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Lacasse JM, Heller C, Kheloui S, Ismail N, Raval AP, Schuh KM, Tronson NC, Leuner B. Beyond Birth Control: The Neuroscience of Hormonal Contraceptives. J Neurosci 2024; 44:e1235242024. [PMID: 39358019 PMCID: PMC11450536 DOI: 10.1523/jneurosci.1235-24.2024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2024] [Revised: 07/23/2024] [Accepted: 07/23/2024] [Indexed: 10/04/2024] Open
Abstract
Hormonal contraceptives (HCs) are one of the most highly prescribed classes of drugs in the world used for both contraceptive and noncontraceptive purposes. Despite their prevalent use, the impact of HCs on the brain remains inadequately explored. This review synthesizes recent findings on the neuroscience of HCs, with a focus on human structural neuroimaging as well as translational, nonhuman animal studies investigating the cellular, molecular, and behavioral effects of HCs. Additionally, we consider data linking HCs to mood disorders and dysregulation of the hypothalamic-pituitary-adrenal (HPA) axis and stress response as a potential mediator. The review also addresses the unique sensitivity of the adolescent brain to HCs, noting significant changes in brain structure and function when HCs are used during this developmental period. Finally, we discuss potential effects of HCs in combination with smoking-derived nicotine on outcomes of ischemic brain damage. Methodological challenges, such as the variability in HC formulations and user-specific factors, are acknowledged, emphasizing the need for precise and individualized research approaches. Overall, this review underscores the necessity for continued interdisciplinary research to elucidate the neurobiological mechanisms of HCs, aiming to optimize their use and improve women's health.
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Affiliation(s)
- Jesse M Lacasse
- Department of Psychology, Brock University, St Catharines, Ontario L2S 3A1, Canada
- Centre for Neuroscience, Brock University, St Catharines, Ontario L2S 3A1, Canada
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Ontario M6J 1H4, Canada
| | - Carina Heller
- Department of Clinical Psychology, Friedrich Schiller University Jena, Jena 07743, Germany
- Department of Psychiatry and Psychotherapy, Jena University Hospital, Jena 07743, Germany
- German Center for Mental Health (DZPG), Partner Site Jena-Magdeburg-Halle, Jena 07743, Germany
- Center for Intervention and Research on Adaptive and Maladaptive Brain Circuits Underlying Mental Health (C-I-R-C), Partner Site Jena-Magdeburg-Halle, Jena 07743, Germany
| | - Sarah Kheloui
- NISE Lab, School of Psychology, Faculty of Social Sciences, University of Ottawa, Ottawa, Ontario K1N 6N5, Canada
| | - Nafissa Ismail
- NISE Lab, School of Psychology, Faculty of Social Sciences, University of Ottawa, Ottawa, Ontario K1N 6N5, Canada
| | - Ami P Raval
- Peritz Scheinberg Cerebral Vascular Disease Research Laboratories, Department of Neurology, Leonard M. Miller School of Medicine, University of Miami and Bruce W. Carter Department of Veterans Affairs Medical Center, Miami, Florida 33136
| | - Kristen M Schuh
- Psychology Department, University of Michigan, Ann Arbor, Michigan 48109
| | - Natalie C Tronson
- Psychology Department, University of Michigan, Ann Arbor, Michigan 48109
| | - Benedetta Leuner
- Department of Psychology, The Ohio State University, Columbus, Ohio 43210
- Department of Neuroscience, The Ohio State University, Columbus, Ohio 43210
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Brouillard A, Davignon LM, Vachon-Presseau É, Roy M, Marin MF. Starting the pill during adolescence: Age of onset and duration of use influence morphology of the hippocampus and ventromedial prefrontal cortex. Eur J Neurosci 2024. [PMID: 39245916 DOI: 10.1111/ejn.16509] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2023] [Revised: 07/29/2024] [Accepted: 07/31/2024] [Indexed: 09/10/2024]
Abstract
From adolescence, women become more likely to experience fear dysregulation. Oral contraceptives (OCs) can modulate the brain regions involved in fear processes. OCs are generally used for years and often initiated during adolescence, a sensitive period where certain brain regions involved in the fear circuitry are still undergoing important reorganization. It remains unknown whether OC use during adolescence may induce long-lasting changes in the fear circuitry. This study aimed to examine whether age of onset moderated the relationship between duration of use and fear-related brain structures. We collected structural MRI data in 98 healthy adult women (61 current users, 37 past users) and extracted grey matter volumes (GMV) and cortical thickness (CT) of key regions of the fear circuitry. Non-linear multiple regressions revealed interaction effects between age of onset and quadratic duration of use on GMV of the right hippocampus and right ventromedial prefrontal cortex (vmPFC). Among women who initiated OCs earlier in adolescence, a short duration of use was associated with smaller hippocampal GMV and thicker vmPFC compared to a longer duration of use. For both GMV and CT of the right vmPFC, women with an early OC onset had more grey matter at a short duration of use than those with a later onset. Our results suggest that OC use earlier in adolescence may induce lasting effects on structural correlates of fear learning and its regulation. These findings support further investigation into the timing of OC use to better comprehend how OCs could disrupt normal brain development processes.
