Decreased cognition is associated with altered cardiovascular autonomic functions and decreased baroreflex sensitivity in women with premenstrual syndrome

Abstract

Premenstrual syndrome (PMS) is a clinical entity of concern in women of reproductive age group with its onset during the late luteal phase of the menstrual cycle that typically resolves within a few days after the onset of menstruation. Female reproductive hormones stimulate the gene promotor region of Gonadal steroids, which are modulators of the hypothalamic-pituitary axis, in association with the autonomic nervous system (ANS), form the stress system, which regulates the homeostatic mechanisms of the body. Disruption of this mechanism can lead to sympathovagal imbalance and cognitive deficits. Objectives: This study was aimed to compare the autonomic functions and cognition between PMS and control group. Methodology: This cross-sectional study was conducted as a pilot study with 20 subjects in each group. Autonomic function test and P300 were recorded. Study participants were also asked to answer Montreal cognitive assessment (MOCA) questionnaire. Results: On comparison of the test results between the two groups, individuals in PMS group were found to have increased sympathetic activity and reduced cognition when compared to the no PMS (control) group. Conclusion: The findings from this study proves a detrimental effect of gonadal steroids on autonomic nervous system and cognition.

Effect of pranayama on sympatho-vagal imbalance and cognitive deficit in premenstrual syndrome

“…[ 20 ] Because the symptoms of PMS are attributed to sympathetic overactivity in the late luteal phase of the menstrual cycle and autonomic imbalance is also associated with cognitive impairment, yoga and pranayama practices that have been shown to have beneficial effects on cardiac autonomic functions can be used in the management of premenstrual symptoms. [ 7 21 ] In our study, systolic blood pressure, Mean HR, LF nu, LF/HF ratio, Δ DBP IHG , and P300 latency were considerably lowered, whereas Total power, HF nu, SDNN, RMSSD, HFnu, 30:15 ratio, E:I ratio, and MOCA score were significantly improved after 8 weeks of pranayama practice. Sympathetic activity is denoted by LFnu, sympathovagal imbalance by LF: HF, and parasympathetic activity by HFnu.…”

“…The pathophysiology of PMS is ascribed to elevated and aberrant amounts of gonadal hormones, which leads to disturbed homeostasis. [ 7 ] As a result, the aberrant variation of gonadal steroids in PMS can be related to sympatho-vagal imbalance. Cardiovascular morbidity is predicted by sympathetic-vagal imbalance.…”

“…[ 10 ] The autonomic nervous system interacts with higher mental functions such as cognition, and research shows that enhanced parasympathetic activity improves cognition. [ 7 ] In PMS, excessive sympathetic activity in the late luteal phase causes cognitive impairment. P300 is a key component of Event Related Potential (ERP), which is used to test cognition.…”