The versatile clinical manifestations of the Hashimoto's chronic autoimmune thyroiditis often include psycho-neurological disorders. Although hypothyroidism disturbs significantly the ontogenesis and functions of central nervous system, causing in severe cases of myxedema profound impairment of cognitive abilities and even psychosis, the behavioral, motor and other psychoneurological disorders accompany euthyroid and slightly hypothyroid cases and periods of Hashimoto's disease as well, thus constituting the picture of so called "Hashimoto's encephalopathy". The entity, although discussed and explored for more than 50 years since its initial descriptions, remains an enigma of thyroidology and psychiatry, because its etiology and pathogenesis are obscure. The paper describes the development of current views on the role of thyroid in ontogeny and functions of brain, as well as classical and newest ideas on the etiology and pathogenesis of Hashimot's encephalopathy. The synopsis of the world case reports and research literature on this disorder is added with authors' own results obtained by study of 17 cases of Hashimoto's thyroiditis with schizophrenia-like clinical manifestations. The relation of the disease to adjuvant-like etiological factors is discussed. Three major mechanistic concepts of Hashimoto's encephalopathy are detailed, namely cerebral vasculitis theory, hormone dysregulation theory and concept, explaining the disease via direct action of the autoantibodies against various thyroid (thyroperoxidase, thyroglobulin, and TSH-receptor) and several extrathyroid antigens (alpha-enolase and other enzymes, gangliosides and MOG-protein, onconeuronal antigens) - all of them expressed in the brain. The article demonstrates that all above mentioned concepts intermingle and prone to unification, suggesting the unified scheme of pathogenesis for the Hashimoto's encephalopathy. The clinical manifestations, criteria, forms, course, treatment and prognosis of Hashimoto's encephalopathy and its comorbidity to other diseases - are also discussed in brief. The relation between Hashimoto's encephalopathy and non-vasculitis autoimmune encephalomyelitides of paraneoplastic and non-paraneoplastic origin is emphasized [1 figure, bibliography - 200 references].

中文翻译：

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甲状腺和大脑：桥本脑病之谜。

桥本氏慢性自身免疫性甲状腺炎的多种临床表现通常包括心理神经系统疾病。尽管甲状腺功能低下会严重干扰中枢神经系统的发生和功能，在粘液水肿的严重病例中引起认知能力甚至精神病的严重损害，但是行为，运动和其他心理神经系统疾病会伴随甲状腺功能正常和轻度甲状腺功能减退的病例以及桥本氏病的发作，因此构成了所谓的“桥本脑病”。尽管该实体自最初描述以来已进行了50多年的讨论和探索，但由于其病因和发病机理尚不清楚，因此仍然是甲状腺和精神病学的谜。本文描述了关于甲状腺在个体发育和脑功能中作用的最新观点的发展，以及关于Hashimot脑病的病因和发病机制的经典和最新观点。通过对17例具有精神分裂症样临床表现的桥本甲状腺炎进行研究，作者们获得了有关该疾病的世界病例报告和研究文献的摘要。讨论了该疾病与佐剂样病因的关系。详述了桥本脑病的三个主要机制概念，即脑血管炎理论，激素失调理论和概念，它们通过自身抗体对各种甲状腺（甲状腺素过氧化物酶，甲状腺球蛋白，和TSH受体）和几种甲状腺外抗原（α-烯醇酶和其他酶，神经节苷脂和MOG蛋白，脑膜上抗原）-它们都在大脑中表达。这篇文章证明了上述所有概念都混杂在一起并且容易统一，这暗示了桥本脑病发病机制的统一方案。还简要讨论了桥本脑病的临床表现，标准，形式，病程，治疗和预后以及与其他疾病的合并症。强调桥本脑病与副肿瘤和非副肿瘤起源的非血管炎自身免疫性脑脊髓炎之间的关系[1个图，参考书目-200参考]。onconeuronal抗原）-它们都在大脑中表达。这篇文章证明了上述所有概念都混杂在一起并且容易统一，这暗示了桥本脑病发病机制的统一方案。还简要讨论了桥本脑病的临床表现，标准，形式，病程，治疗和预后以及与其他疾病的合并症。强调桥本脑病与副肿瘤和非副肿瘤起源的非血管炎自身免疫性脑脊髓炎之间的关系[1个图，参考书目-200参考]。onconeuronal抗原）-它们都在大脑中表达。这篇文章证明了上述所有概念都混杂在一起并且易于统一，这暗示了桥本脑病发病机制的统一方案。还简要讨论了桥本脑病的临床表现，标准，形式，病程，治疗和预后以及与其他疾病的合并症。强调桥本脑病与副肿瘤和非副肿瘤起源的非血管炎自身免疫性脑脊髓炎之间的关系[1个图，参考书目-200参考]。还简要讨论了桥本脑病的标准，形式，病程，治疗和预后以及与其他疾病的合并症。强调桥本脑病与副肿瘤和非副肿瘤起源的非血管炎自身免疫性脑脊髓炎之间的关系[1个图，参考书目-200参考]。还简要讨论了桥本脑病的标准，形式，病程，治疗和预后以及与其他疾病的合并症。强调桥本脑病与副肿瘤和非副肿瘤起源的非血管炎自身免疫性脑脊髓炎之间的关系[1个图，参考书目-200参考]。