title: Estrogens as neuroprotectants: Estrogenic actions in the context of cognitive aging and brain injury.
abstract: There is ample empirical evidence to support the notion that the biological impacts of estrogen extend beyond the gonads to other bodily systems, including the brain and behavior. Converging preclinical findings have indicated a neuroprotective role for estrogen in a variety of experimental models of cognitive function and brain insult. However, the surprising null or even detrimental findings of several large clinical trials evaluating the ability of estrogen-containing hormone treatments to protect against age-related brain changes and insults, including cognitive aging and brain injury, led to hesitation by both clinicians and patients in the use of exogenous estrogenic treatments for nervous system outcomes. That estrogen-containing therapies are used by tens of millions of women for a variety of health-related applications across the lifespan has made identifying conditions under which benefits with estrogen treatment will be realized an important public health issue. Here we provide a summary of the biological actions of estrogen and estrogen-containing formulations in the context of aging, cognition, stroke, and traumatic brain injury. We have devoted special attention to highlighting the notion that estrogen appears to be a conditional neuroprotectant whose efficacy is modulated by several interacting factors. By developing criteria standards for desired beneficial peripheral and neuroprotective outcomes among unique patient populations, we can optimize estrogen treatments for attenuating the consequences of, and perhaps even preventing, cognitive aging and brain injury.
authors.affiliation: Center for Basic and Translational Stroke Research, West Virginia University, Morgantown, WV 26506, United States; Department of Physiology and Pharmacology, West Virginia University, Morgantown, WV 26506, United States. Electronic address: elengler@hsc.wvu.edu.
authors.forename: E B
authors.initials: EB
authors.lastname: Engler-Chiurazzi
authors.affiliation: Center for Basic and Translational Stroke Research, West Virginia University, Morgantown, WV 26506, United States; Department of Neurobiology and Anatomy, West Virginia University, Morgantown, WV 26506, United States. Electronic address: cdbrown2@hsc.wvu.edu.
authors.forename: C M
authors.initials: CM
authors.lastname: Brown
authors.affiliation: Center for Basic and Translational Stroke Research, West Virginia University, Morgantown, WV 26506, United States; Department of Pediatrics, West Virginia University, Morgantown, WV 26506, United States. Electronic address: jpovrozn@mix.wvu.edu.
authors.forename: J M
authors.initials: JM
authors.lastname: Povroznik
authors.affiliation: Center for Basic and Translational Stroke Research, West Virginia University, Morgantown, WV 26506, United States; Department of Physiology and Pharmacology, West Virginia University, Morgantown, WV 26506, United States. Electronic address: jwsimpkins@hsc.wvu.edu.
authors.forename: J W
authors.initials: JW
authors.lastname: Simpkins
mesh_terms: D000818:Animals; D001930:Brain Injuries / Q000188:drug therapy* / Q000378:metabolism / Q000523:psychology; D000066492:Cognitive Aging / Q000502:physiology; D004967:Estrogens / Q000378:metabolism / Q000494:pharmacology* / Q000627:therapeutic use; D006801:Humans; D018696:Neuroprotective Agents / Q000494:pharmacology* / Q000627:therapeutic use; D018697:Nootropic Agents / Q000494:pharmacology* / Q000627:therapeutic use; D020521:Stroke / Q000188:drug therapy* / Q000378:metabolism / Q000523:psychology
chemical_list: D004967:Estrogens; D018696:Neuroprotective Agents; D018697:Nootropic Agents
keywords: Aging; Cognition; Estrogen; Neuroprotection; Stroke; Traumatic brain injury