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González-Burgos I, Velázquez-Zamora DA, González-Tapia D. Estradiol-mediated modulation of memory and of the underlying dendritic spine plasticity through the life span. Histol Histopathol 2024; 39:411-423. [PMID: 37966087 DOI: 10.14670/hh-18-672] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2023]
Abstract
The morphophysiology of the nervous system changes and adapts in response to external environmental inputs and the experiences of individuals throughout their lives. Other changes in the organisms internal environment can also contribute to nervous system restructuring in the form of plastic changes that underlie its capacity to adapt to emerging psychophysiological conditions. These adaptive processes lead to subtle modifications of the organisms internal homeostasis which is closely related with the activity of chemical messengers, such as neurotransmitters and hormones. Hormones reach the brain through the bloodstream, where they activate specific receptors through which certain biochemical, physiological, and morphological changes take place in numerous regions. Fetal development, infancy, puberty, and adulthood are all periods of substantial hormone-mediated brain remodeling in both males and females. Adulthood, specifically, is associated with a broad range of life events, including reproductive cycles in both sexes, and pregnancy and menopause in women. Events of this kind occur concomitantly with eventual modifications in behavioral performance and, especially, in cognitive abilities like learning and memory that underlie, at least in part, plastic changes in the dendritic spines of the neuronal cells in cerebral areas involved in processing cognitive information. Estrogens form a family that consists of three molecules [17β-estradiol (E2), estrone, estriol] which are deeply involved in regulating numerous bodily functions in different stages of the life-cycle, including the modulation of cognitive performance. This review addresses the effects of E2 on the dendritic spine-mediated synaptic organization of cognitive performance throughout the life span.
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Affiliation(s)
| | | | - David González-Tapia
- Department of Health-disease as an individual and collective process, Health Division, Tlajomulco University Centre, University of Guadalajara, Tlajomulco de Zúñiga, Jalisco, México
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2
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Johnson CE, Duncan MJ, Murphy MP. Sex and Sleep Disruption as Contributing Factors in Alzheimer's Disease. J Alzheimers Dis 2024; 97:31-74. [PMID: 38007653 PMCID: PMC10842753 DOI: 10.3233/jad-230527] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2023]
Abstract
Alzheimer's disease (AD) affects more women than men, with women throughout the menopausal transition potentially being the most under researched and at-risk group. Sleep disruptions, which are an established risk factor for AD, increase in prevalence with normal aging and are exacerbated in women during menopause. Sex differences showing more disrupted sleep patterns and increased AD pathology in women and female animal models have been established in literature, with much emphasis placed on loss of circulating gonadal hormones with age. Interestingly, increases in gonadotropins such as follicle stimulating hormone are emerging to be a major contributor to AD pathogenesis and may also play a role in sleep disruption, perhaps in combination with other lesser studied hormones. Several sleep influencing regions of the brain appear to be affected early in AD progression and some may exhibit sexual dimorphisms that may contribute to increased sleep disruptions in women with age. Additionally, some of the most common sleep disorders, as well as multiple health conditions that impair sleep quality, are more prevalent and more severe in women. These conditions are often comorbid with AD and have bi-directional relationships that contribute synergistically to cognitive decline and neuropathology. The association during aging of increased sleep disruption and sleep disorders, dramatic hormonal changes during and after menopause, and increased AD pathology may be interacting and contributing factors that lead to the increased number of women living with AD.
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Affiliation(s)
- Carrie E. Johnson
- University of Kentucky, College of Medicine, Department of Molecular and Cellular Biochemistry, Lexington, KY, USA
| | - Marilyn J. Duncan
- University of Kentucky, College of Medicine, Department of Neuroscience, Lexington, KY, USA
| | - M. Paul Murphy
- University of Kentucky, College of Medicine, Department of Molecular and Cellular Biochemistry, Lexington, KY, USA
- University of Kentucky, Sanders-Brown Center on Aging, Lexington, KY, USA
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3
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Zainal NH, Newman MG. A cross-lagged prospective network analysis of depression and anxiety and cognitive functioning components in midlife community adult women. Psychol Med 2023; 53:4160-4171. [PMID: 35534458 PMCID: PMC9646930 DOI: 10.1017/s0033291722000848] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/07/2021] [Revised: 02/25/2022] [Accepted: 03/09/2022] [Indexed: 12/18/2022]
Abstract
BACKGROUND Scar theory proposes that heightened depression and anxiety precede and predict worse cognitive functioning outcomes, whereas the vulnerability theory posits the opposite pathway. However, most investigations on this topic have been cross-sectional, precluding causal inferences. Thus, we used cross-lagged prospective network analyses to facilitate causal inferences in understanding the relations between psychopathology and cognitive functioning components. METHODS Racially-diverse midlife women (n = 1816) participated in the Study of Women's Health Across the Nation at two time-points, spanning one year apart. Five psychopathology (anxiety severity, depressed mood, somatic symptoms, positive affect, interpersonal problems) and four cognitive functioning nodes (working memory (WM), processing speed (PS), facial recognition (FCR), and verbal memory (VRM)) were assessed. All analyses adjusted for age, menopausal status, estradiol, and follicle-stimulating hormones. RESULTS Contemporaneous networks yielded notable inverse between-node relations (edges) between interpersonal problems and reduced FCR and PS, and between depressed mood and lower FCR, VRM, or PS. Nodes that had the highest likelihood to bridge other constructs were positive affect, anxiety severity, WM, and VRM. Temporal networks produced edges consistent with the scar (v. vulnerability) hypotheses. Higher somatic symptoms were related to reduced PS and WM, and greater depressed mood was correlated with lower future PS and WM. Also, higher anxiety severity coincided with decreased future PS and WM. Greater positive affect was associated with stronger future PS, FCR, and WM. Also, positive affect had the strongest relations with other nodes. CONCLUSIONS Findings suggest the importance of targeting symptoms and cognitive functioning simultaneously.
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Affiliation(s)
- Nur Hani Zainal
- Department of Psychology, The Pennsylvania State University, University Park, Pennsylvania, United States
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4
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Maitreyee R, Varley R, Cowell PE. Verbal ability in postmenopausal women in relation to age, cognitive and reproductive factors. Acta Psychol (Amst) 2023; 238:103963. [PMID: 37364371 DOI: 10.1016/j.actpsy.2023.103963] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2023] [Revised: 06/13/2023] [Accepted: 06/15/2023] [Indexed: 06/28/2023] Open
Abstract
Word-finding difficulties have been associated with age and, in women, lowered sex hormone levels following menopause. However, there is limited understanding of the ways that specific aspects of word-finding are shaped by women's age, reproductive histories, and background factors such as education. The current study investigated the effects of age, cognitive and reproductive factors on word-finding abilities in 53 healthy postmenopausal women aged 48-79. A questionnaire was used to gather demographic information and reproductive history. A battery of verbal fluency, continuous series, and naming tasks was designed to assess word-finding across different sensory modalities and cognitive demands. Category and letter fluency were quantified as total number of correct words produced on each task. For continuous series, switch rates and switch costs were computed. For the naming tasks, accuracy and latency measures were used. There were three key findings. Firstly, there was a consistent positive association between education and all word-finding measures, i.e., verbal fluency, continuous series, and naming. Secondly, age-related declines were seen on tasks heavily dependent on working memory such as the continuous series task. Thirdly, reproductive factors across the lifespan such as age at menarche and reproductive years showed subtle effects on naming abilities, but not on verbal fluency or continuous series. The results highlight that word-finding abilities in healthy postmenopausal women are shaped by factors associated with their early years (education, age at menarche) and later adult life (age, reproductive years). The study also distinguished between the more global effects of education, and the more task-specific associations with age and reproductive variables, on verbal task performance after menopause.
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Affiliation(s)
- Ramya Maitreyee
- Division of Human Communication Sciences, Health Sciences School, The University of Sheffield, 362 Mushroom Lane, Sheffield S10 2TS, United Kingdom.
| | - Rosemary Varley
- Division of Psychology and Language Sciences, UCL, 313, Chandler House, 2 Wakefield Street, London WC1N 1PF, United Kingdom.
| | - Patricia E Cowell
- Division of Human Communication Sciences, Health Sciences School, The University of Sheffield, 362 Mushroom Lane, Sheffield S10 2TS, United Kingdom.
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5
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Kling JM, Dowling NM, Bimonte-Nelson H, Gleason CE, Kantarci K, Stonnington CM, Harman SM, Naftolin F, Pal L, Cedars M, Manson JE, James TT, Brinton EA, Miller VM. Associations between pituitary-ovarian hormones and cognition in recently menopausal women independent of type of hormone therapy. Maturitas 2023; 167:113-122. [PMID: 36395695 PMCID: PMC10077876 DOI: 10.1016/j.maturitas.2022.10.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2022] [Revised: 09/07/2022] [Accepted: 10/14/2022] [Indexed: 11/15/2022]
Abstract
OBJECTIVES To examine associations of pituitary-ovarian hormone levels with cognition before and after different formulations of hormone therapy (HT) or placebo independent of treatment group. METHODS Recently menopausal, healthy women were randomized to 0.45 mg/day oral conjugated equine estrogens (o-CEE, n = 109), 50 μg/day transdermal 17β (tE2, n = 107) or placebo pills and patches (n = 146); women on active treatment received oral 200 mg/day micronized progesterone for 12 days per month. Levels of estrone, 17β-estradiol, follicle stimulating hormone, luteinizing hormone, androstenedione, and testosterone were determined prior to and after 48 months of study participation. Neuropsychological testing was administered at baseline, and months 18, 36 and 48. Latent growth curve models controlling for education level, age, APOE allele status, waist circumference, and treatment examined the trajectories of each cognitive domain after accounting for the effect of hormone levels at baseline and months 18, 36 and 48. A linear multivariate mixed model examined the effect of changes in hormone levels on changes in trajectories of complex attention tasks with varying degrees of difficulty. RESULTS All women were adherent to treatment at month 48. Higher baseline estrone levels were associated with poorer global cognition, auditory attention and working memory, visual attention, and executive function, but not working memory. Higher levels of baseline 17β-E2 were associated with poorer cognitive performance, with marginal significance at baseline in speeded language and mental flexibility (p = 0.013). Other hormone levels were not associated with cognition. Controlling for all treatments, hormone levels at baseline and at month 48 did not have any significant correlation with cognitive trajectories over time. SUMMARY In healthy, recently menopausal women, baseline estrone levels were inversely associated with selected cognitive factors independent of two types of HT or placebo during 4 years of follow-up. Baseline levels of the other pituitary-ovarian hormones studied were not associated with baseline cognition, nor were changes in any hormones associated with changes in cognition during the study. The marginal association between estradiol levels and cognitive factors warrants further investigation. CLINICALTRIALS GOV NUMBERS NCT00154180, NCT00623311.
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Affiliation(s)
- Juliana M Kling
- Division of Women's Health Internal Medicine, Mayo Clinic, Scottsdale, AZ, USA.
| | - N Maritza Dowling
- Department of Acute & Chronic Care, School of Nursing, Department of Epidemiology & Biostatistics, Milken Institute School of Public Health, The George Washington University, Washington, DC, USA
| | - Heather Bimonte-Nelson
- Department of Psychology, Arizona State University, Tempe, AZ, USA; Arizona Alzheimer's Consortium, Phoenix, AZ 85006, USA
| | - Carey E Gleason
- Division of Geriatrics, Department of Medicine, University of Wisconsin School of Medicine and Public Health and the Wisconsin Alzheimer's Disease Research Center, Madison VA GRECC, Madison, WI, USA
| | - Kejal Kantarci
- Department of Radiology, Mayo Clinic, Rochester, MN, USA
| | | | | | | | - Lubna Pal
- Department of Obstetrics, Gynecology & Reproductive Sciences, Yale School of Medicine, New Haven, CT, USA
| | - Marcelle Cedars
- Department of Obstetrics and Gynecology, University of California San Francisco School of Medicine, San Francisco, CA, USA
| | - JoAnn E Manson
- Division of Preventive Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Taryn T James
- School of Medicine and Public Health, University of Wisconsin-Madison, Madison, WI, USA
| | | | - Virginia M Miller
- Department of Surgery, Mayo Clinic, United States; Department of Physiology and Biomedical Engineering, Mayo Clinic, USA
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Mao L, Wang L, Bennett S, Xu J, Zou J. Effects of follicle-stimulating hormone on fat metabolism and cognitive impairment in women during menopause. Front Physiol 2022; 13:1043237. [PMID: 36545281 PMCID: PMC9760686 DOI: 10.3389/fphys.2022.1043237] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2022] [Accepted: 11/22/2022] [Indexed: 12/07/2022] Open
Abstract
Lipid metabolism disorder is a common pathological manifestation of menopausal women, and is also an important risk factor for many diseases at this stage of life. Epidemiological studies have shown that high levels of follicle-stimulating hormone (FSH) in menopausal women are closely associated with changes in body composition, central obesity, and cognitive decline. Exogenous FSH causes growth and proliferation of adipose, whereas blockage of the FSH signaling pathway leads to decline in adipose. Mechanistically, FSH, FSH receptor (FSHR), G protein coupling, gene mutation and other pathways are involved in adipogenesis and cognitive impairment. Here, we review the critical role and potential interactions of FSH in adipogenesis and cognitive impairment in menopausal women. Further understanding of the exact mechanisms of FSH aggravating obesity and cognitive impairment may provide a new perspective for promoting healthy aging in menopausal women.
