Date of Completion
College of Arts and Science Honors
cerebrovascular health, pre-pregnancy, fractional anisotropy, mean diffusivity, white matter hyperintensities
Pregnancy places women in a state of metabolic change that can exacerbate underlying risk factors for disease. Prior studies note physiological risk factors for pregnancy-induced hypertensive disorders, but few have focused on whether these cardiovascular and metabolic risk factors affect brain structure in early adulthood prior to pregnancy. Therefore, more research is needed to assess how subclinical cardiovascular and metabolic risk factors may affect brain health or be exacerbated by the hormonal and metabolic imbalances caused by pregnancy. This study examined how specific cardiovascular and metabolic risk factors assessed prior to pregnancy affected brain white matter microstructural integrity. This study examined 62 participants, all young (mean age 31 years), healthy women, who received both metabolic and cardiovascular assessments as well as multi-modality MRI imaging including acquisition of T2 Fluid-Attenuated Inversion Recovery (FLAIR) sequencing and Diffusion Tensor Imaging (DTI). The hypotheses were that abnormal cardiovascular and metabolic profiles would be associated with increased white matter hyperintensities (WMH), and abnormal cardiovascular and metabolic findings would be related to lower Fractional Anisotropy (FA) and increased Mean Diffusivity (MD) in posterior cortical areas. The results showed that the presence of WMH was related to increased MD in bilateral white matter tracts and altered measures of cardiac function. FA and MD in numerous posterior and occipital tracts, commissural fibers and subcortical structures correlated with age, BMI, and measures of cardiovascular and metabolic function such as pulse wave velocity (PWV), cholesterol and insulin resistance (HOMA-IR). These relationships shed light on women’s cerebrovascular health as it relates to subclinical risk factors at a young age, prior to pregnancy. More research must be done to examine how subclinical risk factors may impact potentially dangerous pregnancy outcomes in the form of hypertensive disorders such as pre-eclampsia and how these early life influences on brain structure impact brain functioning in late age.
Russom, Zane M., "Subclinical Metabolic and Cardiovascular Factors and Brain White Matter Microstructural Integrity in Young Women" (2022). UVM College of Arts and Sciences College Honors Theses. 110.