Perimenopause, DAN, and Cognition: An fMRI Study

AbstractObjectiveTo evaluate the functional changes of the dorsal attention network (DAN) in perimenopausal women using functional magnetic resonance imaging (fMRI) and explore the relationship between sex hormones and cognitive function.MethodsA total of 25 perimenopausal women and 25 premenopausal women underwent sex hormone level measurements, scale - based assessments, cognition evaluations, and magnetic resonance imaging (MRI) scans. Resting - state fMRI data were acquired using a 3.0 Tesla magnetic resonance scanner. Independent component analysis (ICA) was employed to assess the differences in DAN functional connections between the two groups. Gray matter volume (GMV) values of brain regions with differences in DAN functional connections were extracted, and the GMV differences between the two groups were compared. Correlation analyses were performed between the connection strengths of DAN functional connections, GMV values of regions of interest (ROIs), sex hormone levels, and clinical and neuropsychological assessment results in both groups. Additionally, sensitivity and exploratory analyses were conducted on the existing data, and the results were compared with those of existing studies.ResultsCompared with the premenopausal group, the perimenopausal group showed enhanced functional connections in the right inferior parietal lobule (IPL) and the right angular gyrus (AG) within the DAN. There were no significant differences in GMV values between the two groups. Correlation analysis indicated that in perimenopausal women, the connection strength of the right IPL negatively correlated with the estradiol level and positively correlated with the reaction time of the STROOP color - word test. Sensitivity analysis showed that the main results were robust to the influence of extreme values. Exploratory analysis identified potential subgroups within perimenopausal women. Comparison with existing studies confirmed the consistency of some findings while also revealing differences.ConclusionsICA results suggest that DAN functional changes in perimenopausal women may trigger the brain’s compensatory mechanisms to cope with physiological and psychological challenges during the reproductive transition. These findings contribute to a better understanding of the brain function changes in perimenopausal women. However, limitations such as a small sample size still exist, and future research directions are proposed.