Cognitive function evaluation in premenstrual syndrome during the follicular and luteal phases using near-infrared spectroscopy

BACKGROUND: Many adult females experience periodic mental and physical symptoms associated with premenstrual syndrome (PMS). Diagnosis of PMS is generally based on self-reported symptoms over several menstrual cycles, but there are concerns about its accuracy and duration. It is well known that decreased cognitive function is one of the symptoms of PMS. Near-infrared spectroscopy (NIRS) is one of the methods for imaging brain activity, similar to magnetic resonance imaging (MRI), electroencephalography (EEG), and positron emission tomography (PET). NIRS has been used to assess cognitive function decline demonstrated by decline in brain activity. However, to the best of our knowledge, there have been no report characterizing brain activity pattern in females with PMS during the luteal and follicular phases separately. OBJECTIVE: We aimed to characterize the cognitive function of females with PMS during the follicular and luteal phases using NIRS. METHODS: The level of brain activity in the prefrontal cortex was detected with NIRS while PMS women were performing cognitive tasks. NIRS detected brain activity by measuring the oxy-hemoglobin and deoxy-hemoglobin levels. Participants were females between the ages of 20 and 25 with PMS (n = 11) and without PMS (n = 11). During the participants’ follicular and luteal phases, the participants were asked to perform the cognitive task; an N-back task (0-, 1-, and 2-back tasks), which is widely used for assessing cognitive function. We also calculated the oxyhemoglobin integral value during the N-back task using the NIRS signal; this value represented the total amount of change in cerebral oxyhemoglobin and the brain activation level. RESULTS: The correct response rate on the 2-back task was significantly lower during both the follicular and luteal phases in females with PMS compared to that in females without PMS (P = 0.01; P = 0.02, during the follicular and luteal phases, respectively). During the luteal phase, brain activation was significantly lower in participants with PMS than in that in females without PMS (P = 0.04). In addition, during the luteal phase, the participants with PMS also had higher negative mood than those without PMS. CONCLUSION: The cognitive decline during the luteal phase in participants with PMS was detected by NIRS with significant differences from participants without PMS. The difference was observed only during the luteal phase, not in the follicular phase and were related to the increase in negative mood. These results may provide an objective method for diagnosing PMS based on brain activity. We believe that the use of instruments (e.g., NIRS, MRI, EEG … etc.) to detect cognitive function decline will lead to rapid and reliable diagnosis of PMS and premenstrual dysphoric disorder.