Change in brain and lesion volumes after CEE therapies: The WHIMS-MRI studies

Laura H. Coker, Mark A. Espeland, Patricia E. Hogan, Susan M. Resnick, R. Nick Bryan, Jennifer G. Robinson, Joseph S. Goveas, Christos Davatzikos, Lewis H. Kuller, Jeff D. Williamson, Cheryl D. Bushnell, Sally A. Shumaker

Research output: Contribution to journalArticle

Abstract

Objectives: To determine whether smaller brain volumes in older women who had completed Women's Health Initiative (WHI)-assigned conjugated equine estrogen-based hormone therapy (HT), reported by WHI Memory Study (WHIMS)-MRI, correspond to a continuing increased rate of atrophy an average of 6.1 to 7.7 years later in WHIMS-MRI2. Methods: A total of 1,230 WHI participants were contacted: 797 (64.8%) consented, and 729 (59%) were rescanned an average of 4.7 years after the initial MRI scan. Mean annual rates of change in total brain volume, the primary outcome, and rates of change in ischemic lesion volumes, the secondary outcome, were compared between treatment groups using mixedeffect models with adjustment for trial, clinical site, age, intracranial volumes, and time between MRI measures. Results: Total brain volume decreased an average of 3.22 cm3/y in the active arm and 3.07 cm3/y in the placebo arm (p = 0.53). Total ischemic lesion volumes increased in both arms at a rate of 0.12 cm3/y (p = 0.88). Conclusions: Conjugated equine estrogen-based postmenopausal HT, previously assigned atWHI baseline, did not affect rates of decline in brain volumes or increases in brain lesion volumes during the 4.7 years between the initial and follow-up WHIMS-MRI studies. Smaller frontal lobe volumes were observed as persistent group differences among women assigned to active HT compared with placebo. Women with a history of cardiovascular disease treated with active HT, compared with placebo, had higher rates of accumulation in white matter lesion volume and total brain lesion volume. Further study may elucidate mechanisms that explain these findings.

Original languageEnglish (US)
Pages (from-to)427-434
Number of pages8
JournalNeurology
Volume82
Issue number5
DOIs
StatePublished - Feb 4 2014
Externally publishedYes

Fingerprint

Brain
Women's Health
Hormones
Conjugated (USP) Estrogens
Placebos
Therapeutics
Frontal Lobe
Atrophy
Memory Studies
Therapy
Lesion
Cardiovascular Diseases
Magnetic Resonance Imaging
Clinical Trials
Placebo
Brain Lesion
Estrogen

ASJC Scopus subject areas

  • Clinical Neurology
  • Arts and Humanities (miscellaneous)

Cite this

Coker, L. H., Espeland, M. A., Hogan, P. E., Resnick, S. M., Bryan, R. N., Robinson, J. G., ... Shumaker, S. A. (2014). Change in brain and lesion volumes after CEE therapies: The WHIMS-MRI studies. Neurology, 82(5), 427-434. https://doi.org/10.1212/WNL.0000000000000079

Change in brain and lesion volumes after CEE therapies : The WHIMS-MRI studies. / Coker, Laura H.; Espeland, Mark A.; Hogan, Patricia E.; Resnick, Susan M.; Bryan, R. Nick; Robinson, Jennifer G.; Goveas, Joseph S.; Davatzikos, Christos; Kuller, Lewis H.; Williamson, Jeff D.; Bushnell, Cheryl D.; Shumaker, Sally A.

In: Neurology, Vol. 82, No. 5, 04.02.2014, p. 427-434.

Research output: Contribution to journalArticle

Coker, LH, Espeland, MA, Hogan, PE, Resnick, SM, Bryan, RN, Robinson, JG, Goveas, JS, Davatzikos, C, Kuller, LH, Williamson, JD, Bushnell, CD & Shumaker, SA 2014, 'Change in brain and lesion volumes after CEE therapies: The WHIMS-MRI studies', Neurology, vol. 82, no. 5, pp. 427-434. https://doi.org/10.1212/WNL.0000000000000079
Coker LH, Espeland MA, Hogan PE, Resnick SM, Bryan RN, Robinson JG et al. Change in brain and lesion volumes after CEE therapies: The WHIMS-MRI studies. Neurology. 2014 Feb 4;82(5):427-434. https://doi.org/10.1212/WNL.0000000000000079
Coker, Laura H. ; Espeland, Mark A. ; Hogan, Patricia E. ; Resnick, Susan M. ; Bryan, R. Nick ; Robinson, Jennifer G. ; Goveas, Joseph S. ; Davatzikos, Christos ; Kuller, Lewis H. ; Williamson, Jeff D. ; Bushnell, Cheryl D. ; Shumaker, Sally A. / Change in brain and lesion volumes after CEE therapies : The WHIMS-MRI studies. In: Neurology. 2014 ; Vol. 82, No. 5. pp. 427-434.
@article{55096f21f2054b72976cd64b503eea26,
title = "Change in brain and lesion volumes after CEE therapies: The WHIMS-MRI studies",
abstract = "Objectives: To determine whether smaller brain volumes in older women who had completed Women's Health Initiative (WHI)-assigned conjugated equine estrogen-based hormone therapy (HT), reported by WHI Memory Study (WHIMS)-MRI, correspond to a continuing increased rate of atrophy an average of 6.1 to 7.7 years later in WHIMS-MRI2. Methods: A total of 1,230 WHI participants were contacted: 797 (64.8{\%}) consented, and 729 (59{\%}) were rescanned an average of 4.7 years after the initial MRI scan. Mean annual rates of change in total brain volume, the primary outcome, and rates of change in ischemic lesion volumes, the secondary outcome, were compared between treatment groups using mixedeffect models with adjustment for trial, clinical site, age, intracranial volumes, and time between MRI measures. Results: Total brain volume decreased an average of 3.22 cm3/y in the active arm and 3.07 cm3/y in the placebo arm (p = 0.53). Total ischemic lesion volumes increased in both arms at a rate of 0.12 cm3/y (p = 0.88). Conclusions: Conjugated equine estrogen-based postmenopausal HT, previously assigned atWHI baseline, did not affect rates of decline in brain volumes or increases in brain lesion volumes during the 4.7 years between the initial and follow-up WHIMS-MRI studies. Smaller frontal lobe volumes were observed as persistent group differences among women assigned to active HT compared with placebo. Women with a history of cardiovascular disease treated with active HT, compared with placebo, had higher rates of accumulation in white matter lesion volume and total brain lesion volume. Further study may elucidate mechanisms that explain these findings.",
author = "Coker, {Laura H.} and Espeland, {Mark A.} and Hogan, {Patricia E.} and Resnick, {Susan M.} and Bryan, {R. Nick} and Robinson, {Jennifer G.} and Goveas, {Joseph S.} and Christos Davatzikos and Kuller, {Lewis H.} and Williamson, {Jeff D.} and Bushnell, {Cheryl D.} and Shumaker, {Sally A.}",
year = "2014",
month = "2",
day = "4",
doi = "10.1212/WNL.0000000000000079",
language = "English (US)",
volume = "82",
pages = "427--434",
journal = "Neurology",
issn = "0028-3878",
publisher = "Lippincott Williams and Wilkins",
number = "5",

