Cláudia Santos Silva1,2, Marta Gromicho3, Miguel Oliveira Santos4,3, Susana Pinto3, Michael Swash3,5, Mamede de Carvalho4,3. 1. Department of Neurosciences and Mental Health, Hospital de Santa Maria, Centro Hospitalar Universitário Lisboa-Norte, 1649-035, Lisbon, Portugal. csantosilva2@gmail.com. 2. Faculdade de Medicina- Instituto de Medicina Molecular, Universidade de Lisboa, Lisbon, Portugal. csantosilva2@gmail.com. 3. Faculdade de Medicina- Instituto de Medicina Molecular, Universidade de Lisboa, Lisbon, Portugal. 4. Department of Neurosciences and Mental Health, Hospital de Santa Maria, Centro Hospitalar Universitário Lisboa-Norte, 1649-035, Lisbon, Portugal. 5. Departments of Neurology and Neuroscience, Barts and the London School of Medicine, Queen Mary University of London and Royal London Hospital, London, UK.
Abstract
INTRODUCTION: Thyroid hormones influence neuromuscular function, and it has been thought that this might contribute to degeneration of motor neurons. METHODS: We used case-control methods to investigate the prevalence of thyroid dysfunction (hyperthyroidism and hypothyroidism) in ALS patients followed in our centre, between 2015 and 2020. Data from patients with neuromuscular disorders not derived from thyroid dysfunction, followed within the same time frame, were used as controls. Thyroid dysfunction was defined by previous thyroid replacement medication managed by an endocrinologist. We used odds ratios (OR) with a 95% confidence interval (CI) to compare 579 ALS patients and 415 age-gender-matched disease controls. Additionally, we provide a summarized review of the literature. RESULTS: Hypothyroidism (prevalence of 5.0 versus 8.6%; OR = 0.56, 95% CI 0.34-0.92, p = 0.023), hyperthyroidism (prevalence of 0.3 versus 1.2%; OR = 0.28, 95% CI 0.06-1.47, p = 0.134) and overall thyroid dysfunction (prevalence of 5.4 versus 9.9%; OR = 0.52, 95% CI 0.32-0.84, p = 0.015) were less prevalent in ALS patients than in controls, but similar to the national epidemiological data for thyroid disease. Our data are in line with the findings of most previous studies. CONCLUSIONS: We conclude that thyroid dysfunction is not associated with ALS.
INTRODUCTION: Thyroid hormones influence neuromuscular function, and it has been thought that this might contribute to degeneration of motor neurons. METHODS: We used case-control methods to investigate the prevalence of thyroid dysfunction (hyperthyroidism and hypothyroidism) in ALS patients followed in our centre, between 2015 and 2020. Data from patients with neuromuscular disorders not derived from thyroid dysfunction, followed within the same time frame, were used as controls. Thyroid dysfunction was defined by previous thyroid replacement medication managed by an endocrinologist. We used odds ratios (OR) with a 95% confidence interval (CI) to compare 579 ALS patients and 415 age-gender-matched disease controls. Additionally, we provide a summarized review of the literature. RESULTS: Hypothyroidism (prevalence of 5.0 versus 8.6%; OR = 0.56, 95% CI 0.34-0.92, p = 0.023), hyperthyroidism (prevalence of 0.3 versus 1.2%; OR = 0.28, 95% CI 0.06-1.47, p = 0.134) and overall thyroid dysfunction (prevalence of 5.4 versus 9.9%; OR = 0.52, 95% CI 0.32-0.84, p = 0.015) were less prevalent in ALS patients than in controls, but similar to the national epidemiological data for thyroid disease. Our data are in line with the findings of most previous studies. CONCLUSIONS: We conclude that thyroid dysfunction is not associated with ALS.
Authors: Jeremy M Shefner; Ammar Al-Chalabi; Mark R Baker; Li-Ying Cui; Mamede de Carvalho; Andrew Eisen; Julian Grosskreutz; Orla Hardiman; Robert Henderson; Jose Manuel Matamala; Hiroshi Mitsumoto; Walter Paulus; Neil Simon; Michael Swash; Kevin Talbot; Martin R Turner; Yoshikazu Ugawa; Leonard H van den Berg; Renato Verdugo; Steven Vucic; Ryuji Kaji; David Burke; Matthew C Kiernan Journal: Clin Neurophysiol Date: 2020-04-19 Impact factor: 3.708