Abstract:

Potential link between preeclampsia (PE) and posterior cortical atrophy (PCA): PCA is a neurodegenerative disorder affecting the parietal, occipital, and occipital-temporal brain regions, often manifesting as a decline in visual processing and perception skills in affected individuals. The most common underlying pathology of PCA is Alzheimer’s disease, which disproportionally affects women. Indeed, approximately two-thirds of Alzheimer’s disease patients are women and some studies suggest that PCA is more common among women than men, although other studies report no sex differences in PCA incidence. Taken together, these findings point to the potential involvement of sex-specific factors such as pregnancy and pregnancy disorders like PE, in driving the increased risk of neurodegenerative diseases in women. While there are no studies showing a direct link between PE and PCA, a recent study reported decreased gray matter volume in the posterior brain region of women with a history of PE and subsequent late-life hypertension. Importantly, during pregnancy, not only do PE patients often present with visual symptoms but abnormal brain imaging findings are consistent most commonly with posterior cerebral or occipital lobe abnormalities, suggesting that PE-induced abnormalities occur most frequently in the posterior cerebrum. These findings support the hypothesis that women with a history of PE may be more likely to present with PCA later in life; however, no studies have specifically addressed this question. Furthermore, because of low awareness of the disorder, not much is known regarding the underlying pathophysiological mechanisms, and prevention and treatment strategies are lacking. A recent publication provided evidence that reduced utero-placental blood flow and resulting placental ischemia during pregnancy, led to neuroinflammation and increased water content in the posterior cortex at two months postpartum while other brain regions such as anterior cerebrum, striatum, and hippocampus were spared. Herein, we present that the rat model of placental ischemia may be a suitable tool to assess the underlying mechanisms of postpartum posterior cortical abnormalities.