Functional connectivity of limbic system and prefrontal cortex years after pre-eclampsia: 7-Tesla functional magnetic resonance imaging study

OBJECTIVE: Preeclampsia is a vascular complication of pregnancy with a long-term risk of cerebrovascular and mental disorders. We explored whether differences in functional brain organization are present in formerly preeclamptic women, especially in regions that may explain the generally reported emotional symptoms and cognitive complaints even years after the pregnancy.

METHODS: In 55 formerly preeclamptic women and 17 control women with previous normotensive pregnancies, structural and functional 7 Tesla MRI scans were acquired. Using graph theoretical analysis, the efficiency and clustering coefficient of the functional brain network were investigated. Analyses were focused to particular brain structures, i.e. regions of the limbic system and prefrontal cortex, as well as to the global (whole) brain. Multivariable linear regression was used to investigate the relation between brain network-related graph measures and pregnancy condition (formerly preeclamptic or control).

RESULTS: Former preeclamptic women had higher local efficiency in the prefrontal cortex (p = 0.048) and anterior cingulate cortex (p = 0.03), but a lower local efficiency and local clustering coefficient in the amygdala (p < 0.03) and parahippocampal cortex (p < 0.009) compared to control women with previous normotensive pregnancies. No differences were found in global brain organization.

CONCLUSIONS: Formerly preeclamptic women displayed a different local functional organization. These differences in functional connectivity, especially in the limbic regions and prefrontal cortex, are in line with the often expressed psychological and cognitive complaints remaining after a preeclamptic pregnancy. This article is protected by copyright. All rights reserved.