Oral Contraceptive Effects on Cognition

Oral contraception (OC) has been a common method of birth control for decades, yet the effects of this hormone manipulation on cognition are largely unknown. Although some studies have addressed this subject, efforts to make definitive conclusions are hampered by methodological issues including variations in OC type and hormone constituents, inconsistencies in cognitive tasks used, and insufficient power to detect effects. This chapter will review existing data on the effects of OCs on verbal memory, spatial memory, and emotional memory. It ends by considering ways in which to improve the methodological approaches used in studies of OCs to enable a better understanding of the ways in which these exogenous hormone treatments may influence cognitive function.

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Emotional Memory in Oral Contraceptive Users: Negative Stimuli Are More Forgettable

Psychological Reports ◽

10.1177/0033294119856554 ◽

2019 ◽

Vol 123 (6) ◽

pp. 2282-2304 ◽

Cited By ~ 1

Author(s):

Brandi Person ◽

Kirsten A. Oinonen

Keyword(s):

Oral Contraceptive ◽

Spatial Memory ◽

Contraceptive Use ◽

Spatial Location ◽

Emotional Memory ◽

Memory Test ◽

Hormonal Contraceptives ◽

Emotional Stimuli ◽

Immediate Recall ◽

Oral Contraceptive Use

Recent research suggests oral contraceptive use is associated with altered memory for emotional story information, blunted stress hormone responses to emotional stimuli, and altered structure or function of the amygdala and hippocampus. This study examined the extent to which oral contraceptives influence relative recall of (a) the spatial location of emotional versus neutral stimuli and (b) positive versus negative emotional stimuli. Participants (58 oral contraceptive users, 40 nonusers, and 37 men) completed an Emotional Spatial Memory test and were evaluated on short-term recall and long-term (one week) recall. There was no evidence for group differences in recall of the locations of emotional versus neutral stimuli. However, oral contraceptive users remembered relatively more positive than negative items compared with nonusers and men on the spatial memory test. This effect was driven by oral contraceptive users recalling fewer negative items than free cyclers. The results indicate that hormonal contraceptives may decrease immediate recall of negative emotional stimuli.

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Serum sodium in relation to various domains of cognitive function in the elderly US population

BMC Geriatrics ◽

10.1186/s12877-021-02260-4 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Sohyae Lee ◽

Jin-young Min ◽

Beom Kim ◽

Sang-Won Ha ◽

Jeohng Ho Han ◽

...

Keyword(s):

Executive Function ◽

Cognitive Function ◽

Serum Sodium ◽

Verbal Memory ◽

The Elderly ◽

Cognitive Change ◽

Cognitive Test ◽

P Value ◽

Digit Symbol Substitution Test ◽

Cross Sectional

Abstract Background Recent evidence suggests that sodium imbalances may be associated with cognitive impairment; however, the association between specific domains of cognition remains unclear. This study examines the association between serum sodium levels and immediate and delayed verbal memory as measured by the CERAD Word Learning Test (CERAD WLT), executive function as measured by the Animal Fluency test (AFT), and sustained attention, working memory, and processing speed as measured by the Digit Symbol Substitution test (DSST) in the elderly population of the US aged 60 and older who participated in the 2011–2014 National Health and Nutrition Examination Surveys (n = 2,541). Methods Cognitive function tests were performed by trained interviewers and sodium levels were measured using indirect ion selective electrode methodology. Results After adjusting for all covariates, quintiles of CERAD WLT scores showed significant positive associations with log-transformed sodium levels (Immediate recall (IR) β = 4.25 (SE = 1.83, p-value 0.027); Delayed recall (DR) β = 6.54 (SE = 1.82, p-value 0.001)). Compared to normal sodium levels, hyponatremia was significantly associated with lower CERAD WLT-IR (β = -0.34, SE = 0.15, p-value 0.035) and CERAD WLT-DR scores (β -0.48, SE = 0.10, p-value < 0.001) and showed borderline significance with AFT scores (β = = -0.38, SE = 0.19, p-value 0.052). Hypernatremia did not show any significant relationships with cognitive test scores, compared to normal sodium levels. Conclusions Our cross-sectional study showed that lower sodium levels were associated with cognitive change, especially regarding memory and executive function.

