BOSTON – Women who complain about cognitive problems after menopause might have increases rather than decreases in volume of certain brain regions, reported investigators at the Alzheimer’s Association International Conference 2013.
Brain imaging studies of 48 women in the early years of menopause showed that those with subjective cognitive complaints had significantly greater volumes in certain regions of the brain than did noncomplainers, including the right posterior cingulate gyrus (P less than .04), the right transverse temporal cortex (P less than .03), The left caudal middle frontal gyrus, and the right paracentral gyrus (P less than .05 for both), said Lilia Zurkovsky, Ph.D., a postdoctoral fellow from the Center for Cognitive Medicine at Vanderbilt University Medical Center in Nashville, Tenn.
Dr. Lilia Zurkovsky
The findings appear to run counter to those of another study (Neurology 2006;12:67: 834-42) showing that older adults with cognitive complaints had smaller volumes in temporal and frontal areas, compared with healthy age-matched controls, Dr. Zurkovsky acknowledged. She noted, however, that her group studied postmenopausal women in their 50s and 60s, whereas the earlier study included men. In addition, the mean age for each group in that study was above 70 years.
Combined with recent findings pointing to subjective cognitive and/or memory complaints as possible early signs of Alzheimer’s disease, the studies hint at a possible pattern of change as women age.
"If we look at all the data together, it would seem as though in early middle age, 50- to 60-year old individuals with complaints may be having some sort of compensatory mechanism. That’s speculation; all we know is that they have this increase in volume before they have a decrease in volume as shown by other papers," Dr. Zurkovsky said.
She and her colleagues scanned the participants with T1-weight magnetic resonance imaging with a 3 Tesla magnet, and measured cognitive complaints with the Cognitive Complaint Index (CCI) and five surveys with 120 total questions about the individual’s perceptions of cognitive abilities since menopause.
Brain changes in healthy postmenopausal women were the focus of a second, unrelated study also reported at AAIC2013.
Dr. Paul Yates
Australian investigators followed participants in the Womens Healthy Ageing Project, a longitudinal study of the menopausal transition among cognitively normal women. The investigators looked at MRI brain scans conducted in 2002 and 2012, and brain-amyloid imaging studies with 18-F florbetaben positron emission tomography (FBB-PET). Florbetaben is an investigational amyloid imaging agent, similar to florbetapir (Amyvid).
They found that among the 26 women who had both FBB-PET and the two MRI scans spaced a decade apart, a significant decline was found over time in hippocampal volume, but not in gray matter volume. There was also a nonsignificant trend correlating higher levels of FBB uptake, as measured by a standardized uptake value ratio (SUVR) with greater declines in hippocampal volume.
"Those who were in the higher tertile of florbetaben SUVR have had an 18%-19% decrement in hippocampal volume over that 10-year period," said lead author Paul Yates, Ph.D., a neuroscientist and imaging research fellow at Austin Health in Heidelberg, Australia.
Although these findings are preliminary and the changes observed were at the trend level only, they suggest that people with intermediate levels of uptake of an amyloid imaging agent might be at increased risk for Alzheimer’s disease, he said.
Dr. Zurkovsky’s study is supported by funding from the National Institute on Aging, Vanderbilt University, and the University of Vermont, Burlington. Dr. Yates’s study is supported by the National Ageing Research Institute at the University of Melbourne, with additional support from Bayer and Piramal Imaging. Neither Dr. Zurkovsky nor Dr. Yates reported having financial disclosures.