High-dose estradiol improves cognition for women with AD - Results of a randomized study
High-dose estradiol improves cognition for women with AD - Results of a randomized study
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DOI：
10.1212/wnl.57.4.605
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发表时间：
2001-08-28
期刊：
影响因子：
9.9
通讯作者：
Plymate, SR
中科院分区：
文献类型：
--
作者：
Asthana, S;Baker, LD;Plymate, SR
目的：探讨绝经后AD患者接受高剂量雌激素治疗后的认知和神经内分泌反应。方法：20名绝经后AD妇女随机接受0.10 mg/天的17 β -雌二醇皮肤贴片或安慰剂贴片，持续8周。在治疗期间的基线、第3周、第5周和第8周以及治疗结束后的第8周对受试者进行评估。在每次访问期间，通过一系列神经心理学测试评估认知能力，并收集血液样本以测量血浆雌二醇以及其他一些感兴趣的神经内分泌标志物。结果：雌激素治疗对注意（Stroop Color Word Interference Test）、言语记忆（Buschke Selective提醒Test）和视觉记忆（Figure Copy/ memory）均有显著影响。此外，与接受安慰剂的受试者相比，接受雌激素治疗的女性在语义记忆测试（波士顿命名测试）中表现出更好的表现。雌激素似乎对胰岛素样生长因子（IGF）系统有抑制作用，在雌激素治疗期间，血浆中IGF结合蛋白-3的浓度显著降低，血浆中雌二醇和IGF- 1的水平呈负相关。结论：高剂量雌激素可增强绝经后AD患者的注意力和记忆力。尽管这些发现提供了进一步的临床证据来支持雌激素对AD女性的认知益处，但在确定雌激素替代对AD女性的治疗潜力之前，评估雌二醇给药效果的研究，特别是使用更大的样本量和更长的治疗持续时间是有必要的。
Objective: To characterize the cognitive and neuroendocrine response to treatment with a high dose of estrogen for postmenopausal women with AD. Methods: Twenty postmenopausal women with AD were randomized to receive either 0.10 mg/day of 17 beta -estradiol by skin patch or a placebo patch for 8 weeks. Subjects were evaluated at baseline, at weeks 3, 5, and 8 during treatment, and again 8 weeks after treatment termination. During each visit, cognition was assessed with a battery of neuropsychological tests, and blood samples were collected to measure plasma estradiol as well as several other neuroendocrine markers of interest. Results: Significant effects of estrogen treatment were observed on attention (Stroop Color Word Interference Test), verbal memory (Buschke Selective Reminding Test), and visual memory (Figure Copy/Memory). In addition, women treated with estrogen demonstrated improved performance on a test of semantic memory (Boston Naming Test) compared with subjects who received a placebo. Estrogen appeared to have a suppressive effect on the insulin-like growth factor (IGF) system such that plasma concentration of IGF binding protein-3 was significantly reduced and plasma levels of estradiol and IGF-I were negatively correlated during estrogen treatment. Conclusions: Administration of a higher dose of estrogen may enhance attention and memory for postmenopausal women with AD. Although these findings provide further clinical evidence to support a cognitive benefit of estrogen for women with AD, studies evaluating the effect of estradiol administration, in particular, using larger sample sizes and for longer treatment durations are warranted before the therapeutic potential of estrogen replacement for women with AD can be firmly established.