The impact of Graves’ disease in the brain: from why to how

We have shown structural brain changes, a broad immune activation, and a high proportion of persistent mental fatigue (MF) after treatment of Graves’ disease (GD), the most common form of hyperthyroidism in Sweden (~1% prevalence and primarily women). Supported by these data, we hypothesise that MF is an autoimmune complication to GD that affects brain metabolism.

We aim to be first to identify and characterise neurological, autoimmune, metabolic and personal trait biomarkers for MF to propose a mechanism for GD.

We will:Characterise the structural and functional effects in GD patients with/without MF using whole brain neuromorphology, and magnetoencephalography compared to controls (present-2027)Determine biomarkers for persistent MF in GD using blood, cerebrospinal fluid, and questionnaires to detect autoimmune and metabolic reactions targeting the brain and personal traits (personality, coping, perceived stress and self-efficacy connected to worse mental outcome of GD patients with/without MF compared to controls in one cohort, and validate these markers in a second cohort (present-2027)Identify the autoimmune effects on the brain in GD by correlating the best immunomarkers to structural and functional brain imaging data (2026-2028)This project will expand our knowledge of brain dysfunction in GD and will be applicable to GD patients worldwide.

We aim to open the door for personalised treatments for both GD patients and for patients with other autoimmune diseases.