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Affiliation(s)
- Liwei Mao
- School of Kinesiology, Shanghai University of Sport, Shanghai, China
| | - Lian Wang
- School of Kinesiology, Shanghai University of Sport, Shanghai, China
| | - Samuel Bennett
- School of Biomedical Sciences, The University of Western Australia, Perth, WA, Australia
| | - Jiake Xu
- School of Biomedical Sciences, The University of Western Australia, Perth, WA, Australia
| | - Jun Zou
- School of Kinesiology, Shanghai University of Sport, Shanghai, China
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Griksiene R, Monciunskaite R, Ruksenas O. What is there to know about the effects of progestins on the human brain and cognition? Front Neuroendocrinol 2022; 67:101032. [PMID: 36029852 DOI: 10.1016/j.yfrne.2022.101032] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/29/2022] [Revised: 07/24/2022] [Accepted: 08/19/2022] [Indexed: 12/27/2022]
Abstract
Progestins are an important component of hormonal contraceptives (HCs) and hormone replacement therapies (HRTs). Despite an increasing number of studies elucidating the effects of HCs and HRTs, little is known about the effects of different types of progestins included in these medications on the brain. Animal studies suggest that various progestins interact differently with sex steroid, mineralocorticoid and glucocorticoid receptors and have specific modulatory effects on neurotransmitter systems and on the expression of neuropeptides, suggesting differential impacts on cognition and behavior. This review focuses on the currently available knowledge from human behavioral and neuroimaging studies pooled with evidence from animal research regarding the effects of progestins on the brain. The reviewed information is highly relevant for improving women's mental health and making informed choices regarding specific types of contraception or treatment.
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Affiliation(s)
- Ramune Griksiene
- Department of Neurobiology and Biophysics, Life Sciences Center, Vilnius University, Lithuania
| | - Rasa Monciunskaite
- Department of Neurobiology and Biophysics, Life Sciences Center, Vilnius University, Lithuania
| | - Osvaldas Ruksenas
- Department of Neurobiology and Biophysics, Life Sciences Center, Vilnius University, Lithuania
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8
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Jett S, Schelbaum E, Jang G, Boneu Yepez C, Dyke JP, Pahlajani S, Diaz Brinton R, Mosconi L. Ovarian steroid hormones: A long overlooked but critical contributor to brain aging and Alzheimer's disease. Front Aging Neurosci 2022; 14:948219. [PMID: 35928995 PMCID: PMC9344010 DOI: 10.3389/fnagi.2022.948219] [Citation(s) in RCA: 18] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2022] [Accepted: 06/28/2022] [Indexed: 01/19/2023] Open
Abstract
Ovarian hormones, particularly 17β-estradiol, are involved in numerous neurophysiological and neurochemical processes, including those subserving cognitive function. Estradiol plays a key role in the neurobiology of aging, in part due to extensive interconnectivity of the neural and endocrine system. This aspect of aging is fundamental for women's brains as all women experience a drop in circulating estradiol levels in midlife, after menopause. Given the importance of estradiol for brain function, it is not surprising that up to 80% of peri-menopausal and post-menopausal women report neurological symptoms including changes in thermoregulation (vasomotor symptoms), mood, sleep, and cognitive performance. Preclinical evidence for neuroprotective effects of 17β-estradiol also indicate associations between menopause, cognitive aging, and Alzheimer's disease (AD), the most common cause of dementia affecting nearly twice more women than men. Brain imaging studies demonstrated that middle-aged women exhibit increased indicators of AD endophenotype as compared to men of the same age, with onset in perimenopause. Herein, we take a translational approach to illustrate the contribution of ovarian hormones in maintaining cognition in women, with evidence implicating menopause-related declines in 17β-estradiol in cognitive aging and AD risk. We will review research focused on the role of endogenous and exogenous estrogen exposure as a key underlying mechanism to neuropathological aging in women, with a focus on whether brain structure, function and neurochemistry respond to hormone treatment. While still in development, this research area offers a new sex-based perspective on brain aging and risk of AD, while also highlighting an urgent need for better integration between neurology, psychiatry, and women's health practices.
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Affiliation(s)
- Steven Jett
- Department of Neurology, Weill Cornell Medical College, New York, NY, United States
| | - Eva Schelbaum
- Department of Neurology, Weill Cornell Medical College, New York, NY, United States
| | - Grace Jang
- Department of Neurology, Weill Cornell Medical College, New York, NY, United States
| | - Camila Boneu Yepez
- Department of Neurology, Weill Cornell Medical College, New York, NY, United States
| | - Jonathan P. Dyke
- Department of Radiology, Weill Cornell Medical College, New York, NY, United States
| | - Silky Pahlajani
- Department of Neurology, Weill Cornell Medical College, New York, NY, United States
- Department of Radiology, Weill Cornell Medical College, New York, NY, United States
| | - Roberta Diaz Brinton
- Department of Pharmacology, University of Arizona, Tucson, AZ, United States
- Department of Neurology, University of Arizona, Tucson, AZ, United States
| | - Lisa Mosconi
- Department of Neurology, Weill Cornell Medical College, New York, NY, United States
- Department of Radiology, Weill Cornell Medical College, New York, NY, United States
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9
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Harrington YA, Parisi JM, Duan D, Rojo-Wissar DM, Holingue C, Spira AP. Sex Hormones, Sleep, and Memory: Interrelationships Across the Adult Female Lifespan. Front Aging Neurosci 2022; 14:800278. [PMID: 35912083 PMCID: PMC9331168 DOI: 10.3389/fnagi.2022.800278] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2021] [Accepted: 06/09/2022] [Indexed: 01/26/2023] Open
Abstract
As the population of older adults grows, so will the prevalence of aging-related conditions, including memory impairments and sleep disturbances, both of which are more common among women. Compared to older men, older women are up to twice as likely to experience sleep disturbances and are at a higher risk of cognitive decline and Alzheimer's disease and related dementias (ADRD). These sex differences may be attributed in part to fluctuations in levels of female sex hormones (i.e., estrogen and progesterone) that occur across the adult female lifespan. Though women tend to experience the most significant sleep and memory problems during the peri-menopausal period, changes in memory and sleep have also been observed across the menstrual cycle and during pregnancy. Here, we review current knowledge on the interrelationships among female sex hormones, sleep, and memory across the female lifespan, propose possible mediating and moderating mechanisms linking these variables and describe implications for ADRD risk in later life.
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Affiliation(s)
- Yasmin A. Harrington
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States
| | - Jeanine M. Parisi
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States
| | - Daisy Duan
- Division of Endocrinology, Diabetes and Metabolism, Johns Hopkins University School of Medicine, Baltimore, MD, United States
| | - Darlynn M. Rojo-Wissar
- The Initiative on Stress, Trauma, and Resilience (STAR), Department of Psychiatry and Human Behavior, Center for Behavioral and Preventive Medicine, The Miriam Hospital, Warren Alpert Medical School of Brown University, Providence, RI, United States
| | - Calliope Holingue
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States
- Center for Autism and Related Disorders, Kennedy Krieger Institute, Baltimore, MD, United States
| | - Adam P. Spira
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins School of Medicine, Baltimore, MD, United States
- Johns Hopkins Center on Aging and Health, Baltimore, MD, United States
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10
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Jett S, Malviya N, Schelbaum E, Jang G, Jahan E, Clancy K, Hristov H, Pahlajani S, Niotis K, Loeb-Zeitlin S, Havryliuk Y, Isaacson R, Brinton RD, Mosconi L. Endogenous and Exogenous Estrogen Exposures: How Women's Reproductive Health Can Drive Brain Aging and Inform Alzheimer's Prevention. Front Aging Neurosci 2022; 14:831807. [PMID: 35356299 PMCID: PMC8959926 DOI: 10.3389/fnagi.2022.831807] [Citation(s) in RCA: 40] [Impact Index Per Article: 20.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2021] [Accepted: 02/07/2022] [Indexed: 01/14/2023] Open
Abstract
After advanced age, female sex is the major risk factor for late-onset Alzheimer's disease (AD), the most common cause of dementia affecting over 24 million people worldwide. The prevalence of AD is higher in women than in men, with postmenopausal women accounting for over 60% of all those affected. While most research has focused on gender-combined risk, emerging data indicate sex and gender differences in AD pathophysiology, onset, and progression, which may help account for the higher prevalence in women. Notably, AD-related brain changes develop during a 10-20 year prodromal phase originating in midlife, thus proximate with the hormonal transitions of endocrine aging characteristic of the menopause transition in women. Preclinical evidence for neuroprotective effects of gonadal sex steroid hormones, especially 17β-estradiol, strongly argue for associations between female fertility, reproductive history, and AD risk. The level of gonadal hormones to which the female brain is exposed changes considerably across the lifespan, with relevance to AD risk. However, the neurobiological consequences of hormonal fluctuations, as well as that of hormone therapies, are yet to be fully understood. Epidemiological studies have yielded contrasting results of protective, deleterious and null effects of estrogen exposure on dementia risk. In contrast, brain imaging studies provide encouraging evidence for positive associations between greater cumulative lifetime estrogen exposure and lower AD risk in women, whereas estrogen deprivation is associated with negative consequences on brain structure, function, and biochemistry. Herein, we review the existing literature and evaluate the strength of observed associations between female-specific reproductive health factors and AD risk in women, with a focus on the role of endogenous and exogenous estrogen exposures as a key underlying mechanism. Chief among these variables are reproductive lifespan, menopause status, type of menopause (spontaneous vs. induced), number of pregnancies, and exposure to hormonal therapy, including hormonal contraceptives, hormonal therapy for menopause, and anti-estrogen treatment. As aging is the greatest risk factor for AD followed by female sex, understanding sex-specific biological pathways through which reproductive history modulates brain aging is crucial to inform preventative and therapeutic strategies for AD.
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Affiliation(s)
- Steven Jett
- Department of Neurology, Weill Cornell Medical College, New York, NY, United States
| | - Niharika Malviya
- Department of Neurology, Weill Cornell Medical College, New York, NY, United States
| | - Eva Schelbaum
- Department of Neurology, Weill Cornell Medical College, New York, NY, United States
| | - Grace Jang
- Department of Neurology, Weill Cornell Medical College, New York, NY, United States
| | - Eva Jahan
- Department of Neurology, Weill Cornell Medical College, New York, NY, United States
| | - Katherine Clancy
- Department of Neurology, Weill Cornell Medical College, New York, NY, United States
| | - Hollie Hristov
- Department of Neurology, Weill Cornell Medical College, New York, NY, United States
| | - Silky Pahlajani
- Department of Neurology, Weill Cornell Medical College, New York, NY, United States
- Department of Radiology, Weill Cornell Medical College, New York, NY, United States
| | - Kellyann Niotis
- Department of Neurology, Weill Cornell Medical College, New York, NY, United States
| | - Susan Loeb-Zeitlin
- Department of Obstetrics and Gynecology, Weill Cornell Medical College, New York, NY, United States
| | - Yelena Havryliuk
- Department of Obstetrics and Gynecology, Weill Cornell Medical College, New York, NY, United States
| | - Richard Isaacson
- Department of Neurology, Weill Cornell Medical College, New York, NY, United States
| | - Roberta Diaz Brinton
- Department of Pharmacology, University of Arizona, Tucson, AZ, United States
- Department of Neurology, University of Arizona, Tucson, AZ, United States
| | - Lisa Mosconi
- Department of Neurology, Weill Cornell Medical College, New York, NY, United States
- Department of Radiology, Weill Cornell Medical College, New York, NY, United States
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11
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Mishra A, Wang Y, Yin F, Vitali F, Rodgers KE, Soto M, Mosconi L, Wang T, Brinton RD. A tale of two systems: Lessons learned from female mid-life aging with implications for Alzheimer's prevention & treatment. Ageing Res Rev 2022; 74:101542. [PMID: 34929348 PMCID: PMC8884386 DOI: 10.1016/j.arr.2021.101542] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2021] [Revised: 12/05/2021] [Accepted: 12/13/2021] [Indexed: 02/03/2023]
Abstract
Neurological aging is frequently viewed as a linear process of decline, whereas in reality, it is a dynamic non-linear process. The dynamic nature of neurological aging is exemplified during midlife in the female brain. To investigate fundamental mechanisms of midlife aging that underlie risk for development of Alzheimer's disease (AD) in late life, we investigated the brain at greatest risk for the disease, the aging female brain. Outcomes of our research indicate that mid-life aging in the female is characterized by the emergence of three phases: early chronological (pre-menopause), endocrinological (peri-menopause) and late chronological (post-menopause) aging. The endocrinological aging program is sandwiched between early and late chronological aging. Throughout the three stages of midlife aging, two systems of biology, metabolic and immune, are tightly integrated through a network of signaling cascades. The network of signaling between these two systems of biology underlie an orchestrated sequence of adaptative starvation responses that shift the brain from near exclusive dependence on a single fuel, glucose, to utilization of an auxiliary fuel derived from lipids, ketone bodies. The dismantling of the estrogen control of glucose metabolism during mid-life aging is a critical contributor to the shift in fuel systems and emergence of dynamic neuroimmune phenotype. The shift in fuel reliance, puts the largest reservoir of local fatty acids, white matter, at risk for catabolism as a source of lipids to generate ketone bodies through astrocytic beta oxidation. APOE4 genotype accelerates the tipping point for emergence of the bioenergetic crisis. While outcomes derived from research conducted in the female brain are not directly translatable to the male brain, the questions addressed in a female centric program of research are directly applicable to investigation of the male brain. Like females, males with AD exhibit deficits in the bioenergetic system of the brain, activation of the immune system and hallmark Alzheimer's pathologies. The drivers and trajectory of mechanisms underlying neurodegeneration in the male brain will undoubtedly share common aspects with the female in addition to factors unique to the male. Preclinical and clinical evidence indicate that midlife endocrine aging can also be a transitional bridge to autoimmune disorders. Collectively, the data indicate that endocrinological aging is a critical period "tipping point" in midlife which can initiate emergence of the prodromal stage of late-onset-Alzheimer's disease. Interventions that target both immune and metabolic shifts that occur during midlife aging have the potential to alter the trajectory of Alzheimer's risk in late life. Further, to achieve precision medicine for AD, chromosomal sex is a critical variable to consider along with APOE genotype, other genetic risk factors and stage of disease.
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Affiliation(s)
- Aarti Mishra
- Center for Innovation in Brain Science, University of Arizona, Tucson, AZ 85719, USA
| | - Yiwei Wang
- Center for Innovation in Brain Science, University of Arizona, Tucson, AZ 85719, USA
| | - Fei Yin
- Center for Innovation in Brain Science, University of Arizona, Tucson, AZ 85719, USA
| | - Francesca Vitali
- Center for Innovation in Brain Science, University of Arizona, Tucson, AZ 85719, USA
| | - Kathleen E Rodgers
- Center for Innovation in Brain Science, University of Arizona, Tucson, AZ 85719, USA
| | - Maira Soto
- Center for Innovation in Brain Science, University of Arizona, Tucson, AZ 85719, USA
| | - Lisa Mosconi
- Department of Neurology, Weill Cornell Medicine, New York, NY 10021, USA
| | - Tian Wang
- Center for Innovation in Brain Science, University of Arizona, Tucson, AZ 85719, USA
| | - Roberta D Brinton
- Center for Innovation in Brain Science, University of Arizona, Tucson, AZ 85719, USA.
