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更年期如何影响大脑

How menopause affects the brain | Lisa Mosconi

TED 值得传播的想法
Women are works of art.
女人像一件艺术品
On the outside as on the inside.
外表和内在一样可贵
I am a neuroscientist, and I focus on the inside,
作为一个神经科学家 我专注于内在的研究
especially on women’s brains.
尤其是关于女性的大脑
There are many theories on
现在有很多理论
how women’s brains differ from men’s brains,
是关于女性和男性大脑之间的区别的
and I’ve been looking at brains for 20 years
而我已经研究大脑20年之久了
and can guarantee that there is no such thing
我可以断定没有
as a gendered brain.
性别化大脑的这个概念
Pink and blue, Barbie and Lego,
粉色或是蓝色 芭比娃娃或是乐高
those are all inventions that have nothing to do
这些发明和我们的大脑运行方式
with the way our brains are built.
没有任何关系
That said, women’s brains differ from men’s brains in some respects.
即便如此 在某些方面女性和男性的大脑是有区别的
And I’m here to talk about these differences,
我在这里将谈论关于这些区别
because they actually matter for our health.
因为他们实际是对我们的健康有影响的
For example,
举例来说
women are more likely than men to be diagnosed
相比于男性 女性更容易
with an anxiety disorder or depression,
患上焦虑症和抑郁症
not to mention headaches and migraines.
且不说还有头痛及偏头痛
But also, at the core of my research,
另外女性更容易患阿尔兹海默症
women are more likely than men to have Alzheimer’s disease.
这也是我研究的核心
Alzheimer’s disease is the most common cause
阿尔兹海默症是造成痴呆症
of dementia on the planet,
最常见的因素
affecting close to six million people in the United States alone.
仅仅在美国 就有接近6百万人受其困扰
But almost two thirds of all those people
但是其中接近三分之二的人
are actually women.
实际上都是女性患者
So for every man suffering from Alzheimer’s
即患有这种疾病的女性
there are two women.
是男性的两倍
So why is that overall?
那么这究竟是为什么呢?
Is it age?
是年龄的原因?
Is it lifespan?
是寿命的原因?
What else could it be?
还可能是什么其他的原因?
A few years ago,
几年以前
I launched the Women’s Brain Initiative
为了回答这些问题
at Weill Cornell Medicine in New York City,
我在纽约市的威尔·康奈尔医学大学
exactly to answer those questions.
发起了“女性大脑计划”
And tonight, I’m here with some answers.
今晚 我将在这里解释其中一些疑问
So it turns out our brains age differently,
事实证明 我们大脑的年龄有所不同
and menopause plays a key role here for women.
而更年期在女性中起着关键作用
Now most people think of the brain as a kind of black box,
目前 大多数人认为我们的大脑是一种黑盒子
isolated from the rest of the body.
并和身体的其他部分是独立的
But in reality, our brains are in
但是实际上我们的大脑
constant interaction with the rest of us.
在不断地和身体其他部分交流
And perhaps surprisingly,
出乎意料的是
the interactions with the reproductive system
其与生殖系统的交流
are crucial for brain aging in women.
可能对女性大脑衰老至关重要
These interactions are mediated by our hormones.
这些交流通过激素来介导
And we know that hormones differ between the genders.
我们知道 不同性别的激素是不同的
Men have more testosterone,
男性分泌更多的睾酮
women have more estrogens.
而女性分泌雌激素更多
But what really matters here
但真正重要的是
is that these hormones differ in their longevity.
这些激素的寿命不同
Men’s testosterone doesn’t run out until late in life,
男性的睾酮直到生命的晚期才用尽
which is a slow and pretty much
这当然是一个缓慢
symptom-free process, of course.
且几乎没有症状的过程
(Laughter)
[笑]
Women’s estrogens, on the other hand,
另一方面 女性的雌激素
start fading in midlife, during menopause,
在中年的更年期阶段开始减少
which is anything but symptom-free.
这绝对不是没有症状的
