Disturbed retrieval network and prospective memory decline in postpartum women

Shin, Na‐Young; Bak, Yunjin; Nah, Yoonjin; Han, Sanghoon; Kim, Dong Joon; Kim, Se Joo; Lee, Jong Eun; Lee, Sang‐Guk; Lee, Seung‐Koo; Lee, Seung‐Koo; Lee, Seung‐Koo · 2018 · OpenAlex-citations

DOI: 10.1038/s41598-018-23875-5

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Summary

This study investigates the neural and clinical correlates of prospective memory (PM) decline in postpartum women, a phenomenon often colloquially referred to as "momnesia." While previous research has documented subjective cognitive complaints and behavioral deficits in pregnant women, there was a lack of neuroimaging data specifically addressing the postpartum period. The authors aimed to determine whether postpartum women exhibit decreased PM performance, identify the underlying brain regions responsible, and establish clinical predictors for this decline. The researchers conducted a comparative study involving 25 postpartum women and 26 nulliparous, age- and education-matched control women. Participants underwent functional magnetic resonance imaging (fMRI) while performing a PM task that required remembering to execute a delayed intention during an ongoing activity. The study also collected clinical data, including serum estradiol levels, sleep patterns (specifically nocturnal awakenings), and depressive symptoms measured via the Beck Depression Inventory. Behavioral performance was assessed through accuracy, reaction time, and error types (omissions and commissions). The results demonstrated that postpartum women had significantly poorer PM performance, characterized by fewer correct responses, more omission errors, and longer reaction times compared to controls. Neuroimaging revealed that postpartum women exhibited decreased functional connectivity (FC) between the right hippocampus and the ventral frontoparietal network (FPN) during retrieval-dominant PM trials. This network is associated with bottom-up spontaneous retrieval processes. Multivariate analysis identified decreased FC between the right hippocampus and ventral FPN, along with a higher number of nocturnal awakenings, as independent predictors of poor PM performance. Mediation analysis further showed that lower serum estradiol levels indirectly affected PM accuracy by altering this functional connectivity. The findings suggest that the decline in prospective memory during the postpartum period is linked to disturbances in the neural networks supporting spontaneous retrieval, specifically involving the right hippocampus and ventral FPN. This disruption is mediated by the abrupt drop in estradiol levels following pregnancy. Additionally, sleep fragmentation, particularly nocturnal awakenings, independently contributes to PM deficits. The study implies that interventions targeting sleep quality could potentially mitigate PM decline in postpartum women. It also highlights that structural and functional changes in these brain regions may be adaptive processes for motherhood, potentially reducing responsiveness to non-relevant cues.

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• prospective memory interruptions