A study of the correlation between cognitive function and thyroid hormones in patients with Parkinson's disease.

OBJECTIVE

The aim of the present study was investigating the relationship between thyroid hormone levels and cognitive function in Parkinson's disease (PD).

METHODS

431 PD patients were continuously enrolled from The First Affiliated Hospital of Kunming Medical University between January 2019 and December 2024. This study classified PD patients into PDNC and PDMCI groups based on the PDMCI diagnostic criteria defined by MDS. Clinical information including age, gender, length of illness, BMI, education, and levodopa equivalent daily dose (LEDD), and the presence of underlying diseases such as hypertension and diabetes mellitus were collected from all subjects, and all subjects completed the assessment of UPDRS-III score, H-Y staging, MMSE, MoCA (Beijing version), HAMA, and HAMD scale and underwent the evaluation of thyroid hormone serum T3, T4, FT3, FT4, TSH, TG, TMab, and aTG levels. The differences in general clinical data and thyroid hormone levels between the two groups were compared, and the correlation between thyroid hormone levels and each clinical data and different cognitive domains was analyzed.

RESULTS

Patients in the PDMCI group were older, had a higher proportion of females, had a longer disease duration but fewer years of education, and had higher UPDRS-III, H-Y staging, HAMA, HAMD scores, and LEDDs and lower TSH (all p < 0.05) than those in the PDNC group, but there were no statistically significant differences in comorbidities or thyroid-related markers. In PD patients, FT3 levels were negatively correlated with age, HAMA score, HAMD score, and H-Y staging; FT3 levels were positively correlated with the total MoCA score (p < 0.05) and attention (r = 0.165, p = 0.001), and this association remained independent and significant after multivariate adjustment and multiple-testing correction. The dose-response relationship between TSH levels and cognitive scores shows a clear inverted U-shape.

CONCLUSION

This study suggests that thyroid hormone dysregulation may be associated with cognitive function in Parkinson's disease patients, though this relationship requires further investigation to confirm. This highlights the need for future research to evaluate whether therapeutic modulation of thyroid function could influence cognitive outcomes during the progression of Parkinson's disease.