We associate menopause with the ovaries,
我们将卵巢和更年期联系在一起
but when women say that they’re having hot flashes,
但是当女性抱怨她们出现潮热
night sweats, insomnia, memory lapses, depression, anxiety,
盗汗 失眠 记忆力减退 抑郁 焦虑
those symptoms don’t start in the ovaries.
那些症状可不是始于卵巢的
They start in the brain.
它们起始于大脑
Those are neurological symptoms.
那些是神经性的症状
We’re just not used to thinking about them as such.
我们只是不习惯这么想
So why is that?
为什么会这样呢?
Why are our brains impacted by menopause?
为什么更年期会影响我们的大脑?
Well, first of all,
首先
our brains and ovaries are part of the neuroendocrine system.
大脑和卵巢都属于神经内分泌系统
As part of the system, the brain talks to the ovaries
作为系统的一部分 大脑把信息传递给卵巢
and the ovaries talk back to the brain,
卵巢又将信息传回大脑
every day of our lives as women.
这个过程在女性生活中每天都会发生
So the health of the ovaries is linked to the health of the brain.
因此卵巢的健康和大脑的健康息息相关
And the other way around.
反过来也是这样
At the same time,
与此同时的是
hormones like estrogen are not only involved in reproduction,
像雌激素的这种激素不仅仅参与生殖过程
but also in brain function.
也和大脑功能有关
And estrogen in particular, or estradiol,
特别是雌激素或雌二醇
is really key for energy production in the brain.
的确是大脑产生能量的关键
At the cellular level,
在细胞水平上
estrogen literally pushes neurons to burn glucose to make energy.
雌激素会促使神经元消耗葡萄糖来产生能量
If your estrogen is high,
如果你的雌激素水平高
your brain energy is high.
你的大脑能量就会高
When your estrogen declines though,
然而当你的雌激素开始减少时
your neurons start slowing down and age faster.
你的神经元就开始衰退并且加快衰老
And studies have shown that this process
研究表明这个过程
can even lead to the formation of amyloid plaques,
甚至会导致淀粉样蛋白斑
or Alzheimer’s plaques,
或者阿尔兹海默症病斑的形成
which are a hallmark of Alzheimer’s disease.
这些都是患阿尔兹海默症的标志
These effects are stronger in specific brain regions,
这些作用 在大脑特定的区域更强
starting with the hypothalamus, which is in charge of regulating body temperature.
起始于控制体温的下丘脑
When estrogen doesn’t activate the hypothalamus correctly,
当雌激素无法正确激活下丘脑时
the brain cannot regulate body temperature correctly.
大脑便不能正常调控体温了
So those hot flashes that women get,
所以女性就会有潮红的症状
that’s the hypothalamus.
那就是下丘脑引起的
Then there’s the brain stem, in charge of sleep and wake.
然后是负责睡眠和觉醒的脑干
When estrogen doesn’t activate the brain stem correctly,
当雌激素不能正确激活脑干时
we have trouble sleeping.
我们就难以入睡
Or it’s the amygdala,
或者是杏仁核
the emotional center of the brain, close to the hippocampus,
它是大脑的情绪中心
the memory center of the brain.
离大脑的记忆中心海马体很近
When estrogen levels ebb in these regions,
当这些区域的雌激素水平下降时
we start getting mood swings perhaps
我们可能就会有情绪波动
and forget things.
以及忘事的症状
So this is the brain anatomy of menopause, if you will.
这是处于更年期大脑的解剖图
But let me show you
让我来为你展示
what an actual woman’s brain can look like.
一位正常女性的大脑是什么样的
So this is a kind of brain scan
这是一种大脑扫描技术
called positron emission tomography or PET.
我们叫它正电子发射断层扫描或是PET
It looks at brain energy levels.
它能展示大脑的能量水平
And this is what you want your brain to look like
这个图像当是你40岁时
when you’re in your 40s.
你所希望你的大脑的样子
Really nice and bright.
的确很不错也很亮
Now this brain belongs to a woman who was 43 years old
现在我们看到的大脑属于一位43岁的女性
when she was first scanned, before menopause.
这是她第一次扫描 在更年期来临之前
