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Insulin resistance and medial prefrontal gyrus metabolism in women receiving hormone therapy


Rasgon, Natalie L., Kenna, Heather A., Wroolie, Tonita E., Williams, Katherine E., DeMuth, Bevin N., Silverman, Daniel H. S.


Psychiatry Research, Volume: 223, No.: 1, Pages.: 28-36

Year of Publication



Insulin resistance (IR) is a putative risk factor for cognitive decline and dementia, and has been shown to impede neuronal glucose metabolism in animal models. This post hoc study focused on metabolic changes in the medial prefrontal region, a brain region exhibiting decline years before documented cognitive changes, relative to high or low IR status in a cohort of postmenopausal women at risk for dementia who were randomized to continue or discontinue existing stable hormone therapy (HT) for 2 years. Subjects were dichotomized into high and low IR groups based on the homeostatic model assessment of insulin resistance, which was within clinically normal limits for the group as a whole at both baseline and 2-year follow-up. Results showed that high and low IR groups showed significant differences in metabolic decline of the medial prefrontal gyrus, regardless of HT randomization group. However, HT randomization was predictive of metabolic decline only in women with low HOMA (homeostatic assessment of insulin resistance). Performance in working memory was consistent with observed metabolic changes. These results suggest IR may be an independent moderator of regional metabolic changes, while protective metabolic effects of HT are most apparent in those at low-end range of IR. If replicated in future studies, these findings will help to better understand the interaction between putative risk and protective factors, and further delineate cohort postmenopausal women who may benefit from HT. ; Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

Bibtex Citation

@article{Rasgon_2014, doi = {10.1016/j.pscychresns.2014.04.004}, url = {}, year = 2014, month = {jul}, publisher = {Elsevier {BV}}, volume = {223}, number = {1}, pages = {28--36}, author = {Natalie L. Rasgon and Heather A. Kenna and Tonita E. Wroolie and Katherine E. Williams and Bevin N. DeMuth and Daniel H.S. Silverman}, title = {Insulin resistance and medial prefrontal gyrus metabolism in women receiving hormone therapy}, journal = {Psychiatry Research: Neuroimaging} }


adverse effects, aged, and, changes, dementia, estrogen replacement therapy, estrogens, female, gyrus cinguli, homeostasis, hormone therapy, humans, insulin resistance, medial prefrontal gyrus, memory, menopause, metabolic, metabolism, middle aged, models biological, neuropsychological tests, physiology, postmenopause, prefrontal cortex, progesterone, risk factors, therapeutic use, working

Countries of Study


Types of Dementia

Mild Cognitive Impairment (MCI)

Types of Study

Randomised Controlled Trial

Type of Outcomes

ADLs/IADLs, Other



Type of Interventions

Risk Factor Modification

Risk Factor Modifications

At risk population