Postmenopausal hormone therapy and regional brain volumes: the WHIMS-MRI Study
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 MedicineDocument Type
Journal ArticlePublication Date
2009-01-13Keywords
Age FactorsAged
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
Metadata
Show full item recordAbstract
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.cfPermanent Link to this Item
http://hdl.handle.net/20.500.14038/50964PubMed ID
19139364Related Resources
ae974a485f413a2113503eed53cd6c53
10.1212/01.wnl.0000339037.76336.cf