Introduction. Premature ovarian insufficiency (POI) is currently regarded as a multisystem condition characterized by prolonged hypoestrogenism and potential effects on the central nervous system. Available evidence suggests a possible association of POI with cognitive impairment as well as structural and functional alterations of the brain. However, early neurophysiological and neuroimaging markers reflecting central nervous system involvement in this condition remain insufficiently studied. Objective. To evaluate the potential of a multimodal assessment of brain status in patients with POI using electroencephalography (EEG) and resting-state functional magnetic resonance imaging (rs-fMRI) for the identification of early functional features. Materials and Methods. A pilot observational cross-sectional study was conducted. The study group included two patients with POI who underwent comprehensive evaluation and treatment using novel surgical technologies at the Department of Operative Gynecology and General Surgery of the Kulakov National Medical Research Center for Obstetrics, Gynecology and Perinatology of the Ministry of Health of the Russian Federation. As part of the preoperative assessment, in addition to general clinical, hormonal, immunological, and genetic studies, brain functional activity was evaluated using fMRI and EEG. The control group consisted of eight age-matched women without a history of gynecological disease. Within the study protocol, EEG was performed on the same day using the standard 10—20 system with an additional ECG channel for 30 minutes, along with structural and functional MRI on a 3T scanner. The primary outcome was the difference in brain functional organization between groups based on rs-fMRI data, assessed through spatial maps of independent components and measures of functional inter-network connectivity. Preprocessing was conducted using SPM12, ICA analysis using the GIFT Toolbox, and statistical analysis using the MANCOVAN module with a two-sample t-test. Results. In both patients with POI, no pathological activity was detected on EEG, and structural MRI revealed no evidence of organic brain pathology. Independent component analysis (ICA) identified canonical resting-state networks, including the visual network, auditory network, central executive network, default mode network, and basal ganglia network. Intergroup analysis of spatial maps of independent components and measures of functional internetwork connectivity did not demonstrate statistically significant differences; only isolated local clusters were observed without an anatomically consistent pattern. Conclusions. No significant abnormalities were detected in patients with POI based on EEG and resting-state fMRI compared to healthy controls. At the same time, the study confirmed the technical feasibility and reproducibility of a comprehensive multimodal approach and provides a foundation for further investigations in larger and clinically stratified cohorts.
Adamyan et al. (Mon,) studied this question.