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12
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Klusek J, Fairchild A, Moser C, Mailick MR, Thurman AJ, Abbeduto L. Family history of FXTAS is associated with age-related cognitive-linguistic decline among mothers with the FMR1 premutation. J Neurodev Disord 2022; 14:7. [PMID: 35026985 PMCID: PMC8903682 DOI: 10.1186/s11689-022-09415-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/30/2021] [Accepted: 01/02/2022] [Indexed: 01/16/2023] Open
Abstract
BACKGROUND Women who carry a premutation allele of the FMR1 gene are at increased vulnerability to an array of age-related symptoms and disorders, including age-related decline in select cognitive skills. However, the risk factors for age-related decline are poorly understood, including the potential role of family history and genetic factors. In other forms of pathological aging, early decline in syntactic complexity is observed and predicts the later onset of neurodegenerative disease. To shed light on the earliest signs of degeneration, the present study characterized longitudinal changes in the syntactic complexity of women with the FMR1 premutation across midlife, and associations with family history of fragile X-associated tremor/ataxia syndrome (FXTAS) and CGG repeat length. METHODS Forty-five women with the FMR1 premutation aged 35-64 years at study entry participated in 1-5 longitudinal assessments spaced approximately a year apart (130 observations total). All participants were mothers of children with confirmed fragile X syndrome. Language samples were analyzed for syntactic complexity and participants provided information on family history of FXTAS. CGG repeat length was determined via molecular genetic testing. RESULTS Hierarchical linear models indicated that women who reported a family history of FXTAS exhibited faster age-related decline in syntactic complexity than those without a family history, with that difference emerging as the women reached their mid-50 s. CGG repeat length was not a significant predictor of age-related change. CONCLUSIONS Results suggest that women with the FMR1 premutation who have a family history of FXTAS may be at increased risk for neurodegenerative disease, as indicated by age-related loss of syntactic complexity. Thus, family history of FXTAS may represent a personalized risk factor for age-related disease. Follow-up study is needed to determine whether syntactic decline is an early indicator of FXTAS specifically, as opposed to being a more general age-related cognitive decline associated with the FMR1 premutation.
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Affiliation(s)
- Jessica Klusek
- Department of Communication Sciences and Disorders, Arnold School of Public Health, University of South Carolina, 1705 College Street, SC 29208, Columbia, USA
| | - Amanda Fairchild
- Department of Psychology, University of South Carolina, 1512 Pendleton Street Columbia, Columbia, SC 29208 USA
| | - Carly Moser
- Department of Communication Sciences and Disorders, Arnold School of Public Health, University of South Carolina, 1705 College Street, SC 29208, Columbia, USA
| | - Marsha R. Mailick
- Waisman Center, University of Wisconsin-Madison, 1500 Highland Ave, Madison, WI 53705 USA
| | - Angela John Thurman
- Department of Psychiatry and Behavioral Sciences and MIND Institute, University of California Davis Health, 2825 50th Street, Sacramento, CA 95817 USA
| | - Leonard Abbeduto
- Department of Psychiatry and Behavioral Sciences and MIND Institute, University of California Davis Health, 2825 50th Street, Sacramento, CA 95817 USA
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13
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Tirkkonen A, Kekäläinen T, Aukee P, Kujala UM, Laakkonen EK, Kokko K, Sipilä S. Bidirectional associations between cognitive functions and walking performance among middle-aged women. Menopause 2021; 29:200-209. [PMID: 34930867 PMCID: PMC8785773 DOI: 10.1097/gme.0000000000001896] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2021] [Revised: 09/27/2021] [Accepted: 09/27/2021] [Indexed: 11/29/2022]
Abstract
OBJECTIVE This study investigated whether (1) cognitive functions change after the transition from the perimenopausal to the postmenopausal stage, (2) cognitive functions and walking are associated in middle-aged women, and (3) cognitive functions assessed in perimenopause are associated with walking after reaching the postmenopause or vice versa. METHODS In total, 342 women, categorized as early (n = 158) or late perimenopausal (n = 184), were included in the study and followed up until postmenopausal. Psychomotor speed, executive functions related to set-shifting and updating, working memory, and visual memory were assessed. Walking was assessed with walking speed, walking distance, and dual-task cost in walking speed. Data was analyzed using the paired-samples t test, Wilcoxon signed rank test, multiple linear regression analysis, and structural equation modeling. RESULTS We found small but significant improvements in psychomotor speed (P = 0.01) and working memory (P < 0.001) among early perimenopausal and in psychomotor speed (P = 0.001), set-shifting (P = 0.02), visual memory (P = 0.002), and working memory (P < 0.001) among late perimenopausal women after the transition from peri- to postmenopause. Walking speed (β = 0.264, P = 0.001) and dual-task cost (β = 0.160, P = 0.03) were associated with updating, and walking distance was associated with updating and set-shifting (β = 0.198, P = 0.02, β=-0.178 P = 0.04 respectively) among the late perimenopausal women. We found no longitudinal associations between cognitive functions and walking. CONCLUSION Cognitive performance remained unchanged or improved after reaching postmenopause. Cognitive functions and walking were associated during the late perimenopause, but the association depended on the cognitive process and nature of the physical task. Cognitive performance was not associated with walking after reaching postmenopause or vice versa.
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Affiliation(s)
- Anna Tirkkonen
- Gerontology Research Center and Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland
| | - Tiia Kekäläinen
- Gerontology Research Center and Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland
| | - Pauliina Aukee
- Department of Obstetrics and Gynecology, Central Finland Health Care District, Jyväskylä, Finland
| | - Urho M. Kujala
- Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland
| | - Eija K. Laakkonen
- Gerontology Research Center and Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland
| | - Katja Kokko
- Gerontology Research Center and Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland
| | - Sarianna Sipilä
- Gerontology Research Center and Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland
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14
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Hogervorst E, Craig J, O'Donnell E. Cognition and mental health in menopause: A review. Best Pract Res Clin Obstet Gynaecol 2021; 81:69-84. [PMID: 34969617 DOI: 10.1016/j.bpobgyn.2021.10.009] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2021] [Accepted: 10/25/2021] [Indexed: 11/02/2022]
Abstract
Cognitive and mood changes are frequently mentioned as complaints before, during and after menopausal transition. There is substantial biological evidence for such associations to occur, as there are many mechanisms through which oestrogens can affect the brain: by regulating metabolism, increasing cerebral blood flow and dendritic outgrowth, by acting on nerve growth factors through the co-localisation of receptors via neurotransmitter synthesis and turnover and many more. However, the evidence for objective and longer-term changes in cognitive function and mental health over the menopausal transition and beyond is less clear. While hormone treatment (HT) including oestrogens could potentially reverse these psychological issues, the evidence of long-term benefit is also inconclusive. However, for women with severe menopausal complaints, and particularly for those who undergo early menopause, including women with premature ovarian insufficiency, personalised HT at least up to the natural age of menopause around 50 should be considered, which is probably safe up to 10 years of treatment, unless contraindicated. This paper reviews the evidence for changes in psychological health related to menopausal transition and HTs.
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Affiliation(s)
- Eef Hogervorst
- School of Sports Exercise and Health Sciences, Loughborough University, UK.
| | - Jen Craig
- School of Sports Exercise and Health Sciences, Loughborough University, UK
| | - Emma O'Donnell
- School of Sports Exercise and Health Sciences, Loughborough University, UK
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15
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Narvaez Linares NF, Poitras M, Burkauskas J, Nagaratnam K, Burr Z, Labelle PR, Plamondon H. Neuropsychological Sequelae of Coronary Heart Disease in Women: A Systematic Review. Neurosci Biobehav Rev 2021; 127:837-851. [PMID: 34062209 DOI: 10.1016/j.neubiorev.2021.05.026] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2020] [Revised: 04/28/2021] [Accepted: 05/27/2021] [Indexed: 12/17/2022]
Abstract
Heart disease, such as coronary heart disease (CHD), is the leading cause of death among aging women. However, over the past years, the mortality rate has declined, resulting in an increased number of CHD survivors. In this context, research has uncovered relationships between cardiovascular disease (CVD) and the development of neurodegenerative diseases, suggesting that CHD can act as a precursor. Despite heart disease affecting both sexes, CVD research has significantly neglected women. Therefore, we conducted the first systematic review of neuropsychological sequelae of CHD in women to gain a clear portrait of the current knowledge of the association of CHD on women's neuropsychological status. We found that studies continue to include an insufficient number of women in their research. Our work also uncovered that there is variability in the definition of CHD by researchers (i.e., operationalization of the variable), which could explain inconsistencies across studies. Overall, we found evidence that supports the heart-brain disease hypothesis. To conclude, we provide several guidelines for future research involving the impact of CHD in women.
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Affiliation(s)
- N F Narvaez Linares
- Behavioural Neuroscience Group, School of Psychology, University of Ottawa, 136 Jean-Jacques Lussier, Ottawa, ON, K1N 6N5, Canada.
| | - M Poitras
- Behavioural Neuroscience Group, School of Psychology, University of Ottawa, 136 Jean-Jacques Lussier, Ottawa, ON, K1N 6N5, Canada.
| | - J Burkauskas
- Laboratory of Behavioral Medicine, Neuroscience Institute, Lithuanian University of Health Sciences, Vyduno al. 4, Palanga, LT-00135, Lithuania.
| | - K Nagaratnam
- Behavioural Neuroscience Group, School of Psychology, University of Ottawa, 136 Jean-Jacques Lussier, Ottawa, ON, K1N 6N5, Canada; Faculty of Health Sciences, 125 University Private, Ottawa, ON, K1N 6N5, Canada.
| | - Z Burr
- Behavioural Neuroscience Group, School of Psychology, University of Ottawa, 136 Jean-Jacques Lussier, Ottawa, ON, K1N 6N5, Canada.
| | - P R Labelle
- University of Ottawa Library, 120 University Private, Ottawa, ON, K1N 6N5, Canada.
| | - H Plamondon
- Behavioural Neuroscience Group, School of Psychology, University of Ottawa, 136 Jean-Jacques Lussier, Ottawa, ON, K1N 6N5, Canada.
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16
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van Heesewijk JO, Dreijerink KMA, Wiepjes CM, Kok AAL, van Schoor NM, Huisman M, den Heijer M, Kreukels BPC. Long-Term Gender-Affirming Hormone Therapy and Cognitive Functioning in Older Transgender Women Compared With Cisgender Women and Men. J Sex Med 2021; 18:1434-1443. [PMID: 37057450 DOI: 10.1016/j.jsxm.2021.05.013] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2020] [Revised: 05/10/2021] [Accepted: 05/15/2021] [Indexed: 11/17/2022]
Abstract
BACKGROUND Long-term gender-affirming hormone therapy (GHT) in older transgender individuals could have beneficial effects on cognitive functioning. Cardiovascular risk factors and psychological factors are known determinants of cognition. Despite the rising number of older transgender individuals, only few studies have examined cognitive functioning in this population. AIM We aimed to assess differences in cognitive functioning between transgender women, and non-transgender (cisgender) women and men, and investigated the contribution of cardiovascular risk factors and psychological factors on these differences. METHODS In this study, 37 transgender women (age range 55 to 69) receiving GHT for at least ten years (range 10.2 to 41.6) were examined, and their cognitive functioning was compared to an age and education level matched cohort consisting of 222 cisgender women and men from the Longitudinal Aging Study Amsterdam. Linear regression analyses were performed. OUTCOMES Cognitive functioning was assessed by neuropsychological tests including Mini-Mental State Examination (MMSE), Category Fluency animals, Letter Fluency D, 15-Word test (15WT) immediate and delayed recall. Additionally, cardiovascular risk factors and psychological factors such as cardiovascular disease, hypertension, antihypertensive use, statin use, diabetes mellitus, overweight, smoking, alcohol consumption, psychopharmaceutical use, anxiety and depression symptoms were collected. RESULTS Transgender women had higher MMSE scores compared with cisgender women (+0.9, 95% CI 0.4 to 1.5), and cisgender men (+1.1, 95% CI 0.4 to 1.8). On all other tests transgender women performed similar to cisgender men. Transgender women performed at a lower level than cisgender women on 15WT immediate recall, -5.5, 95% CI -7.6 to -3.4, and 15WT delayed recall, -2.7, 95% CI -3.7 to -1.7, and equal to cisgender women on Fluency animals and Fluency D. Cardiovascular and psychological factors (i.e., cardiovascular disease and depression symptoms) partly explained differences on MMSE score between transgender women and cisgender-control groups. CLINICAL IMPLICATIONS The results of this study do not indicate a need for tailored hormone treatment strategies for older transgender women, based on cognitive aspects after long-term GHT. STRENGTHS & LIMITATIONS As one of the first studies, this study compared older transgender women to a large cohort of cisgender men and women regarding cognitive functioning and took into account numerous potential influencing factors. Limitations include difference in test procedures and the cross-sectional design of the study. CONCLUSION Cognitive differences between transgender women and cisgender women and men were small, albeit significant. This may suggest that long-term GHT effects on cognitive functioning in older transgender women are minimal. van Heesewijk JO, Dreijerink KMA, Wiepjes CM, et al. Long-Term Gender-Affirming Hormone Therapy and Cognitive Functioning in Older Transgender Women Compared With Cisgender Women and Men. J Sex Med 2021;18:1434-1443.
