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Association of bilateral salpingo-oophorectomy before menopause with medial temporal lobe neurodegeneration

JAMA Jan 17, 2019

Zeydan B, et al. - In women who underwent bilateral salpingo-oophorectomy (BSO) before age 50 years and before reaching natural menopause, researchers studied medial temporal lobe structure, white matter lesion load, and β-amyloid deposition. In this case-control study, abrupt hormonal changes in premenopausal women linked to BSO might lead to structural abnormalities of the medial temporal lobe later in life.

Methods

  • This investigation using the population-based Mayo Clinic Cohort Study of Oophorectomy and Aging-2 (MOA-2) and the Mayo Clinic Study of Aging (MCSA) in Olmsted County, MN, involved women who had BSO from 1988 through 2007 and a control group from the intersection of the two cohorts.
  • Premenopausal women who were younger than 50 years who had BSO and control participants who had a neuropsychological evaluation, magnetic resonance imaging (MRI), and Pittsburgh compound B positron emission tomography (PiB-PET) were involved.
  • From November 2017 to August 2018, data analysis was performed.
  • Using the standard uptake value ratio, cortical β-amyloid deposition on PiB-PET scan was calculated.
  • For this analysis, they also measured white matter hyperintensity volume and biomarkers for medial temporal lobe neurodegeneration (eg, amygdala volume, hippocampal volume, and parahippocampal-entorhinal cortical thickness) on structural MRI and entorhinal white matter fractional anisotropy on diffusion tensor MRI.

Results

  • Forty-one BSO women and 49 control participants were recruited.
  • After the diagnosis of an ovarian malignant condition, one woman was excluded from the BSO group and six women were excluded from the control group after BSO was registered.
  • Data reported that 20 control participants and 23 women who had undergone BSO completed all examinations.
  • In the BSO group, the median (interquartile range [IQR]) age at imaging was 65 (62-68) years and 63 (60-66) years in the control group.
  • It was noted that amygdala volume was smaller in the BSO group (median [IQR], 1.74 [1.59-1.91] cm3) vs the control group (2.15 [2.05-2.37] cm3; P < .001).
  • Findings revealed that the parahippocampal-entorhinal cortex was thinner in the BSO group (median [IQR], 3.91 [3.64-4.00] mm) vs the control group (3.97 [3.89-4.28] mm; P=.046).
  • They discovered that entorhinal white matter fractional anisotropy was lower in the BSO group (median [IQR], 0.19 [0.18-0.22]) vs the control group (0.22 [0.20-0.23]; P=.03).
  • Results of the global cognitive status test did not differ among the groups.
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