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Cortisol reactivity and emotional memory after psychosocial stress in oral contraceptive users

Journal of Neuroscience Research ◽

10.1002/jnr.23904 ◽

2016 ◽

Vol 95 (1-2) ◽

pp. 126-135 ◽

Cited By ~ 13

Author(s):

Kristen L. Mordecai ◽

Leah H. Rubin ◽

Erin Eatough ◽

Erin Sundermann ◽

Lauren Drogos ◽

...

Keyword(s):

Oral Contraceptive ◽

Psychosocial Stress ◽

Emotional Memory ◽

Cortisol Reactivity

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Prostate-Specific Antigen and Testosterone Levels as Biochemical Indicators of Cognitive Function in Prostate Cancer Survivors and the Role of Diabetes

Journal of Clinical Medicine ◽

10.3390/jcm10225307 ◽

2021 ◽

Vol 10 (22) ◽

pp. 5307

Author(s):

Alicja Popiołek ◽

Bartosz Brzoszczyk ◽

Piotr Jarzemski ◽

Aleksandra Chyrek-Tomaszewska ◽

Radosław Wieczór ◽

...

Keyword(s):

Prostate Cancer ◽

Cognitive Impairment ◽

Cognitive Function ◽

Prostate Specific Antigen ◽

Verbal Memory ◽

Demographic Data ◽

Specific Antigen ◽

Hormonal Treatment ◽

Cognitive Test ◽

Prostate Cancer Survivors

Prostate cancer (PC) is one of the most common malignancies in men. The increase in the number of PC survivors is associated with many problems including cognitive impairment. Early detection of such problems facilitates timely protective intervention. This study examined the association between prostate-specific antigen (PSA) or testosterone (T) levels and cognitive function in patients undergoing radical prostatectomy. Such a correlation could help identify patient groups at risk of cognitive impairment. Participants underwent clinical (demographic data, medical history, physical examination, and blood analyses) and neuropsychological assessment (cognitive test battery). Preoperative PSA or T levels were not associated with cognitive function. However, long-term follow-up after prostatectomy showed a strong correlation between PSA levels and the results of verbal memory and executive function tests. A trend toward significance was also observed for visuospatial memory. The levels of free T and total T were not correlated with cognitive function. Only the levels of free T after hormonal treatment were significantly correlated with executive functions. Comorbid diabetes affected these correlations. In conclusion, PSA levels at a distant postoperative time and free T level after hormonal treatment may be biomarkers of cognitive function.

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Internet-based cognitive testing in multiple sclerosis

Multiple Sclerosis Journal ◽

10.1177/1352458507077626 ◽

2007 ◽

Vol 13 (8) ◽

pp. 1011-1019 ◽

Cited By ~ 19

Author(s):

M. Younes ◽

J. Hill ◽

J. Quinless ◽

M. Kilduff ◽

B. Peng ◽

...

Keyword(s):