And this is the same brain just eight years later,
而这是仅仅8年后的同一个大脑
after menopause.
在经历更年期之后
If we put them side by side,
如果我们把它们并排放在一起
I think you can easily see how the bright yellow
我认为你可以清楚地发现
turned orange, almost purple.
原来明亮的黄色变成了橙色 几乎是紫色了
That’s a 30 percent drop in brain energy levels.
大脑的能量水平下降了30%
Now in general,
而通常来说
this just doesn’t seem to happen to a man of the same age.
这种现象不会发生在同龄男性身上
In our studies with hundreds of people,
在一项对数百人的研究中
we show that middle-aged men usually have high brain energy levels.
我们发现中年男子的大脑能量通常很高
For women, brain energy is usually fine before menopause,
对于女性来说 大脑能量在更年期之前是正常的
but then it gradually declines during the transition.
但是之后就开始在过渡中逐渐衰减
And this was found independent of age.
并且这与年龄无关
It didn’t matter if the women were 40, 50 or 60.
它和女性是40 50还是60岁没有任何关系
What mattered most was that they were in menopause.
最重要的是她们处于更年期
So of course we need more research to confirm this,
当然我们需要更多的研究来证明这一点
but it looks like women’s brains in midlife
但是看起来中年女性的大脑
are more sensitive to hormonal aging
对荷尔蒙老化的敏感程度
than just straight up chronological aging.
要比按时间老化的敏感程度更高
And this is important information to have,
这是一个很重要的信息
because so many women can feel these changes.
因为很多女性都能感受到这些变化
So many of our patients have said to me
很多病人对我说过
that they feel like their minds are playing tricks on them, to put it mildly.
嗯 婉转点说 她们感觉自己的脑在捉弄她们
So I really want to validate this, because it’s real.
所以我想澄清一下
And so just to clarify, if this is you,
如果你也有这样的感觉
you are not crazy.
你并没有发疯
(Laughter)
[笑]
(Applause)
[掌声]
Thank you.
谢谢
It’s important.
这真的很重要
So many women have worried that they might be losing their minds.
很多女性担心她们可能会失去理智
But the truth is that your brain might be going through a transition,
但事实是 你的大脑会经历一个转变
or is going through a transition
或者它可能正在经历这个转变
and needs time and support to adjust.
并需要时间和帮助来调整
Also, if anyone is concerned
另外 如果有人担心
that middle-aged women might be underperformers,
中年女性可能表现不佳
I’ll just quickly add that we looked at cognitive performance,
我想快速补充一句 我们看看认知表现
God forbid, right?
但愿不会发生这样的事情 对吧?
(Laughter)
[笑]
Let’s not do that.
我们不要这么做
But we looked at cognitive performance,
我们观察了认知表现
and we found absolutely no differences between men and women
我们发现男性和女性在更年期前后
before and after menopause.
完全没有区别
And other studies confirm this.
其它研究也证实了这一点
So basically, we may be tired,
也就是说 基本上女性可能会很累
but we are just as sharp.
但是我们依然保持敏锐
(Laughter)
[笑]
Get that out of the way.
尽管如此
That all said,
大家都知道
there is something else more serious that deserves our attention.
还有一些更严重的问题值得我们关注
If you remember,
如果你还记得
I mentioned that estrogen declines could potentially promote
我提到过雌激素的减少可能会促进
the formation of amyloid plaques, or Alzheimer’s plaques.
淀粉样斑块 或阿尔兹海默症病斑的形成
But there’s another kind of brain scan that looks exactly at those plaques.
有另一种脑扫描可以精确地观察到这些斑块
And we used it to show that middle-aged men hardly have any,
我们使用它来观察男性 发现几乎没有
which is great.
这很不错
But for women,
但是对于女性来说
there’s quite a bit of an increase during the transition to menopause.
在向更年期过渡的过程中会有相当多的斑块增加
And I want to be really, really clear here
