title: Gender-Specific Degeneration of Dementia-Related Subcortical Structures Throughout the Lifespan.
abstract: Age-related changes in brain structure are a question of interest to a broad field of research. Structural decline has been consistently, but not unambiguously, linked to functional consequences, including cognitive impairment and dementia. One of the areas considered of crucial importance throughout this process is the medial temporal lobe, and primarily the hippocampal region. Gender also has a considerable effect on volume deterioration of subcortical grey matter (GM) structures, such as the hippocampus. The influence of age×gender interaction on disproportionate GM volume changes might be mediated by hormonal effects on the brain. Hippocampal volume loss appears to become accelerated in the postmenopausal period. This decline might have significant influences on neuroplasticity in the CA1 region of the hippocampus highly vulnerable to pathological influences. Additionally, menopause has been associated with critical pathobiochemical changes involved in neurodegeneration. The micro- and macrostructural alterations and consequent functional deterioration of critical hippocampal regions might result in clinical cognitive impairment-especially if there already is a decline in the cognitive reserve capacity. Several lines of potential vulnerability factors appear to interact in the menopausal period eventually leading to cognitive decline, mild cognitive impairment, or Alzheimer's disease. This focused review aims to delineate the influence of unmodifiable risk factors of neurodegenerative processes, i.e., age and gender, on critical subcortical GM structures in the light of brain derived estrogen effects. The menopausal period appears to be of key importance for the risk of cognitive decline representing a time of special vulnerability for molecular, structural, and functional influences and offering only a narrow window for potential protective effects.
authors: Department of Neurology, Albert Szent-Györgyi Clinical Center, Faculty of Medicine, University of Szeged, Szeged, Hungary.
authors: Viola Luca
authors: VL
authors: Nemeth
authors: Department of Neurology, Albert Szent-Györgyi Clinical Center, Faculty of Medicine, University of Szeged, Szeged, Hungary.
authors: Anita
authors: A
authors: Must
authors: Department of Psychiatry, Albert Szent-Györgyi Clinical Center, Faculty of Medicine, University of Szeged, Szeged, Hungary.
authors: Szatmar
authors: S
authors: Horvath
authors: Department of Neurology, Albert Szent-Györgyi Clinical Center, Faculty of Medicine, University of Szeged, Szeged, Hungary.
authors: Andras
authors: A
authors: Király
authors: Department of Neurology, Albert Szent-Györgyi Clinical Center, Faculty of Medicine, University of Szeged, Szeged, Hungary.|International Clinical Research Center, St. Anne's University Hospital Brno, Brno, Czech Republic.
authors: Zsigmond Tamas
authors: ZT
authors: Kincses
authors: Department of Neurology, Albert Szent-Györgyi Clinical Center, Faculty of Medicine, University of Szeged, Szeged, Hungary.|MTA-SZTE Neuroscience Research Group, Szeged, Hungary.
authors: László
authors: L
authors: Vécsei
mesh_terms: D000375:Aging; D001921:Brain / Q000473:pathology*; D003704:Dementia / Q000209:etiology / Q000473:pathology*; D005260:Female; D006801:Humans; D008297:Male; D019636:Neurodegenerative Diseases / Q000150:complications; D012727:Sex Characteristics
keywords: Aging; cognitive decline; gender; hippocampus CA1 region; subcortical grey matter