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Affiliation(s)
- Jason O van Heesewijk
- Amsterdam University Medical Centers, location VUmc, Department of Endocrinology, , Amsterdam, the Netherlands
- Amsterdam University Medical Centers, location VUmc, Center of Expertise on Gender Dysphoria, , Amsterdam, the Netherlands
| | - Koen M A Dreijerink
- Amsterdam University Medical Centers, location VUmc, Department of Endocrinology, , Amsterdam, the Netherlands
- Amsterdam University Medical Centers, location VUmc, Center of Expertise on Gender Dysphoria, , Amsterdam, the Netherlands
| | - Chantal M Wiepjes
- Amsterdam University Medical Centers, location VUmc, Department of Endocrinology, , Amsterdam, the Netherlands
- Amsterdam University Medical Centers, location VUmc, Center of Expertise on Gender Dysphoria, , Amsterdam, the Netherlands
| | - Almar A L Kok
- Amsterdam University Medical Centers, location VUmc, Department of Epidemiology and Data Science, , Amsterdam, the Netherlands
| | - Natasja M van Schoor
- Amsterdam University Medical Centers, location VUmc, Department of Epidemiology and Data Science, , Amsterdam, the Netherlands
| | - Martijn Huisman
- Amsterdam University Medical Centers, location VUmc, Department of Epidemiology and Data Science, , Amsterdam, the Netherlands
| | - Martin den Heijer
- Amsterdam University Medical Centers, location VUmc, Department of Endocrinology, , Amsterdam, the Netherlands
- Amsterdam University Medical Centers, location VUmc, Center of Expertise on Gender Dysphoria, , Amsterdam, the Netherlands
| | - Baudewijntje P C Kreukels
- Amsterdam University Medical Centers, location VUmc, Department of Medical Psychology, , Amsterdam, the Netherlands
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17
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Bernatoniene J, Kazlauskaite JA, Kopustinskiene DM. Pleiotropic Effects of Isoflavones in Inflammation and Chronic Degenerative Diseases. Int J Mol Sci 2021; 22:ijms22115656. [PMID: 34073381 PMCID: PMC8197878 DOI: 10.3390/ijms22115656] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2021] [Revised: 05/24/2021] [Accepted: 05/25/2021] [Indexed: 12/12/2022] Open
Abstract
Isoflavones are phytoestrogens of plant origin, mostly found in the members of the Fabaceae family, that exert beneficial effects in various degenerative disorders. Having high similarity to 17-β-estradiol, isoflavones can bind estrogen receptors, scavenge reactive oxygen species, activate various cellular signal transduction pathways and modulate growth and transcription factors, activities of enzymes, cytokines, and genes regulating cell proliferation and apoptosis. Due to their pleiotropic activities isoflavones might be considered as a natural alternative for the treatment of estrogen decrease-related conditions during menopause. This review will focus on the effects of isoflavones on inflammation and chronic degenerative diseases including cancer, metabolic, cardiovascular, neurodegenerative diseases, rheumatoid arthritis and adverse postmenopausal symptoms.
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Affiliation(s)
- Jurga Bernatoniene
- Department of Drug Technology and Social Pharmacy, Faculty of Pharmacy, Medical Academy, Lithuanian University of Health Sciences, Sukileliu pr. 13, LT-50161 Kaunas, Lithuania
- Institute of Pharmaceutical Technologies, Faculty of Pharmacy, Medical Academy, Lithuanian University of Health Sciences, Sukileliu pr. 13, LT-50161 Kaunas, Lithuania; (J.A.K.); (D.M.K.)
- Correspondence:
| | - Jurga Andreja Kazlauskaite
- Institute of Pharmaceutical Technologies, Faculty of Pharmacy, Medical Academy, Lithuanian University of Health Sciences, Sukileliu pr. 13, LT-50161 Kaunas, Lithuania; (J.A.K.); (D.M.K.)
| | - Dalia Marija Kopustinskiene
- Institute of Pharmaceutical Technologies, Faculty of Pharmacy, Medical Academy, Lithuanian University of Health Sciences, Sukileliu pr. 13, LT-50161 Kaunas, Lithuania; (J.A.K.); (D.M.K.)
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18
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Weber MT, Rubin LH, Schroeder R, Steffenella T, Maki PM. Cognitive profiles in perimenopause: hormonal and menopausal symptom correlates. Climacteric 2021; 24:401-407. [PMID: 33759672 DOI: 10.1080/13697137.2021.1892626] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
OBJECTIVE Perimenopause is associated with declines in attention, working memory and verbal memory; however, there are significant individual differences. Further, the contributions of hormones and menopausal symptoms to domain-specific cognitive functions remain unknown. This longitudinal study aimed to determine whether there were distinct cognitive profiles in perimenopause and to identify factors associated with each profile. DESIGN In a sample of 85 women evaluated over 400 bi-annual visits, we administered a comprehensive neuropsychological battery, assessed menopausal symptoms and measured 17β-estradiol and follicle stimulating hormone. Multilevel latent profile analysis was used to identify cognitive profiles. Regressions were conducted to determine differences in hormones and symptoms by profile after adjusting for Stages of Reproductive Aging Workshop + 10 (STRAW + 10) stage and demographic factors. RESULTS Perimenopausal cognitive profiles consisted of cognitively normal (Profile 1; n = 162), weaknesses in verbal learning and memory (Profile 2; n = 94), strengths in verbal learning and memory (Profile 3; n = 98) and strengths in attention and executive function (Profile 4; n = 61). Profile 2 was differentiated by less hormonal variability and more sleep disturbance than Profile 1 (p < 0.05). CONCLUSIONS There is significant heterogeneity in cognition during perimenopause. While most women do not develop impairments, a significant minority experience weaknesses in verbal learning and memory. Profile analysis may identify at-risk populations and inform interventions.
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Affiliation(s)
- M T Weber
- Department of Neurology, University of Rochester Medical Center, Rochester, NY, USA.,Department of Obstetrics and Gynecology, University of Rochester Medical Center, Rochester, NY, USA
| | - L H Rubin
- Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, MD, USA.,Department of Psychiatry, Johns Hopkins University School of Medicine, Baltimore, MD, USA.,Department of Epidemiology, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - R Schroeder
- Department of Psychology, University of Illinois at Chicago, Chicago, IL, USA
| | - T Steffenella
- School of Nursing, University of Rochester Medical Center, Rochester, NY, USA
| | - P M Maki
- Department of Psychology, University of Illinois at Chicago, Chicago, IL, USA.,Department of Psychiatry, University of Illinois at Chicago, Chicago, IL, USA.,Department of Obstetrics and Gynecology, University of Illinois at Chicago, Chicago, IL, USA
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19
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Gurvich C, Le J, Thomas N, Thomas EHX, Kulkarni J. Sex hormones and cognition in aging. VITAMINS AND HORMONES 2021; 115:511-533. [PMID: 33706960 DOI: 10.1016/bs.vh.2020.12.020] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Hormones of the hypothalamic-pituitary-gonadal axis that regulate reproductive function are also potent neurosteriods that have multiple effects on the development, maintenance and function of the brain. There is a growing body of evidence linking sex hormones to cognitive functioning across the lifespan. Both subjective and objective cognitive changes can occur with aging. For women, cognitive complains are commonly associated with the menopause transition-a time of significant hormone flux. Sex differences in neurodegenerative conditions associated with cognitive dysfunction, such as Alzheimer's disease and Parkinson's disease, suggest a potential link between sex hormones and cognitive decline. Evidence for the effects of hormone therapy on cognition is growing, but remains inconclusive. This chapter provides an overview of sex hormones and cognition in association with healthy aging, including a focus on the menopause transition, as well as reviewing findings linking sex hormones to cognitive decline associated with Alzheimer's disease and Parkinson's disease. An overview of hormone therapy and cognition is also provided.
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Affiliation(s)
- Caroline Gurvich
- Monash Alfred Psychiatry Research Centre, Monash University Central Clinical School and The Alfred Hospital, Melbourne, VIC, Australia.
| | - Jessica Le
- Monash Alfred Psychiatry Research Centre, Monash University Central Clinical School and The Alfred Hospital, Melbourne, VIC, Australia
| | - Natalie Thomas
- Monash Alfred Psychiatry Research Centre, Monash University Central Clinical School and The Alfred Hospital, Melbourne, VIC, Australia
| | - Elizabeth H X Thomas
- Monash Alfred Psychiatry Research Centre, Monash University Central Clinical School and The Alfred Hospital, Melbourne, VIC, Australia
| | - Jayashri Kulkarni
- Monash Alfred Psychiatry Research Centre, Monash University Central Clinical School and The Alfred Hospital, Melbourne, VIC, Australia
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20
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Abstract
OBJECTIVE Vasomotor symptoms (VMS) are associated with decreased memory performance and alterations in brain function. We conducted a preliminary examination of VMS and patterns of brain activity during a verbal memory task to provide insights into the VMS-related brain mechanisms that can contribute to memory problems in midlife women. METHODS Fourteen postmenopausal women (mean age 53.5, 64% African-American) with moderate-to-severe VMS (>35/wk) and not taking hormone therapy completed functional magnetic resonance imaging (fMRI) assessments during word encoding and recognition, 24-hour physiologic VMS monitoring, symptom questionnaires, and two verbal memory tests. RESULTS In regression analyses, a higher number of physiologic VMS, but not reported VMS, was associated with worse verbal memory on immediate and delayed logical memory (r = 0.53 and r = 0.72, P < 0.05). On fMRI assessments, a higher number of physiologic VMS, but not subjective VMS, was associated with greater activation in the left orbitofrontal cortex, left medial and superior frontal gyrus, right superior frontal gyrus, and right parahippocampal gyrus during the encoding task (P < 0.005). During the recognition task, physiologic VMS were associated with greater activation in the left medial and superior frontal gyrus, left parahippocampal gyrus and hippocampus, right medial and superior frontal gyrus, right parahippocampal gyrus and hippocampus (P < 0.005), and with decreased activation in the ventral medial prefrontal cortex (P < 0.005). Those associations were independent of symptoms and hormone levels. CONCLUSIONS Preliminary data suggest that VMS may contribute to memory performance through effects on the hippocampus and prefrontal cortex. Larger studies are warranted to determine the robustness of these initial observations. : Video Summary:http://links.lww.com/MENO/A508.
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21
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Martino PL, Cervigni MA, Pulopulos MM, Audisio EO, Bonet JL, De Bortoli MA, Politis DG. Reproductive aging and executive functions in healthy women. AGING NEUROPSYCHOLOGY AND COGNITION 2020; 29:181-196. [PMID: 33307979 DOI: 10.1080/13825585.2020.1859083] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
The aim of this study was to analyze the influence of reproductive aging on executive functions. We assessed executive functions in three groups of healthy women in the premenopausal (n = 45, mean age = 30.89, SD = 10.5), perimenopausal (n = 31, mean age = 50.06, SD = 3.6) and postmenopausal (n = 24, mean age = 63.39, SD = 6.5) phase. No differences between groups were observed in working memory, verbal fluency, inhibitory control, planning, and cognitive flexibility. However, when the analyses were repeated with participants with occupations with lower intellectual demands, perimenopausal and postmenopausal women performed worse than premenopausal women in semantic verbal fluency. This study provides important evidence to understand the effects of reproductive aging on cognitive performance in healthy women. Our findings indicate that cognitive reserve-related factors may be important to understand the differences in executive functions associated with reproductive aging.
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Affiliation(s)
- Pablo L Martino
- Rosario Neuroscience Research Center, National University of Rosario, Rosario, Argentina.,National Scientific and Technical Research Council (CONICET), Argentina
| | - Mauricio A Cervigni
- Rosario Neuroscience Research Center, National University of Rosario, Rosario, Argentina.,National Scientific and Technical Research Council (CONICET), Argentina
| | - Matias M Pulopulos
- Department of Experimental Clinical and Health Psychology, Ghent University, Ghent, Belgium.,Department of Psychobiology, National Distance Education University (UNED), Madrid, Spain.,Department of Psychology and Sociology, University of Zaragoza, Zaragoza, Spain
| | - Eduardo O Audisio
- Faculty of Psychology, National University of Rosario, Rosario, Argentina
| | - José L Bonet
- Faculty of Human and Behavioral Sciences, Favaloro University, Buenos Aires, Argentina
| | | | - Daniel G Politis
- National Scientific and Technical Research Council (CONICET), Argentina.,Faculty of Psychology, University of Buenos Aires, Buenos Aires, Argentina
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22
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Isaac Tseng WY, Hsu YC, Chen CL, Kang YJ, Kao TW, Chen PY, Waiter GD. Microstructural differences in white matter tracts across middle to late adulthood: a diffusion MRI study on 7167 UK Biobank participants. Neurobiol Aging 2020; 98:160-172. [PMID: 33290993 DOI: 10.1016/j.neurobiolaging.2020.10.006] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2019] [Revised: 09/23/2020] [Accepted: 10/08/2020] [Indexed: 12/21/2022]
Abstract
White matter fiber tracts demonstrate heterogeneous vulnerabilities to aging effects. Here, we estimated age-related differences in tract properties using UK Biobank diffusion magnetic resonance imaging data of 7167 47- to 76-year-old neurologically healthy people (3368 men and 3799 women). Tract properties in terms of generalized fractional anisotropy, axial diffusivity, radial diffusivity, and mean diffusivity were sampled on 76 fiber tracts; for each tract, age-related differences were estimated by fitting these indices against age in a linear model. This cross-sectional study demonstrated 4 age-difference patterns. The dominant pattern was lower generalized fractional anisotropy and higher axial diffusivity, radial diffusivity, and mean diffusivity with age, constituting 45 of 76 tracts, mostly involving the association, projection, and commissure fibers connecting the prefrontal lobe. The other 3 patterns constituted only 14 tracts, with atypical age differences in diffusion indices, and mainly involved parietal, occipital, and temporal cortices. By analyzing the large volume of diffusion magnetic resonance imaging data available from the UK Biobank, the study has provided a detailed description of heterogeneous age-related differences in tract properties over the whole brain which generally supports the myelodegeneration hypothesis.
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Affiliation(s)
- Wen-Yih Isaac Tseng
- Institute of Medical Device and Imaging, National Taiwan University College of Medicine, Taipei, Taiwan; Molecular Imaging Center, National Taiwan University, Taipei, Taiwan
| | | | - Chang-Le Chen
- Institute of Medical Device and Imaging, National Taiwan University College of Medicine, Taipei, Taiwan
| | - Yun-Jing Kang
- Institute of Medical Device and Imaging, National Taiwan University College of Medicine, Taipei, Taiwan
| | - Te-Wei Kao
- Institute of Medical Device and Imaging, National Taiwan University College of Medicine, Taipei, Taiwan
| | - Pin-Yu Chen
- Institute of Medical Device and Imaging, National Taiwan University College of Medicine, Taipei, Taiwan
| | - Gordon D Waiter
- Aberdeen Biomedical Imaging Centre, School of Medicine, Medical Sciences and Nutrition, University of Aberdeen, Aberdeen, UK.
