| Objecive:Perimenopausal women suffer from cognitive impairment due to ovarian decline and estrogen levels drop,however the neural mechanism is unclear.This study uses multimoding resting-state functional magnetic resonance imaging(rs-f MRI)technology,combined with independent component analysis(ICA),amplitude of low frequency fluctuations(ALFF),regional homogeneity(Re Ho)technology,and voxel-based morphometry(VBM)methods,to study the changes in the brain function and structure of perimenopausal women and their relationship with cognitive function.Subjects and Methods:75 women were recruited in the study,25 women in the perimenopausal group(average age 53.19 ± 3.82 years)were selected to meet the entry criteria;25 women in the premenopausal cycle group(average age 47.67 ± 3.48 years)and 25 women in the postmenopausal group(average age 58.53 ± 2.17 years)as the control groups.Each volunteer completed scale assessments,sex hormone level test and cogniton tasks.GE 3.0T Discovery MR 750 magnetic resonance scanner was used to collect resting state functional and structural images of all volunteers.(1)The SPM12 software based on Matlab R2012 a platform was used to pre-process the resting state functional data.The pre-processing process includes: time correction,head motion correction,spatial standardization,spatial smoothing,linear regressed,low-frequency filtering and removal of covariates.The SPM12 software plug-in package VBM-DARTEL based on the Matlab R2012 a platform was used to pre-process the high-resolution structural images.The pre-processing includes: tissue segmentation,registration,spatial standardization and spatial smoothing.(2)The pre-processed resting state functional data was analyzed the differences by group ICA analysis,ALFF analysis,and Re Ho analysis using the MICA software and REST software based on Matlab R2012 a platform to obtain resting state brain networks,whole brain ALFF maps,and whole brain Re Ho maps between perimenopausal women group and the two control groups.Using age and years ofeducation as covariates,the changes in brain function and their relationship with cognitive function in perimenopausal women were studied.(3)The pre-processed high-resolution structural image data was based on the difference brain regions of ICA analysis,ALFF analysis,and Re Ho analysis between perimenopausal women group and the two control groups as region of interest(ROI)to extract the gray matter volume.Using age and years of education as covariates,the changes of gray matter volume in brain regions based on differences in brain function and their relationship with cognitive function in perimenopausal women.Results:(1)Compared with the premenopausal cycle group in the perimenopausal group,there were statistical differences in age,menopausal rating scale(MRS),prolactin,follicle-stimulating hormone,estradiol,STROOP response time and 1-back response time(P<0.05).Years of education,depression screening scale(PHQ-9),testosterone,progesterone,luteinizing hormone,STROOP accuracy rate,1-back accuracy rate,2-back response time and accuracy rate were not statistically different(P>0.05).Compared with the postmenopausal group in the perimenopausal group,there were statistical differences in age,follicle-stimulating hormone,estradiol,STROOP response time,1-back response time,and 2-back response time(P<0.05).Years of education,PHQ-9,MRS,prolactin,testosterone,progesterone,luteinizing hormone,STROOP accuracy rate,1-back accuracy rate and 2-back accuracy rate were not statistically different(P> 0.05).(2)The functional connectivity differences of the resting brain networks in the perimenopausal group compared with the two control groups were analyzed by ICA analysis,including the bilateral subparietal lobules and the right angular gyrus of the dorsal attention network,the left inferior parietal lobule,the left angular gyrus,the left superior frontal gyrus of the left frontoparietal network,the bilateral superior frontal gyrus of the anterior default mode network,the left putamen,posterior cingulate gyrus of the posterior default mode network and the right precentral gyrus of the executive control network.Decreased gray matter volume in brain regions based on functional connectivity differences including the left inferior parietal lobe of the left frontoparietal network and the right precentral gyrus of the executive controlnetwork.After partial correlation analysis,the functional connectivity of the right subparietal lobe of the dorsal attention network was negatively correlated with the estradiol,and positively correlated with STROOP response time.(3)The brain regions of the ALFF increased in the perimenopausal group compared with the two control groups were analyzed by ALFF analysis,including the left orbital gyrus,the left lingual gyrus,and the gray matter volume of the left orbital gyrus decreased.The brain regions of the ALFF decreased,including the left inferior temporal gyrus,the right middle temporal gyrus,the right postcentral gyrus,the left precentral gyrus,the left superior temporal gyrus,the left inferior frontal gyrus and the left insula,the gray matter volume of the left superior temporal gyrus decreased.After partial correlation analysis,the ALFF value of the left orbital gyrus was negatively correlated with the estradiol,the ALFF value of the left precentral gyrus was positively correlated with STROOP response time.(4)The brain regions of the Re Ho increased in the perimenopausal group compared with the two control groups were analyzed by Re Ho analysis,including the right orbital gyrus,the right superior frontal gyrus,the left lingual gyrus,the right precentral gyrus,and the gray matter volume of the right orbital gyrus decreased.The brain regions of the Re Ho decreased,including the left inferior temporal gyrus,the bilateral putamen,the left inferior parietal gyrus.After partial correlation analysis,the Re Ho value of the right superior frontal gyrus was negatively correlated with the estradiol,and positively correlated with 2-back response time.The Re Ho values of the left inferior temporal gyrus was positively correlated with STROOP response time.Conclusion:(1)The function of resting brain in perimenopausal women was affected by estrogen and affected cognitive function.(2)Most of the changes in perimenopausal women's brain function were independent in the changes of brain structure.(3)The decreased neural activity may be related to the impairment of cognitive function,while the increased neural activity in the perimenopausal group may be a compensation for brain function. |
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