我想非常非常清楚地说明
that not all women develop the plaques,
不是所有女性都会出现这种斑块
and not all women with the plaques develop dementia.
也不是所有有斑块的女性都会患痴呆
Having the plaques is a risk factor,
有斑块只是一个风险因素
it is not in any way a diagnosis, especially at this stage.
这完全不是一种诊断方法 特别是在这个阶段
But still, it’s quite an insight to associate Alzheimer’s with menopause.
但是 把阿尔茨海默症和更年期联系起来 还是很有见地的
We think of menopause as belonging to middle age
人们认为更年期属于中年
and Alzheimer’s as belonging to old age.
阿尔茨海默症属于老年
But in reality,
但事实上
many studies, including my own work, had shown that
包括我自己工作在内的许多研究都表明
Alzheimer’s disease starts with negative changes in the brain
早在出现临床症状的前几年 虽然不至于成十年
years, if not decades, prior to clinical symptoms.
阿尔茨海默症就已经在大脑中产生了负面的变化
So for women,
对于女性来说
it looks like this process starts in midlife,
这个过程似乎始于中年
during menopause.
发生在更年期
Which is important information to have,
这是很重要的信息
because it gives us a time line to start looking for those changes.
因为它为我们提供了开始寻找这些变化的时间线
So in terms of a time line,
就时间线而言
most women go through menopause in their early 50s.
大多数女性在50岁出头的时候进入更年期
But it can be earlier,
但更年期可能来得更早
often because of medical interventions.
这通常是因为医疗干预
And the common example is a hysterectomy and/or an oophorectomy,
最常见的例子是子宫切除和卵巢切除
which is the surgical removal of the uterus
也就是用手术的手段
and/or the ovaries.
把子宫和卵巢切除
And unfortunately, there is evidence
不幸的是
that having the uterus and, more so, the ovaries removed
有证据表明在绝经前
prior to menopause
摘除子宫和卵巢
correlates with the higher risk of dementia in women.
会有更高的风险患痴呆症
And I know that this is upsetting news,
我知道这是令人苦恼的消息
and it’s definitely depressing news,
这绝对是令人沮丧的消息
but we need to talk about it
但我们需要谈论它
because most women are not aware of this correlation,
因为大多数女性没有意识到这种相关性
and it seems like very important information to have.
这看起来是非常重要的信息
Also, no one is suggesting that
这并不是说要建议女性
women decline these procedures
当她们需要的时候
if they need them.
拒绝做这些手术
The point here is that
这里的重点是
we really need to better understand
我们真的需要更好地了解
what happens to our brains as we go through menopause,
我们的大脑在更年期的时候发生了什么
natural or medical,
无论是自然的还是医学上的
and how to protect our brains in the process.
以及在这个过程中怎样保护我们的大脑
So how do we do that?
那我们接下来要怎么做呢?
How do we protect our brains?
我们怎样保护我们的大脑?
Should we take hormones?
我们应该服用激素吗?
That’s a fair question, it’s a good question.
这是个好问题
And the shortest possible answer right now
目前最简短的回答是
is that hormonal therapy can be helpful
激素疗法可以帮助缓解
to alleviate a number of symptoms, like hot flashes,
一些更年期的症状 比如潮热
but it’s not currently recommended for dementia prevention.
但目前还不推荐用于痴呆症的预防
And many of us are working on testing different formulations
我们很多科学家在测试不同的配方
and different dosages and different time lines,
不同的剂量和不同的时间线
and hopefully, all this work will lead to
并希望所有这些工作将导致
a change in recommendations in the future.
未来在临床建议方面的改变
Meanwhile, there are other things that we can do today
与此同时 我们还可以做一些其它事情
to support our hormones and their effects on the brain
来维持我们的荷尔蒙和它们对脑的正面影响
that do not require medications
这些不需要药物
