Understanding the Cognitive Risks With Preeclampsia and Raising Awareness: Vesna Garovic, MD, PhD

WATCH TIME: 4 minutes

"Maybe by identifying some of these markers, we can identify those at particular risk, because not every woman who had preeclampsia will develop cognitive decline. When it comes to the personal level, who are these women that are actually at risk? The field is wide open."

At the 2022 Alzheimer’s Association International Conference (AAIC), July 31 to August 4, in San Diego, California, researchers from Mayo Clinic presented a study on the long-term effects of preeclampsia (PE), a pregnancy specific hypertensive disorder. A cohort of 40 women with histories of normotensive pregnancies and 40 age- and parity-matched women with a history of mild (n = 33) and severe (n = 7) PE were assessed. Blood-borne extracellular vesicles (EVs) derived from neurovascular cellular activation were determined by standardized digital flow cytometry, while plasma concentration of amyloid-ß was measured by ELISA.

The findings showed that women with a history of severe PE had a significantly higher concentration of amyloid-ß carrying EVs compared with controls (P = .003). Additionally, EVs positive for the markers of blood-brain barrier-endothelial damage and inflammatory coagulation pathway activator were significantly higher in women with a history of severe PE compared with controls (P = .008 and P = .002, respectively).1 These new observations of elevated neuroinflammation and neurovascular damage add to preexisting literature which has linked PE with increased risk for stroke, cognitive decline, and smaller brain volumes.

NeurologyLive^® sat down with senior investigator Vesna Garovic, MD, PhD, to better understand whether these findings change the way clinical trials are designed and conducted. Garovic, chair of the nephrology division at Mayo Clinic, provided insight on the state of research for PE, the questions that still need answering, and whether these findings change the way clinicians treat or monitor the hypertensive disorder.

REFERENCE
1. Suvokov S, Norby A, Abou-Hassan C, et al. Circulating extracellular vesicles of neurovascular origin are elevated in women with severe preeclampsia years after their affected pregnancies. Presented at: 2022 Alzheimer’s Association International Conference; July 31 to Aug 4; San Diego, CA. 62360