Assistant Professor Psychology Washington State University Pullman, WA 99164-4820   Phone: 509-335-5547 Email:parmenter@wsu.edu   Ph.D. University of Kansas, 2004 RESEARCH INTERESTS: Sex hormones & cognition RESEARCH SUMMARY: Sex differences in multiple sclerosis (MS) are well documented. Not only is the prevalence of MS approximately twice as high for women as it is for men, but there is evidence that the course of the disease and severity of symptoms can differ according to sex. It has been hypothesized that sex hormones may account for some of these differences by affecting the inflammation, damage, and repair mechanisms seen in MS (Tomassini et al., 2005). Much of the research investigating the role of sex hormones in MS has focused on the disease in women during times that hormones are known to change, such as during menopause, pregnancy, and menses. For example, a worsening of symptoms has been reported after menopause (Smith & Studd, 1992). Additionally, there is evidence that women may experience a remission of symptoms during pregnancy followed by an exacerbation within the first three months post-partum (Hutchinson, 1993; Confavreux, Hutchinson, Hours, Cortinovis-Tourniaire, & Moreau, 1998; Vukusic et al., 2004). Changes in disease symptoms have also been associated with a woman’s menstrual cycle (Coyle, 2005). Finally, there is evidence that sex hormones may play a role in the development of brain tissue damage in MS, with these hormones affecting women and men differently (Tomassini et al., 2005). Despite the attention on sex and disease activity, only a handful of studies have explored sex differences in cognitive functioning in this population. Cognitive dysfunction affects between 30-70% of patients with this disease (Amato et al., 1995; Heaton et al, 1985; Peyser & Poser, 1986; Rao et al., 1991). Men have been found to perform more poorly on measures of memory, processing speed, verbal fluency, and higher executive functioning (Beatty & Aupperle, 2002; Beatty, Goodkin, Hertsgaard, & Monson, 1990; Beatty et al., 1995; Parmenter, Denney, & Lynch, in press). Group differences in cognition could be related to sex hormones and how they interact with the disease. However, according to a recent review of the literature, no studies have investigated the role of sex hormones on cognitive functioning in this population. I am proposing a study designed to explore the relationship between sex hormones, such as estradiol, progesterone, and testosterone, and cognition in healthy controls and patients with MS. References Amato, M. P., Ponziani, G., Pracucci, G., Bracco, L., et al. (1995). Cognitive impairment in early-onset multiple sclerosis: pattern, predictors, and impact on everyday life in a 4-year follow-up. Archives of Neurology, 52, 168-172. Beatty, W.W. & Aupperle, R.L. (2002). Sex differences in cognitive impairment in multiple sclerosis. The Clinical Neuropsychologist, 16(4), 472-480. Beatty, W.W., Goodkin, D.E., Hertsgaard, D., & Monson, N. (1990). Clinical and demographic predictors of cognitive impairment in multiple sclerosis: do diagnostic type, disease duration and disability status matter? Archives of Neurology, 47, 305-309. Beatty, W.W., Paul, R.H., Wilbanks, S.L., Hames, K.A., et al. (1995). Identifying multiple sclerosis patients with mild or global cognitive impairment using the Screening Examination for Cognitive Impairment (SEFCI). Neurology, 45, 718-723. Confavreuex, C., Hutchinson, M., Hours, M.M., Cortinovis-Touniaire, P., & Moreau, T. (1998). Rate of pregnancy-related relapse in multiple sclerosis. New England Journal of Medicine, 339, 285-291. Coyle, P.K. (2005). Gender