ORIGINAL RESEARCH article
Front. Aging Neurosci.
Sec. Neurocognitive Aging and Behavior
Volume 17 - 2025 | doi: 10.3389/fnagi.2025.1593366
Cognitive Function Changes and DTI -ALPS Index in Postmenopausal Women
Provisionally accepted
- 1Second Hospital of Tianjin Medical University, Tianjin, China
- 2Tianjin Medical University, Tianjin, Tianjin Municipality, China
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Background Cognitive decline in postmenopausal women is a growing public health concern, with estrogen deficiency linked to brain aging.However, the role of the brain's lymphatic-like system-assessed via the diffusion tensor imaging along the perivascular space (DTI-ALPS) index-in mediating estrogen-cognitive associations remains unclear.This study investigated whether the DTI-ALPS index mediates the relationship between estrogen levels and cognitive function in postmenopausal women. . Methods Data from 55 women recruited from outpatient clinics were analyzed. A combination of traditional and advanced statistical methods was used. These included MANOVA, non -linear correlation analysis, structural equation modeling , and machine learning algorithms.Postmenopausal women exhibited lower right and mean ALPS indices (P < 0.05) and worse cognitive performance on reaction time tasks (P < 0.05). The mean ALPS index fully mediated the relationship between estrogen and cognitive accuracy (e.g., Stroop: r = 0.588, P < 0.01), with machine learning ranking ALPS index and estrogen as top predictors of cognitive function.Conclusions Reduced brain lymphatic function (lower ALPS index) is associated with cognitive decline in postmenopausal women, and this relationship is mediated by estrogen levels. The DTI-ALPS index may serve as a novel biomarker for menopause-related cognitive health.
Keywords: DTI -ALPS index, postmenopausal women, Cognitive Function, statistical analysis, estrogen
Received: 19 Mar 2025; Accepted: 09 Jun 2025.
Copyright: © 2025 Liu, Zhang, Fu and Liu. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Ningning Liu, Second Hospital of Tianjin Medical University, Tianjin, China
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