}

TY - JOUR

T1 - Change in brain and lesion volumes after CEE therapies

T2 - The WHIMS-MRI studies

AU - Coker, Laura H.

AU - Espeland, Mark A.

AU - Hogan, Patricia E.

AU - Resnick, Susan M.

AU - Bryan, R. Nick

AU - Robinson, Jennifer G.

AU - Goveas, Joseph S.

AU - Davatzikos, Christos

AU - Kuller, Lewis H.

AU - Williamson, Jeff D.

AU - Bushnell, Cheryl D.

AU - Shumaker, Sally A.

PY - 2014/2/4

Y1 - 2014/2/4

N2 - Objectives: To determine whether smaller brain volumes in older women who had completed Women's Health Initiative (WHI)-assigned conjugated equine estrogen-based hormone therapy (HT), reported by WHI Memory Study (WHIMS)-MRI, correspond to a continuing increased rate of atrophy an average of 6.1 to 7.7 years later in WHIMS-MRI2. Methods: A total of 1,230 WHI participants were contacted: 797 (64.8%) consented, and 729 (59%) were rescanned an average of 4.7 years after the initial MRI scan. Mean annual rates of change in total brain volume, the primary outcome, and rates of change in ischemic lesion volumes, the secondary outcome, were compared between treatment groups using mixedeffect models with adjustment for trial, clinical site, age, intracranial volumes, and time between MRI measures. Results: Total brain volume decreased an average of 3.22 cm3/y in the active arm and 3.07 cm3/y in the placebo arm (p = 0.53). Total ischemic lesion volumes increased in both arms at a rate of 0.12 cm3/y (p = 0.88). Conclusions: Conjugated equine estrogen-based postmenopausal HT, previously assigned atWHI baseline, did not affect rates of decline in brain volumes or increases in brain lesion volumes during the 4.7 years between the initial and follow-up WHIMS-MRI studies. Smaller frontal lobe volumes were observed as persistent group differences among women assigned to active HT compared with placebo. Women with a history of cardiovascular disease treated with active HT, compared with placebo, had higher rates of accumulation in white matter lesion volume and total brain lesion volume. Further study may elucidate mechanisms that explain these findings.

AB - Objectives: To determine whether smaller brain volumes in older women who had completed Women's Health Initiative (WHI)-assigned conjugated equine estrogen-based hormone therapy (HT), reported by WHI Memory Study (WHIMS)-MRI, correspond to a continuing increased rate of atrophy an average of 6.1 to 7.7 years later in WHIMS-MRI2. Methods: A total of 1,230 WHI participants were contacted: 797 (64.8%) consented, and 729 (59%) were rescanned an average of 4.7 years after the initial MRI scan. Mean annual rates of change in total brain volume, the primary outcome, and rates of change in ischemic lesion volumes, the secondary outcome, were compared between treatment groups using mixedeffect models with adjustment for trial, clinical site, age, intracranial volumes, and time between MRI measures. Results: Total brain volume decreased an average of 3.22 cm3/y in the active arm and 3.07 cm3/y in the placebo arm (p = 0.53). Total ischemic lesion volumes increased in both arms at a rate of 0.12 cm3/y (p = 0.88). Conclusions: Conjugated equine estrogen-based postmenopausal HT, previously assigned atWHI baseline, did not affect rates of decline in brain volumes or increases in brain lesion volumes during the 4.7 years between the initial and follow-up WHIMS-MRI studies. Smaller frontal lobe volumes were observed as persistent group differences among women assigned to active HT compared with placebo. Women with a history of cardiovascular disease treated with active HT, compared with placebo, had higher rates of accumulation in white matter lesion volume and total brain lesion volume. Further study may elucidate mechanisms that explain these findings.

UR - http://www.scopus.com/inward/record.url?scp=84895726348&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84895726348&partnerID=8YFLogxK

U2 - 10.1212/WNL.0000000000000079

DO - 10.1212/WNL.0000000000000079

M3 - Article

C2 - 24384646

AN - SCOPUS:84895726348

VL - 82

SP - 427

EP - 434

JO - Neurology

JF - Neurology

SN - 0028-3878

IS - 5

ER -