Department of Psychology, University of Pittsburgh, Pittsburgh, Pennsylvania 15260, USA.
Neuropsychology. 2010 Jan;24(1):68-76. doi: 10.1037/a0017292.
The influence of hormone treatment on brain and cognition in postmenopausal women has been a controversial topic. Contradictory patterns of results have prompted speculation that a critical period, or limited window of opportunity, exists for hormone treatment to protect against neurocognitive. In this cross-sectional study of 102 postmenopausal women, we examined whether hippocampal, amygdala, or caudate nucleus volumes and spatial memory performance were related to the interval between menopause and the initiation of hormone treatment. Consistent with a critical period hypothesis, we found that shorter intervals between menopause and the initiation of hormone treatment were associated with larger hippocampal volumes compared with longer intervals between menopause and treatment initiation. Initiation of hormone treatment at the time of menopause was also associated with larger hippocampal volumes when compared with peers who had never used hormone treatment. Furthermore, these effects were independent from potentially confounding factors such as age, years of education, the duration of hormone treatment, current or past use of hormone therapy, the type of therapy, and age at menopause. Larger hippocampal volumes in women who initiated hormone treatment at the time of menopause failed to translate to improved spatial memory performance. There was no relationship between timing of hormone initiation, spatial memory performance, and amygdala or caudate nucleus volume. Our results provide support for a limited window of opportunity for hormone treatment to influence hippocampal volume, yet the degree to which these effects translate to improved memory performance is uncertain.
激素治疗对绝经后妇女大脑和认知的影响一直是一个有争议的话题。相互矛盾的结果提示人们存在一个关键时期或有限的机会窗口，在此期间激素治疗可以预防神经认知障碍。在这项对 102 名绝经后妇女的横断面研究中，我们研究了海马体、杏仁核或尾状核体积和空间记忆表现是否与绝经后和开始激素治疗之间的时间间隔有关。与关键时期假说一致，我们发现与绝经后和开始激素治疗之间的时间间隔较长相比，绝经后和开始激素治疗之间的时间间隔较短与海马体体积较大有关。与从未使用过激素治疗的同龄人相比，在绝经时开始激素治疗也与较大的海马体体积有关。此外，这些影响独立于年龄、受教育年限、激素治疗持续时间、当前或过去使用激素治疗、治疗类型和绝经年龄等潜在混杂因素。在绝经时开始激素治疗的女性中海马体体积较大并未转化为空间记忆表现的改善。激素治疗开始的时间、空间记忆表现与杏仁核或尾状核体积之间没有关系。我们的研究结果为激素治疗影响海马体体积的机会窗口有限提供了支持，但这些影响转化为改善记忆表现的程度尚不确定。
