Effects of Aging and Estrogen on Memory and Cognition
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Purpose
This study will focus on how aging affects changes in the way the brain works when affected by estrogen in areas of the brain associated with memory.
| Condition | Intervention |
|---|---|
|
Memory Loss Cognitive Changes Postmenopausal Symptoms |
Drug: Estradiol |
| Study Type: | Interventional |
| Study Design: | Allocation: Randomized Endpoint Classification: Efficacy Study Intervention Model: Crossover Assignment Masking: Double Blind (Subject, Caregiver, Investigator, Outcomes Assessor) Primary Purpose: Treatment |
| Official Title: | Effects of Aging and Estrogen on Cortical Function |
- Neuroimaging changes in response to estrogen [ Time Frame: 48 hrs and 28-30 days ] [ Designated as safety issue: No ]
- Neuropsychological testing changes in response to receiving estradiol [ Time Frame: 48 hrs and 28-30 days ] [ Designated as safety issue: No ]
| Estimated Enrollment: | 60 |
| Study Start Date: | November 2009 |
| Estimated Study Completion Date: | September 2013 |
| Estimated Primary Completion Date: | September 2013 (Final data collection date for primary outcome measure) |
| Arms | Assigned Interventions |
|---|---|
| Postmenopausal women 45-55 years old |
Drug: Estradiol
1mg/day for 30 days administered through a capsule
Other Name: Micronized Estradiol from Mylan Pharmaceuticals
|
| Postmenopausal women 65-80 years old |
Drug: Estradiol
1mg/day for 30 days administered through a capsule
Other Name: Micronized Estradiol from Mylan Pharmaceuticals
|
| Women with Premature Ovarian Insufficiency (POI) < 45 yrs |
Drug: Estradiol
1mg/day for 30 days administered through a capsule
Other Name: Micronized Estradiol from Mylan Pharmaceuticals
|
Detailed Description:
The broad goal of this proposal is to determine the effect of aging on areas of the brain whose function is impacted by gonadal steroids in women. The overarching hypothesis is that aging differentially alters the effects of estrogen on the brain. Our preliminary data indicate that aging alters the effect of estrogen on brain regions involved in cognition and thus, the current proposal will focus on the impact of aging on functional changes induced by estrogen in cortical and subcortical areas associated with verbal working memory and declarative/episodic memory. As our model, we will use women in whom the absence of gonadal function makes it possible to control the duration and amount of estrogen exposure, specifically young women with Premature Ovarian Insufficiency (POI) < 45 yrs. old (but diagnosed at < 40 yrs.) and postmenopausal women who are younger (45-55) or older (65-80). We will investigate the effects of both short-term (48 hr) and prolonged (28-30 days) estrogen exposure to determine whether the changes in brain regions involved in cognition that were seen with short-term estrogen exposure persist with prolonged exposure, a finding that would have enormous clinical relevance. These studies, using sophisticated neuroimaging tools (structural and functional magnetic resonance imaging [MRI] and [18F] 2-fluoro-2-deoxy-D-glucose positron emission tomography [FDG-PET]), provide a unique window into the brain in the human.
Eligibility| Ages Eligible for Study: | 18 Years to 80 Years |
| Genders Eligible for Study: | Female |
| Accepts Healthy Volunteers: | Yes |
Inclusion Criteria
Three groups of menopausal women will be recruited for these studies:
- young (age 45-55)
- older (age65-80) postmenopausal women (PMW)
- women with Premature Ovarian Insufficiency (POI) < 45 yrs. old (but diagnosed at < 40 yrs.)
- The subjects will be otherwise healthy, non-obese women, normotensive and non-smokers
- History of normal menopause, defined by the absence of menses for at least 12 months
Subjects with premature menopause will have had:
- menarche between the ages of 10 and 15
- regular menstrual cycles before the onset of ovarian failure at < 35
- at least 1 year of amenorrhea before study or no unscheduled menses while on HRT (discontinued at least 3 months before study, as above)
- have normal adrenal function and not be carriers for the Fragile X premutation
- FSH > 26 IU/L (2nd IRP HMG) and E2 < 25 pg/mL at screening and on the initial day of study and normal TSH, and Factor V activity
- Normal or corrected normal vision
- IQ > 70 on the Wechsler Adult Reading Test (WTAR)*
- Absence of Mild Cognitive Impairment (MCI) and depression on the Mini Mental State Examination (MMSE)** and Beck Depression Inventory II (BDI-II).***
- Normal mammogram or breast MRI within the past 2 years (age 45 and older only).
Exclusion Criteria
- On gonadal hormone replacement medication, herbal supplements and/or over the counter menopause treatment for within three months of study
- History of radiotherapy or chemotherapy.
- Absolute contraindications to the use of physiologic replacement doses of estrogen and/or history of coronary artery disease
- History of breast cancer, blood clot, pulmonary embolus, hypercoagulability and stroke.
- On centrally acting medications
- History of head trauma and/or neurologic disorder
- Contraindication to MRI (eg. metal implants) or PET imaging (eg. PET imaging studies in the previous 12 months)
- Concurrent participation in research studies involving medications and/or PET scans.
- Left handedness.
- Current breast lump(s) or family/genetic history of breast cancer in younger women (< 40 years old).
Contacts and Locations| Contact: Taylor A Huhta, BA | 617-726-5384 | thuhta@partners.org |
| United States, Massachusetts | |
| Reproductive Endocrine Unit, Massachusetts General Hospital | Recruiting |
| Boston, Massachusetts, United States, 02114 | |
| Principal Investigator: | Janet E Hall, MD | Massachusetts General Hospital |
More Information
No publications provided
| Responsible Party: | Janet E. Hall, MD, Associate Physician, Massachusetts General Hospital |
| ClinicalTrials.gov Identifier: | NCT01268046 History of Changes |
| Other Study ID Numbers: | 2009P-002311, R01AG013241 |
| Study First Received: | December 28, 2010 |
| Last Updated: | April 22, 2013 |
| Health Authority: | United States: Institutional Review Board |
Keywords provided by Massachusetts General Hospital:
|
aging postmenopausal women estrogen memory |
Additional relevant MeSH terms:
|
Memory Disorders Amnesia Neurobehavioral Manifestations Neurologic Manifestations Nervous System Diseases Signs and Symptoms Delirium, Dementia, Amnestic, Cognitive Disorders Mental Disorders Estradiol Polyestradiol phosphate Estrogens |
Estradiol valerate Estradiol 3-benzoate Estradiol 17 beta-cypionate Hormones Hormones, Hormone Substitutes, and Hormone Antagonists Physiological Effects of Drugs Pharmacologic Actions Contraceptive Agents Reproductive Control Agents Therapeutic Uses Contraceptive Agents, Female |
ClinicalTrials.gov processed this record on June 17, 2013