Postmenopausal hormone treatment alters neural pathways but does not improve verbal cognitive function

Area of Science:

• Neuroscience
• Cognitive Science
• Endocrinology

Background:

• Cognitive outcomes of postmenopausal hormone treatment trials are inconsistent.
• Previous research showed benefits on visual function, but effects on verbal function remain unclear.
• Understanding the impact of hormone therapy timing and duration on cognitive domains is crucial.

Purpose of the Study:

• To investigate the effects of prior versus current hormone treatment on verbal function in postmenopausal women.
• To examine neural activation patterns during a verbal task using functional magnetic resonance imaging (fMRI).
• To correlate brain activity with verbal performance metrics.

Main Methods:

• Cross-sectional study of 57 postmenopausal women (38 hormone users, 19 never-users).
• Hormone users received conjugated equine estrogens with or without medroxyprogesterone acetate for at least 10 years, starting within 2 years of menopause.
• Verbal function assessed using the Hopkins Verbal Learning Test and an fMRI-based verbal discrimination task.

Main Results:

• No significant differences in overall verbal function scores between hormone users and never-users.
• Women ever treated with hormones exhibited increased activation in the left inferior frontal and right prefrontal cortex during the verbal task.
• Hormone-treated women showed slower response times (P=0.03) and a trend towards poorer verbal recall.

Conclusions:

• Hormone treatment alters neural pathways involved in verbal discrimination but does not enhance verbal function.
• Increased frontal activation in hormone users correlated with less efficient cognitive processing, indicated by slower responses and poorer recall.
• Findings suggest that long-term hormone therapy may not benefit, and could potentially impair, verbal cognitive function.