issues. Neurologic Clinics, 23, 39-60. Heaton, R.K., Nelson, L.M., Thompson, D.S., Burks, J.S., & Franklin, G.M. (1985). Neuropsychological findings in relapsing-remitting and chronic progressive multiple sclerosis. Journal of Consulting and Clinical Psychology, 53, 103-110. Hutchinson, M. (1993). Pregnancy in multiple sclerosis. Journal of Neurology, Neurosurgery, and Psychiatry, 56, 1043-1045. Parmenter, B.A., Denney, D.R., & Lynch, S.G. (in press). Sex differences in verbal memory in multiple sclerosis [Abstract]. International Neuropsychological Society. Peyser, J.M. & Poser, C.M. (1986). Neuropsychological correlate of multiple sclerosis. In Filskov, S.B. & Boll, T.J. (Eds). Handbook of Clinical Neuropsychology (pp. 364-397). New York, NY: John Wiley & Sons, Inc. Rao, S.M., Leo, G.J., Bernardin, L., & Unverzagt, F. (1991). Cognitive dysfunction in multiple sclerosis: frequency, patterns, and prediction. Neurology, 41, 685-691. Smith, R. & Studd, J.W.W. (1992). A pilot study of the effect upon multiple sclerosis of the menopause, hormone therapy and the menstrual cycle. Journal of the Royal Society of Medicine, 85(10), 612-613. Tomassini, V., Onesti, E., Mainero, C., Guigni, E., et al. (2005). Sex hormones modulate brain damage in multiple sclerosis: MRI evidence. Journal of Neurology, Neurosurgery, and Psychiatry, 76, 272-275. Vukusic, S., Hutchinson, M., Hours, M., et al. (2004). Pregnancy and multiple sclerosis (the PRIMS) study: clinical predictors of post-partum relapse. Brain, 127, 1353-1360. REPRESENTATIVE PUBLICATIONS: Parmenter, B.A., Weinstock-Guttman, B., Garg, N, Munschauer, F, & Benedict, R.H.B. (in press). Using the Symbol Digit Modalities Test (SDMT) as a Screening Measure of Cognitive Impairment in Multiple Sclerosis. Multiple Sclerosis. Parmenter, B.A., Denney, D.R., Lynch, S.G., Heinze, L.S., & Harlan, L.M. (in press). Cognitive Impairment in Patients with Multiple Sclerosis: Association with the APOE Gene and Promoter Polymorphisms. Multiple Sclerosis. Parmenter, B.A., Zivadinov, R., Kerenyi, L., Gavett, R., Weinstock-Guttman, B., Dwyer, M.G., Garg, N., Munschauer, F., & Benedict, R.H.B. (in press). Comparing the validity of the Wisconsin Card Sorting Test and the Delis-Kaplan Executive Function System (DKEFS) Sorting Tests in patients with multiple sclerosis. Journal of Clinical and Experimental Neuropsychology. Parmenter, B.A., Shucard, J.L., Benedict, R.H.B., & Shucard, D.W. (2006). Working memory deficits in multiple sclerosis: comparison between the n-back task and Paced Auditory Serial Addition Test. Journal of the International Neuropsychological Society, 12, 677-687. Middleton, L.S., Denney, D.R., Lynch, S.G., & Parmenter, B.A. (2006). The relationship between perceived and objective cognitive functioning in multiple sclerosis. Archives of Clinical Neuropsychology, 21, 487-494. Shucard, D.W., Parmenter, B.A., & El Sohl, A.A. (2006). Computer analysis of sleep studies. In Encyclopedia of Medical Devices and Instrumentation. Hoboken, NJ: John Wiley & Sons Lynch, S.G., Parmenter, B.A., & Denney, D.R. (2005). The association between cognitive impairment and physical disability in multiple sclerosis. Multiple Sclerosis, 11, 469-476 Denney, D.R., Lynch, S.G., Parmenter, B.A., & Horne, N. (2004). Cognitive impairment in relapsing and primary progressive multiple sclerosis: mostly a matter of speed. Journal of the International Neuropsychological Society, 10, 948-956. Parmenter, B.A., Denney, D.R., & Lynch, S.G. (2003). The cognitive performance of patients with multiple sclerosis during periods of high and low fatigue. Multiple Sclerosis, 9(2), 111-118.