The impact of Graves’ disease on the brain: from if to how

In Graves’ disease (GD), the most common form of hyperthyroidism in Sweden, we have previously shown that 38% (800 patients/year) remain with mental fatigue (MF) after treatment of hyperthyroidism.

Supported by this data, we hypothesize that MF is an autoimmune complication to GD and for the first time, aim to detect and characterize structural, functional or immunological biomarkers.

Specifically, we will:Characterize the structural and functional effects in GD patient cohorts with/without MF using whole-brain neuromorphology, functional near-infrared spectroscopy, and magnetoencephalography  compared to controlsExplore the autoimmune reaction in blood and cerebrospinal fluid of GD patients with/without MF compared to controls, to identify immunomarkers in one cohort using brain maps, then validate these markers in a second cohortAssess the autoimmune effect on the brain by correlating the immunomarkers with structural and functional brain changesInvestigate if autoimmunity is a common mechanism for MF in thyroid diseases, by applying immunomarkers in GD patients during thyroid destruction by radioactive iodine that activates the immune system, and in autoimmune hypothyroidism with/ without MF.This project will expand our knowledge on brain dysfunction in GD and will be applicable to GD patients worldwide.

We hope that it may open the way for personalized treatments that would be valuable both for GD patients as well as for patients with other autoimmune diseases.