Multiple Sclerosis ◽

Cognitive Function ◽

Verbal Memory ◽

Stability Index ◽

Cross Sectional Study ◽

Cognitive Testing ◽

The Internet ◽

Cross Sectional ◽

Multiple Sclerosis Patients

Cognitive impairment in multiple sclerosis is difficult to study because of the heterogeneity and variability of this disease. The gold standard for measurement of cognitive function in multiple sclerosis is a full battery of neurocognitive tests, which is time consuming and expensive. Some cognitive tests like the PASAT, a measure of working verbal memory and processing speed, have been proposed for screening and follow-up of cognitive function in clinical trials. We studied whether we could measure cognitive function in multiple sclerosis over the Internet. For this we used the Cognitive Stability Index (CSI)™, developed for persons with known or suspected primary central nervous system illness. The CSI was compared with formal neurocognitive testing (NPsych) and the PASAT in a cross-sectional study of 40 consecutive multiple sclerosis patients with subjective cognitive complaints. NPsych revealed that only 18 of the 40 patients (46%) were cognitively impaired. Although both the CSI and the PASAT were equalivalent in their specificity (86%), the CSI was significantly more sensitive than the PASAT (83% versus 28%). We conclude that the CSI, because of its availability over the Internet, has great potential as a tool for screening and follow up of cognitive function in multiple sclerosis. Multiple Sclerosis 2007; 13: 1011—1019. http://msj.sagepub.com

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Concussion History and Cognitive Function in a Large Cohort of Adolescent Athletes

The American Journal of Sports Medicine ◽

10.1177/0363546518798801 ◽

2018 ◽

Vol 46 (13) ◽

pp. 3262-3270 ◽

Cited By ~ 4

Author(s):

Kathryn M. Taylor ◽

Marianthi-Anna Kioumourtzoglou ◽

Jim Clover ◽

Brent A. Coull ◽

Jack T. Dennerlein ◽

...

Keyword(s):

High School ◽

Cognitive Function ◽

Verbal Memory ◽

Impulse Control ◽

Visual Memory ◽

Test Battery ◽

Cognitive Test ◽

Effect Estimate ◽

Cognitive Score ◽

And Performance

Background: The incidence of reported concussions in the adolescent population is increasing, yet research on the effects of concussions in this population is minimal and inconclusive. Purpose: To assess the association between concussion and performance on a cognitive test battery. Study Design: Cross-sectional study; Level of evidence, 3. Methods: Using multivariate models, the authors assessed the association between concussion and performance on a cognitive test battery among 5616 high school and junior high school athletes. The researchers utilized a global cognitive score and scores for 5 domains: verbal memory, visual memory, visual motor, reaction time, and impulse control. Each cognitive score was converted to a z score with the mean and SD of the nonconcussed population. Results from each model were then interpreted as change in the standardized unit score. In the models, concussion was evaluated as ever having a concussion, number of concussions, time since last concussion, and age at first concussion. Results: Ever having a concussion was associated with a mean decrease of 0.11 standardized units (95% CI, −0.20 to −0.01) on the global cognitive score and lower scores in all cognitive domains. Each additional concussion was associated with lower scores on global cognitive function (effect estimate, −0.06; 95% CI, −0.11 to −0.02), verbal memory, visual memory, and impulse control. Concussion in early childhood was associated with lower global cognition (effect estimate, −0.05; 95% CI, −0.08 to −0.01), visual memory, and motor visual scores as compared with concussions in later childhood. The associations between time since last concussion and cognitive test scores were nonlinear, and on all tests, lower scores were observed even ≥1 year after the concussion. Conclusion: On the basis of objective performance metrics for cognitive function, concussions had a more persistent effect on cognitive function than previously thought. The age at which an individual has his or her first concussion may be an important factor in determining long-lasting cognitive effects.

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An investigation into the cognitive and neuropsychological sequelae of minor head injury in children – a prospective pilot study

Emergency Medicine Journal ◽

10.1136/emj.2010.103150.12 ◽

2010 ◽

Vol 27 (Suppl 1) ◽

pp. A5.1-A5

Author(s):

Jacques Kerr

Keyword(s):