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23
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Petrine JCP, Del Bianco-Borges B. The influence of phytoestrogens on different physiological and pathological processes: An overview. Phytother Res 2020; 35:180-197. [PMID: 32780464 DOI: 10.1002/ptr.6816] [Citation(s) in RCA: 28] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2020] [Revised: 06/01/2020] [Accepted: 07/02/2020] [Indexed: 02/06/2023]
Abstract
Functional foods have nutritional properties and organic functions, which are beneficial to health. Certain types of functional food components are so-called phytoestrogens, non-steroidal compounds derived from the metabolism of precursors contained in plants, which originate secondary metabotypes known to induce biological responses and by mimicry or modulating the action of endogenous estrogen. These molecules are involved in several physiological and pathological processes related to reproduction, bone remodeling, skin, cardiovascular, nervous, immune systems, and metabolism. This review aimed to present an overview of phytoestrogens regarding their chemical structure, actions, and effects in the organism given several pathologies. Several studies have demonstrated beneficial phytoestrogen actions, such as lipid profile improvement, cognitive function, menopause, oxidative stress, among others. Phytoestrogens effects are not completely elucidated, being necessary future research to understand the exact action mechanisms, whether they are via estrogen receptor or whether other hidden mechanisms produce these effects. Thus, this review makes a general approach to the phytoestrogen actions, beneficial effects, risk and limitations. However, the complexities of biological effects after ingestion of phytoestrogens and the differences in their metabolism and bioavailability indicate that interpretation of either risk or benefits needs to be made with caution.
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Affiliation(s)
- Jéssica C P Petrine
- Departamento de Ciências da Saúde, Universidade Federal de Lavras, Lavras, Brasil
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24
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Beltz AM, Moser JS. Ovarian hormones: a long overlooked but critical contributor to cognitive brain structures and function. Ann N Y Acad Sci 2020; 1464:156-180. [DOI: 10.1111/nyas.14255] [Citation(s) in RCA: 41] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2019] [Revised: 08/13/2019] [Accepted: 09/18/2019] [Indexed: 12/23/2022]
Affiliation(s)
- Adriene M. Beltz
- Department of PsychologyUniversity of Michigan Ann Arbor Michigan
| | - Jason S. Moser
- Department of PsychologyMichigan State University East Lansing Michigan
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25
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Raglan GB, Schulkin J, Micks E. Depression during perimenopause: the role of the obstetrician-gynecologist. Arch Womens Ment Health 2020; 23:1-10. [PMID: 30758732 DOI: 10.1007/s00737-019-0950-6] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/16/2018] [Accepted: 01/31/2019] [Indexed: 02/07/2023]
Abstract
Depression in women is more common during perimenopause (the transition to menopause) than at other times in the life cycle. Symptoms of depression may be different in perimenopausal women compared to younger or older women, and are often dismissed as part of normal menopause. This is an expert narrative review. There are several evidence-based screening modalities which can be integrated into routine women's health visits, and can facilitate distinguishing between depression and normal perimenopausal symptoms. There is emerging evidence regarding the effect of hormonal changes on the development of perimenopausal depression and its optimal treatment, though critical research gaps remain. Obstetrician-gynecologists and other primary care providers play a vital role in the detection and management of depression in women. Providers caring for women during perimenopause have a unique opportunity to diagnose depression in their patients and identify appropriate treatment options.
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Affiliation(s)
- Greta B Raglan
- Department of Psychiatry, University of Michigan, Ann Arbor, MI, USA
| | - Jay Schulkin
- Department of Obstetrics and Gynecology, University of Washington School of Medicine, 1959 NE Pacific St., Box 356460, Seattle, WA, 98195-6460, USA
| | - Elizabeth Micks
- Department of Obstetrics and Gynecology, University of Washington School of Medicine, 1959 NE Pacific St., Box 356460, Seattle, WA, 98195-6460, USA.
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26
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Conner MR, Adeyemi OM, Anderson BJ, Kritzer MF. Domain-specific contributions of biological sex and sex hormones to what, where and when components of episodic-like memory in adult rats. Eur J Neurosci 2020; 52:2705-2723. [PMID: 31943448 DOI: 10.1111/ejn.14676] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2019] [Revised: 01/03/2020] [Accepted: 01/08/2020] [Indexed: 12/21/2022]
Abstract
Episodic memory involves the integration and recall of discrete events that include information about what happened, where it happened and when it occurred. Episodic memory function is critical to daily life, and its dysfunction is both a first identifiable indicator and an enduring core feature of cognitive decline in ageing and in neuropsychiatric disorders including Alzheimer's disease and schizophrenia. Available evidence from human studies suggests that biological sex and sex hormones modulate episodic memory function in health and disease. However, knowledge of how this occurs is constrained by the limited availability and underutilization of validated animal models in investigating hormone impacts on episodic-like memory function. Here, adult female, adult male and gonadally manipulated adult male rats were tested on the what-where-when episodic-like memory task to determine whether rats model human sex differences in episodic memory and how the hormonal milieu impacts episodic-like memory processes in this species. These studies revealed salient ways in which rats model human sex differences in episodic memory, including a male advantage in spatial episodic memory performance. They also identified domain-specific roles for oestrogens and androgens in modulating what, where and when discriminations in male rats that were unlike those engaged in corresponding novel object recognition and novel object location tasks. These studies thus identify rats and the what-where-when task as suitable for investigating the neuroendocrine bases of episodic-like memory, and provide new information about the unique contributions that sex and sex hormones make to this complex mnemonic process.
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Affiliation(s)
- Meagan R Conner
- Graduate Program in Neuroscience, Stony Brook University, Stony Brook, NY, USA.,Department of Neurobiology and Behavior, Stony Brook University, Stony Brook, NY, USA
| | | | - Brenda J Anderson
- Department of Psychology, Stony Brook University, Stony Brook, NY, USA
| | - Mary F Kritzer
- Department of Neurobiology and Behavior, Stony Brook University, Stony Brook, NY, USA
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27
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Schneider MA, Spritzer PM, Suh JS, Minuzzi L, Frey BN, Schwarz K, Costa AB, da Silva DC, Garcia CCG, Fontanari AMV, Anes M, Castan JU, Cunegatto FR, Picon FA, Luders E, Lobato MIR. The Link between Estradiol and Neuroplasticity in Transgender Women after Gender-Affirming Surgery: A Bimodal Hypothesis. Neuroendocrinology 2020; 110:489-500. [PMID: 31461715 DOI: 10.1159/000502977] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/07/2019] [Accepted: 08/28/2019] [Indexed: 11/19/2022]
Abstract
For transgender individuals, gender-affirming surgery (GAS) and cross-sex hormone therapy (CSHT) are part of the gender transition process. Scientific evidence supporting the maintenance of CSHT after GAS-related gonadectomy is accumulating. However, few data are available on the impact of CSHT on the brain structure following hypogonadism. Thus, we aimed to investigate links between estradiol and brain cortical thickness (CTh) and cognition in 18 post-gonadectomy transgender women using a longitudinal design. For this purpose, the participants underwent a voluntary period of CSHT washout of at least 30 days, followed by estradiol re-institution for 60 days. High-resolution T1-weighted brain images, hormonal measures, working and verbal memory were collected at 2 time points: on the last day of the washout (t1) and on the last day of the 2-month CSHT period (t2). Between these 2 time points, CTh increased within the left precentral gyrus and right precuneus but decreased within the right lateral occipital cortex. However, these findings did not survive corrections of multiple comparisons. Nevertheless, there was a significant negative correlation between changes in estradiol levels and changes in CTh. This effect was evident in the left superior frontal gyrus, the left middle temporal gyrus, the right precuneus, the right superior temporal gyrus, and the right pars opercularis. Although there was an improvement in verbal memory following hypogonadism correction, we did not observe a significant relationship between changes in memory scores and CTh. Altogether, these findings suggest that there is a link between estradiol and CTh.
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Affiliation(s)
- Maiko A Schneider
- Gender Identity Program, Psychiatry Service, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil,
- Mood Disorders Program and Women's Health Concerns Clinic, St. Joseph's Healthcare, Hamilton, Ontario, Canada,
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Ontario, Canada,
| | - Poli M Spritzer
- Gender Identity Program, Psychiatry Service, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil
- Department of Physiology, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
- Division of Endocrinology, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil
| | - Jee Su Suh
- Mood Disorders Program and Women's Health Concerns Clinic, St. Joseph's Healthcare, Hamilton, Ontario, Canada
- Neuroscience Graduate Program, McMaster University, Hamilton, Ontario, Canada
| | - Luciano Minuzzi
- Mood Disorders Program and Women's Health Concerns Clinic, St. Joseph's Healthcare, Hamilton, Ontario, Canada
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Ontario, Canada
- Neuroscience Graduate Program, McMaster University, Hamilton, Ontario, Canada
| | - Benicio N Frey
- Mood Disorders Program and Women's Health Concerns Clinic, St. Joseph's Healthcare, Hamilton, Ontario, Canada
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Ontario, Canada
- Neuroscience Graduate Program, McMaster University, Hamilton, Ontario, Canada
| | - Karine Schwarz
- Gender Identity Program, Psychiatry Service, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil
| | - Angelo B Costa
- Graduate Program in Psychology, Pontifícia Universidade do Rio Grande do Sul, Porto Alegre, Brazil
| | - Dhiordan C da Silva
- Gender Identity Program, Psychiatry Service, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil
- Post-Graduation Program, Universidade Federal do Rio Grand do Sul, Porto Alegre, Brazil
| | - Claudia C G Garcia
- Gender Identity Program, Psychiatry Service, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil
- Post-Graduation Program, Universidade Federal do Rio Grand do Sul, Porto Alegre, Brazil
| | - Anna M V Fontanari
- Gender Identity Program, Psychiatry Service, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil
- Post-Graduation Program, Universidade Federal do Rio Grand do Sul, Porto Alegre, Brazil
| | - Mauricio Anes
- Medical Physics and Radiation Protection Service, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil
| | - Juliana U Castan
- Psychology Service, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil
| | | | - Felipe A Picon
- ADHD Outpatient Program, Adult Division, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil
| | - Eileen Luders
- School of Psychology, University of Auckland, Auckland, New Zealand
- Laboratory of Neuro Imaging, School of Medicine, University of Southern California, Los Angeles, California, USA
| | - Maria I R Lobato
- Gender Identity Program, Psychiatry Service, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil
- Mood Disorders Program and Women's Health Concerns Clinic, St. Joseph's Healthcare, Hamilton, Ontario, Canada
- Psychiatry and Forensic Medical Service, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil
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28
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Gurvich C, Thomas N, Kulkarni J. Sex differences in cognition and aging and the influence of sex hormones. HANDBOOK OF CLINICAL NEUROLOGY 2020; 175:103-115. [PMID: 33008519 DOI: 10.1016/b978-0-444-64123-6.00008-4] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
Sex differences in cognitive functioning have been consistently reported in some cognitive tasks, with varying effect sizes. The most consistent findings in healthy adults are sex differences in the areas of mental rotation and aspects of attention and verbal memory. Sex differences in the vulnerability and manifestation of several psychiatric and neurologic diseases that involve cognitive disruption provide strong justification to continue investigating the social and biologic influences that underpin sex differences in cognitive functioning across health and disease. The biologic influences are thought to include genetic and epigenetic factors, sex chromosomes, and sex hormones. Sex steroid hormones that regulate reproductive function have multiple effects on the development, maintenance, and function of the brain, including significant effects on cognitive functioning. The aim of the current chapter is to provide a theoretical review of sex differences across different cognitive domains in adulthood and aging, as well as provide an overview on the role of sex hormones in cognitive function and cognitive decline.
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Affiliation(s)
- Caroline Gurvich
- Monash Alfred Psychiatry Research Centre, Monash University Central Clinical School and Alfred Hospital, Melbourne, VIC, Australia.
| | - Natalie Thomas
- Monash Alfred Psychiatry Research Centre, Monash University Central Clinical School and Alfred Hospital, Melbourne, VIC, Australia
| | - Jayashri Kulkarni
- Monash Alfred Psychiatry Research Centre, Monash University Central Clinical School and Alfred Hospital, Melbourne, VIC, Australia
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29
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Postmenopausal hormone treatment alters neural pathways but does not improve verbal cognitive function. Menopause 2019; 25:1424-1431. [PMID: 29994967 DOI: 10.1097/gme.0000000000001157] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
OBJECTIVE Cognitive outcomes in trials of postmenopausal hormone treatment have been inconsistent. Differing outcomes may be attributed to hormone formulation, treatment duration and timing, and differential cognitive domain effects. We previously demonstrated treatment benefits on visual cognitive function. In the present study, we describe the effects of hormone treatment on verbal outcomes in the same women, seeking to understand the effects of prior versus current hormone treatment on verbal function. METHODS This is a cross-sectional evaluation of 57 women (38 hormone users [25 prior long-term users and 13 current users] and 19 never-users). Hormone users took identical formulations of estrogen or estrogen + progestin (0.625 mg/d conjugated equine estrogens with or without medroxyprogesterone acetate) for at least 10 years, beginning within 2 years of menopause. Women were evaluated with tests of verbal function and functional magnetic resonance imaging (fMRI) of a verbal discrimination task. RESULTS All women scored similarly on assessments of verbal function (Hopkins Verbal Learning Test and a verbal discrimination task performed during the fMRI scanning session); however, women ever treated with hormones had more left inferior frontal (T = 3.72; P < 0.001) and right prefrontal cortex (T = 3.53; P < 0.001) activation during the verbal task. Hormone-treated women performed slightly worse on the verbal discrimination task (mean accuracy 81.72 ± 11.57 ever-treated, 85.30 ± 5.87 never-treated, P = 0.14), took longer to respond (mean reaction time 1.10 ± 0.17 s ever-treated, 1.02 ± 0.11 never-treated, P = 0.03), and remembered fewer previously viewed words (mean accuracy 62.21 ± 8.73 ever-treated, 65.45 ± 7.49 never-treated, P = 0.18). Increased posterior cingulate activity was associated with longer response times (R = 0.323, P = 0.015) and worse delayed verbal recall (R = -0.328, P = 0.048), suggesting that increased activation was associated with less efficient cognitive processing. We did not detect between group differences in activation in the left prefrontal cortex, superior frontal cortex, thalamus, or occipital/parietal junction. CONCLUSIONS Although current and past hormone treatment was associated with differences in neural pathways used during verbal discrimination, verbal function was not higher than never-users.
