AHA Scientific Sessions 2026 Abstract · Nov 2, 2026
Amygdala Cerebrovascular Reactivity and Memory in Postmenopausal Women
By Joyce J, Alitin JP, Barker M et al.
Background: Cerebrovascular reactivity (CVR), the ability of cerebral blood vessels to modulate blood flow in response to vasoactive stimuli, is a dynamic measure of vascular brain health. Prior studies demonstrate that medial temporal lobe CVR predicts memory dysfunction in older adults. However, other limbic regions critical to memory, including the amygdala, remain unstudied in the CVR literature. The amygdala supports memory consolidation through emotional memory tagging and has been implicated in Alzheimer's disease pathology and cardiovascular disease risk. Menopausal estradiol loss may further compromise cerebrovascular and amygdala health, leaving postmenopausal women at greater risk. Estradiol coordinates amygdala-cortex activity to facilitate memory consolidation, and postmenopausal amygdala volumetric changes have been linked to cognitive decline. However, the vascular health of the amygdala in postmenopausal women remains unstudied. We examined whether amygdala CVR is associated with memory performance in older women. Hypothesis: Greater amygdala CVR will be associated with better story-based memory performance in older women. Method: This study included 80 community-dwelling older women without dementia or stroke (mean age=68.9 years, SD=7.4, range=60-89). Pseudo-continuous arterial spin labeling MRI quantified cerebral perfusion in the amygdala during breath-hold induced vasodilation. Lower CVR values represent reduced vasodilatory function. Delayed story recall was assessed with the Wechsler Memory Scale Logical Memory II. Linear regression evaluated the relationship between amygdala CVR and memory, adjusting for age and education. Sensitivity analysis examined whether findings persisted after adjusting for cumulative vascular risk factor burden. Result: Greater amygdala CVR was associated with better delayed story recall (B=0.22, p=.004), adjusting for age and education. Findings remained significant after adjusting for cumulative vascular risk factor burden (B=0.22, p=.005) and excluding participants with CVR values exceeding three standard deviations above the mean (B=0.24, p=.008). Conclusion: Amygdala vascular health emerged as a predictor of memory function in older women. Findings extend the CVR-memory literature beyond the MTL to understudied limbic regions and implicate amygdala CVR as a vascular determinant of cognitive health in postmenopausal women. Future work should examine sex-specific mechanisms, including reproductive history (e.g. menopause age, parity) and sex hormone levels, that may influence amygdala cerebrovascular health and memory in aging women.