Prefrontal cortex as the site of estrogen's effect on cognition
Prefrontal cortex as the site of estrogen's effect on cognition
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DOI：
10.1016/s0306-4530(01)00013-0
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发表时间：
2001-08-01
影响因子：
3.7
通讯作者：
Moore, GJ
中科院分区：
文献类型：
--
作者：
Keenan, PA;Ezzat, WH;Moore, GJ
长期以来，海马一直被认为是雌激素对认知作用的主要部位;外显记忆被认为是最容易受到绝经期雌激素损失的认知功能。相反，我们假设前额叶皮层及其神经回路是雌激素在认知中作用的主要介质。Vile还提出，先前报道的绝经期认知能力下降，推测是由大脑介导的，可能继发于执行功能障碍。我们采用横断面设计比较了9名接受激素替代疗法（HRT）的绝经期妇女和10名先前未接受HRT的绝经期妇女在神经心理学测试中的表现。该电池主要包括记忆和执行功能的测试。执行功能由额叶介导，包括工作记忆、定向注意、抑制不当反应、认知转换和行为监测。与大多数以前的研究不同，我们使用了一种记忆测量方法，该方法产生多个分数，反映了各种解决问题的策略和错误类型，从而隔离了备用和受损的认知过程。结果产生了定性和定量的证据，证明额叶而不是海马体破坏了认知过程：1）尽管在列表学习任务（CVLT）中自由回忆完好无损，但未经治疗的绝经期妇女在正确识别先前学习的单词并将其与不在列表上的项目区分开来方面相对受损（辨别力），2）未经治疗的妇女也难以抑制持续错误形式的不适当反应，3）非HRT组在工作记忆的N-back测试中表现一贯较差。前额叶皮层对完整的工作记忆至关重要，雌激素可以提高工作记忆任务的表现。总之，这项研究提供了执行功能障碍的初步证据，未经治疗的绝经期妇女与HRT的妇女优于妇女没有HRT的测试需要直接注意，抑制不适当的反应，和认知秒切换。(C)2001爱思唯尔科技有限公司版权所有。
The hippocampus has long been presumed the primary site of action of estrogens on cognition; and explicit memory is considered the cognitive function most vulnerable to menopausal loss of estrogen. We hypothesize instead that the prefrontal cortex and its neural circuitry are prime mediators of estrogen's role in cognition. Vile also propose that previously reported menopausal cognitive decline, presumed to be hippocampally mediated, may be secondary to executive dysfunction. We used a cross sectional design to compare the performance of nine menopausal women on hormone replacement therapy (HRT) and 10 menopausal women with no prior exposure to HRT on a battery of neuropsychological tests. The battery was comprised primarily of tests of memory and executive functioning. Executive functioning is mediated by the frontal lobes and encompasses working memory, directed attention, the inhibition of inappropriate responses, cognitive set switching, and behavioral monitoring. Unlike most previous studies, we used a memory measure that yields multiple scores reflecting various problem-solving strategies and error types, thus isolating spared and impaired cognitive processes. Results yielded both qualitative and quantitative evidence for disruption of cognitive processes subserved by the frontal lobes rather than the hippocampus: 1) despite intact free recall on a list-learning task (CVLT), untreated menopausal women were relatively impaired in correctly recognizing words previously learned and distinguishing them from items not on the list (discriminability), 2) untreated women also had difficulty inhibiting inappropriate responses in the form of perseverative errors, and 3) the non-HRT group consistently performed worse on the N-back test of working memory. The prefrontal cortex is critical for intact working memory and estrogen enhances performance on working memory tasks. In conclusion, this study provides preliminary evidence for executive dysfunction in untreated menopausal women as women with HRT outperformed women without HRT on tests requiring directed attention, inhibition of inappropriate responses, and cognitive sec switching. (C) 2001 Elsevier Science Ltd. All rights reserved.