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    Postmenopausal hormone therapy and regional brain volumes: the WHIMS-MRI Study

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    Authors
    Resnick, Susan M.
    Espeland, Mark A.
    Jaramillo, Sarah A.
    Hirsch, C.
    Stefanick, Marcia L.
    Murray, A. M.
    Ockene, Judith K.
    Davatzikos, C.
    UMass Chan Affiliations
    Department of Medicine, Division of Preventive and Behavioral Medicine
    Document Type
    Journal Article
    Publication Date
    2009-01-13
    Keywords
    Age Factors
    Aged
    Atrophy
    Brain
    Causality
    Cognition Disorders
    Dementia
    Estrogen Replacement Therapy
    Estrogens
    Estrogens, Conjugated (USP)
    Female
    Hippocampus
    Humans
    Magnetic Resonance Imaging
    Neuropsychological Tests
    Prefrontal Cortex
    Life Sciences
    Medicine and Health Sciences
    Women's Studies
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    Link to Full Text
    https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2677493/
    Abstract
    OBJECTIVES: To determine whether menopausal hormone therapy (HT) affects regional brain volumes, including hippocampal and frontal regions. METHODS: Brain MRI scans were obtained in a subset of 1,403 women aged 71-89 years who participated in the Women's Health Initiative Memory Study (WHIMS). WHIMS was an ancillary study to the Women's Health Initiative, which consisted of two randomized, placebo-controlled trials: 0.625 mg conjugated equine estrogens (CEE) with or without 2.5 mg medroxyprogesterone acetate (MPA) in one daily tablet. Scans were performed, on average, 3.0 years post-trial for the CEE + MPA trial and 1.4 years post-trial for the CEE-Alone trial; average on-trial follow-up intervals were 4.0 years for CEE + MPA and 5.6 years for CEE-Alone. Total brain, ventricular, hippocampal, and frontal lobe volumes, adjusted for age, clinic site, estimated intracranial volume, and dementia risk factors, were the main outcome variables. RESULTS: Compared with placebo, covariate-adjusted mean frontal lobe volume was 2.37 cm(3) lower among women assigned to HT (p = 0.004), mean hippocampal volume was slightly (0.10 cm(3)) lower (p = 0.05), and differences in total brain volume approached significance (p = 0.07). Results were similar for CEE + MPA and CEE-Alone. HT-associated reductions in hippocampal volumes were greatest in women with the lowest baseline Modified Mini-Mental State Examination scores (scoresCONCLUSIONS: Conjugated equine estrogens with or without MPA are associated with greater brain atrophy among women aged 65 years and older; however, the adverse effects are most evident in women experiencing cognitive deficits before initiating hormone therapy.
    Source

    Neurology. 2009 Jan 13;72(2):135-42. Link to article on publisher's site

    DOI
    10.1212/01.wnl.0000339037.76336.cf
    Permanent Link to this Item
    http://hdl.handle.net/20.500.14038/50964
    PubMed ID
    19139364
    Related Resources

    Link to Article in PubMed

    ae974a485f413a2113503eed53cd6c53
    10.1212/01.wnl.0000339037.76336.cf
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