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Zhou Y, Lin J, Li C, Zheng Y, Meng Z, Teng Y, Tao M. A fNIRS investigation of menopausal-related symptoms and brain cortical activity in menopause. J Affect Disord 2024; 353:101-108. [PMID: 37979627 DOI: 10.1016/j.jad.2023.11.021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/29/2023] [Revised: 11/05/2023] [Accepted: 11/07/2023] [Indexed: 11/20/2023]
Abstract
BACKGROUND This study aimed to delineate the association between menopausal-related symptoms and brain cortical hemodynamics in peri-postmenopause women. METHODS Cross-sectional data from a total of 358 Han-Chinese women who visited the Menopause Clinic in the Shanghai Sixth People's Hospital from August 2019 to August 2022. Menopausal-related symptoms were analyzed through Kupperman index (KMI) scale and PSQI scale, while cerebral blood flow was measured using a functional near-infrared spectroscopy (fNIRS). Multiple linear regression model was used to assess the risk factors for subregions of brain hemodynamic response. RESULTS After adjusting for confounding factors, we identified that menopausal symptom (B = -1.575, 95 % CI (-2.661, -0.488), p = 0.005) and duration of menopause (B = -14.583, 95 % CI (-26.753, -4.192), p = 0.007) were independently associated with the lower brain hemodynamic response in the prefrontal lobe, while in the temporal lobe, overweight (BMI ≥ 24 kg/m2) was negatively associated with the lower brain cortical activity (B = -36.882, 95 % CI (-72.708, -1.056), p = 0.044) after adjusting for other confounding variables. CONCLUSIONS Our findings proposed that menopausal symptom and overweight should be attached great importance to the postmenopausal women, which provides clinical evidence for the feasible early detection and effective prevention such as menopausal hormone therapy (MHT) of brain health in postmenopausal women.
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Affiliation(s)
- Yang Zhou
- Department of Gynecology and Obstetrics, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, 600 Yishan Road, Shanghai 200233, People's Republic of China
| | - Jiawen Lin
- Department of Gynecology and Obstetrics, Shanghai First Maternity and Infant Hospital, Tongji University, Shanghai 200126, People's Republic of China
| | - Changbin Li
- Department of Gynecology and Obstetrics, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, 600 Yishan Road, Shanghai 200233, People's Republic of China
| | - Yuanyi Zheng
- Department of Ultrasonography, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, 600 Yishan Road, Shanghai 200233, People's Republic of China
| | - Zheying Meng
- Department of Ultrasonography, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, 600 Yishan Road, Shanghai 200233, People's Republic of China
| | - Yincheng Teng
- Department of Gynecology and Obstetrics, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, 600 Yishan Road, Shanghai 200233, People's Republic of China.
| | - Minfang Tao
- Department of Gynecology and Obstetrics, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, 600 Yishan Road, Shanghai 200233, People's Republic of China.
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Moon CM, Heo SH, Yoon W, Baek BH, Shin SS, Kim SK, Lee YY. Altered Sexual Response-Related Functional Connectivity and Morphometric Changes Influenced by Sex Hormones across Menopausal Status. J Clin Med 2024; 13:387. [PMID: 38256520 PMCID: PMC10816754 DOI: 10.3390/jcm13020387] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2023] [Revised: 12/29/2023] [Accepted: 01/09/2024] [Indexed: 01/24/2024] Open
Abstract
Our study retrospectively investigated differential patterns of the functional connectivity (FC) of core brain regions synchronous with morphometric changes associated with sexual dysfunction in menopausal women, and their correlations with sexual hormones. Twenty-three premenopausal women (mean age: 41.52 ± 7.38 years) and 21 menopausal women (mean age: 55.52 ± 2.80 years) underwent sex hormone level measurements with high-resolution T1 and functional magnetic resonance imaging (MRI) during rest, neutral, and sexual arousal conditions. Analysis of covariance adjusted for age was used to compare the FC and gray matter (GM) volume between the two groups. Menopausal women showed lower GM volumes in the superior frontal gyrus (SFG), superior temporal pole, parahippocampal gyrus (PHG), hippocampus (Hip), amygdala (Amg), and cerebellum (Cb) compared to premenopausal women (p < 0.05). In addition, compared to premenopausal women, menopausal women showed decreased FC of seed regions involved in the SFG, frontal eye fields, and Amg, as well as target regions involved in the PHG, Hip, inferior frontal gyrus, Cb, and vermis (p < 0.005). Furthermore, the FC between the right Amg and right Cb and between the left Amg and right Cb during sexual arousal in both groups was positively correlated with total estrogen and estradiol levels, respectively (p < 0.01). The GM volume values in the right Amg and right Cb were positively correlated with total estrogen and estradiol levels (p < 0.05). Our study demonstrated an association between menopause-related differential FC and GM volume variations and fluctuating sex hormones. Our findings highlight that overlapping brain regions with functional alterations and morphometric changes are closely linked with menopausal symptom-related decreases in sexual arousal and hormone levels.
