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Background: The menopause transition is associated with an increasing risk of cerebrovascular disorders. However, the direct effect of menopause status on brain perfusion hemodynamics remains unclear. This study aimed to explore the influence of menopause status on cerebral blood flow (CBF) using arterial spin labeling magnetic resonance imaging., Methods: In this cross-sectional study, 185 subjects underwent arterial spin labeling magnetic resonance imaging at a hospital in China between September 2020 and December 2022, including 38 premenopausal women (mean age, 47.74±2.02 years), 42 perimenopausal women (mean age, 50.62±3.15 years), 42 postmenopausal women (mean age, 54.02±4.09 years), and 63 men (mean age, 52.70±4.33 years) of a similar age range. Mean CBF values in the whole brain, gray matter, white matter, cortical gray matter, subcortical gray matter, juxtacortical white matter, deep white matter, and periventricular white matter were extracted. ANCOVA was used to compare mean CBF among the 4 groups, controlling for confounding factors. Student t test was applied to compare mean CBF between the 3 female groups and age-matched males, respectively. Multivariable regression analysis was used to analysis the effect of age, sex, and menopause status on the CBF of the whole brain, gray matter, white matter, and subregions., Results: Perimenopausal and postmenopausal women showed a higher proportion of white matter hyperintensities compared with the other 2 groups ( P <0.001). Premenopausal women exhibited higher CBF in the whole brain, gray matter, white matter, and subregions, compared with perimenopausal, postmenopausal women and men ( P ≤0.001). Multivariable regression analysis demonstrated significant effect of age and insignificant effect of sex on CBF for all participants. In addition, menopause status and the interaction between age and menopause status on CBF of whole brain, gray matter, white matter, and the subregions were observed in female participants, except for the deep and periventricular white matter regions, with premenopausal women exhibited a slight increase in CBF with age, while perimenopausal and postmenopausal women exhibited declines in CBF with age., Conclusions: The current findings suggest that alterations of brain perfusion hemodynamics begin during the perimenopause period, which may be due to the increased burden of white matter hyperintensities., Competing Interests: Disclosures None.

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., (© 2023. The Author(s), under exclusive licence to European Society of Radiology.)

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., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2021 He, Guo, Qiu, An and Lu.)

Purpose: Anisometropic amblyopia usually occurs during early childhood and results in monocular visual deficit. Recent neuroimaging studies have demonstrated structural and functional alterations in pediatric anisometropic amblyopia (PAA) patients. However, the relationship between structural and functional alterations remains largely unknown. The aim of this study was to investigate the relationship between structural and functional alterations in PAA patients., Materials and Methods: Eighteen PAA patients and 14 healthy children underwent a multimodal MRI scanning including T1WI and functional MRI (fMRI). Voxel-based morphometry was used to assess structural alterations between PAA patients and healthy children. Regional homogeneity (ReHo) was used to investigate changes in local spontaneous brain activity in the enrolled subjects. Correlations between structural, functional alterations, and clinical information were analyzed in the PAA group., Results: Compared with healthy children, PAA patients exhibited significantly reduced ReHo of spontaneous brain activity in the right superior temporal gyrus (STG) and right middle frontal gyrus (MFG) and increased gray matter volume in the right lobules 4 and 5 of the cerebellum. The gray matter volume of the right lobules 4 and 5 of the cerebellum was negatively correlated with the ReHo values of the right MFG., Conclusions: Our findings may suggest that PAA patients experience structural and functional abnormalities in brain regions related to oculomotor and visual-spatial information. In addition, the increased gray matter volume may compensate the decreased brain activity in the oculomotor regions, which reflects compensatory or neural plasticity in PAA patients., Competing Interests: The authors have no financial relationships relevant to this article to disclose., (Copyright © 2020 Weizhao Lu et al.)

Purpose: To evaluate the effects of high intraocular pressure (IOP) on central nervous system in patients with high-tension glaucoma (HTG) by using resting-state functional magnetic resonance imaging (rs-fMRI)., Methods: Thirty-six patients with HTG and twenty age- and gender-matched healthy controls (HCs) were recruited and underwent IOP measurement and rs-fMRI scan. The whole brain regional homogeneity (ReHo) value was calculated among the enrolled subjects. Two-sample t tests with permutation test and threshold-free cluster enhancement was performed between HTG group and HCs. Correlation analyses between IOP and ReHo values were conducted., Results: Compared with HCs, HTG group showed increased ReHo values in the left lobule 8 of cerebellar hemisphere, left lobule 4 and 5 of cerebellar hemisphere and left fusiform gyrus (FG) (p < 0.05). HTG group showed decreased ReHo value in the left middle frontal gyrus (MFG) (p < 0.05). Intraocular pressure of the left eye in HTG group experienced a significant positive correlation with ReHo value of the left FG (r = 0.370, p = 0.026), IOP of the right eye in HTG group showed a significant negative correlation with ReHo value in the left MFG (r = -0.421, p = 0.011)., Conclusion: Resting-state fMRI ReHo analyses associated elevated IOP with abnormal regional activity in several brain regions related to higher visual function and visual memory consolidation. High-tension glaucoma patients also showed diminished integration of visual information and cerebellar function. These results may provide imaging support for pathophysiological research of HTG and may reveal new targets for the accurate treatment of HTG., (© 2019 Acta Ophthalmologica Scandinavica Foundation. Published by John Wiley & Sons Ltd.)

