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结合静息态功能磁共振成像评估绝经激素治疗对围绝经期女性认知障碍影响的研究进展
作者:彭维1 3  陈梦珠2  施勇2  高丽婷1  彭丹红2 
单位:1. 东南大学医学院 妇产科, 江苏 南京 210009;
2. 东南大学附属中大医院 妇产科, 江苏 南京 210009;
3. 贵州中医药大学第一附属医院 产科, 贵州 贵阳 550001
关键词:围绝经期 认知功能障碍 雌激素 绝经激素治疗 静息态功能磁共振成像 
分类号:R445.2; R711.75
出版年·卷·期(页码):2023·42·第六期(939-944)
摘要:

围绝经期女性由于雌激素水平的下降、睡眠障碍、抑郁或焦虑等各种原因会有不同程度的认知功能变化。目前关于绝经激素治疗(MHT)对认知功能影响的研究结果没有定论,这可能与研究设计、MHT类型、启动时机、用药时限或研究纳入人群的差异等有关。功能磁共振成像是一种能髙效、安全、无创地检查、定位和探索大脑的语言、记忆等功能的重要工具,目前已广泛应用于神经心理学和神经系统疾病影像学等领域的研究,并趋于静息态功能磁共振成像(rs-fMRI)的研究。本文作者将综述已有研究成果,包括对围绝经期女性认知障碍现状及机制,尤其是雌激素对认知功能影响相关机制; MHT在认知功能下降和痴呆中的作用及更年期女性认知功能改变相关磁共振成像的研究现状等进行归纳和阐述。

参考文献:

[1] WANG M,KARTSONAKI C,GUO Y,et al.Factors related to age at natural menopause in China: results from the China Kadoorie Biobank[J].Menopause,2021, 28(10):1130-1142.
[2] 郁琦,崔小娟.绝经激素治疗临床应用争议及展望[J].中国计划生育和妇产科, 2022,14(1): 3-6, 28.
[3] GREENDALE G A,KARLAMANGLA A S,MAKI P M.The menopause transition and cognition[J].JAMA,2020,323(15):1495.
[4] No authors listed.Risk reduction of cognitive decline and dementia:WHO Guidelines[M]. Geneva:World Health Organization,2019:1-77.
[5] LIVINGSTON G,HUNTLEY J,SOMMERLAD A,et al.Dementia prevention, intervention, and care: 2020 report of the Lancet Commission[J].The Lancet,2020, 396(10248):413-446.
[6] DOMINGUEZ L J,VERONESE N,VERNUCCIO L,et al.Nutrition, physical activity, and other lifestyle factors in the prevention of cognitive decline and dementia[J].Nutrients,2021,13(11):4080.
[7] BIMONTE-NELSON H A,BERNAUD V E,KOEBELE S V.Menopause, hormone therapy and cognition: maximizing translation from preclinical research[J].Climacteric,2021,24(4):373-381.
[8] KANE R L,BUTLER M,FINK H A,et al.Interventions to prevent age-related cognitive decline, mild cognitive impairment, and clinical Alzheimer's-type dementia[M].Rockville(MD):Agency for Healthcare Research and Quality(US), 2017: 1-205.
[9] CONDE D M,VERDADE R C,VALADARES A L R,et al.Menopause and cognitive impairment: a narrative review of current knowledge[J].World Journal of Psychiatry,2021,11(8):412-428.
[10] GEORGAKIS M K,BESKOU-KONTOU T,THEODORIDIS I,et al.Surgical menopause in association with cognitive function and risk of dementia: a systematic review and meta-analysis[J].Psychoneuroendocrinology,2019,106:9-19.
[11] DESIDERI G,BOCALE R.Is there a relationship between blood pressure values and dementia?[J].European Heart Journal Supplements,2020, 22(Supplement_L): L61-L65.
[12] DURAZZO T C,MATTSSON N,WEINER M W.Smoking and increased Alzheimer's disease risk: a review of potential mechanisms[J].Alzheimer's & Dementia,2014,10(3S):S122-S145.
[13] KUANG Z.Effect of combined antihypertensive and lipid-lowering therapies on cognitive function: a new treatment strategy?[J].Cardiology Research and Practice,2020,2020:1-10.
[14] ZILLIOX L A,CHADRASEKARAN K,KWAN J Y,et al.Diabetes and cognitive impairment[J].Current Diabetes Reports,2016,16(9):87.
[15] ETTINGER S.Diet,gut microbiome, and cognitive decline[J].Current Nutrition Reports,2022,11(4):643-652.
[16] DYE L,BOYLE N B,CHAMPC,et al.The relationship between obesity and cognitive health and decline[J].Proceedings of the Nutrition Society,2017,76(4): 443-454.
[17] ARFANAKIS K,WILSON R S,BARTH C M,et al.Cognitive activity, cognitive function, and brain diffusion characteristics in old age[J].Brain Imaging and Behavior, 2016,10(2):455-463.
