Baxter Mark G, Santistevan Anthony C, Bliss-Moreau Eliza, Morrison John H
Department of Neuroscience, Icahn School of Medicine at Mount Sinai.
Department of Psychology, University of California, Davis, and California National Primate Research Center, Davis.
Behav Neurosci. 2018 Aug;132(4):213-223. doi: 10.1037/bne0000259. Epub 2018 Jun 28.
Some evidence suggests that there may be a limited "window of opportunity" for beneficial effects of hormone therapy after menopause in women. We tested whether the timing of cyclic estradiol (E2) treatment impacted its effect on cognitive function in aged, surgically menopausal (ovariectomized) rhesus monkeys. Monkeys were assigned to one of four treatment conditions after ovariectomy: either vehicle or E2 treatment for the duration of the protocol, vehicle for the first 2 years of the protocol followed by E2 for the remainder (delayed treatment), or E2 for the first 11 months of the protocol followed by vehicle for the remainder (withdrawn treatment). Delayed treatment addressed the hypothesis that E2 treatment initiated more than 2 years postovariectomy would have a reduced effect on cognitive function. Withdrawn treatment mirrored current clinical advice to women to use hormone therapy in the initial postmenopausal period then discontinue it. Two periods of cognitive testing assessed treatment effects on cognition over time. E2 treatment predominantly affected a prefrontal cortex-dependent test of spatiotemporal working memory (delayed response). Monkeys with delayed E2 treatment modestly improved in delayed response performance over time, whereas vehicle-treated monkeys declined. Monkeys with withdrawn E2 treatment maintained their performance across assessments, as did monkeys treated with E2 across the entire protocol. These findings suggest that a "window of opportunity" for hormone treatment after cessation of ovarian function, if present in nonhuman primates, lasts longer than 2 years. They also support the notion that beneficial effects of hormone therapy may persist after discontinuation of treatment. (PsycINFO Database Record
一些证据表明,绝经后女性接受激素治疗产生有益效果的“机会窗口”可能有限。我们测试了周期性雌二醇(E2)治疗的时间是否会影响其对老年、手术绝经(卵巢切除)恒河猴认知功能的作用。卵巢切除术后,猴子被分配到四种治疗条件之一:在整个实验方案期间接受赋形剂或E2治疗;在实验方案的前2年接受赋形剂治疗,其余时间接受E2治疗(延迟治疗);在实验方案的前11个月接受E2治疗,其余时间接受赋形剂治疗(撤药治疗)。延迟治疗验证了这样一个假设,即卵巢切除术后2年以上开始的E2治疗对认知功能的影响会减弱。撤药治疗反映了当前对女性的临床建议,即在绝经后的最初阶段使用激素治疗,然后停止使用。两个阶段的认知测试评估了治疗随时间对认知的影响。E2治疗主要影响了一项依赖前额叶皮质的时空工作记忆测试(延迟反应)。随着时间的推移,延迟接受E2治疗的猴子在延迟反应表现上有适度改善,而接受赋形剂治疗的猴子则出现下降。接受撤药E2治疗的猴子在各次评估中保持了它们的表现,在整个实验方案中接受E2治疗的猴子也是如此。这些发现表明,如果在非人灵长类动物中存在卵巢功能停止后激素治疗的“机会窗口”,其持续时间超过2年。它们还支持了激素治疗的有益效果在停止治疗后可能持续存在的观点。(《心理学文摘数据库记录》