Estrogen effects on the hippocampus and frontal lobes.

Basic science and clinical studies have investigated the potential neuroprotective effects of estrogen. One apparent area of convergence in these studies is the selective benefits of estrogen on cognitive tasks mediated by the hippocampus and frontal lobes. Findings in non-human primates parallel findings from neuroimaging and behavioral studies in humans and suggest that estrogen might influence memory tasks mediated by the hippocampus as well as working memory tasks mediated by the prefrontal cortex. This evidence provides a framework for the design of future hormone studies, wherein such tasks can serve as primary outcomes. In studies of symptomatic women, hormone therapy can benefit a broader range of cognitive domains, particularly effortful tests that are sensitive to remittance of dysphoria, sleep difficulty, and hot flushes. Serotonin might play a critical role in these potential indirect benefits, and therapies that target these symptoms, even those without estrogenic actions, might have indirect benefits on cognition.