[18] CLOUSTON S A P,SMITH D M,MUKHERJEES,et al.Education and cognitive decline: an integrative analysis of global longitudinal studies of cognitive aging[J].The Journals of Gerontology: Series B,2020,75(7):e151-e160.
[19] SMALL B J,DIXON R A,MCARDLE J J,et al.Do changes in lifestyle engagement moderate cognitive decline in normal aging? Evidence from the Victoria Longitudinal Study[J].Neuropsychology,2012,26(2):144-155.
[20] NEEDHAM L P,LU K,NICHOLAS J M,et al.A comprehensive assessment of age at menopause with well-characterized cognition at 70 years: a population-based British birth cohort[J].Maturitas,2023,170:31-38.
[21] SOCHOCKA M,KARSKA J,PSZCZOȽOWSKA M,et al.Cognitivedecline in early and premature menopause[J].International Journal of Molecular Sciences,2023,24(7):6566.
[22] LAVEN J S E.Early menopause results from instead of causes premature general ageing[J].Reproductive BioMedicine Online,2022,45(3):421-424.
[23] DI CARLO A,BALDERESCHI M,AMADUCCI L,et al.Incidence of dementia, Alzheimer's disease, and vascular dementia in Italy.The ILSA Study[J].J Am Geriatr Soc,2002,50(1):41-48.
[24] RENTZ D M,WEISS B K,JACOBS E G,et al.Sex differences in episodic memory in early midlife: impact of reproductive aging[J].Menopause,2017,24(4): 400-408.
[25] SULLIVAN MITCHELL E,FUGATE WOODS N.Midlife women's attributions about perceived memory changes: observations from the seattle midlife women's health study[J].Journal of Women's Health & Gender-Based Medicine,2001,10(4): 351-362.
[26] VAARI T,ENGBLOM J,HELENIUS H,et al.Survey of sleep problems in 3 421 women aged 41-55 years[J].Menopause Int,2008,14(2):78-82.
[27] GOLD E B.Relation of demographic and lifestyle factors to symptoms in a multi-racial/ethnic population of women 40-55 years of age[J].American Journal of Epidemiology,2000,152(5):463-473.
[28] FUH J,WANG S,LEE S,et al.A longitudinal study of cognition change during early menopausal transition in a rural community[J].Maturitas,2006,53(4):447-453.
[29] MAKI P M,SPRINGER G,ANASTOS K,et al.Cognitive changes during the menopausal transition: a longitudinal study in women with and without HIV[J].Menopause,2021,28(4):360-368.
[30] 明浩,邱珍,夏中元.女性卵巢激素与睡眠和认知功能的关系[J].医学综述,2018,24(22):4523-4527.
[31] STEFANOWSKI B,KUCHARSKI M,SZELIGA A,et al.Cognitive decline and dementia in women after menopause: prevention strategies[J].Maturitas,2023,168: 53-61.
[32] HAN X,AENLLE K K,BEAN L A,et al.Role of estrogen receptor α and β in preserving hippocampal function during aging[J].The Journal of Neuroscience,2013, 33(6):2671-2683.
[33] ZHU D,MONTAGNE A,ZHAO Z.Alzheimer's pathogenic mechanisms and underlying sex difference[J].Cellular and Molecular Life Sciences,2021,78(11): 4907-4920.
[34] ISING C,STANLEY M,HOLTZMAN D M.Current thinking on the mechanistic basis of Alzheimer's and implications for drug development[J].Clinical Pharmacology & Therapeutics,2015,98(5):469-471.
[35] REDDY P H,TONK S,KUMAR S,et al.A critical evaluation of neuroprotective and neurodegenerative MicroRNAs in Alzheimer's disease[J].Biochemical and Biophysical Research Communications,2017,483(4):1156-1165.
[36] BARRETO G E.Targeting astrocytes in brain injuries: a translational research approach[J].Progress in Neurobiology,2016,144:1-4.
[37] HU H,TAN C,TAN L,et al.A mitocentric view of Alzheimer's disease[J].Molecular Neurobiology,2017,54(8):6046-6060.
[38] 孙畅,赵世刚.卒中后认知障碍与内分泌激素变化的关系[J].中国伤残医学,2014,22(6):322-324.
[39] PERTESI S,COUGHLAN G,PUTHUSSERYPPADY V,et al.Menopause, cognition and dementia —a review[J].Post Reproductive Health,2019,25(4): 200-206.
[40] 郭威.静息态功能磁共振在围绝经期女性认知改变中的研究[D].泰安:泰山医学院,2018.
[41] 中华医学会妇产科学分会绝经学组.中国绝经管理与绝经激素治疗指南2023版[J].中华妇产科杂志,2023,58(1):4-21.
[42] SAVOLAINEN-PELTONEN H,RAHKOLA-SOISALO P,HOTI F,et al.Use of postmenopausal hormone therapy and risk of Alzheimer's disease in Finland: nationwide case-control study[J].BMJ,2019,364:l665.