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Affiliation(s)
- Chung Man Moon
- Research Institute of Medical Sciences, Chonnam National University, 264 Seoyang-ro, Hwasun-eup, Hwasun-gun 58128, Jeollanam-do, Republic of Korea
| | - Suk Hee Heo
- Department of Radiology, Chonnam National University Hwasun Hospital, 322 Seoyang-ro, Hwasun-eup, Hwasun-gun 58128, Jeollanam-do, Republic of Korea
- Department of Radiology, Chonnam National University Medical School, 42 Jebong-ro, Dong-gu, Gwangju 61469, Gyeonggi-do, Republic of Korea
| | - Woong Yoon
- Department of Radiology, Chonnam National University Medical School, 42 Jebong-ro, Dong-gu, Gwangju 61469, Gyeonggi-do, Republic of Korea
- Department of Radiology, Chonnam National University Hospital, 42 Jebong-ro, Dong-gu, Gwangju 61469, Gyeonggi-do, Republic of Korea
| | - Byung Hyun Baek
- Department of Radiology, Chonnam National University Medical School, 42 Jebong-ro, Dong-gu, Gwangju 61469, Gyeonggi-do, Republic of Korea
- Department of Radiology, Chonnam National University Hospital, 42 Jebong-ro, Dong-gu, Gwangju 61469, Gyeonggi-do, Republic of Korea
| | - Sang Soo Shin
- Department of Radiology, Chonnam National University Medical School, 42 Jebong-ro, Dong-gu, Gwangju 61469, Gyeonggi-do, Republic of Korea
- Department of Radiology, Chonnam National University Hospital, 42 Jebong-ro, Dong-gu, Gwangju 61469, Gyeonggi-do, Republic of Korea
| | - Seul Kee Kim
- Department of Radiology, Chonnam National University Hwasun Hospital, 322 Seoyang-ro, Hwasun-eup, Hwasun-gun 58128, Jeollanam-do, Republic of Korea
- Department of Radiology, Chonnam National University Medical School, 42 Jebong-ro, Dong-gu, Gwangju 61469, Gyeonggi-do, Republic of Korea
| | - Yun Young Lee
- Department of Radiology, Chonnam National University Hospital, 42 Jebong-ro, Dong-gu, Gwangju 61469, Gyeonggi-do, Republic of Korea
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Lu W, Sun Y, Gao H, Qiu J. A review of multi-modal magnetic resonance imaging studies on perimenopausal brain: a hint towards neural heterogeneity. Eur Radiol 2023; 33:5282-5297. [PMID: 36977851 DOI: 10.1007/s00330-023-09549-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2022] [Revised: 01/05/2023] [Accepted: 03/06/2023] [Indexed: 03/30/2023]
Abstract
The population ageing process worldwide is leading to an increasing number of women in the perimenopausal phase. Many of the perimenopausal symptoms, such as headache, depression, insomnia, and cognitive decline, are neurological in nature. Therefore, the study of the perimenopausal brain is of great importance. In addition, relevant studies can also provide an imaging basis for multiple therapies to treat perimenopausal symptoms. Because of its non-invasive nature, magnetic resonance imaging (MRI) has now been widely applied to the study of perimenopausal brains, revealing alterations in the brain associated with symptoms during the menopause transition. In this review, we collected papers and works of literature on the perimenopausal brain using MRI techniques in the Web of Science database. We firstly described the general principles and analysis methods of different MRI modalities briefly and then reviewed the structural, functional, perfusion, and metabolic compounds changes in the brain of perimenopausal women respectively, and described the latest advances in probing the perimenopausal brain using MRI, resulting in summary diagrams and figures. Based on the summary of existing works of the literature, this review further provided a perspective on multi-modal MRI studies in the perimenopausal brain, suggesting that population-based, multi-center, and longitudinal studies will be beneficial to the comprehensive understanding of changes in the perimenopausal brain. In addition, we found a hint towards neural heterogeneity in the perimenopausal brain, which should be addressed by future MRI studies to provide more help for the precise diagnosis and personalized treatment of perimenopausal symptoms. KEY POINTS: • Perimenopause is not only a physiological transition but also a period of neurological transition. • Multi-modal MRI studies have revealed that perimenopause is accompanied by alterations in the brain, which is implicated in many perimenopausal symptoms. • The diversity in the multi-modal MRI findings may give a hint to neural heterogeneity in the perimenopausal brain.