Cognitive Function ◽

Pilot Study ◽

Head Injury ◽

Verbal Memory ◽

Repeated Measures ◽

Group Performance ◽

Memory Span ◽

Minor Head Injury ◽

Head Injured ◽

Minimum Number

ObjectivesAlthough the majority of head-injured children are Glasgow Coma Scale (GCS) 15 and do not require admission or further investigations there is evidence that some children with a minor head injury (MHI) will go on to experience significant morphological and functional brain deficits. In view of the lack of controlled studies into the sequelae of MHI in children we carried out a pilot study that examined the neuropsychological performance in children who had sustained an MHI.MethodsChildren aged 6–12 years who presented to the Emergency Department of the Royal Hospital for Sick Children in Edinburgh with a MHI (GCS 15) were recruited to the study. Neuropsychological assessment was performed using the Cambridge Neuropsychological Test Automated Battery (CANTAB); a computerised battery of tests, which measures motor skills, visual attention, spatial memory, working memory and non-verbal memory span. CANTAB also assesses executive function, which is the highest level of cognitive function that manages planning and allows flexible thought and action.Results15 head-injured children were recruited over the study period (eleven boys and four girls). A 2 (subject groups) × 3 (time points) repeated measures Analysis of variance was used on the number of problems solved using the minimum number of computer moves at each time point, which showed a significant interaction (p=0.003). Bonferroni posthoc comparisons demonstrated that in week 1 the head-injured group were significantly lower in performance compared to normative data (p=0.03), but significantly increased in performance between week 1 and 12 months (p=0.0001). The difference in the head-injured group performance between week 1 and week 6 approached significance (p=0.05).ConclusionThe MHI group show a significantly poorer performance with regards to problem-solving in a minimum number of moves, which may indicate impulsive tendencies and insufficient planning ability. Children with a MHI may therefore be at risk of developing problems with high-level cognitive function postinjury.

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Abstract 22: Visit-to-Visit Variability in Blood Pressure is Related to Late-Life Cognitive Decline

Circulation ◽

10.1161/circ.131.suppl_1.22 ◽

2015 ◽

Vol 131 (suppl_1) ◽

Author(s):

Bo Qin ◽

Anthony J Viera ◽

Linda S Adair ◽

Brenda L Plassman ◽

Lloyd J Edwards ◽

...

Keyword(s):

Blood Pressure ◽

Older Adults ◽

Cognitive Function ◽

Cognitive Decline ◽

Verbal Memory ◽

Repeated Measures ◽

Community Dwelling ◽

Cognitive Testing ◽

Cognitive Test ◽

Nutrition Survey

Introduction: Recent studies suggest higher visit-to-visit variability of blood pressure (BP) is associated with worse cognitive function, but evidence based on longitudinal cognitive testing has not been reported. Hypothesis: We assessed the hypothesis that higher visit-to-visit variability in BP, but not mean BP, would be associated with faster decline in cognitive function among community-dwelling older adults. Methods: This prospective cohort study comprised 1213 adults who had two or more waves of BP measurements as part of the China Health and Nutrition Survey from 1991, up to their first cognitive tests, and completed a cognitive screening test at two or more waves in 1997, 2000 or 2004. Mean (SD) age at first cognitive test was 64 (6) y. Outcomes were repeated measures of global cognitive scores (baseline mean ± SD: 19 ± 6 points), standardized composite cognitive and verbal memory scores (standardized units [SU]). Visit-to visit BP variability was expressed as the standard deviation [SD] or as the variation independent of mean (SD/mean^x, with x derived from curve fitting) in BP measures obtained at a mean interval of 3.6 years. Multivariable-adjusted linear mixed-effects models were used to determine the association of changes in cognitive scores with visit-to visit BP variability. Results: Higher visit-to-visit variability in systolic BP, but not mean systolic BP, was associated with a faster decline of cognitive function (adjusted mean difference [95% CI] for high vs. low tertile of SD in variability (Figure): global score -0.23 points/y [-0.41 to -0.04], composite scores -0.029 SU/y [-0.056 to -0.002] and verbal memory -0.044 SU/y [-0.075 to -0.012]). Higher visit-to-visit variability in diastolic BP was associated with a faster decline of global cognitive function only among adults 55-64 years, independent of mean diastolic BP. Conclusion: Higher long-term BP visit-to-visit variability predicted a faster rate of cognitive decline among older adults.

