Eighty-five percent of the studies of patients with congenital hypothyroidism (CH) treated with Levothyroxine (L-T₄) report neuropsychological sequelae throughout life. In neonates and infants, there is a deficit in sensorimotor skills (impaired balance). In preschool and elementary school children and adolescents, there are alterations in intellectual quotient (low scores), language (delayed phonological acquisition), memory (visual, verbal, visuospatial, visuoconstructive, autobiographical, and semantic), sensorimotor skills (impaired fine and gross motor control), and visuoconstructive–visuospatial domain (low scores in spatial location, block design, and object assembly). These neuropsychological domains are also affected in young adults, except for language (adequate verbal fluency) and visuoconstructive–visuospatial domain (no data). The onset and severity of neuropsychological sequelae in patients with treated CH depend on several factors: extrinsic, related to L-T₄ treatment and social aspects, and intrinsic, such as severity and etiology of CH, as well as structural and physiological changes in the brain. In this review, we hypothesized that thyroid hormone hyposensitivity (THH) could also contribute to neuropsychological alterations by reducing the effectiveness of L-T₄ treatment in the brain. Thus, further research could approach the THH hypothesis at basic and clinical levels to implement new endocrinological and neuropsychological therapies for CH patients.

Hypothyroidism is a prevalent thyroid condition in which the thyroid gland fails to secrete an adequate amount of thyroid hormone into the bloodstream. This condition may develop due to genetic or acquired factors. The most frequent cause of acquired hypothyroidism is chronic autoimmune thyroiditis, also known as Hashimoto’s disease. Acquired hypothyroidism is diagnosed when patients present with overt hypothyroidism (also known as clinical hypothyroidism), as they exhibit increased TSH and decreased T₃ and T₄ serum levels. This article examines the prevalence of psychiatric disorders among patients diagnosed with acquired hypothyroidism with or without Levothyroxine treatment. We discuss the available evidence indicating that acquired hypothyroidism may be a risk factor for psychiatric disorders, and the effectiveness of thyroid treatment in relieving psychiatric symptoms. Additionally, we provide critical details on thyroid hormone cutoff values reported in the literature, their potential clinical importance, and their correlation with psychiatric symptoms. Finally, we examined the various mechanisms by which acquired hypothyroidism can lead to depression. The high rate of comorbidity between hypothyroidism and psychiatric disorders deserves special attention, indicating the importance of consistent monitoring and timely identification of psychiatric symptoms to prevent disease exacerbation and facilitate therapeutic management. On the other hand, several mechanisms underlie the strong association between depression and acquired hypothyroidism. Deeper research into these mechanisms will allow knowledge of the pathophysiology of depression in patients with acquired hypothyroidism and will provide clues to design more precise therapeutic strategies for these patients.

Sucrose consumption impairs behavioral and cognitive functions that correlate with decreased neurogenesis in animal models. When consumed during early adolescence, this disaccharide promotes anxious and depressive behaviors, along with a reduction in the generation of new neurons in the dentate gyrus of the hippocampus. Data concerning sucrose consumption during late adolescence are lacking, and the effect of sucrose intake on the ventral dentate gyrus of the hippocampus (which modulates anxiety and depression) remains elusive. Here, we tested whether sucrose intake during late adolescence causes anxiety or impaired neurogenesis in the ventral dentate gyrus. Rats did not display anxiety-like behaviors neither at the light–dark box test nor at the open field exploration. However, there was a significant increase in proliferative cells in the subgranular zone of the ventral dentate gyrus in rats exposed to sucrose (p < 0.05). This increased proliferation corresponded to neural stem cells (Radial Type 1 cells) in the group exposed to sucrose until adulthood but was not present in rats exposed to sucrose only during late adolescence. Remarkably, the phosphorylation of ERK1/2 kinases was increased in the hippocampi of rats exposed to sucrose only during late adolescence, suggesting that the increased proliferation in this group could be mediated by the MAPK pathway. On the other hand, although no differences were found in the number of immature granular neurons, we observed more immature granular neurons with impaired dendritic orientation in both groups exposed to sucrose. Finally, GAD65/67 and BCL2 levels did not change between groups, suggesting an unaltered hippocampal GABAergic system and similar apoptosis, respectively. This information provides the first piece of evidence of how sucrose intake, starting in late adolescence, impacts ventral dentate gyrus neurogenesis and contributes to a better understanding of the effects of this carbohydrate on the brain at postnatal stages.

The adult rodent hippocampus is capable of maintaining its capacity to generate new neurons in the subgranular zone (SGZ) of the dentate gyrus (DG). Interestingly, proliferative cells have also been described in the hilus. The involvement of the hilar neurogenesis process in hippocampal physiology is unknown. Thyroid hormones (THs) are necessary for the survival of postmitotic progenitor cells, neuroblasts, and immature granule neurons in the SGZ. In contrast, evidence concerning the role of THs in the hilar neurogenesis process is limited. The present study characterized the mitotic activity, cell survival, and neuronal differentiation of hilar neurogenesis under physiological and hypothyroid conditions and compared them with those of the granular layer (GL) and the SGZ of the DG in adult Wistar rats. We found that, under physiological conditions, the hilus harbors fewer proliferative cells than the neurogenic zone (GL/SGZ) does, with a rate of cell survival of 18.9% and a rate of differentiation into granular neurons of 19%. Interestingly, hypothyroidism provokes decreased cell proliferation and an increased rate of cell survival without affecting neuronal differentiation. These effects induced by hypothyroidism in the hilus were different or inclusive, contrary to those observed in the neurogenic zone.

Emerging evidence highlights a strong association between cerebrovascular accident (CVA) and major depressive disorder (MDD), mediated by immune dysregulation. Elevated levels of proinflammatory cytokines, reduced adaptive immune responses, altered immune cell composition, and increased microglial activation characterize this bidirectional relationship. Microglial activation appears to be a central molecular mechanism linking CVA and MDD, underscoring the immune system’s crucial role in disease pathogenesis. This interplay suggests that immune-driven processes not only exacerbate neurological damage but also contribute to psychiatric manifestations. Based on current literature, the role of proinflammatory processes, particularly microglial activation, in the relationship between CVA and MDD warrants special attention. In this context, the participation of myeloid differentiation factor 88 (MyD88), a cytosolic adaptor protein, appears to play a key role in proinflammatory signaling pathways driving microglial activation. Thus, focusing on MyD88 emerges as a promising complementary strategy for future research and for advancing our understanding of the mechanisms underlying microglial homeostasis dysregulation and its link to the pathophysiology of MDD and CVA.