid hormon seviyeleri ile motor semptomları arasındaki ilişkisinin araştırılmasıdır.
Gereç ve Yöntemler: 01.01.2018 ve 01.04.2021 tarihleri arasında Parkinson hastalığı tanısı almış olan ve tiroid fonksiyon testleri ölçülmüş olan hastaların nöroloji kliniği kayıtları seçildi. Primer tiroid hormon bozukluğu tanısı olanlar dışlandı. Kayıtlar incelenerek modifiye Hoehn ve Yahr ölçeğine (modified Hoehn and Yahr scale, mHYS) göre motor semptom evreleri belirlendi. Tiroid fonksiyon test sonuçlarına göre motor semptomlarda fark olup olmadığı, hastalık süresi ve ilaçların etkileri incelendi.
Bulgular: Çalışmaya dahil edilen 93 hastanın 53’ü (%57,0) erkek ve 40’ı (%43,0) kadın idi. Hastaların medyan yaşı 71 yıl idi. Hastaların motor semptomları 21 (%22,6) hastada evre 1, 18 (%19,4) hastada evre 1.5, 29 (%31,2) hastada evre 2, 13 (%14,0) hastada evre 2.5, 4 (%4,3) hastada evre 3, 6 (%6,5) hastada evre 4 ve 2 (%2,2) hastada evre 5 olarak sınıflandırıldı. Medyan TSH, fT3 ve fT4 düzeyleri sırasıyla 2,075 uIU/ml, 2,925 ng/dl ve 1,235 ng/dl idi. Hastaların mHYS evreleri ile TSH (r=-0,148; p=0,164), fT3 (r=-0,073; p=0,623) ve fT4 (r=0,075; p=0,491) düzeyleri arasında anlamlı bir korelasyon yoktu.
Sonuç: Tiroid fonksiyonları normal olan hastalarda motor semptomların şiddeti ve hormon seviyeleri arasında bir ilişki yoktur. Tiroid fonksiyon bozuklukları Parkinson hastalarındaki birçok motor bulguyu taklit edebilir, fakat motor bulgularının şiddetini etkilememektedir.

Anahtar Kelimeler

Parkinson Hastalığı, Motor Semptomlar, Tiroid fonsiyonları

The Relationship of Thyroid Hormone Levels and Motor Symptoms in Parkinson's Disease

Öz

Aim: This study aimed to investigate the relationship between thyroid hormone levels and the motor symptoms of Parkinson's patients.
Material and Methods: Neurology clinic logs of the patients diagnosed with Parkinson's disease and whose thyroid function tests were measured between 01.01.2018 and 01.04.2021 were selected. Those with primary thyroid hormone disorder were excluded. Motor symptom stages were determined according to the modified Hoehn and Yahr scale (mHYS) by records. According to the thyroid function test results, whether there was a difference in motor symptoms, duration of the disease, and effects of the drugs were examined.
Results: Of the 93 patients included in the study, 53 (57.0%) were male and 40 (43.0%) were female. The median age of the patients was 71 years. The motor symptoms of the patients were classified as stage 1 in 21 (22.6%), stage 1.5 in 18 (19.4%), stage 2 in 29 (31.2%), stage 2.5 in 13 (14.0%), stage 3 in 4 (4.3%), stage 4 in 6 (6.5%), and stage 5 in 2 (2.2%) patients. The median levels of TSH, fT3, and fT4 were 2.075 uIU/ml, 2.925 ng/dl, and 1.235 ng/dl, respectively. There was no significant correlation between the mHYS stages of the patients and TSH (r=-0.148, p=0.164), fT3 (r=-0.073, p=0.623), and fT4 levels (r=0.075, p=0.491).
Conclusion: There was no relationship between the severity of motor symptoms and hormone levels in patients with normal thyroid functions. Thyroid dysfunction may mimic many motor findings, but they do not affect the severity of motor findings in Parkinson's patients.

