Abstract
Purpose: Prior research has demonstrated that the postpartum period is associated with an increased risk of cognitive impairment. This study aims to investigate whether disrupted spontaneous neural activity exists in postpartum women without depression using resting-state functional magnetic resonance imaging (rs-fMRI) and to detect the relationship between these abnormalities and cognitive impairment.Materials and Methods: Postpartum women (n = 22) were compared with age- and education-matched nulliparous women (n = 23) using rs-fMRI. We calculated the amplitude of low-frequency fluctuation (ALFF) and regional homogeneity (ReHo) values to evaluate spontaneous neural activity and detect the relationship between rs-fMRI data and cognitive performance.Results: Relative to nulliparous women, postpartum women had significantly decreased ALFF and ReHo values primarily in the left posterior cingulate cortex (PCC) and prefrontal cortex and increased ALFF values in left cerebellar posterior lobe. We found a positive correlation between the ALFF and ReHo values in the PCC and the complex figure test (CFT)-delayed scores in postpartum women (r = 0.693, p = 0.001; r = 0.569, p = 0.011, respectively). Moreover, the clock-drawing test (CDT) scores showed positive correlations with the ALFF and ReHo values in the right superior frontal gyrus (SFG; r = 0.492, p = 0.033; r = 0.517, p = 0.023, respectively).Conclusion: Our combined ALFF and ReHo analyses revealed decreased spontaneous neural activity, mainly in the PCC and prefrontal cortex, which was correlated with specific impaired cognitive functioning in postpartum women. This study may elucidate the neurophysiological mechanisms underlying postpartum cognitive impairment and enhance our understanding of the neurobiological aspects of the postpartum period.
Highlights
Postpartum women experience a multitude of physical and environmental changes and are at risk of developing worsening of underlying affective disorders (Munk-Olsen et al, 2009, 2012; Agrati and Lonstein, 2016; Esscher et al, 2016; Gingnell et al, 2017)
On the basis of prior work and theoretical considerations, we aimed to combine amplitude of low-frequency fluctuation (ALFF) and regional homogeneity (ReHo) to explore the spontaneous neural activity in postpartum women compared with that in nulliparous women and hypothesized that (1) aberrant ALFF and ReHo values would be identified within several brain regions involved in emotional processing, attention, and cognitive function and (2) disrupted spontaneous neural activity would be associated with impaired cognitive performance
The other neuropsychological tests showed no significant differences between postpartum women and nulliparous women
Summary
Postpartum women experience a multitude of physical and environmental changes and are at risk of developing worsening of underlying affective disorders (Munk-Olsen et al, 2009, 2012; Agrati and Lonstein, 2016; Esscher et al, 2016; Gingnell et al, 2017). The postpartum period has been linked with an increased risk of cognitive impairment, which primarily presents. Alterations in hormone levels, such as estrogen, progesterone, and glucocorticoid levels, may result in cognitive impairment during the postpartum period (Henry and Sherwin, 2012). Previous studies have indicated that women during the postpartum period have significant cognitive deficits that may occur prior to affective disorder (Christensen et al, 2010; Postma et al, 2014; Meena et al, 2016). Postpartum-related cognitive impairment may play a major role in various postpartum psychiatric disorders (Henry and Rendell, 2007; Chan et al, 2015; Hoekzema et al, 2017). The neuropathological mechanism of postpartum cognitive impairment still remains largely unknown
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