Abstract
Background: Early postmenopausal women frequently suffer from cognitive impairments and emotional disorders, such as lack of attention, poor memory, deficits in executive function and depression. However, the underlying mechanisms of these impairments remain unclear.Method: Forty-three early postmenopausal women and forty-four age-matched premenopausal controls underwent serum sex hormone analysis, neuropsychological testing and resting-state functional magnetic resonance imaging (rs-fMRI). Degree centrality (DC) analysis was performed to confirm the peak points of the functionally abnormal brain areas as the centers of the seeds. Subsequently, the functional connectivity (FC) between these abnormal seeds and other voxels across the whole brain was calculated. Finally, the sex hormone levels, neuroimaging indices and neuropsychological data were combined to detect potential correlations.Results: Compared with the premenopausal controls, the early postmenopausal women exhibited significantly higher serum follicle-stimulating hormone (FSH) levels, more severe climacteric and depressive symptoms, worse sleep quality and more extensive cognitive impairments. Concurrently, the neuroimaging results showed elevated DC values in the left amygdala (AMYG.L), reduced DC values in the left middle occipital gyrus (MOG.L) and right middle occipital gyrus (MOG.R). When we used the AMYG.L as the seed point, FC with the left insula (INS.L), bilateral prefrontal cortex (PFC) and right superior frontal gyrus (SFG.R) was increased; these regions are related to depressive states, poor sleep quality and decreased executive function. When bilateral MOG were used as the seed points, FC with left inferior parietal gyrus (IPG.L), this area closely associated with impaired memory, was decreased.Conclusion: These results illuminated the regional and network-level brain dysfunction in early postmenopausal women, which might provide information on the underlying mechanisms of the different cognitive impairments and emotional alterations observed in this group.
Highlights
Menopause is a progressive recession of the female reproductive system and is characterized by a decline in ovarian function and the termination of menstruation, with excessive levels of folliclestimulating hormone (FSH) and reduced levels of estrogen
Crosssectional magnetic resonance imaging (MRI) comparisons of early postmenopausal women and age-matched premenopausal women are of interest because the aging process of the brain lead to structural and functional brain changes, and this was proved in the hypothesis of a limited window for the effects of hormone therapy (HT) (Georgakis et al, 2016; AguirreVidal et al, 2017; Hwang et al, 2017)
Numerous studies have proved that the frontal cortex was involved in the executive function (Huang et al, 2015; Girard et al, 2017) and the insula was related to the negative emotional experiences and regulation of bodily homeostasis, these functions of the two regions were associated with clinical symptoms among the early postmenopausal women
Summary
Menopause is a progressive recession of the female reproductive system and is characterized by a decline in ovarian function and the termination of menstruation, with excessive levels of folliclestimulating hormone (FSH) and reduced levels of estrogen. Numerous studies have proved that the frontal cortex was involved in the executive function (Huang et al, 2015; Girard et al, 2017) and the insula was related to the negative emotional experiences and regulation of bodily homeostasis (von Leupoldt et al, 2008; Critchley, 2010), these functions of the two regions were associated with clinical symptoms among the early postmenopausal women We designed this cross-sectional study to detect the brain dysfunction in early postmenopausal subjects.
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