Anahtar Kelimeler

Parkinson's disease, motor symptoms, Thyroid functions

Kaynakça

• Aygun D, Akpinar CK, Yon S, Onar MK. Effect of clinical autonomic dysfunction on cognitive functions in Parkinson’s disease. Dicle Med J. 2017;44(3):225-31.
• Postuma RB, Berg D, Stern M, Poewe W, Olanow CW, Oertel W, et al. MDS clinical diagnostic criteria for Parkinson’s disease. Mov Disord. 2015;30(12):1591-601.
• Feldman AZ, Shrestha RT, Hennessey JV. Neuropsychiatric manifestations of thyroid disease. Endocrinol Metab Clin North Am. 2013;42(3):453-76.
• Hayes MT. Parkinson's Disease and parkinsonism. Am J Med. 2019;132(7):802-7.
• Mohammadi S, Dolatshahi M, Rahmani F. Shedding light on thyroid hormone disorders and Parkinson disease pathology: mechanisms and risk factors. J Endocrinol Invest. 2021;44(1):1-13.
• Goetz CG, Poewe W, Rascol O, Sampaio C, Stebbins GT, Counsell C, et al. Movement disorder society task force report on the Hoehn and Yahr staging scale: status and recommendations. Mov Disord. 2004;19(9):1020-8.
• Simon DK, Tanner CM, Brundin P. Parkinson disease epidemiology, pathology, genetics, and pathophysiology. Clin Geriatr Med. 2020;36(1):1-12.
• Odabaş FÖ, Uca AU. The evaluation of quality of life of relatives caring for patients with Parkinson’s disease. Dicle Med J. 2018;45(2):201-8.
• Bülbül NG, Akbostancı MC. [Parkinson’s disease and prodromal symptoms]. Parkinson Hast Harek Boz Derg. 2017;20(1-2):28-32. Turkish.
• Yazar T, Olgun Yazar H. [Evaluation of C-reactive protein/albumin ratio according to stage in patients with idiopathic Parkinson disease]. Turk J Neurol. 2019;25(3):123-8. Turkish.
• Geyik S, Yiğiter R, Akgül GP, Elçi MA, Ekmekyapar Fırat Y. [The relationship between Parkinson’s disease and mean platelet volume]. Parkinson Hast Harek Boz Derg. 2016;19(1-2):31-4. Turkish.
• Gürbüz M, Akdağ G, Arıcı Düz Ö, Özer F, Çokar Ö, Hanoğlu L. [Relation of apathy to motor and non-motor findings in Parkinson’s disease]. Med Bull Haseki. 2019;57(2):129-34. Turkish.
• Pasqualetti G, Pagano G, Rengo G, Ferrara N, Monzani F. Subclinical hypothyroidism and cognitive impairment: systematic review and meta-analysis. J Clin Endocrinol Metab. 2015;100(11):4240-8.
• Villanueva I, Alva-Sánchez C, Pacheco-Rosado J. The role of thyroid hormones as inductors of oxidative stress and neurodegeneration. Oxid Med Cell Longev. 2013;2013:218145.
• Wei Z, Li X, Li X, Liu Q, Cheng Y. Oxidative stress in Parkinson's Disease: a systematic review and meta-analysis. Front Mol Neurosci. 2018;11:236.
• Kimber J, Watson L, Mathias CJ. Neuroendocrine responses to levodopa in multiple system atrophy (MSA). Mov Disord. 1999;14(6):981-7.
• Gupta A, Haboubi N, Thomas P. Screening for thyroid dysfunction in the elderly. Arch Intern Med. 2001;161(1):130.
• Stern RA, Davis JD, Rogers BL, Smith KER, Harrington CJ, Ott BR, et al. Preliminary study of the relationship between thyroid status and cognitive and neuropsychiatric functioning in euthyroid patients with Alzheimer dementia. Cogn Behav Neurol. 2004;17(4):219-23.
• Tan Y, Gao L, Yin Q, Sun Z, Man X, Du Y, et al. Thyroid hormone levels and structural parameters of thyroid homeostasis are correlated with motor subtype and disease severity in euthyroid patients with Parkinson’s disease. Int J Neurosci. 2021;131(4):346-56.
• Kim JH, Lee HS, Ahn JH, Oh JK, Chang IB, Song JH, et al. Association between thyroid diseases and Parkinson’s disease: a nested case-control study using a national health screening cohort. J Parkinsons Dis. 2021;11(1):211-20.