Change Of Cognitive State In Perimenopausal Women:a Resting-state Magneatic Resonance Imaging Study

Objective:This study aimed at using resting-state functional magnetic resonance imaging?rsfMRI?to inspect the changes of brain activation in perimenopausal women,to evaluate the relationship between estrogen and changes of brain activation related to cognition,to provide evidence of imaging for early screening of change of cognitive state in perimenopausal women.Matertial and Methods:According to the inclusion criterion,the 48 perimenopausal women were recruited randomly from Affiliated Hospital of Taishan Medical University from Jan,2016 to Jan,2018 as experimental group,the 46 normal menstruation women were recruited randomly from our hospital staff,unrelated families of patients and inhabitants as healthy control group.By means of randomized double-blind trial,to measure the estrogen level of subjects by chemiluminescence immunoassay,to collect data by 3T resting state functional magnetic resonance imaging data,to assess the cognitive state by MMSE score test.After that,all images were preprocessed and analyzed by specific softwares?MatLab,DPABI?in order to calculate the ALFF,Falff,ReHo and FC value and were applied statistical analysis.We make a comparison and analysis the difference of experimental group and healthy control group.Statistical software SPSS 20.0 were utilized to analyze the correlation among MMSE scores,the functional parameters and clinical statistics.Results:1.The relationship in perimenopausal women between the changes of brain regions which were measured by the parameters of resting-state functional magnetic resonance imaging and the estrogen level showed that: ALFF value in the left rectal gyrus was inversely correlated with MMSE scores,FC in the left cerebellum posterior lobe and left cingulate gyrus?ROI?was positively correlated with MMSE score,two sample t test was used to analyze the difference,and the difference was statistically significant;FC in the left cingulate gyrus?ROI?and right frontal middle gyrus was inversely correlated with estrogen level,FC in the right postcentral gyrus and left amygdala?ROI?was positively correlated with estrogen level,two sample t test was used to analyze the difference,and the difference was statistically significant.2.The ALFF value which was changed occurred in the left frontal lobe?rectal gyrus,brodmann area 11,Frontal_Inf_Tri_L?,right temporal Lobe?right superior temporal Gyrus,brodmann area 42?.The fALFF value which was changed occurred in Thalamus_L,Frontal_Inf_Tri_L.The ReHo value which was changed occurred in the right cerebellum posterior lobe,left middle frontal gyrus,left cingulate gyrus.3.There are some changes of strength of FC appeared in some brain regions in perimenopausal.We take hypothalamus as region of interest,the strength of FC of which and right paracentral lobule has changed;taking left praecuneus?BNA151?as region of interest,the strength of FC of which and Temporal_Sup_L?aal?,Temporal_Mid_L?aal?,Left corpus Callosum;taking right praecuneus?BNA153?as region of interest,the strength of FC of which and Temporal_Pole_Sup_L?aal?,Frontal_Inf_Orb_L?aal?,Left corpus Callosum;taking left cingulate gyrus?BNA177?as region of interest,the strength of FC of which and Cerebelum_Crus2_L?aal?,Cerebelum_6L?aal?,Precuneus_R have changed;taking right cingulate gyrus?BNA182?as region of interest,the strength of FC of which and Cerebelum_9R?aal?,Cerebellar Tonsil,Vermis₈?aal?Temporal_Pole_Sup_L?aal?,Temporal_Sup_L?aal?,Precentral_L?aal?have changed;taking left cingulate gyrus?BNA183?as region of interest,the strength of FC of which and Cerebelum_Crus2_L?aal?,Frontal_Med_Orb_L?aal?,brodmann area 39,Right Superior Temporal Gyrus,Cuneus_L?aal?,Right Middle Frontal Gyrus have changed;taking left amygdale?BNA211?as region of interest,the strength of FC of which and Frontal_Mid_Orb_R?aal?,Postcentral_R?aal?have changed;taking right amygdale?BNA212?as region of interest,the strength of FC of which and SupraMarginal_L?aal?Frontal_Sup_R?aal?have changed;Conclusion:1.In the perimenopausal women with no cognitive impairment,the brain function was changed compared with the normal reproductive group,which mainly involved some areas of the brain limbic system,frontal lobe,temporal lobe,parietal lobe and cerebellum invo-lved in memory,executive power and other cognitive activities.2.To some extent,MMSE scores can reflect the changes of brain activation related to cognition in perimenopausal women.3.The level of estrogen in perimenopausal women has a correlation with the functional connections of the left cingulate gyrus,left amygdala and other brain regions,suggesting that estrogen may have an effect on the cognitive function of the brain.4.Resting functional magnetic resonance imaging?including ALFF,Falff,ReHo and FC?can reflect the changes of brain function in perimenopausal women,and predict and evaluate the location of early cognitive changes.