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Disturbed sleep is associated with reduced verbal episodic memory and entorhinal cortex volume in younger middle-aged women with risk-reducing early ovarian removal
Univ Toronto, Canada; Rotman Res Inst Baycrest Hlth Sci, Canada; Univ Groningen, Netherlands.
Univ Toronto, Canada.
Univ Toronto, Canada.
Univ Toronto, Canada.
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2023 (English)In: Frontiers in Endocrinology, ISSN 1664-2392, E-ISSN 1664-2392, Vol. 14, article id 1265470Article in journal (Refereed) Published
Abstract [en]

Introduction: Women with early ovarian removal (<48 years) have an elevated risk for both late-life Alzheimers disease (AD) and insomnia, a modifiable risk factor. In early midlife, they also show reduced verbal episodic memory and hippocampal volume. Whether these reductions correlate with a sleep phenotype consistent with insomnia risk remains unexplored. Methods: We recruited thirty-one younger middleaged women with risk-reducing early bilateral salpingo-oophorectomy (BSO), fifteen of whom were taking estradiol-based hormone replacement therapy (BSO+ERT) and sixteen who were not (BSO). Fourteen age-matched premenopausal (AMC) and seventeen spontaneously peri-postmenopausal (SM) women who were similar to 10y older and not taking ERT were also enrolled. Overnight polysomnography recordings were collected at participants home across multiple nights (M=2.38 SEM=0.19), along with subjective sleep quality and hot flash ratings. In addition to group comparisons on sleep measures, associations with verbal episodic memory and medial temporal lobe volume were assessed. Results: Increased sleep latency and decreased sleep efficiency were observed on polysomnography recordings of those not taking ERT, consistent with insomnia symptoms. This phenotype was also observed in the older women in SM, implicating ovarian hormone loss. Further, sleep latency was associated with more forgetting on the paragraph recall task, previously shown to be altered in women with early BSO. Both increased sleep latency and reduced sleep efficiency were associated with smaller anterolateral entorhinal cortex volume. Discussion: Together, these findings confirm an association between ovarian hormone loss and insomnia symptoms, and importantly, identify an younger onset age in women with early ovarian removal, which may contribute to poorer cognitive and brain outcomes in these women.

Place, publisher, year, edition, pages
FRONTIERS MEDIA SA , 2023. Vol. 14, article id 1265470
Keywords [en]
bilateral salpingo-oophorectomy; BRCA1/2; estradiol; sleep phenotype; verbal episodic memory; structural neuroimaging; entorhinal cortex
National Category
Endocrinology and Diabetes
Identifiers
URN: urn:nbn:se:liu:diva-198973DOI: 10.3389/fendo.2023.1265470ISI: 001084842300001PubMedID: 37859979OAI: oai:DiVA.org:liu-198973DiVA, id: diva2:1810135
Note

Funding Agencies|This work was supported by the Wilfred and Joyce Posluns Chair in Womens Brain Health and Aging (GE; WJP-150643), the Alzheimers Association Research Fellowship and Brain Canada Foundation (AARF-17-504715; NJG); Canadian Institutes of Health Research (CI [WJP-150643]; Joyce Posluns Chair in Womens Brain Health and Aging; Alzheimers Association Research Fellowship [AARF-17-504715]; Brain Canada Foundation [CNA 163902, MOP-143311]; Canadian Institutes of Health Research (CIHR); CIHR Masters award [310336]; Canadian Cancer Society; Ontario Brain Institute; Alzheimers Society of Canada; Womens Brain Health Initiative; NSERC Postgraduate Scholarships Doctoral Award; Ontario Graduate Scholarship award; General Motors Women in Science and Mathematics Award

Available from: 2023-11-07 Created: 2023-11-07 Last updated: 2023-11-07

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