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Starting oral contraceptives – which, when and how?

Drug and Therapeutics Bulletin ◽

10.1136/dtb.30.11.41 ◽

1992 ◽

Vol 30 (11) ◽

pp. 41-44

Keyword(s):

Oral Contraceptive ◽

Sexual Activity ◽

Medical History ◽

Oral Contraceptives ◽

New Products ◽

Oral Contraceptive Pill ◽

Oral Contraception ◽

Planned Parenthood ◽

Combined Oral Contraceptive ◽

Free Interval

About one quarter of women in Britain aged 18–44 use oral contraceptives,1 and almost half of those aged 20–29.2 Many will use more than one type during their years of sexual activity. Changes will occur as new products are introduced and new risks identified or in response to unwanted effects. Decisions may also be prompted by the need to restart oral contraception after a break as part of planned parenthood. Oral contraception is chosen chiefly because it is reliable and does not interrupt spontaneous sexual activity. Whether a combined oral contraceptive pill (COC) or a progestagen-only pill (POP) would be the more appropriate depends mainly on the woman’s medical history, smoking habits and age. Most women will want good cycle control, and a few will prefer to take an inactive pill for a few days in each cycle rather than have a pill-free interval. This article discusses the choice when starting, restarting or switching oral contraception.

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Regional differences in Alzheimer’s disease pathology confound behavioural rescue after amyloid-β attenuation

Brain ◽

10.1093/brain/awz371 ◽

2019 ◽

Vol 143 (1) ◽

pp. 359-373 ◽

Cited By ~ 5

Author(s):

Christopher D Morrone ◽

Paolo Bazzigaluppi ◽

Tina L Beckett ◽

Mary E Hill ◽

Margaret M Koletar ◽

...

Keyword(s):

Alzheimer’S Disease ◽

Alzheimer's Disease ◽

Clinical Trials ◽

Cognitive Function ◽

Spatial Memory ◽

Regional Differences ◽

Amyloid Β ◽

Amyloid Β Peptide ◽

Barnes Maze ◽

Tau Pathology

Abstract Failure of Alzheimer’s disease clinical trials to improve or stabilize cognition has led to the need for a better understanding of the driving forces behind cognitive decline in the presence of active disease processes. To dissect contributions of individual pathologies to cognitive function, we used the TgF344-AD rat model, which recapitulates the salient hallmarks of Alzheimer’s disease pathology observed in patient populations (amyloid, tau inclusions, frank neuronal loss, and cognitive deficits). scyllo-Inositol treatment attenuated amyloid-β peptide in disease-bearing TgF344-AD rats, which rescued pattern separation in the novel object recognition task and executive function in the reversal learning phase of the Barnes maze. Interestingly, neither activities of daily living in the burrowing task nor spatial memory in the Barnes maze were rescued by attenuating amyloid-β peptide. To understand the pathological correlates leading to behavioural rescue, we examined the neuropathology and in vivo electrophysiological signature of the hippocampus. Amyloid-β peptide attenuation reduced hippocampal tau pathology and rescued adult hippocampal neurogenesis and neuronal function, via improvements in cross-frequency coupling between theta and gamma bands. To investigate mechanisms underlying the persistence of spatial memory deficits, we next examined neuropathology in the entorhinal cortex, a region whose input to the hippocampus is required for spatial memory. Reduction of amyloid-β peptide in the entorhinal cortex had no effect on entorhinal tau pathology or entorhinal-hippocampal neuronal network dysfunction, as measured by an impairment in hippocampal response to entorhinal stimulation. Thus, rescue or not of cognitive function is dependent on regional differences of amyloid-β, tau and neuronal network dysfunction, demonstrating the importance of staging disease in patients prior to enrolment in clinical trials. These results further emphasize the need for combination therapeutic approaches across disease progression.

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