This study investigates the relationship between estradiol and olfaction in schizophrenia. Fifteen premenopausal and 15 postmenopausal women with schizophrenia and 30 controls will be enrolled. To date, two patients have been recruited. The investigator plans to request an extension of the study if patient recruitment will not be completed by the expected date of June 2000. There is growing evidence that estrogen my have an influence on early central nervous system development as well as later functional influences. Studies have indicated that gonadal hormones may play a role in the promotion and/or prevention of neural atrophy with aging in healthy adults. The protective influence of estrogen may also explain the reported gender differences in patients with schizophrenia. Studies from both clinical and neuroimaging domains suggest a biological substrate and a potential contribution from sex-related hormones in schizophrenia. Taken as a whole, these studies demonstrate the relevance and importance of examining the role of sex-related hormones in patient populations and in healthy persons. The current study addresses the influence of sex-related hormones on behavior by utilizing olfactory probes in combination with indices of hormonal status to uniquely assess the integrity of frontolimbic brain structures and to explore the relationship between olfactory abnormalities, estrogen levels, and clinical measures in pre-and postmenopausal healthy women and women with schizophrenia across the lifespan. Subjects will include 15 premenopausal (ages 18-40) and 15 postmenopausal (ages 40-65) women with schizophrenia and 30 demographically balanced healthy controls. Olfactory testing, including threshold testing and olfactory identification assessment, mood questionnaires, and blood draws for hormonal assays will be performed twice for each subject. Premenopausal subjects will be tested on the first day of menses and again at ovulation, which will be determined by asking subjects to predict ovulation by using home testing kits; postmenopausal women will be assess on a random Day 1 and approximately 14 days later. It is expected that, overall, women with schizophrenia will have intact olfactory thresholds and lower levels of extradiol than healthy controls and will therefore perform worse on olfactory identification. Also, premenopausal subjects will outperform older women. This work may provide further evidence for a raised vulnerability threshold in women with schizophrenia such that the brain abnormalities resulting in olfactory dysfunction appear later (relative to males) and may be further exaggerated by the depletion of estrogen.
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