Clinical Neuroscience Research Unit, Department of Psychiatry, Robert Larner M.D. College of Medicine, University of Vermont, 1 South Prospect St, Burlington, VT, 05401, USA.
Curr Psychiatry Rep. 2018 Sep 17;20(11):96. doi: 10.1007/s11920-018-0963-2.
Previous literature has shown inconsistent findings regarding the effects of neurosteroids on the brain in postmenopausal women. The goal of this paper is to examine how and whether advances in neuroimaging have helped elucidate the relationship between the withdrawal of and/or treatment with neurosteroids and cognition at menopause.
Neuroimaging techniques such as structural and functional MRI have been used in recent studies to examine the relationship between neurosteroids and brain structure and functioning. However, the recent literature shows that different formulations of postmenopausal hormones given at different times, through different routes of administration, and in different combinations with progestins result in a variety of relationships with the brain outcomes. We suggest that still further research is needed to understand how the structural changes resulting from estrogen withdrawal or therapy at menopause can influence cognitive functioning. However, imaging studies are time-, resource-, and expertise-intensive. We believe that this information will help uncover the mechanisms and relationships that can aid in the explanation of the individual differences in the effects of menopause on the brain as well as how this menopause-related hormone change influences risk for pathological aging.
既往文献表明,神经甾体对绝经后妇女大脑的影响存在不一致的发现。本文的目的是探讨神经影像学的进展如何以及是否有助于阐明神经甾体的撤退和/或治疗与绝经时认知之间的关系。
结构和功能磁共振成像等神经影像学技术已在最近的研究中用于研究神经甾体与大脑结构和功能之间的关系。然而,最近的文献表明,不同配方的绝经后激素在不同时间、通过不同的给药途径、与孕激素以不同的组合给予,与大脑结果的关系各不相同。我们认为,仍需要进一步的研究来了解绝经后雌激素撤退或治疗引起的结构变化如何影响认知功能。然而,影像学研究是时间密集型、资源密集型和专业知识密集型的。我们相信,这些信息将有助于揭示机制和关系,从而有助于解释绝经对大脑的影响以及这种与绝经相关的激素变化如何影响病理性衰老的风险的个体差异。