Effects of Thyroid Hormone on Brain Development

Effects of Thyroid Hormone on Brain Development

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ABSTRACT
Thyroid hormones are essential for normal brain development. They influence neurogenesis, neuronal and glial cell differentiation and migration, synaptogenesis, and myelination. Thyroid hormone deficiency may severely affect the brain during fetal and postnatal development, causing retarded maturation, intellectual deficits, and neurological impairment. Neural cells express the thyroid hormone nuclear receptors THRA and THRB, which mediate most actions of T3, the active hormone. Brain T3 derives in part from the circulation, and part from type-2 deiodinase-mediated 5’-deiodination of T4 in glial cells. Type 3 deiodinase inactivates T4 and T3 by 5-deiodination in neurons. Membrane transporters facilitate the passage of T4 and T3 across the brain barriers. The main transporters are the monocarboxylate transporter 8 (MCT8) and the organic anion transporter polypeptide 1C1 (OATP1C1). MCT8 facilitates T4 and T3 transport whereas OATP1C1 transports T4 but not T3. T3 regulates the expression of a large number of genes in the brain, mostly during developmental stages, but also in the adult. Rodent models of disease have provided most of our knowledge on thyroid hormone action in the brain. However, species-specific differences in brain maturation and organization make it difficult sometimes to extrapolate the data obtained in rodent models to the human. This review will present a summary of the main concepts developed from rodent studies, with a focus on the human brain.

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INTRODUCTION
Thyroid hormones are crucial for brain development, and influence brain function throughout life. In adults, hypothyroidism causes lethargy, hyporeflexia, and poor motor coordination (1,2), is associated with bipolar affective disorders, depression, or loss of cognitive functions (3,4). Subclinical hypothyroidism is often associated with memory impairment. Conversely, hyperthyroidism causes hyperreflexia, irritability, and anxiety among other symptoms (5). Hypo- or hyperthyroidism can lead to mood disorders, dementia, confusion, and personality changes. Most of these disorders are usually reversible with proper treatment, indicating that adult-onset thyroid hormone alterations affect neural function but do not leave permanent structural defects.

Effects of Thyroid Hormone on Brain Development

The actions of thyroid hormones during mammalian brain maturation are qualitatively different. They influence many developmental processes, usually during limited time windows. They are required for the timely synchronization of independent events and facilitate the transition between fetal and postnatal stages (6,7), similarly to promoting amphibian metamorphosis (8,9). Thyroid hormone deficiency during critical transition periods may lead to irreversible brain damage, the consequences of which depend on the severity and duration of the deficiency, and most importantly its time of onset (10-14).

Until recently, the rat was the most widely used animal model in the study of thyroid physiology and the actions of thyroid hormones in the brain. However, for more than 20 years, the mouse is the preferred animal model, and the use of knockout and knockin mice has facilitated our understanding. However, it is important to be aware of species specificities which make it difficult to extrapolate the results to the human situation. The timing of development in relation to birth among mammals presents substantial differences, even if the sequence of events might be similar (15-17). The web resource www.translatingtime.org (18) provides tools to compare neurodevelopmental time across species. As an approximation, the newborn rat may be compared with a second-trimester human fetus, and the maturation of a newborn human cerebral cortex to that of a 12-13-day old rat pup (19). For integrative reviews on molecular and evolutionary aspects of the cerebral cortex and cerebellar development and the effects of thyroid hormones see (20-23).

Whenever possible, this chapter focuses on observations in humans. Gene and protein notations follow the HUGO nomenclature (http://www.genenames.org): for human genes, names are in italics and in capital letters, protein names are written in non-italic capital letters irrespective of species.

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STRUCTURAL DEFECTS CAUSED BY THYROID HORMONE DEFICIENCY
As an approach to understanding how thyroid hormones influence brain development, the changes caused by thyroid hormone deprivation are informative. In rats, perinatal hypothyroidism causes reduced myelination and diverse structural defects (for a classical review on this topic see (24). A reduction of the neuropil causes increased cell density in the cerebral cortex (25,26). Reduction in total cell numbers of regions with significant neurogenesis during the postnatal period, such as the olfactory bulb and the granular layers of the hippocampus and cerebellum (26-28). Transient structures show retarded disappearance. An important example is the subplate, a transient structure of the cortex involved in the organization of thalamic afferents to the cortex (29). In the cerebellum, regression of the external granular, or germinal layer, is retarded by a few days (30). The Cajal-Retzius cells, formed early during cortical development and involved in the regulation of the inside-out migration of neurons have delayed appearance (Fig. 1 left panel) (31). The GABAergic interneurons have altered distribution and connectivity, and the parvalbumin subclass is reduced in number (32-35). The maturation of several types of neurons is compromised, with stunted dendritic and/or axonal growth and maturation, for example cholinergic cells (36), cerebellar Purkinje cells (Fig. 1 central panel) (37,38), and cortex layer V pyramidal cells (39,40). Changes in dendritic spine number are also observed in the cortex and hippocampus after adult-onset hypothyroidism and are reversible with thyroxine treatment (41,42). Hypothyroidism also causes delayed and poor deposition of myelin (43-46) whereas hyperthyroidism accelerates myelination (47).