Distinct cognitive effects of estrogen and progesterone in menopausal women.
Distinct cognitive effects of estrogen and progesterone in menopausal women.
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DOI：
10.1016/j.psyneuen.2015.04.020
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发表时间：
2015-09
影响因子：
3.7
通讯作者：
Smith, Yolanda R.
中科院分区：
文献类型：
--
作者：
Berent-Spillson, Alison;Briceno, Emily;Pinsky, Alana;Simmen, Angela;Persad, Carol C.;Zubieta, Jon-Kar;Smith, Yolanda R.
绝经后激素治疗对认知结果的影响在文献中不一致。新出现的证据表明，认知效果受到特定激素制剂的影响，孕酮比合成的孕酮更有可能与积极的结果相关。关于绝经后妇女无对抗性孕酮的研究很少，也没有使用功能性神经影像学（一种敏感的神经生物学功能测量方法）的研究。在这项研究中，29最近绝经后妇女，我们使用功能性MRI和神经心理学的措施，分别评估雌激素或孕激素治疗对视觉和言语认知功能的影响。妇女随机接受90天的雌二醇或孕酮与安慰剂平衡。在每个治疗组后，女性接受了一系列的言语和视觉认知功能以及工作记忆测试，并接受了功能性MRI，包括言语处理和视觉工作记忆任务。我们发现，雌二醇和孕酮都与言语加工过程中激活模式的变化有关。与安慰剂相比，接受雌二醇治疗的女性在左前额叶皮层有更大的激活，这是一个与语言处理和编码相关的区域。在视觉记忆任务中，预后与局部大脑激活模式的变化有关，与安慰剂相比，左前额叶皮层和右海马体的激活程度更高。在功能磁共振成像扫描过程中进行口头任务后，两种治疗都与记忆单词数量的统计学无显著性增加相关，而与安慰剂相比，只有黄体酮与口头工作记忆的神经心理学指标改善相关。这些结果指出了雌激素和孕激素的潜在认知益处。
The effects of postmenopausal hormone treatment on cognitive outcomes are inconsistent in the literature. Emerging evidence suggests that cognitive effects are influenced by specific hormone formulations, and that progesterone is more likely to be associated with positive outcomes than synthetic progestin. There are very few studies of unopposed progesterone in postmenopausal women, and none that use functional neuroimaging, a sensitive measure of neurobiological function. In this study of 29 recently postmenopausal women, we used functional MRI and neuropsychological measures to separately assess the effects of estrogen or progesterone treatment on visual and verbal cognitive function. Women were randomized to receive 90 days of either estradiol or progesterone counterbalanced with placebo. After each treatment arm, women were given a battery of verbal and visual cognitive function and working memory tests, and underwent functional MRI including verbal processing and visual working memory tasks. We found that both estradiol and progesterone were associated with changes in activation patterns during verbal processing. Compared to placebo, women receiving estradiol treatment had greater activation in the left prefrontal cortex, a region associated with verbal processing and encoding. Progesterone was associated with changes in regional brain activation patterns during a visual memory task, with greater activation in the left prefrontal cortex and right hippocampus compared to placebo. Both treatments were associated with a statistically nonsignificant increase in number of words remembered following the verbal task performed during the fMRI scanning session, while only progesterone was associated with improved neuropsychological measures of verbal working memory compared to placebo. These results point to potential cognitive benefits of both estrogen and progesterone.
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