Moreover, under the influence of the disorder, some patients might progress towards a state of permanent hypothyroidism.[19] Contemporary research suggests that thyroid hormones can bind to thyroid hormone nuclear receptors in brain vascular endothelial cells, promoting the activation of the phosphoinositide 3-kinase (PI3K)/protein kinase B (Akt) signaling pathway. This evidence concerns the gene AKT1 and hypothyroidism.