title: Menopause Analytical Hormonal Correlate Outcome Study (MAHCOS) and the association to brain electrophysiology (P300) in a clinical setting.
abstract: Various studies have demonstrated that increased leptin levels and obesity are inversely related to cognitive decline in menopausal women. It is hypothesized that adiposity is inversely correlated with cognitive decline, as women with increased weight are less vulnerable to diminishing cognition. However, it is increasingly observed that menopausal women, even with increased adiposity, experience significant cognitive decline. Positron emission tomography (PET) has been used to analyze cognitive function and processing in menopausal women. Evoked potentials (P300) and neurophysiologic tests have validated brain metabolism in cognitively impaired patients. Post-hoc analyses of 796 female patients entering PATH Medical Clinic, between January 4, 2009 and February 24, 2013, were performed as part of the "Menopause Analytical Hormonal Correlate Outcome Study" (MAHCOS). Patient age range was 39-76 years (46.7 ± 0.2). P300 latency and amplitude correlated with a number of hormones: follicle stimulating hormone (FSH), luteinizing hormone (LH), estradiol, estrone, estriol, DHEA, pregnenolone, progesterone, free and total testosterone, thyroid stimulating hormone (TSH), Vitamins D 1.25 and D 25OH, leptin, and insulin-like growth factor-binding protein 3 (IGF-BP3). Corrected statistics did not reveal significant associations with P300 latency or amplitude for these hormones except for leptin plasma levels. However, factor analysis showed that FSH and LH clustered together with Vitamin D1.25 and Vitamin D25OH, P300 latency (not amplitude), and log leptin were found to be associated in the same cluster. Utilizing regression analysis, once age adjusted, leptin was the only significant predictor for latency or speed (p = 0.03) with an effect size of 0.23. Higher plasma leptin levels were associated with abnormal P300 speed (OR = 0.98). Our findings show a significant relationship of higher plasma leptin levels, potentially due to leptin resistance, and prolonged P300 latency. This suggests leptin resistance may delay electrophysiological processing of memory and attention, which appears to be the first of such an association.
authors.affiliation: Department of Clinical Neurology, PATH Foundation NY, New York, New York, United States of America; Department of Psychiatry, University of Florida, College of Medicine and McKnight Brain Institute, Gainesville, Florida, United States of America.
authors.forename: Eric R
authors.initials: ER
authors.lastname: Braverman
authors.affiliation: Department of Management Science and Statistics, University of Texas at San Antonio, San Antonio, Texas, United States of America.
authors.forename: David
authors.initials: D
authors.lastname: Han
authors.affiliation: Departments of Psychiatry, Neurology, and Anatomy & Neurobiology, Boston University School of Medicine, and Boston VA Healthcare System, Boston, Massachusetts, United States of America.
authors.forename: Marlene
authors.initials: M
authors.lastname: Oscar-Berman
authors.affiliation: Department of Clinical Neurology, PATH Foundation NY, New York, New York, United States of America.
authors.forename: Tatiana
authors.initials: T
authors.lastname: Karikh
authors.affiliation: Department of Clinical Neurology, PATH Foundation NY, New York, New York, United States of America.
authors.forename: Courtney
authors.initials: C
authors.lastname: Truesdell
authors.affiliation: Department of Clinical Neurology, PATH Foundation NY, New York, New York, United States of America.
authors.forename: Kristina
authors.initials: K
authors.lastname: Dushaj
authors.affiliation: Department of Clinical Neurology, PATH Foundation NY, New York, New York, United States of America.
authors.forename: Florian
authors.initials: F
authors.lastname: Kreuk
authors.affiliation: Department of Clinical Neurology, PATH Foundation NY, New York, New York, United States of America.
authors.forename: Mona
authors.initials: M
authors.lastname: Li
authors.affiliation: Department of Clinical Neurology, PATH Foundation NY, New York, New York, United States of America.
authors.forename: Danielle
authors.initials: D
authors.lastname: Stratton
authors.affiliation: Department of Clinical Neurology, PATH Foundation NY, New York, New York, United States of America; Department of Psychiatry, University of Florida, College of Medicine and McKnight Brain Institute, Gainesville, Florida, United States of America; Department of Psychiatry, Human Integrated Services Unit, University of Vermont, Center for Clinical and Translational Science, Burlington, Vermont, United States of America; Institute of Integrative Omics and Applied Biotechnology, Nonakuri, Purba Medinipur, West Bengal, India; Dominion Diagnostics, LLC., North Kingstown, Rhode Island, United States of America.
authors.forename: Kenneth
authors.initials: K
authors.lastname: Blum
mesh_terms: D000328:Adult; D000368:Aged; D000704:Analysis of Variance; D001921:Brain / Q000502:physiology*; D004958:Estradiol / Q000097:blood; D018913:Event-Related Potentials, P300 / Q000502:physiology*; D005260:Female; D005640:Follicle Stimulating Hormone / Q000097:blood; D006728:Hormones / Q000097:blood*; D006801:Humans; D018972:Insulin-Like Growth Factor Binding Protein 3 / Q000097:blood; D020738:Leptin / Q000097:blood; D016014:Linear Models; D007986:Luteinizing Hormone / Q000097:blood; D008593:Menopause / Q000097:blood*; D008875:Middle Aged; D017063:Outcome Assessment, Health Care; D025341:Principal Component Analysis; D011374:Progesterone / Q000097:blood; D013739:Testosterone / Q000097:blood; D014807:Vitamin D / Q000097:blood
chemical_list: D006728:Hormones; D018972:Insulin-Like Growth Factor Binding Protein 3; D020738:Leptin; D014807:Vitamin D; D013739:Testosterone; D011374:Progesterone; D004958:Estradiol; D007986:Luteinizing Hormone; D005640:Follicle Stimulating Hormone