Premenopausal Bilateral Oophorectomy Before Age 40 Affects Brain White Matter

2024-07-09

TUESDAY, July 9, 2024 -- Women who undergo premenopausal bilateral oophorectomy (PBO) before age 40 years have reduced brain white matter integrity in later life, according to a study published online June 20 in Alzheimer's & Dementia.

Michelle M. Mielke, Ph.D., from Wake Forest University School of Medicine in Winston-Salem, North Carolina, and colleagues assessed the impact of PBO and PBO age on white matter integrity in later life. Data were included for participants with regional diffusion tensor imaging metrics of fractional anisotropy (FA) and mean diffusivity (MD; 22 with PBO at younger than 40 years, 43 with PBO at ages 40 to 45 years, 39 with PBO at ages 46 to 49 years, and 907 referents without PBO at younger than 50 years).

The researchers found that compared with referents, women with PBO at younger than 40 years had lower FA and higher MD in the anterior corona radiata, genu of the corpus collosum, inferior fronto-occipital fasciculus, superior occipital, and superior temporal white matter. Some changes in white matter integrity were also seen in women who underwent PBO at ages 45 to 49 years.

"PBO results in abrupt decreases in both estrogen and testosterone in women," the authors write. "Given the effects of testosterone on brain white matter, and the result in our study that most women who underwent PBO used estrogen replacement therapy but still have reduced white matter integrity, it may be hypothesized that the explanation for our results is in part due to loss of testosterone."

One author disclosed ties to the pharmaceutical industry.

Abstract/Full Text

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