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Affiliation(s)
- Weizhao Lu
- Department of Radiology, The Second Affiliated Hospital of Shandong First Medical University, No. 366 Taishan Street, Taian, 271000, China
| | - Yuanyuan Sun
- Department of Radiology, Shandong First Medical University & Shandong Academy of Medical Sciences, No. 619 Changcheng Road, Taian, 271016, China
| | - Hui Gao
- Department of Gynaecology, Beijing Tian Tan Hospital, Beijing, China
| | - Jianfeng Qiu
- Department of Radiology, The Second Affiliated Hospital of Shandong First Medical University, No. 366 Taishan Street, Taian, 271000, China.
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van 't Hof SR, Cera N. Specific factors and methodological decisions influencing brain responses to sexual stimuli in women. Neurosci Biobehav Rev 2021; 131:164-178. [PMID: 34560132 DOI: 10.1016/j.neubiorev.2021.09.013] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2021] [Revised: 08/29/2021] [Accepted: 09/06/2021] [Indexed: 11/19/2022]
Abstract
Most of the neuroimaging studies on sexual behavior have been conducted with male participants, leading to men-based models of sexual arousal. Here, possible factors and methodological decisions that might influence brain responses to sexual stimuli, specifically for the inclusion of women, will be reviewed. Based on this review, we suggest that future studies consider the following factors: menstrual phase, hormonal contraception use, history of sexual or psychiatric disorders or diseases, and medication use. Moreover, when researching sexual arousal, we suggest future studies assess sexual orientation and preferences, that women should select visual sexual stimuli, and a longer duration than commonly used. This review is thought to represent a useful guideline for future research in sexual arousal, which hopefully will lead to a higher inclusion of women and therefore more accurate neurobiological models of sexual arousal.
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Affiliation(s)
| | - Nicoletta Cera
- Centre for Psychology at University of Porto -CPUP, Faculty of Psychology and Education Sciences, University of Porto, Portugal
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Abstract
Prolactin is a proteic hormone best known for its role in enabling the production of milk by female mammals. Secreted by the pituitary gland in response to the stimuli of eating, estrogen treatment, mating, ovulation and nursing, prolactin is involved in over 300 separate processes in a range of vertebrates, including humans. The hormone is released in a pulsatile manner and plays an essential role in metabolism, as well as in the regulation of the immune system and pancreatic development. Nevertheless, prolactin exerts other relevant roles, as it acts at the central nervous system level to modulate behavior, arousal and sexuality. In this experts' opinion, we aim to give insights into the main activities of prolactin to advance the ability of medical doctors and specialists in obstetrics and gynecology to provide more emphasis in their clinical practices to the link between prolactin and sexuality.