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30
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Seitz J, Kubicki M, Jacobs EG, Cherkerzian S, Weiss BK, Papadimitriou G, Mouradian P, Buka S, Goldstein JM, Makris N. Impact of sex and reproductive status on memory circuitry structure and function in early midlife using structural covariance analysis. Hum Brain Mapp 2018; 40:1221-1233. [PMID: 30548738 DOI: 10.1002/hbm.24441] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2018] [Revised: 10/11/2018] [Accepted: 10/13/2018] [Indexed: 01/13/2023] Open
Abstract
Research on age-related memory alterations traditionally targets individuals aged ≥65 years. However, recent studies emphasize the importance of early aging processes. We therefore aimed to characterize variation in brain gray matter structure in early midlife as a function of sex and menopausal status. Subjects included 94 women (33 premenopausal, 29 perimenopausal, and 32 postmenopausal) and 99 demographically comparable men from the New England Family Study. Subjects were scanned with a high-resolution T1 sequence on a 3 T whole body scanner. Sex and reproductive-dependent structural differences were evaluated using Box's M test and analysis of covariances (ANCOVAs) for gray matter volumes. Brain regions of interest included dorsolateral prefrontal cortex (DLPFC), inferior parietal lobule (iPAR), anterior cingulate cortex (ACC), hippocampus (HIPP), and parahippocampus. While we observed expected significant sex differences in volume of hippocampus with women of all groups having higher volumes than men relative to cerebrum size, we also found significant differences in the covariance matrices of perimenopausal women compared with postmenopausal women. Associations between ACC and HIPP/iPAR/DLPFC were higher in postmenopausal women and correlated with better memory performance. Findings in this study underscore the importance of sex and reproductive status in early midlife for understanding memory function with aging.
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Affiliation(s)
- Johanna Seitz
- Psychiatry Neuroimaging Laboratory, Department of Psychiatry, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts
| | - Marek Kubicki
- Psychiatry Neuroimaging Laboratory, Department of Psychiatry, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts.,Departments of Psychiatry, Neurology and Radiology, Athinoula A. Martinos Center for Biomedical Imaging, Center for Morphometric Analysis, Center for Neural Systems Investigations, Massachusetts General Hospital, Harvard Medical School, Charlestown, Massachusetts.,Department of Psychiatry, Obstetrics and Gynecology, Massachusetts General Hospital, Harvard Medical School, Charlestown, Massachusetts
| | - Emily G Jacobs
- Department of Medicine, Harvard Medical School, Boston, Massachusetts.,Division of Women's Health, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts
| | - Sara Cherkerzian
- Department of Psychiatry, Obstetrics and Gynecology, Massachusetts General Hospital, Harvard Medical School, Charlestown, Massachusetts.,Department of Medicine, Harvard Medical School, Boston, Massachusetts.,Division of Women's Health, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts
| | - Blair K Weiss
- Department of Medicine, Harvard Medical School, Boston, Massachusetts.,Division of Women's Health, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts
| | - George Papadimitriou
- Departments of Psychiatry, Neurology and Radiology, Athinoula A. Martinos Center for Biomedical Imaging, Center for Morphometric Analysis, Center for Neural Systems Investigations, Massachusetts General Hospital, Harvard Medical School, Charlestown, Massachusetts
| | - Palig Mouradian
- Departments of Psychiatry, Neurology and Radiology, Athinoula A. Martinos Center for Biomedical Imaging, Center for Morphometric Analysis, Center for Neural Systems Investigations, Massachusetts General Hospital, Harvard Medical School, Charlestown, Massachusetts
| | - Stephen Buka
- Department of Community Health, Brown University, Providence, Rhode Island
| | - Jill M Goldstein
- Departments of Psychiatry, Neurology and Radiology, Athinoula A. Martinos Center for Biomedical Imaging, Center for Morphometric Analysis, Center for Neural Systems Investigations, Massachusetts General Hospital, Harvard Medical School, Charlestown, Massachusetts.,Department of Psychiatry, Obstetrics and Gynecology, Massachusetts General Hospital, Harvard Medical School, Charlestown, Massachusetts.,Department of Medicine, Harvard Medical School, Boston, Massachusetts.,Division of Women's Health, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts
| | - Nikos Makris
- Psychiatry Neuroimaging Laboratory, Department of Psychiatry, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts.,Departments of Psychiatry, Neurology and Radiology, Athinoula A. Martinos Center for Biomedical Imaging, Center for Morphometric Analysis, Center for Neural Systems Investigations, Massachusetts General Hospital, Harvard Medical School, Charlestown, Massachusetts
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31
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The Menopausal Brain. Obstet Gynecol 2018; 132:1323-1324. [DOI: 10.1097/aog.0000000000002988] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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32
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Lu W, Guo W, Hou K, Zhao H, Shi L, Dong K, Qiu J. Grey matter differences associated with age and sex hormone levels between premenopausal and perimenopausal women: A voxel-based morphometry study. J Neuroendocrinol 2018; 30:e12655. [PMID: 30372794 DOI: 10.1111/jne.12655] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/13/2018] [Revised: 09/22/2018] [Accepted: 10/24/2018] [Indexed: 11/30/2022]
Abstract
The present study aimed to explore brain morphological alterations associated with age and sex hormone levels between premenopausal and perimenopausal women using magnetic resonance imaging (MRI) T1 -weighted structural images. Thirty-two premenopausal women aged (mean ± SD) 47.75 ± 1.55 years and twenty-five recently perimenopausal women aged 51.60 ± 1.63 years were evaluated for sex hormone levels, including prolactin, follicle-stimulating hormone, luteinising hormone, oestradiol, free testosterone and progesterone. A 3.0-Tesla MRI scanner was utilised to acquire T1 images. Voxel-based morphometry (VBM) was used to evaluate changes in grey matter volume between the two groups. The general linear model was applied with false discovery rate correction for between group voxel-wise statistics. Spearman partial correlation analyses were conducted between age, sex hormone levels and regions of grey matter volume showing significant differences between the two groups. The VBM analysis revealed that age and menopause per se lead to grey matter volume reduction in certain brain structures. These structural changes might be potential causes of sexual dysfunction, nervous system degeneration and depression, which need to be examined in future studies. Our findings might provide evidence and guide future research in understanding the menopausal transition.
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Affiliation(s)
- Weizhao Lu
- Medical Engineering and Technical Center, Taishan Medcial University, Taian, China
- Department of Radiology, Taishan Medical University, Taian, China
| | - Wei Guo
- Affiliated Hospital of Taishan Medical University, Taian, China
| | - Kun Hou
- Medical Engineering and Technical Center, Taishan Medcial University, Taian, China
- Department of Radiology, Taishan Medical University, Taian, China
| | - Huihui Zhao
- Medical Engineering and Technical Center, Taishan Medcial University, Taian, China
- Department of Radiology, Taishan Medical University, Taian, China
| | - Liting Shi
- Medical Engineering and Technical Center, Taishan Medcial University, Taian, China
- Department of Radiology, Taishan Medical University, Taian, China
| | - Kejiang Dong
- Department of Radiology, Taishan Medical University, Taian, China
| | - Jianfeng Qiu
- Medical Engineering and Technical Center, Taishan Medcial University, Taian, China
- Department of Radiology, Taishan Medical University, Taian, China
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33
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Zhang S, Hu J, Fan W, Liu B, Wen L, Wang G, Gong M, Yang C, Zhang D. Aberrant Cerebral Activity in Early Postmenopausal Women: A Resting-State Functional Magnetic Resonance Imaging Study. Front Cell Neurosci 2018; 12:454. [PMID: 30534056 PMCID: PMC6275219 DOI: 10.3389/fncel.2018.00454] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2018] [Accepted: 11/09/2018] [Indexed: 12/29/2022] Open
Abstract
Background: Early postmenopausal women frequently suffer from cognitive impairments and emotional disorders, such as lack of attention, poor memory, deficits in executive function and depression. However, the underlying mechanisms of these impairments remain unclear. Method: Forty-three early postmenopausal women and forty-four age-matched premenopausal controls underwent serum sex hormone analysis, neuropsychological testing and resting-state functional magnetic resonance imaging (rs-fMRI). Degree centrality (DC) analysis was performed to confirm the peak points of the functionally abnormal brain areas as the centers of the seeds. Subsequently, the functional connectivity (FC) between these abnormal seeds and other voxels across the whole brain was calculated. Finally, the sex hormone levels, neuroimaging indices and neuropsychological data were combined to detect potential correlations. Results: Compared with the premenopausal controls, the early postmenopausal women exhibited significantly higher serum follicle-stimulating hormone (FSH) levels, more severe climacteric and depressive symptoms, worse sleep quality and more extensive cognitive impairments. Concurrently, the neuroimaging results showed elevated DC values in the left amygdala (AMYG.L), reduced DC values in the left middle occipital gyrus (MOG.L) and right middle occipital gyrus (MOG.R). When we used the AMYG.L as the seed point, FC with the left insula (INS.L), bilateral prefrontal cortex (PFC) and right superior frontal gyrus (SFG.R) was increased; these regions are related to depressive states, poor sleep quality and decreased executive function. When bilateral MOG were used as the seed points, FC with left inferior parietal gyrus (IPG.L), this area closely associated with impaired memory, was decreased. Conclusion: These results illuminated the regional and network-level brain dysfunction in early postmenopausal women, which might provide information on the underlying mechanisms of the different cognitive impairments and emotional alterations observed in this group.
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Affiliation(s)
- Si Zhang
- Department of Radiology, Xinqiao Hosptial, Third Military Medical University, Chongqing, China
| | - Junhao Hu
- Department of Radiology, Xinqiao Hosptial, Third Military Medical University, Chongqing, China
| | - Weijie Fan
- Department of Radiology, Xinqiao Hosptial, Third Military Medical University, Chongqing, China
| | - Bo Liu
- Department of Radiology, Xinqiao Hosptial, Third Military Medical University, Chongqing, China
| | - Li Wen
- Department of Radiology, Xinqiao Hosptial, Third Military Medical University, Chongqing, China
| | - Guangxian Wang
- Department of Radiology, Xinqiao Hosptial, Third Military Medical University, Chongqing, China
| | - Mingfu Gong
- Department of Radiology, Xinqiao Hosptial, Third Military Medical University, Chongqing, China
| | - Chunyan Yang
- Department of Radiology, Xinqiao Hosptial, Third Military Medical University, Chongqing, China
| | - Dong Zhang
- Department of Radiology, Xinqiao Hosptial, Third Military Medical University, Chongqing, China
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34
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Jacobs EG, Goldstein JM. The Middle-Aged Brain: Biological sex and sex hormones shape memory circuitry. Curr Opin Behav Sci 2018; 23:84-91. [PMID: 30271832 PMCID: PMC6157917 DOI: 10.1016/j.cobeha.2018.03.009] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Affiliation(s)
- Emily G. Jacobs
- Department of Psychological and Brain Sciences, University of California, Santa Barbara
- Neuroscience Research Institute, University of California, Santa Barbara
| | - Jill M. Goldstein
- Departments of Psychiatry and Medicine, Harvard Medical School
- Departments of Psychiatry and Obstetrics and Gynecology, Massachusetts General Hospital
- Athinoula A. Martinos Brain Imaging Center, Massachusetts General Hospital
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35
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Frizell B, Dumas JA. Examining the Relationship Between Neurosteroids, Cognition, and Menopause With Neuroimaging Methods. Curr Psychiatry Rep 2018; 20:96. [PMID: 30221332 DOI: 10.1007/s11920-018-0963-2] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
PURPOSE OF REVIEW Previous literature has shown inconsistent findings regarding the effects of neurosteroids on the brain in postmenopausal women. The goal of this paper is to examine how and whether advances in neuroimaging have helped elucidate the relationship between the withdrawal of and/or treatment with neurosteroids and cognition at menopause. RECENT FINDINGS Neuroimaging techniques such as structural and functional MRI have been used in recent studies to examine the relationship between neurosteroids and brain structure and functioning. However, the recent literature shows that different formulations of postmenopausal hormones given at different times, through different routes of administration, and in different combinations with progestins result in a variety of relationships with the brain outcomes. We suggest that still further research is needed to understand how the structural changes resulting from estrogen withdrawal or therapy at menopause can influence cognitive functioning. However, imaging studies are time-, resource-, and expertise-intensive. We believe that this information will help uncover the mechanisms and relationships that can aid in the explanation of the individual differences in the effects of menopause on the brain as well as how this menopause-related hormone change influences risk for pathological aging.
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Affiliation(s)
- Baillie Frizell
- Clinical Neuroscience Research Unit, Department of Psychiatry, Robert Larner M.D. College of Medicine, University of Vermont, 1 South Prospect St, Burlington, VT, 05401, USA
| | - Julie A Dumas
- Clinical Neuroscience Research Unit, Department of Psychiatry, Robert Larner M.D. College of Medicine, University of Vermont, 1 South Prospect St, Burlington, VT, 05401, USA.