[43] STUTE P,WIENGES J,KOLLER A,et al.Cognitive health after menopause: Does menopausal hormone therapy affect it?[J].Best Practice & Research Clinical Endocrinology & Metabolism,2021,35(6):101565.
[44] SHUMAKER S A.Conjugated equine estrogens and incidence of probable dementia and mild cognitive impairment in postmenopausal women: women's health initiative memory study[J].JAMA,2004,291(24):2947.
[45] IMTIAZ B,TAIPALE H,TANSKANEN A,et al.Risk of Alzheimer's disease among users of postmenopausal hormone therapy: a nationwide case-control study[J].Maturitas,2017,98:7-13.
[46] 张倩.激素替代治疗对绝经后女性认知功能影响的Meta分析[D].唐山:华北理工大学,2021.
[47] BOVE R,SECOR E,CHIBNIK L B,et al.Age at surgical menopause influences cognitive decline and Alzheimer pathology in older women[J].Neurology,2014,82(3): 222-229.
[48] HENDERSON V W,JOHN J A S,HODIS H N,et al.Cognitive effects of estradiol after menopause[J].Neurology,2016,87(7):699-708.
[49] EVANS I E M,MARTYR A,COLLINS R,et al.Social isolation and cognitive function in later life: a systematic review and Meta-analysis[J].Journal of Alzheimer's Disease,2019,70(s1):S119-S144.
[50] SHAO H,BREITNER J C S,WHITMER R A,et al.Hormone therapy and Alzheimer disease dementia: new findings from the Cache County Study[J].Neurology,2012,79(18):1846-1852.
[51] GLEASON C E,DOWLING N M,WHARTON W,et al.Effects of hormone therapy on cognition and mood in recently postmenopausal women: findings from the randomized, controlled KEEPS-cognitive and affective study[J].PLoS Medicine,2015,12(6):e1001833.
[52] KARIM R,DANG H,HENDERSON V W,et al.Effect of reproductive history and exogenous hormone use on cognitive function in mid- and late life[J].Journal of the American Geriatrics Society,2016,64(12):2448-2456.
[53] SMITHA K A,AKHIL RAJA K,ARUN K M,et al.Resting state fMRI: a review on methods in resting state connectivity analysis and resting state networks[J].The Neuroradiology Journal,2017,30(4):305-317.
[54] OGAWA S,MENON R S,KIM S G,et al.On the characteristics of functional magnetic resonance imaging of the brain[J].Annual Review of Biophysics and Biomolecular Structure,1998,27(1):447-474.
[55] BRINTON R D.Oestrogen therapy affects brain structure but not function[J].Nature Reviews Neurology,2016,12(10):561-562.
[56] NABULSI L,LAWRENCE K E,SANTHALINGAM V,et al.Exogenous sex hormone effects on brain microstructure in women: a diffusion MRI study in the UK Biobank[Z].Cold Spring Harbor:Cold Spring Harbor Laboratory Press,2023:1-11.
[57] BUCKLEY R F,O'DONNELL A,MCGRATH E R,et al.Menopause status moderates sex differences in tau burden: a framingham PET study[J].Ann Neurol, 2022,92(1):11-22.
[58] GAVA G,ORSILI I,ALVISI S,et al.Cognition, mood and sleep in menopausal transition: the role of menopause hormone therapy[J].Medicina,2019,55(10):668.
[59] GIRARD R,MÉTÉREAU E,THOMAS J,et al.Hormone therapy at early post-menopause increases cognitive control-related prefrontal activity[J].Scientific Reports,2017,7(1):44917.
[60] JACOBS E G,WEISS B K,MAKRIS N,et al.Impact of sex and menopausal status on episodic memory circuitry in early midlife[J].The Journal of Neuroscience,2016,36(39):10163-10173.
[61] BERENT-SPILLSON A,KELLEY A S,PERSAD C C,et al.Postmenopausal hormone treatment alters neural pathways but does not improve verbal cognitive function[J].Menopause,2018,25(12):1424-1431.
[62] VEGA J N,ZURKOVSKY L,ALBERT K,et al.Altered brain connectivity in early postmenopausal women with subjective cognitive impairment[J].Frontiers in Neuroscience,2016,10:433.
[63] VON LEUPOLDT A,SOMMER T,KEGAT S,et al.Theunpleasantness of perceived dyspnea is processed in the anterior insula and amygdala[J].American Journal of Respiratory and Critical Care Medicine,2008,177(9):1026-1032.
[64] ZHANG S,HU J,FAN W,et al.Aberrant cerebral activity in early postmenopausal women: a resting-state functional magnetic resonance imaging study[J].Frontiers in Cellular Neuroscience,2018,12(454):1-10.
[65] 刘宁宁.围绝经期女性认知功能的多模态磁共振成像研究[D].天津:天津医科大学,2020.

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