Sexual assault in women associated with an increased risk of stroke and dementia

Traumatic experiences, especially sexual assault, can put women at greater risk for poor brain health.

In the Ms-Brain study, middle-aged women with trauma exposure had greater volumes of white matter hyperintensities (WMHs) than women without trauma. In addition, the differences persisted even after adjusting to depressive or post-traumatic stress symptoms.

WMHs are “an important indicator of small vessel disease in the brain and have been linked to future risk of stroke, dementia, and mortality,” Rebecca Thurston, PhD, of the University of Pittsburgh School of Medicine, Pennsylvania, told Medscape Medical News.

“What I get from this is really that sexual assault has effects on women’s health that go far beyond mere mental health, but also on their cardiovascular health, as we have shown in other papers, and on their stroke and Risk of dementia as we see in this paper, “added Thurston.

The study was presented at the North American Menopause Society (NAMS) annual meeting in Washington, DC, and accepted for publication in the journal Brain Imaging and Behavior.

Beyond the usual suspects

As part of the study, 145 women (mean age 59 years) without clinical cardiovascular disease, stroke or dementia provided their medical history including traumatic experiences, depression and post-traumatic stress disorder and under magnetic resonance imaging of the brain provided WMHs.

More than two-thirds (68%) of women reported at least one trauma, most commonly sexual assault (23%).

In the multivariate analysis, women with trauma exposure had a larger WMH volume than women without trauma (P = .01), with sexual assault being most strongly associated with a larger WMH volume (P = .02).

The associations persisted after adjusting to depressive or post-traumatic stress symptoms.

“A history of sexual assault has been specifically linked to white matter hyperintensities in the parietal lobe, and these types of white matter hyperintensities have been linked to Alzheimer’s disease in fairly prominent ways,” Thurston said.

“When we think of risk factors for stroke and dementia, we need to think beyond our usual suspects and think of women too.” [who experienced] especially psychological trauma and experienced sexual assault. So ask for it and consider it part of your screening program, “she added.

“Blooming” literature

Commenting on the results for Medscape Medical News, Charles Nemeroff, MD, PhD, professor and chairman, Department of Psychiatry and Behavioral Sciences, Dell Medical School, University of Texas at Austin, and director of the Institute for Early Life Adversity Research said: The Research complements the “blossoming literature on the long-term neurobiological consequences of trauma, and particularly sexual abuse, on brain imaging”.

“Our group and others reported a few years ago that patients with mood disorders, particularly bipolar disorder and major depression, had higher rates of WMH than comparable controls. “Said Nemeroff.

“In addition to this finding of increased WMH in trauma-exposed patients, there is a very extensive literature documenting other changes in the central nervous system (CNS) in this population, including thinning of the cortex in certain areas of the brain and clearly a new one Finding that various forms of abuse occur in children. ” associated with very different structural changes in the brain in adulthood, “he noted.

North American Menopause Society (NAMS) Annual Meeting 2021. Summary S-22. Presented on 09/22/2021.

The study was supported by grants from the National Institutes of Health. Thurston and Nemeroff have not disclosed any relevant financial relationships.

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