Short-term hormone treatment modulates emotion response circuitry in postmenopausal women

Abstract

Objective: To study the effects of combination hormone therapy (HT) on emotional processing in postmenopausal women with use of functional neuroimaging.

Design: A randomized, double-blind, placebo-controlled crossover study was performed.

Setting: A tertiary care university medical center.

Participant(s): Ten healthy postmenopausal women (mean age 56.9 years, SD = 1.4 years) were recruited.

Intervention(s): Women were assigned randomly to the order they received combined HT, 5 microg ethinyl E(2) and 1 mg norethindrone acetate, and placebo. Volunteers received HT or placebo for 4 weeks, followed by a 1-month washout period, and then received the other treatment for 4 weeks. Subjects participated in a functional magnetic resonance imaging emotional processing task, where they were asked to rate emotional pictures as positive, negative, or neutral.

Main outcome measure(s): Brain activation patterns were compared between HT and placebo conditions within subjects.

Result(s): During negative emotional presentations, after subtracting the effect of neutral images, areas of significant differences between HT and placebo conditions were identified in the orbital, frontal, cingulate, and occipital cortices. During positive emotional image presentation there were significant differences between placebo and HT conditions within the medial frontal cortex.

Conclusions: Short-term menopausal treatment with combination HT affects regional brain activity within areas implicated in emotional processing.