Connors-BRI Symposium

Incorporating Sex as Biologic Variable to Advance Health

May 24, 2021 | 3-5PM

Virtual Event

Julia Hall, BA

Brigham and Women’s Hospital
Psychiatry, Women’s Health


Background: Many women experience an increase in body weight following menopause the cause of which is not fully understood. Human neuroimaging studies offer conflicting findings with respect to the effects of menopausal status on food reward processing, despite higher rates of obesity in postmenopausal women. We explored the effects of menopausal status on mesolimbic circuitry activation during a food related reward task.

Methods: 20 premenopausal women (PRE) and 29 postmenopausal women (POST) [mean age (in years) ± sd: Pre = 28 ± 6; Post = 55 ± 3] participated in this study. Menopause was defined as amenorrhea for greater than twelve months and serum Follicle stimulating hormone (FSH) greater than 30IU. Participants underwent an fMRI scanning session where participants completed an adapted version of the Food Incentive Delay Task (FID). Given our hypotheses about specific brain regions, main effects were examined using the small-volume correction (SVC) approach in SPM12. Our predefined ROIs for a priori hypotheses were: Nucleus accumbens (NAcc), caudate, putamen, and ventral tegmental area (VTA).

Results: During reward receipt (RR) the PRE group had greater BOLD response than the POST group in several a priori ROIs including the NAcc (t=3.54, p(FWE)=0.04, k=11), and the right putamen (t=3.87, p(FWE)=0.05, k=253). Additionally the Pre group exhibited greater activity in two separate clusters located in the VTA located at MNI coordinates 4,-20,-16 (region 1) (t=3.72, p(FWE)=0.003, k=9) and at -2, -20, -16 (region 2) (t=28, p(FWE)=0.04, k=8)]. No significant differences were observed between groups during reward anticipation (RA) for any a priori ROIs (all p > .129).

Discussion: These results suggest postmenopausal status is associated with deficits in food-related mesolimbic circuitry. These results potentially inform mechanisms underlying the weight gain commonly seen among women after menopause. Longitudinal studies will be necessary to determine the causal role of brain activity changes on weight gain in menopausal women.
Application to Women’s Health Research: Postmenopausal women have the highest rates of obesity greater than any other age group among men or women. Estradiol has been shown to modulate food consumption in women, with higher levels of estradiol having been implicated in lower food intake. The cause of weight gain surrounding menopause remains ill-defined, but the loss of ovarian hormones has been shown to not be the only contributing factor. One other pathway might be through changes in brain activity in relation to rewarding food images. These findings contribute to the understanding of how reward processing in the brain changes after menopause. Additionally, findings offer an insight into the increase in body weight gain commonly experienced by many postmenopausal women during this stage of life.


3PM – Welcome Remarks
3:05PM – Keynote Address
3:45PM – Featured Short Talks
4:20PM – Lightning Talks
4:50PM – Closing Remarks

Keynote Speaker

Janine Austin Clayton, MD

Janine Austin Clayton, M.D., Associate Director for Research on Women’s Health and Director of the Office of Research on Women’s Health (ORWH) at the National Institutes of Health (NIH), is the architect of the NIH policy requiring scientists to consider sex as a biological variable across the research spectrum. This policy is part of NIH’s initiative to enhance reproducibility through rigor and transparency. As co-chair of the NIH Working Group on Women in Biomedical Careers with NIH Director Dr. Francis Collins, Dr. Clayton also leads NIH’s efforts to advance women in science careers.

Prior to joining the ORWH, Dr. Clayton was the Deputy Clinical Director of the National Eye Institute (NEI) for seven years. A board-certified ophthalmologist, Dr. Clayton’s research interests include autoimmune ocular diseases and the role of sex and gender in health and disease. She is the author of more than 120 scientific publications, journal articles, and book chapters.
Dr. Clayton, a native Washingtonian, received her undergraduate degree with honors from Johns Hopkins University and her medical degree from Howard University College of Medicine. She completed a residency in ophthalmology at the Medical College of Virginia. Dr. Clayton completed fellowship training in cornea and external disease at the Wilmer Eye Institute at Johns Hopkins Hospital and in uveitis and ocular immunology at NEI.

Dr. Clayton has received numerous awards, including the Senior Achievement Award from the Board of Trustees of the American Academy of Ophthalmology in 2008 and the European Uveitis Patient Interest Association Clinical Uveitis Research Award in 2010. She was selected as a 2010 Silver Fellow by the Association for Research in Vision and Ophthalmology. In 2015, she was awarded the American Medical Women’s Association Lila A. Wallis Women’s Health Award and the Wenger Award for Excellence in Public Service. Dr. Clayton was granted the Bernadine Healy Award for Visionary Leadership in Women’s Health in 2016. She was also selected as an honoree for the Woman’s Day Red Dress Awards and the American Medical Association’s Dr. Nathan Davis Awards for Outstanding Government Service in 2017.