Exploring Menopause’s Impact on Women’s Brain Health: Lisa Mosconi, PhD

WATCH TIME: 10 minutes

“We learned from many years of research that the risk of Alzheimer disease (AD) starts to manifest in women’s brains already in midlife. We learned that AD is a disease of midlife with symptoms that become clear on clinical grounds in old age but the most important age to focus on for preventative efforts is midlife.”

A main feature of menopause is the decline in the body’s production of estrogen which can lead to various bodily changes such as the cessation of menstruation, but also to neuropsychiatric effects such as “brain fog,” depression, and anxiety. A newly published brain imaging study in Scientific Reports showed that menopause transition was marked by progressively higher density of estrogen receptors (ER) in brain cells. In addition, the study pioneered the use of positron emission tomography (PET) imaging, suggesting that the technique may be a valuable tool for studying the brain effects of menopause and estrogen therapy.^1,2

In the study, lead author Lisa Mosconi, PhD, and colleagues scanned the brains of 54 healthy women aged 40-65 using PET with a tracer that binds to ERs. All told, using scans at different menopausal stages, findings displayed progressively higher ER density in several estrogen-regulated brain networks in the postmenopausal and perimenopausal groups compared with premenopausal controls. The investigators’ analyses revealed that high ER density in some of these regions was associated not only with menopause status but also with patients’ reports of menopause-related cognitive and mood symptoms.

Mosconi, an associate professor of neuroscience in neurology and radiology, and director of the Women’s Brain Initiative at Weill Cornell Medicine, recently sat down with NeurologyLive^® in an interview to discuss the key neurological changes observed in women’s brains during menopause. She also talked about how the new brain imaging technology developed in 2020 helps in understanding menopause’s impact on the brain. Moreover, Mosconi, who also serves the director of the Alzheimer’s Prevention Program at Weill Cornell Medicine and NewYork-Presbyterian, shared her reaction to the surprising findings about estrogen receptors in women’s brains postmenopause.

REFERENCES
1. Mosconi L, Nerattini M, Matthews DC, et al. In vivo brain estrogen receptor density by neuroendocrine aging and relationships with cognition and symptomatology. Sci Rep. 2024;14(1):12680. Published 2024 Jun 20. doi:10.1038/s41598-024-62820-7
2. Scans Show Brain’s Estrogen Activity Changes During Menopause. News Release. Weill Cornell Medicine. Published June 20, 2024. Accessed July 11, 2024. https://news.weill.cornell.edu/news/2024/06/scans-show-brains-estrogen-activity-changes-during-menopause