This review focuses on recent advances in our knowledge of estrogen action in the brain. The greatest amount of attention was devoted to those studies that impact our understanding of estrogen regulation of memory function and prevention of degenerative diseases associated with memory systems, such as Alzheimer's disease. A review of recent advances in our understanding of estrogen receptors, both nuclear and membrane, is also presented. Finally, these data are considered in regard to their relevancy to the use of estrogen replacement therapy for cognitive health throughout menopause and the development of an estrogen replacement therapy designed for the unique requirements of the brain.The relationship between memory function and estrogen was first noted clinically as women entering menopause frequently voiced complaints of memory and concentration difficulties (Sherwin 1999). In fact, changes in cognitive functioning have long been associated with menopause (Neurgaren and Kraines 1965). The shift from observation of this phenomenon to scientific human study occurred in the mid-1980's when Sherwin and colleagues began a systematic analysis of the impact of estrogen loss and replacement on memory function (Sherwin 2000). Results of these analyses demonstrated that verbal memory declined with the loss of estrogen and was restored to premenopausal levels when estrogen replacement therapy was instituted immediately following menopause (Sherwin 1988). An earlier important discovery relevant to estrogen effects on memory function came from basic sciences studies in the mid and late 1970's by Luine and colleagues, who found that 17-estradiol increased choline acetyltransferase activity which led to increased acetylcholine levels (Luine 1985). Based on these findings, Fillit investigated the impact of estrogen replacement therapy on cognitive function in women with Alzheimer's disease (Fillit et al. 1986). The results of this small clinical trial proved to be pivotal and led to multiple international clinical and epidemiological studies which in turn led to an intense study of the impact of estrogen on the mechanisms of memory in both animals and humans (Brinton 1998). Presented here is a review of the more recent studies, with an emphasis on conceptually linking the many individual findings that have been generated in the past several years. In addition, an analysis of emerging data relevant to our understanding of estrogen regulation of memory function and prevention of Alzheimer's disease is presented.
Estrogen-Induced Neurotrophism and Underlying MechanismsEstrogen-induced neurotrophic effects are now well documented in vitro and also in vivo preparations (Fig. 1) (ToranAllerand 1984(ToranAllerand , 2000 Brinton 1993;Murphy and Segal 1996;Brinton et al. 1997bWoolley, 1999). Investigations to determine the mechanism of estrogen-induced neurotrophism have pointed to a temporal cascade of estrogen-inducible effects that are mediated by separate but potentially interacting pathways. It also appears that blockade of ...