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Association of Bilateral Salpingo-Oophorectomy Before Menopause Onset With Medial Temporal Lobe Neurodegeneration
Burcu Zeydan1,2, Nirubol Tosakulwong3, Christopher G Schwarz1
1Department of Radiology, Mayo Clinic, Rochester, Minnesota.
JAMA Neurology
|October 17, 2018
Summary
Bilateral salpingo-oophorectomy before menopause in women under 50 was linked to smaller amygdala volume and thinner entorhinal cortex. These findings suggest potential medial temporal lobe changes, warranting further study on cognitive decline.
Area of Science:
- Neuroscience
- Endocrinology
- Radiology
Background:
- Premenopausal bilateral salpingo-oophorectomy (BSO) increases dementia risk.
- Limited data exist on BSO's impact on neuroimaging biomarkers for medial temporal lobe neurodegeneration and Alzheimer's disease.
Purpose of the Study:
- To investigate medial temporal lobe structure, white matter lesions, and beta-amyloid deposition in premenopausal women (<50 years) who underwent BSO.
Main Methods:
- Nested case-control study using data from the Mayo Clinic Cohort Study of Oophorectomy and Aging-2 (MOA-2) and Mayo Clinic Study of Aging (MCSA).
- Included women who underwent BSO before natural menopause and age 50, compared to controls.
- Evaluated participants using neuropsychological testing, structural MRI, and Pittsburgh Compound B Positron Emission Tomography (PiB-PET).
Main Results:
- Women who underwent BSO showed significantly smaller amygdala volume (P<.001), thinner parahippocampal-entorhinal cortex (P=.046), and lower entorhinal white matter fractional anisotropy (P=.03) compared to controls.
- Despite structural differences, global cognitive status did not differ between groups at the time of imaging.
- Estrogen therapy use differed between groups (96% BSO vs. 53% control).
Conclusions:
- Premenopausal BSO may induce medial temporal lobe structural abnormalities due to abrupt hormonal changes.
- Further longitudinal studies are required to determine if these structural changes precede cognitive decline.
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