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Affiliation(s)
- Rossella E Nappi
- Research Center for Reproductive Medicine, Gynecological Endocrinology and Menopause, IRCCS San Matteo Foundation, Department of Clinical, Surgical, Diagnostic and Pediatric Sciences, University of Pavia, Pavia, Italy
| | | | - Alessandro D Genazzani
- Gynecological Endocrinology Center, Department of Obstetrics and Gynecology, University of Modena and Reggio Emilia, Modena, Italy
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He L, Guo W, Qiu J, An X, Lu W. Altered Spontaneous Brain Activity in Women During Menopause Transition and Its Association With Cognitive Function and Serum Estradiol Level. Front Endocrinol (Lausanne) 2021; 12:652512. [PMID: 34046011 PMCID: PMC8146460 DOI: 10.3389/fendo.2021.652512] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/12/2021] [Accepted: 04/28/2021] [Indexed: 12/25/2022] Open
Abstract
OBJECTIVE Serum hormone deficiencies during menopause transition may affect spontaneous brain activity and global cognition. The purpose of this study was to explore the differences in spontaneous brain activity between premenopausal and perimenopausal women, and to investigate the associations between spontaneous brain activity, serum hormone levels and global cognition. METHODS Thirty-two premenopausal women (47.75 ± 1.55 years) and twenty-five perimenopausal women (51.60 ± 1.63 years) underwent resting-state functional MRI (fMRI) scan. Clinical information including Mini-Mental State Examination (MMSE), levels of estradiol (E2), free testosterone, progesterone, prolactin, follicle-stimulating hormone and luteinizing hormone were measured. Regional homogeneity (ReHo) was used to evaluate spontaneous brain activity alterations between perimenopausal and premenopausal women. Correlation analysis was used to investigate the associations between brain functional alterations and clinical measures in perimenopausal group. RESULTS The results demonstrated increased ReHo value in the right lingual gyrus (LG) and decreased ReHo value in the right superior frontal gyrus (SFG) in perimenopausal women compared with premenopausal women. In perimenopausal group, ReHo of the right LG showed a negative correlation with level of E2 (r = -0.586, p = 0.002), ReHo of the right SFG showed a positive correlation with level of E2 (r = 0.470, p = 0.018) and MMSE (r = 0.614, p = 0.001). CONCLUSIONS The results demonstrated that women approaching menopause suffered from altered functions in brain regions related to cognitive function, working memory, the results also revealed a direct association between levels of E2 and brain functions in perimenopausal women.
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Affiliation(s)
- Lemin He
- Department of Biomedical Engineering, College of Precision Instruments and Optoelectronics Engineering, Tianjin University, Tianjin, China
- Department of Radiology, Shandong First Medical University & Shandong Academy of Medical Sciences, Taian, China
- Academy of Medical Engineering and Translational Medicine, Tianjin University, Tianjin, China
| | - Wei Guo
- Department of Radiology, The Second Affiliated Hospital of Shandong First Medical University, Taian, China
| | - Jianfeng Qiu
- Department of Radiology, Shandong First Medical University & Shandong Academy of Medical Sciences, Taian, China
- Science and Technology Innovation Center, Shandong First Medical University & Shandong Academy of Medical Sciences, Jinan, China
| | - Xingwei An
- Academy of Medical Engineering and Translational Medicine, Tianjin University, Tianjin, China
- *Correspondence: Xingwei An, ; Weizhao Lu,
| | - Weizhao Lu
- Department of Radiology, Shandong First Medical University & Shandong Academy of Medical Sciences, Taian, China
- Science and Technology Innovation Center, Shandong First Medical University & Shandong Academy of Medical Sciences, Jinan, China
- *Correspondence: Xingwei An, ; Weizhao Lu,
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Abstract
Testosterone is an anabolic hormone that is responsible for the development of male sex organs. It also increases muscle mass and fortifies bone density. In addition to being responsible for primary sexual characteristics at birth and puberty (development and changes of sexual organs such as uterus, vagina, penis, and testes), testosterone is also involved in maintaining secondary sexual characteristics. Patients with low testosterone who are symptomatic should be treated with testosterone replacement therapy (TRT) once the diagnosis has been confirmed. The goal of treatment is to improve the symptoms including the physical, sexual, and cognitive health with the aim being to keep the testosterone in the mid-normal limit of the reference range. Male hypogonadism has been increasingly diagnosed and treated in elderly males since the last decade. A proportionate increase in the prescription of testosterone has been seen as well. The relationship of testosterone levels with cardiovascular (CV) outcomes is challenging and has shown conflicting results. Moreover, in patients with established CV disease, those with high CV risk factors including diabetes, or those with significant risk factors for atherosclerotic CV disease (ASCVD), the benefits of TRT should be weighed against the risks of replacement. Risks and benefits of TRT should be discussed with every patient prior to starting or restarting the procedure.
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Affiliation(s)
- Talha Ahmed
- Internal Medicine, University of Maryland Medical Center, Baltimore, USA
| | - May Alattar
- Endocrinology, University of Maryland, Baltimore, USA
| | | | - Reyaz Haque
- Cardiology, University of Maryland, Baltimore, USA
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