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Paipa N, Stephan-Otto C, Cuevas-Esteban J, Núñez-Navarro A, Usall J, Brébion G. Second-to-fourth digit length ratio is associated with negative and affective symptoms in schizophrenia patients. Schizophr Res 2018; 199:297-303. [PMID: 29503231 DOI: 10.1016/j.schres.2018.02.037] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/27/2017] [Revised: 02/20/2018] [Accepted: 02/21/2018] [Indexed: 11/27/2022]
Abstract
BACKGROUND Higher levels of circulating oestrogens in women and testosterone in men have been shown to have a protective effect against the clinical manifestations of schizophrenia, mostly with respect to negative symptomatology. Certain studies suggest that they also have a protective effect against the neuropsychological impairment observed in the disease. We investigated whether greater prenatal exposure to estrogens in women and to testosterone in men, reflected by the 2D:4D ratio, was similarly associated with decreased negative symptomatology and improved neuropsychological functioning in patients. METHOD 51 schizophrenia patients and 50 healthy participants were administered a neuropsychological battery. The 2D:4D ratio was measured in all participants. Positive, negative, and affective symptoms were assessed in patients. Regression analyses were conducted separately in male and female subgroups. RESULTS No associations with positive symptoms were revealed. In male patients, the 2D:4D ratio was positively associated with avolition and inversely associated with anxiety. In female patients, it was inversely associated with alogia, and tended to be positively associated with depression. No association between higher prenatal concentration of the relevant sex hormone and improved neuropsychological performance emerged in patients. CONCLUSIONS Higher concentrations of prenatal testosterone in male patients, and prenatal oestrogens in female patients, are associated with a decrement in certain aspects of negative symptomatology. In addition, prenatal sex hormone concentration seems to be associated with predisposition to anxiety in male patients, and to depression in female patients.
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Affiliation(s)
- Nataly Paipa
- Institut de Recerca Sant Joan de Déu, Esplugues de Llobregat, Spain; Parc Sanitari Sant Joan de Déu, Sant Boi de Llobregat, Spain
| | - Christian Stephan-Otto
- Institut de Recerca Sant Joan de Déu, Esplugues de Llobregat, Spain; Parc Sanitari Sant Joan de Déu, Sant Boi de Llobregat, Spain; Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain
| | - Jorge Cuevas-Esteban
- Servei de Psiquiatria, Hospital Universitari Germans Trias i Pujol, Badalona, Spain
| | - Araceli Núñez-Navarro
- Institut de Recerca Sant Joan de Déu, Esplugues de Llobregat, Spain; Parc Sanitari Sant Joan de Déu, Sant Boi de Llobregat, Spain
| | - Judith Usall
- Institut de Recerca Sant Joan de Déu, Esplugues de Llobregat, Spain; Parc Sanitari Sant Joan de Déu, Sant Boi de Llobregat, Spain; Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain
| | - Gildas Brébion
- Institut de Recerca Sant Joan de Déu, Esplugues de Llobregat, Spain; Parc Sanitari Sant Joan de Déu, Sant Boi de Llobregat, Spain; Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain.
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Gurvich C, Hoy K, Thomas N, Kulkarni J. Sex Differences and the Influence of Sex Hormones on Cognition through Adulthood and the Aging Process. Brain Sci 2018; 8:brainsci8090163. [PMID: 30154388 PMCID: PMC6162653 DOI: 10.3390/brainsci8090163] [Citation(s) in RCA: 67] [Impact Index Per Article: 11.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2018] [Revised: 08/23/2018] [Accepted: 08/23/2018] [Indexed: 12/28/2022] Open
Abstract
Hormones of the hypothalamic-pituitary-gonadal (HPG) axis that regulate reproductive function have multiple effects on the development, maintenance and function of the brain. Sex differences in cognitive functioning have been reported in both health and disease, which may be partly attributed to sex hormones. The aim of the current paper was to provide a theoretical review of how sex hormones influence cognitive functioning across the lifespan as well as provide an overview of the literature on sex differences and the role of sex hormones in cognitive decline, specifically in relation to Alzheimer’s disease (AD). A summary of current hormone and sex-based interventions for enhancing cognitive functioning and/or reducing the risk of Alzheimer’s disease is also provided.
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Affiliation(s)
- Caroline Gurvich
- Monash Alfred Psychiatry Research Centre, Central Clinical School, Monash University and The Alfred Hospital, Melbourne, VIC 3004, Australia.
| | - Kate Hoy
- Monash Alfred Psychiatry Research Centre, Central Clinical School, Monash University and The Alfred Hospital, Melbourne, VIC 3004, Australia.
| | - Natalie Thomas
- Monash Alfred Psychiatry Research Centre, Central Clinical School, Monash University and The Alfred Hospital, Melbourne, VIC 3004, Australia.
| | - Jayashri Kulkarni
- Monash Alfred Psychiatry Research Centre, Central Clinical School, Monash University and The Alfred Hospital, Melbourne, VIC 3004, Australia.
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Baker FC, Sattari N, de Zambotti M, Goldstone A, Alaynick WA, Mednick SC. Impact of sex steroids and reproductive stage on sleep-dependent memory consolidation in women. Neurobiol Learn Mem 2018; 160:118-131. [PMID: 29574082 DOI: 10.1016/j.nlm.2018.03.017] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2017] [Revised: 03/12/2018] [Accepted: 03/20/2018] [Indexed: 01/29/2023]
Abstract
Age and sex are two of the three major risk factors for Alzheimer's disease (ApoE-e4 allele is the third), with women having a twofold greater risk for Alzheimer's disease after the age of 75 years. Sex differences have been shown across a wide range of cognitive skills in young and older adults, and evidence supports a role for sex steroids, especially estradiol, in protecting against the development of cognitive decline in women. Sleep may also be a protective factor against age-related cognitive decline, since specific electrophysiological sleep events (e.g. sleep spindle/slow oscillation coupling) are critical for offline memory consolidation. Furthermore, studies in young women have shown fluctuations in sleep events and sleep-dependent memory consolidation during different phases of the menstrual cycle that are associated with the levels of sex steroids. An under-appreciated possibility is that there may be an important interaction between these two protective factors (sex steroids and sleep) that may play a role in daily fluctuations in cognitive processing, in particular memory, across a woman's lifespan. Here, we summarize the current knowledge of sex steroid-dependent influences on sleep and cognition across the lifespan in women, with special emphasis on sleep-dependent memory processing. We further indicate gaps in knowledge that require further experimental examination in order to fully appreciate the complex and changing landscape of sex steroids and cognition. Lastly, we propose a series of testable predictions for how sex steroids impact sleep events and sleep-dependent cognition across the three major reproductive stages in women (reproductive years, menopause transition, and post-menopause).
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Affiliation(s)
- Fiona C Baker
- Center for Health Sciences, SRI International, Menlo Park, CA 94025, USA; Brain Function Research Group, School of Physiology, University of the Witwatersrand, Johannesburg, South Africa
| | - Negin Sattari
- UC Irvine, Department of Cognitive Sciences, Irvine, CA 92697, USA
| | | | - Aimee Goldstone
- Center for Health Sciences, SRI International, Menlo Park, CA 94025, USA
| | | | - Sara C Mednick
- UC Irvine, Department of Cognitive Sciences, Irvine, CA 92697, USA.
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Jacobs EG, Weiss B, Makris N, Whitfield-Gabrieli S, Buka SL, Klibanski A, Goldstein JM. Reorganization of Functional Networks in Verbal Working Memory Circuitry in Early Midlife: The Impact of Sex and Menopausal Status. Cereb Cortex 2018; 27:2857-2870. [PMID: 27178194 DOI: 10.1093/cercor/bhw127] [Citation(s) in RCA: 34] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023] Open
Abstract
Converging preclinical and human evidence indicates that the decline in ovarian estradiol production during the menopausal transition may play a mechanistic role in the neuronal changes that occur early in the aging process. Here, we present findings from a population-based fMRI study characterizing regional and network-level differences in working memory (WM) circuitry in midlife men and women (N = 142; age range 46-53), as a function of sex and reproductive stage. Reproductive histories and hormonal evaluations were used to determine menopausal status. Participants performed a verbal WM task during fMRI scanning. Results revealed robust differences in task-evoked responses in dorsolateral prefrontal cortex and hippocampus as a function of women's reproductive stage, despite minimal variance in chronological age. Sex differences in regional activity and functional connectivity that were pronounced between men and premenopausal women were diminished for postmenopausal women. Critically, analyzing data without regard to sex or reproductive status obscured group differences in the circuit-level neural strategies associated with successful working memory performance. These findings underscore the importance of reproductive age and hormonal status, over and above chronological age, for understanding sex differences in the aging of memory circuitry. Further, these findings suggest that early changes in working memory circuitry are evident decades before the age range typically targeted in cognitive aging studies.
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Affiliation(s)
- Emily G Jacobs
- Division of Women's Health, Department of Medicine.,Department of Psychiatry, Brigham and Women's Hospital, Boston, MA 02120, USA.,Harvard Medical School, Boston, MA 02120, USA.,Athinoula A. Martinos Center, Massachusetts General Hospital, Charlestown, MA 02129, USA
| | - Blair Weiss
- Department of Psychiatry, Brigham and Women's Hospital, Boston, MA 02120, USA
| | - Nikos Makris
- Harvard Medical School, Boston, MA 02120, USA.,Athinoula A. Martinos Center, Massachusetts General Hospital, Charlestown, MA 02129, USA
| | - Sue Whitfield-Gabrieli
- Department of Brain and Cognitive Sciences, Massachusetts Institute of Technology, Cambridge, MA 02139, USA
| | - Stephen L Buka
- Department of Epidemiology, Brown University School of Public Health, Providence, RI, USA
| | - Anne Klibanski
- Neuroendocrine Unit, Department of Medicine, Massachusetts General Hospital, Boston, MA 02114, USA
| | - Jill M Goldstein
- Division of Women's Health, Department of Medicine.,Department of Psychiatry, Brigham and Women's Hospital, Boston, MA 02120, USA.,Harvard Medical School, Boston, MA 02120, USA.,Athinoula A. Martinos Center, Massachusetts General Hospital, Charlestown, MA 02129, USA
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Abstract
OBJECTIVE Few have characterized cognitive changes with age as a function of menopausal stage relative to men, or sex differences in components of memory in early midlife. The study aim was to investigate variation in memory function in early midlife as a function of sex, sex steroid hormones, and reproductive status. METHODS A total of 212 men and women aged 45 to 55 were selected for this cross-sectional study from a prenatal cohort of pregnancies whose mothers were originally recruited in 1959 to 1966. They underwent clinical and cognitive testing and hormonal assessments of menopause status. Multivariate general linear models for multiple memory outcomes were used to test hypotheses controlling for potential confounders. Episodic memory, executive function, semantic processing, and estimated verbal intelligence were assessed. Associative memory and episodic verbal memory were assessed using Face-Name Associative Memory Exam (FNAME) and Selective Reminding Test (SRT), given increased sensitivity to detecting early cognitive decline. Impacts of sex and reproductive stage on performance were tested. RESULTS Women outperformed men on all memory measures including FNAME (β = -0.30, P < 0.0001) and SRT (β = -0.29, P < 0.0001). Furthermore, premenopausal and perimenopausal women outperformed postmenopausal women on FNAME (initial learning, β= 0.32, P = 0.01) and SRT (recall, β= 2.39, P = 0.02). Across all women, higher estradiol was associated with better SRT performance (recall, β = 1.96, P = 0.01) and marginally associated with FNAME (initial learning, β = 0.19, P = 0.06). CONCLUSIONS This study demonstrated that, in early midlife, women outperformed age-matched men across all memory measures, but sex differences were attenuated for postmenopausal women. Initial learning and memory retrieval were particularly vulnerable, whereas memory consolidation and storage were preserved. Findings underscore the significance of the decline in ovarian estradiol production in midlife and its role in shaping memory function.
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Abstract
OBJECTIVE This study examined the cross-sectional association between phytoestrogens and speed of processing. We hypothesized that higher levels of phytoestrogens would be related to better cognitive performance among older women. METHODS Participants were from the National Health and Nutrition Examination Survey and consisted of 200 older women (M = 74.4 y). Stepwise regressions examined indicators of speed of processing, measured by the Digit Symbol Substitution Test. Isoflavones, lignans, and individual phytoestrogens were added to the regression after including covariates of age, education, race, smoking, and creatinine. Isoflavones were further broken into quartiles among the sample to further evaluate the nature of the curvilinear association. RESULTS Results showed a relationship between cognition and lignans, explaining 3.8% of the variance after including the covariates, indicating fewer lignans were associated with better speed of processing (P < 0.001). A significant curvilinear relationship with isoflavones explained 1.3% additional variance (P < 0.001). The moderate-high, low-moderate, and the lowest quartile of isoflavones were associated with better cognition, whereas the highest amount was associated with worse speed of processing. Among the individual phytoestrogens, only enterodiol accounted for 4.4% additional variance after taking into account covariates and indicated a negative association with cognition (P = 0.03). CONCLUSIONS Results suggest that moderate levels of isoflavones, but not lignans, may be associated with better speed of processing. Caution must remain for high isoflavone amounts due to the negative association with cognition. Given the results, phytoestrogens have the potential to be an intervention target for older females' cognition. To become a viable intervention, further research is needed.
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Understanding women's experience of memory over the menopausal transition: subjective and objective memory in pre-, peri-, and postmenopausal women. Menopause 2018; 23:1319-1329. [PMID: 27483039 DOI: 10.1097/gme.0000000000000705] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
OBJECTIVE Many women complain of forgetfulness during the menopausal transition. This study aimed to examine women's subjective perception of memory and their objective memory performance across the menopausal transition. METHODS One hundred thirty women, aged 40 to 60 years were recruited from outpatient Menopause and Gynaecological clinics at the Royal Women's Hospital, Melbourne. Women were divided into menopausal stage groups according to the Stages of Reproductive Aging Workshop criteria based on menstrual patterns. All women completed self-report measures of depressive, anxiety, vasomotor, and sleep symptoms; attitude to menopause; and various aspects of memory, including memory contentment, frequency of forgetting, sense of control over memory, and use of memory strategies. Women also completed a comprehensive neuropsychological evaluation assessing memory and executive function. RESULTS Comprehensive neuropsychological assessment showed no difference between premenopausal (n = 36), perimenopausal (n = 54), and postmenopausal (n = 40) groups in performance on memory and executive tasks. Perimenopausal women, however, reported significantly more frequent forgetting (η = 0.09, P < 0.01) and less contentment with their memory (η = 0.08, P < 0.01) than pre- and postmenopausal women. CONCLUSIONS Although no impairment was observed in neuropsychological performance, when compared with pre- and postmenopausal women, perimenopausal women were more likely to be dissatisfied with their memory. During the menopausal transition women with a more negative attitude to menopause and more intense depressive, anxiety, vasomotor, and sleep symptoms are more vulnerable to feeling less content with their memory.
