Walsh Melissa Jm, Gibson Kathryn, Gray Reese M, McNeal Mila, Lynch Lucia S, Kang Michelle, Brierley James, Bondy Erin, Dichter Gabriel S, Schiller Crystal Edler
Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
J Cereb Blood Flow Metab. 2025 Jun 19:271678X251348865. doi: 10.1177/0271678X251348865.
Molecular neuroimaging is a powerful tool for studying ovarian steroid effects on the brain. We systematically reviewed non-clinical studies of female reproductive transitions, ovarian suppression, or estradiol (E2) and/or progesterone (P4) administration. Most studies used ≤3T [H]MRS to study neurometabolites or PET imaging of glucose metabolism and serotoninergic activity. Results suggest ovarian steroids dynamically influence neurometabolic activity and serotonin neurotransmission. Elevated E2, whether during the late follicular phase or with postmenopausal administration, enhanced glucose-related metabolic activity and excitatory serotonin signaling, while low postmenopausal E2 may shift metabolism away from glucose for energy production. Rising P4, whether during the luteal phase or with postmenopausal administration, attenuated regional energy storage potential and glucose metabolism, while amplifying excitatory serotonin signaling. The perinatal transition was less studied, mostly with [H]MRS, and showed non-significant or transient effects. Studies examining outcomes related to neuroprotection, neuroinflammation, and hormone receptor density were limited. We highlight the need for further molecular neuroimaging, including multimodal approaches, to systematically characterize ovarian steroid targets and their molecular context. Advances in MRS and PET offer opportunities to study ovarian steroid effects on neuroplasticity, mitochondrial function, neuroprotection, and neuroinflammation, and there is a need for continued robust prospective longitudinal and experimental studies.
分子神经影像学是研究卵巢类固醇对大脑影响的有力工具。我们系统回顾了关于女性生殖过渡、卵巢抑制或雌二醇(E2)和/或孕酮(P4)给药的非临床研究。大多数研究使用≤3T的[H]磁共振波谱(MRS)来研究神经代谢物,或使用正电子发射断层扫描(PET)成像来研究葡萄糖代谢和5-羟色胺能活性。结果表明,卵巢类固醇动态影响神经代谢活动和5-羟色胺神经传递。E2升高,无论是在卵泡晚期还是绝经后给药时,都会增强与葡萄糖相关的代谢活动和兴奋性5-羟色胺信号,而绝经后低水平的E2可能会使代谢从葡萄糖转向用于能量产生的其他物质。P4升高,无论是在黄体期还是绝经后给药时,都会减弱区域能量储存潜力和葡萄糖代谢,同时增强兴奋性5-羟色胺信号。围产期过渡阶段的研究较少,大多使用[H]MRS,结果显示无显著影响或仅有短暂影响。研究神经保护、神经炎症和激素受体密度相关结果的研究有限。我们强调需要进一步的分子神经影像学研究,包括多模态方法,以系统地表征卵巢类固醇靶点及其分子背景。MRS和PET的进展为研究卵巢类固醇对神经可塑性、线粒体功能、神经保护和神经炎症的影响提供了机会,并且需要持续进行强有力的前瞻性纵向研究和实验研究。