Award or grant: Cornell University MRI Facility pilot grant
Multiple sclerosis (MS) is one of the most common chronic inflammatory diseases wherein the body attacks protective tissue surrounding nerves. Women are more likely to develop MS compared to men with a female-to-male ratio of 2.8 to 1. The effect of the hormonal changes, in particular estrogen, on disease progression and annual relapse rate has been established, as MS symptoms decrease during pregnancy and increase during the postpartum period and menopause. Previous studies found a beneficial effect of estrogen on clinical symptoms in young adults; however, no study has investigated the influence of menopausal hormonal changes on cognition and brain connectivity networks in female patients with MS. It has been shown that the brain’s regional structural and static/dynamic functional connectivity (SC and static/dynamic FC) are related to cognition. Therefore, the lab proposes to assess the cross-sectional relationship between cognition and SC and FC between middle-aged female MS patients who are pre- and post-menopausal. First, the lab will test the hypothesis that cognitive impairment will be higher in female MS patients in the post-menopause period compared to those in pre-menopause, due to a decrease in estrogen that may be neuroprotective. Second, the lab will test whether change in cognitive performance pre- and post-menopause is greater in MS than control populations without MS. Third, regression models will be used to identify the relative importance of connectivity types (SC vs static FC vs dynamic FC) most associated with cognitive impairment in MS. A better understanding of mechanisms driving cognitive decline in menopausal MS patients may enable better disease management.