In women, higher levels of sex-related hormones have been associated with increased risk for age-related neurodegenerative diseases such as Alzheimer’s disease. We measured age-associated effects of exogenous sex hormones on brain white matter microstructure in pre- and post-menopausal women, using four diffusion-weighted MRI models (DTI, TDF, NODDI and MAPMRI). Estrogen therapy alone was associated with accelerated aging in white matter metrics, compared to hormone replacement therapy containing both estrogen and progestin. This effect was most evidenced by multi-shell diffusion method NODDI, compared to DTI and other advanced diffusion methods.
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