but do require taking a good look at our lifestyle.
但需要我们保持一个好的生活方式
That’s because the foods we eat,
这是因为我们所吃的食物
how much exercise we get,
我们所做的运动
how much sleep we get or don’t get,
我们睡了多少觉
how much stress we have in our lives,
我们的生活中有多少压力
those are all things that can actually impact our hormones —
这些实际上都会影响我们的荷尔蒙
for better and for worse.
不管是好还是坏
Food, for example.
拿食物来说
There are many diets out there,
市面上有很多食谱
but studies have shown that the Mediterranean diet in particular
但研究表明地中海型饮食
is supportive of women’s health.
对女性健康尤其有益
Women on this diet have a much lower risk
采用这种饮食的女性
of cognitive decline, of depression,
在认知能力下降 抑郁
of heart disease, of stroke and of cancer,
心脏病 中风和癌症方面的风险要低得多
and they also have fewer hot flashes.
而且她们的潮热症状也更少
What’s interesting about this diet
地中海饮食的有趣之处在于
is that it’s quite rich in foods that contain estrogens
它包括了大量含有植物雌激素的食物
in the form of phytoestrogens or estrogens from plants
这些雌激素在我们体内的作用
that act like mild estrogens in our bodies.
类似于温和的雌激素
Some phytoestrogens have been linked to a possible risk of cancer,
有些植物雌激素可能与癌症风险有关
but not the ones in this diet, which are safe.
但地中海饮食中的雌激素是安全的
Especially from flax seeds,
特别是亚麻籽
sesame seeds, dried apricots,
芝麻籽 杏子干
legumes and a number of fruits.
豆类和一些水果里的雌激素
And for some good news,
好消息是
dark chocolate contains phytoestrogens, too.
黑巧克力也含有植物雌激素
So diet is one way to gain estrogens,
因此 饮食是一种获得雌激素的方式
but it’s just as important to avoid things that suppress our estrogens instead,
但是避免雌激素被抑制是同等重要的
especially stress.
尤其是来自于压力
Stress can literally steal your estrogens,
压力会偷走你的雌激素
and that’s because cortisol, which is the main stress hormone,
这是因为皮质醇是主要的压力荷尔蒙
works in balance with our estrogens.
它和我们的雌激素保持着平衡
So if cortisol goes up, your estrogens go down.
如果皮质醇上升 你的雌激素就会下降
If cortisol goes down, your estrogens go back up.
如果皮质醇下降 你的雌激素就会上升
So reducing stress is really important.
所以减轻压力是非常重要的
It doesn’t just help your day,
它不仅帮助你过好每一天
it also helps your brain.
更有助于你的脑健康
So these are just a few things
这不过是我们可做的两件小事
that we can do to support our brains
来维持维持脑部健康
and there are more.
我们还可以做得更多
But the important thing here
但重要的是
is that changing the way we understand the female brain
这改变我们对女性脑部的理解
really changes the way that we care for it,
也确实改变了我们保护它的方式
and the way that we frame women’s health.
同时也改变了我们对女性健康的看法
And the more women demand this information,
女性对这些信息的需求越多
the sooner we’ll be able to break the taboos around menopause,
我们就能越快地打破更年期的禁忌
and also come up with solutions that actually work,
并找到切实有效的解决方案
not just for Alzheimer’s disease,
这不仅对阿尔茨海默病有效
but for women’s brain health as a whole.
对整个女性的脑健康也有效
Brain health is women’s health.
脑健康就是女性的健康
Thank you.
谢谢
(Applause)
[鼓掌]
Thank you.
谢谢你们
Oh, thank you.
再次感谢

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视频概述

更年期对女性的脑有没有影响? 为什么女性得阿尔茨海默病的人数会是男性的两倍? 除了女性活得长,还有没有其它原因? 面对这样的影响,女性又能做些什么? 这个TED最新发布的演讲,可以帮助你寻找答案。

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收集自网络

翻译译者

Karasu

审核员

审核员XY

视频来源

https://www.youtube.com/watch?v=JJZ8z_nTCZQ

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