. Postmenopausal hormone therapy and regional brain volumes: the WHIMS-MRI Study. Neurology. 2009 Jan 13;72(2):135-42. PubMed.

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  1. This important report further elaborates the estrogen replacement therapy-associated increased risk for dementia in women over 65. These women tend to have had somewhat lower than expected cognitive function although not dementia and might very well have had existing AD or vascular neuropathology prior to randomization.

    Here the authors document that women randomized to ERT or combined HRT with medroxyprogesterone showed smaller frontal and hippocampal volumes after several years of treatment followed by about one to four years of being off treatment. So the HRT that they received during the WHIMS trial may have had a rather persistent structural effect that some clinical trialists might characterize as “disease-modifying,” but unfortunately in the adverse direction. Those interested in biomarkers in clinical trials should read this paper.