Shaaban C Elizabeth, Rosano Caterina, Cohen Ann D, Huppert Theodore, Butters Meryl A, Hengenius James, Parks W Tony, Catov Janet M
Department of Epidemiology, University of Pittsburgh, Pittsburgh, PA, United States.
Center for the Neural Basis of Cognition, University of Pittsburgh, Pittsburgh, PA, United States.
Front Aging Neurosci. 2021 May 4;13:637574. doi: 10.3389/fnagi.2021.637574. eCollection 2021.
Preeclampsia is emerging as a sex-specific risk factor for cerebral small vessel disease (SVD) and dementia, but the reason is unknown. We assessed the relationship of maternal vascular malperfusion (MVM), a marker of placental SVD, with cognition and cerebral SVD in women with and without preeclampsia. We hypothesized women with both preeclampsia and MVM would perform worst on information processing speed and executive function. Women ( = 45; mean 10.5 years post-delivery; mean age: 41 years; 42.2% Black) were classified as preeclampsia-/MVM-, preeclampsia+/MVM-, or preeclampsia+/MVM+. Information processing speed, executive function, and memory were assessed. In a pilot sub-study of cerebrovascular reactivity (CVR; = 22), cerebral blood flow during room-air breathing and breath-hold induced hypercapnia were obtained via arterial spin labeling MRI. Non-parametric tests and regression models were used to test associations. Between-group cognitive differences were significant for information processing speed ( = 0.02); preeclampsia+/MVM+ had the lowest scores. Cerebral blood flow increased from room-air to breath-hold, globally and in all regions in the three groups, except the preeclampsia+/MVM+ parietal region ( = 0.12). Lower parietal CVR (less change from room-air breathing to breath-holding) was correlated with poorer information processing speed (partial ρ = 0.63, = 0.005) and executive function (ρ = 0.50, = 0.03) independent of preeclampsia/MVM status. Compared to women without preeclampsia and MVM, midlife women with both preeclampsia and MVM have worse information processing speed and may have blunted parietal CVR, an area important for information processing speed and executive function. MVM in women with preeclampsia is a promising sex-specific indicator of cerebrovascular integrity in midlife.
子痫前期正逐渐成为脑小血管疾病（SVD）和痴呆的性别特异性风险因素，但其原因尚不清楚。我们评估了胎盘SVD的标志物——母体血管灌注不良（MVM）与有或无子痫前期女性的认知及脑SVD之间的关系。我们假设患有子痫前期和MVM的女性在信息处理速度和执行功能方面表现最差。女性（n = 45；产后平均10.5年；平均年龄：41岁；42.2%为黑人）被分为子痫前期 - /MVM -、子痫前期 + /MVM - 或子痫前期 + /MVM +。评估了信息处理速度、执行功能和记忆力。在一项关于脑血管反应性（CVR；n = 22）的试点子研究中，通过动脉自旋标记MRI获取了静息呼吸和屏气诱发高碳酸血症时的脑血流量。使用非参数检验和回归模型来检验相关性。组间在信息处理速度方面的认知差异具有显著性（P = 0.02）；子痫前期 + /MVM + 得分最低。三组从静息呼吸到屏气时，全脑及所有区域的脑血流量均增加，但子痫前期 + /MVM + 的顶叶区域除外（P = 0.12）。较低的顶叶CVR（从静息呼吸到屏气时变化较小）与较差的信息处理速度（偏相关系数ρ = 0.63，P = 0.005）和执行功能（ρ = 0.50，P = 0.03）相关，且独立于子痫前期/MVM状态。与没有子痫前期和MVM的女性相比，患有子痫前期和MVM的中年女性信息处理速度更差，且顶叶CVR可能减弱，顶叶是对信息处理速度和执行功能很重要的区域。子痫前期女性的MVM是中年期脑血管完整性有前景的性别特异性指标。