Background: Perimenopause is associated with increased risk of depression, vasomotor symptoms, and sexual dysfunction., Aims: To explore the effect of sex hormones on the functional connectivity (FC) of different brain regions related to sexual function in perimenopausal women., Methods: 32 premenopausal women (mean age, 47.75 ± 1.55 years) and 25 perimenopausal women (mean age, 51.60 ± 1.63 years) underwent sex hormone level measurements and resting-state fMRI., Main Outcome Measures: Serum levels of sex hormones, including prolactin (PRL), follicle-stimulating hormone (FSH), luteotropic hormone (LH), estradiol (E2), free testosterone (free-T), and progesterone (P), were measured. 10 brain regions related to sexual function were selected according to a meta-analysis, and FCs of the selected regions of interest were calculated as Pearson's correlation coefficient., Results: Compared with premenopausal women, perimenopausal women showed increased FC between the right area 13 (A13&#95;r) and the right medial superior frontal gyrus (mSFG), between the left dorsal granular insula (dIg&#95;L) and the right superior frontal gyrus (SFG) (Gaussian random field-corrected at the voxel level, P < .001, and cluster level, P < .025). Furthermore, the PRL level was negatively correlated with the FC of A13&#95;R with the right mSFG and the FC of dIg&#95;L with the right SFG., Clinical Translation: These findings may be applicable to assessing brain dysfunction with FC changes in women approaching menopause., Strengths & Limitations: This study is the first to evaluate a direct relationship between sex hormone levels and brain FC changes in women approaching menopause. Sexual function was not assessed, which may weaken the conclusions related to sexual function., Conclusions: The results show that women approaching menopause suffered from aberrant intrinsic FC in regions related to sexual function, and reveal a direct relationship between serum sex hormone levels and FC changes related to sexual function. Lu W, Guo W, Cui D, et al. Effect of Sex Hormones on Brain Connectivity Related to Sexual Function in Perimenopausal Women: A Resting-State fMRI Functional Connectivity Study. J Sex Med 2019;16:711-720., (Copyright © 2019 International Society for Sexual Medicine. Published by Elsevier Inc. All rights reserved.)

Background: Generalized q-sampling (GQI) and connectometry analysis provide new indices, i.e., quantitative anisotropy (QA) and spin distribution function (SDF) in comparison with diffusion tensor imaging (DTI). They may provide more age-related changes in white matter (WM) in aging., Purpose: To investigate the feasibility of using GQI and connectometry analysis to determine WM properties changes in aging., Study Type: Cross-cohort research., Population: Fifty normal adults (27 females) aged 21-71 years., Field Strength/sequence: T 1 -weighted images (T 1 WI) and high angular resolution diffusion imaging (HARDI) images were acquired at 1.5T., Assessment: HARDI data were analyzed using DTI and GQI to obtain fractional anisotropy (FA), QA, fiber numbers, and fiber lengths for tract analysis and using q-space diffeomorphic reconstruction (QSDR) for the connectometry analysis. We compared differences of DTI, GQI, and connectometry analysis to reflect WM changes in aging., Statistical Tests: Associations between FA, QA, and fiber numbers and lengths and age were analyzed using Pearson's correlation coefficients. The connectometry analysis was conducted using a multiple linear regression analysis, including age and gender as factors. Uncorrected P-value/false discovery rate (FDR) (corrected for multiple comparisons) < 0.05 was considered statistically significant., Results: More regional changes were detected in FA related to age than changes in QA (17 > 6 regions, P < 0.05). Fewer regional changes in fiber numbers and more changes of fiber lengths were observed for DTI than for GQI (5 < 8/10 > 7 regions, P < 0.05). However, DTI and GQI analyses revealed consistent results in some regions, including the genu of the corpus callosum (GCC), body of the corpus callosum (BCC), fornix (Fx), and anterior coronal radiation (ACR) (P < 0.05). The connectometry analysis showed more tract changes associated with age at an FDR of 0.05, which partially overlapped with the FA and QA., Data Conclusion: GQI and connectometry provide more information about age-related tracts and complement the DTI findings., Level of Evidence: 2 Technical Efficacy: Stage 2 J. MAGN. RESON. IMAGING 2018;48:369-381., (© 2018 International Society for Magnetic Resonance in Medicine.)

Purpose: To investigate brain morphological alterations of high-tension glaucoma patients and explore the association between brain morphological changes and elevated intraocular pressure. Methods: Thirty-six patients with high-tension glaucoma and 20 healthy controls were collected and underwent structural MRI scan. Surface-based morphometry and voxel-based morphometry were applied to assess cortical thickness and subcortical gray matter volume of the enrolled subjects. The association between brain morphometry and intraocular pressure was assessed by partial correlation. Results: Compared with healthy controls, high-tension glaucoma patients showed decreased cortical thickness in the bilateral superior temporal gyrus, bilateral superior parietal gyrus, bilateral lateral occipital gyrus, left fusiform gyrus, left medial orbitofrontal gyrus, right precentral gyrus, and right superior frontal gyrus (p < 0.05). High-tension glaucoma patients also showed reduced gray matter volume in the right hippocampus, bilateral putamen, and bilateral thalamus (p < 0.05). In addition, brain morphological correlates of mean intraocular pressure were found in the left rostral middle frontal gyrus, right precentral gyrus, and left postcentral gyrus in high-tension glaucoma group (p < 0.05). Conclusion: High-tension glaucoma patients experienced morphological reduction in the visual and nonvisual areas throughout the entire brain. Elevated intraocular pressure may contribute to the reduction of cortical thickness in certain areas in the progression of the disease. [ABSTRACT FROM AUTHOR]