Center for Stress and Neural Regulation of Reproductive Aging Health Outcomes

老年妇女经历下丘脑-垂体-性腺（HPG）轴的巨大变化， 生殖激素，产生血管紧张症状（VMS），睡眠问题，认知变化， 心血管代谢风险，增加心血管疾病（CVD）和痴呆症的易感性。VMS发生 在85%的女性中，三分之一的女性在绝经后持续10年以上，可能导致长期的 生活质量中断、睡眠障碍、心脏代谢风险和VMS治疗延长， 进一步增加心血管疾病和痴呆的风险。这些健康结果也可能受到压力暴露的影响， 在寿命和怀孕期间，这可能通过神经机制发挥其作用。布莱根 妇女医院（BWH）和哈佛医学院（HMS）寻求建立一个SCORE，以推进我们的 了解压力暴露和生殖衰老健康结果的神经调节，以及 促进老年妇女的翻译妇女健康和性别差异研究的增长。我们将奉行 通过三个项目的新的转化科学：项目1（Joffe/Mahon;临床科学）将定义诱发 应激反应、功能性脑成像中神经网络的应激相关激活和GABA 浓度作为VMS发生和持续的标志，包括睡眠不良的复合效应 和压力暴露。项目2（Oken/Chavarro;人口科学）将确定围绝经期是否 女性在整个生命周期中更容易受到社会压力和生理压力的影响。 怀孕有更大的心脏代谢风险，睡眠，认知和神经精神症状。项目3 （Kaiser/Navarro;基础科学）将描述kisspeptin，神经激肽和强啡肽（KNDy）的作用 神经元和上游GABA能神经元介导应激和皮质类固醇对HPG的影响 轴，VMS和睡眠障碍的啮齿动物模型。这些科学努力将得到以下方面的关键支持： 我们的核心：睡眠资源核心（Klerman）将通过调查睡眠来扩大我们的科学影响力 人类和啮齿动物的结果。职业提升核心（Rexrode/Rich-Edwards）将促进早期- 职业和新的性别差异调查支持学者，试点项目，旅游交流 奖学金，和一个强大的教育计划。领导管理核心（Joffe/曼森）将 提供科学和行政监督，并与SCORE联盟合作。在现有基础上， 富有成效的合作，我们杰出的跨学科团队的倡导者-领导者在妇女的健康，睡眠 医学、神经影像学、神经内分泌学、应激科学、认知、心脏代谢和生殖 将利用康纳斯妇女健康和性别生物学中心的强大资源 以及BWH的协同女性健康和睡眠项目。这个分数将产生一个显著的 通过推进我们对压力在生产中的作用和机制的理解， 生殖老龄化健康结果与老年妇女的心血管疾病和痴呆易感性有关。

Older women experience dramatic changes in the hypothalamic-pituitary-gonadal (HPG) axis and female reproductive hormones, producing vasomotor symptoms (VMS), sleep problems, cognitive changes, and cardiometabolic risks, which increase susceptibility to cardiovascular disease (CVD) and dementia. VMS occur in 85% of women and persist in one-third for 10+ years after menopause, potentially leading to prolonged disruption of quality of life, sleep disturbance, cardiometabolic risk, and extended VMS treatment, conferring further risk for CVD and dementia. Such health outcomes may also be influenced by stress exposures across the lifespan and during pregnancy, which may exert their effects through neural mechanisms. Brigham and Women’s Hospital (BWH) and Harvard Medical School (HMS) seek to establish a SCORE to advance our understanding of stress exposures and neural regulation of reproductive aging health outcomes, and to catalyze growth of translational women’s health and sex-differences research in aging women. We will pursue novel translational science through three Projects: Project 1 (Joffe/Mahon; clinical science) will define evoked stress responsivity, stress-related activation of neural networks on functional brain imaging, and GABA concentrations as markers of VMS occurrence and persistence, including compounding effects of poor sleep and stress exposures. Project 2 (Oken/Chavarro; population science) will determine whether perimenopausal women with higher exposure to social stressors across the lifespan and physiological stressors across pregnancy have greater cardiometabolic risk, sleep, cognitive, and neuropsychiatric symptoms. Project 3 (Kaiser/Navarro; basic science) will characterize the role of kisspeptin, neurokinin, and dynorphin (KNDy) neurons and upstream GABAergic neurons in mediating the effects of stress and corticosteroids on the HPG axis, VMS, and sleep disturbances in a rodent model. These scientific efforts will receive critical support from our Cores: The Sleep Resource Core (Klerman) will extend our scientific impact by investigating sleep outcomes in humans and rodents. The Career Enhancement Core (Rexrode/Rich-Edwards) will promote early- career and new sex-differences investigators by supporting Scholars, Pilot Projects, Travel Exchange Fellowships, and a robust educational program. The Leadership Administrative Core (Joffe/Manson) will provide scientific and administrative oversight and engage with the SCORE Consortium. Building on existing, fruitful collaborations, our outstanding interdisciplinary team of investigators—leaders in women’s health, sleep medicine, neuroimaging, neuroendocrinology, stress science, cognition, cardiometabolic, and reproductive epidemiology—will leverage robust resources at the Connors Center for Women’s Health and Gender Biology and across synergistic women’s health and sleep programs at BWH. This SCORE will produce a significant public health impact by advancing our understanding of the role and mechanisms of stress in producing reproductive aging health outcomes that are linked with CVD and dementia susceptibility in aging women.