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Hu J, Chu K, Song Y, Chatooah ND, Ying Q, Ma L, Zhou J, Qu F, Zhou J. Higher level of circulating estradiol is associated with lower frequency of cognitive impairment in Southeast China. Gynecol Endocrinol 2017; 33:840-844. [PMID: 28466687 DOI: 10.1080/09513590.2017.1320379] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
Abstract
BACKGROUND Estrogen has been proved to have positive effects on the brain cognitive function. However, many clinical studies investigating the associations between cognitive functions and circulating estrogen levels in perimenopausal and postmenopausal women demonstrated controversial results. METHOD Circulating estradiol and follicle stimulating hormone (FSH) levels were obtained from 199 perimenopausal and postmenopausal women (mean age: 49.61 years). The cognitive function has been assessed using the Beijing version of the Montreal Cognitive Assessment. RESULTS Results revealed that higher estradiol levels were associated with better cognitive function (p < 0.05) both in perimenopausal and postmenopausal women and levels of FSH were unrelated to cognitive performance. CONCLUSIONS In perimenopausal and postmenopausal women, higher levels of circulating estradiol are associated with lower risk of cognitive impairment.
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Affiliation(s)
- Jiling Hu
- a Women's Hospital, School of Medicine, Zhejiang University , Hangzhou , P. R. China
- b Department of Obstetrics and Gynecology , The Second Hospital of Yinzhou , Ningbo , P. R. China
| | - Ketan Chu
- a Women's Hospital, School of Medicine, Zhejiang University , Hangzhou , P. R. China
| | - Yang Song
- a Women's Hospital, School of Medicine, Zhejiang University , Hangzhou , P. R. China
| | | | - Qian Ying
- c Zhejiang Cancer Hospital , Hangzhou , P. R. China , and
| | - Linjuan Ma
- a Women's Hospital, School of Medicine, Zhejiang University , Hangzhou , P. R. China
| | - Jiong Zhou
- d The Second Hospital, School of Medicine, Zhejiang University , Hangzhou , P. R. China
| | - Fan Qu
- a Women's Hospital, School of Medicine, Zhejiang University , Hangzhou , P. R. China
| | - Jianhong Zhou
- a Women's Hospital, School of Medicine, Zhejiang University , Hangzhou , P. R. China
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Estradiol variability, stressful life events, and the emergence of depressive symptomatology during the menopausal transition. Menopause 2016; 23:257-66. [PMID: 26529616 DOI: 10.1097/gme.0000000000000528] [Citation(s) in RCA: 79] [Impact Index Per Article: 9.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
OBJECTIVE The aim of the study was to examine the role of estradiol fluctuation in triggering depressive symptoms in the menopausal transition and assess the role of recent very stressful life events (VSLEs) as a moderating factor in this relationship. METHODS A total of 52 euthymic women in the menopausal transition or early postmenopause (age 45-60) who were assigned to the placebo arm of a randomized controlled trial of hormone therapy provided the data for this report. At enrollment, women's experience of recent VSLEs, depressive symptoms, serum estradiol, and progesterone were assessed. At months 1, 8, and 14, depressive symptoms and hormones were reassessed, and participants underwent a stressor battery involving a speech and a mental arithmetic task. Participants rated their feelings of anxiety, fear, anger, and rejection. The standard deviation of estradiol provided an index of hormone variability over the entire 14 months. RESULTS Greater estradiol variability across the 14 months predicted greater depressive symptoms at month 14, though only in women reporting a higher number of VSLEs at baseline (39% of women reported ≤1 recent event). Greater estradiol variability also predicted greater feelings of rejection to the laboratory stressor at months 8 and 14. Furthermore, among women reporting higher VSLEs at baseline, feelings of rejection in response to the laboratory stressor at month 8 predicted depressive symptoms at month 14. CONCLUSIONS These data suggest that estradiol variability may enhance emotional sensitivity to psychosocial stress, particularly sensitivity to social rejection. Combined with VSLEs proximate to the menopausal transition, this increased sensitivity may contribute to the development of depressed mood.
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Bojar I, Pinkas J, Wierzbińska-Stępniak A, Raczkiewicz D, Owoc A, Gujski M. Cognitive Functions, Concentration of Endogenous Estradiol, Estrogen Receptor α (ERα) Polymorphism in Postmenopausal Women. Med Sci Monit 2016; 22:3469-3478. [PMID: 27680398 PMCID: PMC5045131 DOI: 10.12659/msm.901247] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND The goal of this study was to investigate the relationship between cognitive functions and the level of endogenous estradiol in postmenopausal women, according to which estrogen receptor α (ERα) polymorphism the woman carries. MATERIAL AND METHODS The study group consisted of 210 women. The inclusion criteria were: minimum 2 years after the last menstruation, FSH concentration 30 U/ml, and no dementia signs on Montreal Cognitive Assessment (MoCA). A computerized battery of Central Nervous System Vital Signs (CNS VS) test was used to diagnose cognitive functions. Genotyping of the ERa polymorphism was performed using a polymerase chain reaction and restriction enzymes (PCR-RFLP). Blood plasma was tested for FSH and estradiol (E2). Statistical analysis was performed using STATISTICA software. RESULTS A relationship was confirmed between standard scores for 3 cognitive functions: general memory, verbal memory, and processing speed, and the XbaI polymorphism in the women in the study. In the group of women with genotype TT PvuII, significant positive relationships were observed between the concentration of E2 and the standard scores of 3 cognitive functions: general memory, verbal memory, and processing speed. In the group of women with genotype TC PvuII, significant negative correlations were found between the concentration of E2 and the standard scores of 4 cognitive functions: NCI, general memory, verbal memory, and processing speed. CONCLUSIONS ERα polymorphism exerted an effect on the interaction between the concentration of estradiol and the results for cognitive functions. The concentration of estradiol did not depend on Xba1 and PvuII polymorphisms. The results for cognitive functions depended on which Xba1 polymorphism the woman carried.
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Affiliation(s)
- Iwona Bojar
- Department of Women's Health, Institute of Rural Health in Lublin, Lublin, Poland
| | - Jarosław Pinkas
- School of Public Health, Center for Postgraduate Medical Education, Warsaw, Poland
| | | | - Dorota Raczkiewicz
- Institute of Statistics and Demography, School of Economics, Warsaw, Poland
| | - Alfred Owoc
- Center for Public Health and Health Promotion, Institute of Rural Health in Lublin, Lublin, Poland
| | - Mariusz Gujski
- Department of Prevention of Environmental Hazards and Allergology, Medical University of Warsaw, Warsaw, Poland
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Impact of Sex and Menopausal Status on Episodic Memory Circuitry in Early Midlife. J Neurosci 2016; 36:10163-73. [PMID: 27683911 DOI: 10.1523/jneurosci.0951-16.2016] [Citation(s) in RCA: 65] [Impact Index Per Article: 8.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2016] [Accepted: 08/08/2016] [Indexed: 11/21/2022] Open
Abstract
UNLABELLED Cognitive neuroscience of aging studies traditionally target participants age 65 and older. However, epidemiological surveys show that many women report increased forgetfulness earlier in the aging process, as they transition to menopause. In this population-based fMRI study, we stepped back by over a decade to characterize the changes in memory circuitry that occur in early midlife, as a function of sex and women's reproductive stage. Participants (N = 200; age range, 45-55) performed a verbal encoding task during fMRI scanning. Reproductive histories and serologic evaluations were used to determine menopausal status. Results revealed a pronounced impact of reproductive stage on task-evoked hippocampal responses, despite minimal difference in chronological age. Next, we examined the impact of sex and reproductive stage on functional connectivity across task-related brain regions. Postmenopausal women showed enhanced bilateral hippocampal connectivity relative to premenopausal and perimenopausal women. Across women, lower 17β-estradiol concentrations were related to more pronounced alterations in hippocampal connectivity and poorer performance on a subsequent memory retrieval task, strongly implicating sex steroids in the regulation of this circuitry. Finally, subgroup analyses revealed that high-performing postmenopausal women (relative to low and middle performers) exhibited a pattern of brain activity akin to premenopausal women. Together, these findings underscore the importance of considering reproductive stage, not simply chronological age, to identify neuronal and cognitive changes that unfold in the middle decades of life. In keeping with preclinical studies, these human findings suggest that the decline in ovarian estradiol production during menopause plays a significant role in shaping memory circuitry. SIGNIFICANCE STATEMENT Maintaining intact memory function with age is one of the greatest public health challenges of our time, and women have an increased risk for memory disorders relative to men later in life. We studied adults early in the aging process, as women transition into menopause, to identify neuronal and cognitive changes that unfold in the middle decades of life. Results demonstrate regional and network-level differences in memory encoding-related activity as a function of women's reproductive stage, independent of chronological age. Analyzing data without regard to sex or menopausal status obscured group differences in circuit-level neural strategies associated with successful memory retrieval. These findings suggest that early changes in memory circuitry are evident decades before the age range traditionally targeted by cognitive neuroscience of aging studies.
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Piccardi L, Matano A, D’Antuono G, Marin D, Ciurli P, Incoccia C, Verde P, Guariglia P. Persistence of Gender Related-Effects on Visuo-Spatial and Verbal Working Memory in Right Brain-Damaged Patients. Front Behav Neurosci 2016; 10:139. [PMID: 27445734 PMCID: PMC4923148 DOI: 10.3389/fnbeh.2016.00139] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2016] [Accepted: 06/15/2016] [Indexed: 11/30/2022] Open
Abstract
The aim of the present study was to verify if gender differences in verbal and visuo-spatial working memory would persist following right cerebral lesions. To pursue our aim we investigated a large sample (n. 346) of right brain-damaged patients and healthy participants (n. 272) for the presence of gender effects in performing Corsi and Digit Test. We also assessed a subgroup of patients (n. 109) for the nature (active vs. passive) of working memory tasks. We tested working memory (WM) administering the Corsi Test (CBT) and the Digit Span (DS) using two different versions: forward (fCBT and fDS), subjects were required to repeat stimuli in the same order that they were presented; and backward (bCBT and bDS), subjects were required to repeat stimuli in the opposite order of presentation. In this way, passive storage and active processing of working memory were assessed. Our results showed the persistence of gender-related effects in spite of the presence of right brain lesions. We found that men outperformed women both in CBT and DS, regardless of active and passive processing of verbal and visuo-spatial stimuli. The presence of visuo-spatial disorders (i.e., hemineglect) can affect the performance on Corsi Test. In our sample, men and women were equally affected by hemineglect, therefore it did not mask the gender effect. Generally speaking, the persistence of the men's superiority in visuo-spatial tasks may be interpreted as a protective factor, at least for men, within other life factors such as level of education or kind of profession before retirement.
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Affiliation(s)
- Laura Piccardi
- Life, Health and Environmental Science Department, University of L’Aquila, L’AquilaItaly
- IRCCS Fondazione Santa Lucia, Neuropsychology UnitRome, Italy
| | | | | | | | - Paola Ciurli
- IRCCS Fondazione Santa Lucia, Neuropsychology UnitRome, Italy
| | - Chiara Incoccia
- IRCCS Fondazione Santa Lucia, Neuropsychology UnitRome, Italy
| | - Paola Verde
- Aerospace Medicine Department, Italian Air Force Experimental Flight CentrePratica di Mare, Italy
| | - Paola Guariglia
- Dipartimento Scienze dell’Uomo e della Società, UKE UniversityEnna, Italy
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Schiller CE, Johnson SL, Abate AC, Schmidt PJ, Rubinow DR. Reproductive Steroid Regulation of Mood and Behavior. Compr Physiol 2016; 6:1135-60. [PMID: 27347888 PMCID: PMC6309888 DOI: 10.1002/cphy.c150014] [Citation(s) in RCA: 108] [Impact Index Per Article: 13.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
In this article, we examine evidence supporting the role of reproductive steroids in the regulation of mood and behavior in women and the nature of that role. In the first half of the article, we review evidence for the following: (i) the reproductive system is designed to regulate behavior; (ii) from the subcellular to cellular to circuit to behavior, reproductive steroids are powerful neuroregulators; (iii) affective disorders are disorders of behavioral state; and (iv) reproductive steroids affect virtually every system implicated in the pathophysiology of depression. In the second half of the article, we discuss the diagnosis of the three reproductive endocrine-related mood disorders (premenstrual dysphoric disorder, postpartum depression, and perimenopausal depression) and present evidence supporting the relevance of reproductive steroids to these conditions. Existing evidence suggests that changes in reproductive steroid levels during specific reproductive states (i.e., the premenstrual phase of the menstrual cycle, pregnancy, parturition, and the menopause transition) trigger affective dysregulation in susceptible women, thus suggesting the etiopathogenic relevance of these hormonal changes in reproductive mood disorders. Understanding the source of individual susceptibility is critical to both preventing the onset of illness and developing novel, individualized treatments for reproductive-related affective dysregulation. © 2016 American Physiological Society. Compr Physiol 6:1135-1160, 2016e.
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Affiliation(s)
- Crystal Edler Schiller
- Psychiatry Department, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Sarah L. Johnson
- Psychiatry Department, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Anna C. Abate
- Psychiatry Department, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Peter J. Schmidt
- Section on Behavioral Endocrinology, National Institute of Mental Health, Department of Health and Human Services, Bethesda, Maryland, USA
| | - David R. Rubinow
- Psychiatry Department, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
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Castonguay N, Lussier M, Bugaiska A, Lord C, Bherer L. Executive functions in men and postmenopausal women. J Clin Exp Neuropsychol 2015; 37:193-208. [PMID: 25695230 DOI: 10.1080/13803395.2014.1000267] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
INTRODUCTION This study was designed to assess sex differences in older adults (55-65 years old) in executive functions and to examine the influence of hormone therapy (HT) in postmenopausal women. METHOD We have assessed task performance in memory, visuospatial, and executive functions in 29 women using HT, 29 women who never used HT, and 30 men. RESULTS Men outperformed never users in task switching and updating. HT users outperformed never users in updating. HT users outperformed never users and men in visual divided attention. DISCUSSION The present study support previous findings that sex and HT impact cognition and bring new insights on sex and HT-related differences in executive functions.
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Affiliation(s)
- Nathalie Castonguay
- a Department of Psychology , Université du Québec à Montréal , Montreal , QC , Canada
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