Poor cerebrovascular function is an early marker of cognitive decline in healthy postmenopausal women

Abstract

IntroductionImpairment of cerebrovascular function becomes evident after menopause. No study has yet explored relationships between deficits in cerebrovascular function, cognitive performance, and mood in postmenopausal women.MethodCerebrovascular function was assessed in 80 healthy postmenopausal women by monitoring blood flow velocity (BFV) in the middle and posterior cerebral arteries using transcranial Doppler ultrasound at rest, following a hypercapnic challenge, and during performance of a cognitive test battery; the latter assessed domains of memory and executive functions. Various measures of mood (i.e., Profile of Mood States and Center for Epidemiological Studies Depression Scale) were also assessed.ResultsCerebral artery elasticity and BFV responsiveness to cognitive tests (neurovascular coupling) correlated with cognitive performance but not with depressive symptoms or mood states. Mood deficits were related to poor cognitive performance.ConclusionThese results highlight the importance of adequate cerebral perfusion for optimized cognitive function in healthy postmenopausal women. Preventative strategies to attenuate accelerated cognitive decline should also consider restoring cerebrovascular function.

Cognitive dysfunction is associated with abnormal responses in cerebral blood flow in patients with single ventricular physiology: Novel insights from transcranial Doppler ultrasound

“…Neuronal activation promotes the endothelium to release nitric oxide, resulting in the dilatation of local arterioles, which is reflected in increased blood flow in larger vessels (neurovascular coupling). Impaired vasodilation may reduce the normal perfusion increase during neuronal activation potentially contributing to poor cognitive performance in patients with congenital heart disease; in healthy older women, early deficits in cerebral blood responses predicted cognitive dysfunction, with altered neurovascular coupling associated with cognitive deficits in patients with diabetes mellitus . Impaired cerebral blood flow response to cognitive stimulus has also been associated with abnormal gait patterns, in keeping with differences in gait speed observed between the two cohorts .…”

Does phytoestrogen supplementation improve cognition in humans? A systematic review

“…Similarly, Wong et al . also found acute enhancement of CVR to hypercapnia and in neurovascular coupling capacity in older adults with type 2 diabetes . Both authors provided the key evidence of the vasorelaxatory properties of resveratrol in humans, which could be attributed to an interaction with aspects of NO synthesis .…”

“…Therefore, estrogen decline at menopause can have severe repercussions on the vasculature. Recently, a cross‐sectional study found that impaired cerebrovascular function, particularly CVR to cognitive tests (neurovascular coupling capacity) and cerebral artery stiffness, correlated with poor cognitive performance in healthy postmenopausal women not taking HRT . This observation highlights the importance of preventative strategies to attenuate premature cognitive decline.…”

Sustained Cerebrovascular and Cognitive Benefits of Resveratrol in Postmenopausal Women

“…Identification of early cerebrovascular dysfunction has important diagnostic implications for future cognitive decline [36]. We have previously shown that poor cerebrovascular function is predictive of cognitive decline in healthy postmenopausal women [8].…”

“…Reduced cerebral blood flow (CBF) and CVR are associated with cognitive impairment [7]. We have also reported that reduced CVR during mental task activation (neurovascular coupling) is predictive of poor cognitive performance in postmenopausal women [8]. A meta-analysis has shown that postmenopausal women perform worse on verbal memory and executive function tests compared to peri-menopausal women [9].…”