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Affiliation(s)
- Alexandra Brouillard
- Department of Psychology, Université du Québec à Montréal, Montreal, QC, Canada
- Research Center of the Institut universitaire en santé mentale de Montréal, Montreal, QC, Canada
| | - Lisa-Marie Davignon
- Department of Psychology, Université du Québec à Montréal, Montreal, QC, Canada
- Research Center of the Institut universitaire en santé mentale de Montréal, Montreal, QC, Canada
| | - Étienne Vachon-Presseau
- Department of Anesthesia, McGill University, Montreal, QC, Canada
- Faculty of Dental Medicine and Oral Health Sciences, McGill University, Montreal, QC, Canada
- Alan Edwards Centre for Research on Pain, McGill University, Montreal, QC, Canada
| | - Mathieu Roy
- Alan Edwards Centre for Research on Pain, McGill University, Montreal, QC, Canada
- Department of Psychology, McGill University, Montreal, QC, Canada
| | - Marie-France Marin
- Department of Psychology, Université du Québec à Montréal, Montreal, QC, Canada
- Research Center of the Institut universitaire en santé mentale de Montréal, Montreal, QC, Canada
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Rizor EJ, Babenko V, Dundon NM, Beverly‐Aylwin R, Stump A, Hayes M, Herschenfeld‐Catalan L, Jacobs EG, Grafton ST. Menstrual cycle-driven hormone concentrations co-fluctuate with white and gray matter architecture changes across the whole brain. Hum Brain Mapp 2024; 45:e26785. [PMID: 39031470 PMCID: PMC11258887 DOI: 10.1002/hbm.26785] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2023] [Revised: 06/19/2024] [Accepted: 07/02/2024] [Indexed: 07/22/2024] Open
Abstract
Cyclic fluctuations in hypothalamic-pituitary-gonadal axis (HPG-axis) hormones exert powerful behavioral, structural, and functional effects through actions on the mammalian central nervous system. Yet, very little is known about how these fluctuations alter the structural nodes and information highways of the human brain. In a study of 30 naturally cycling women, we employed multidimensional diffusion and T1-weighted imaging during three estimated menstrual cycle phases (menses, ovulation, and mid-luteal) to investigate whether HPG-axis hormone concentrations co-fluctuate with alterations in white matter (WM) microstructure, cortical thickness (CT), and brain volume. Across the whole brain, 17β-estradiol and luteinizing hormone (LH) concentrations were directly proportional to diffusion anisotropy (μFA; 17β-estradiol: β1 = 0.145, highest density interval (HDI) = [0.211, 0.4]; LH: β1 = 0.111, HDI = [0.157, 0.364]), while follicle-stimulating hormone (FSH) was directly proportional to CT (β1 = 0 .162, HDI = [0.115, 0.678]). Within several individual regions, FSH and progesterone demonstrated opposing relationships with mean diffusivity (Diso) and CT. These regions mainly reside within the temporal and occipital lobes, with functional implications for the limbic and visual systems. Finally, progesterone was associated with increased tissue (β1 = 0.66, HDI = [0.607, 15.845]) and decreased cerebrospinal fluid (CSF; β1 = -0.749, HDI = [-11.604, -0.903]) volumes, with total brain volume remaining unchanged. These results are the first to report simultaneous brain-wide changes in human WM microstructure and CT coinciding with menstrual cycle-driven hormone rhythms. Effects were observed in both classically known HPG-axis receptor-dense regions (medial temporal lobe, prefrontal cortex) and in other regions located across frontal, occipital, temporal, and parietal lobes. Our results suggest that HPG-axis hormone fluctuations may have significant structural impacts across the entire brain.
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Affiliation(s)
- Elizabeth J. Rizor
- Department of Psychological & Brain SciencesUniversity of CaliforniaSanta BarbaraCaliforniaUSA
- Institute for Collaborative BiotechnologiesUniversity of CaliforniaSanta BarbaraCaliforniaUSA
| | - Viktoriya Babenko
- Department of Psychological & Brain SciencesUniversity of CaliforniaSanta BarbaraCaliforniaUSA
- BIOPAC Systems, IncGoletaCaliforniaUSA
| | - Neil M. Dundon
- Department of Psychological & Brain SciencesUniversity of CaliforniaSanta BarbaraCaliforniaUSA
- Institute for Collaborative BiotechnologiesUniversity of CaliforniaSanta BarbaraCaliforniaUSA
- Department of Child and Adolescent Psychiatry, Psychotherapy and PsychosomaticsUniversity of FreiburgFreiburgGermany
| | - Renee Beverly‐Aylwin
- Department of Psychological & Brain SciencesUniversity of CaliforniaSanta BarbaraCaliforniaUSA
| | - Alexandra Stump
- Department of Psychological & Brain SciencesUniversity of CaliforniaSanta BarbaraCaliforniaUSA
| | - Margaret Hayes
- Department of Psychological & Brain SciencesUniversity of CaliforniaSanta BarbaraCaliforniaUSA
| | | | - Emily G. Jacobs
- Department of Psychological & Brain SciencesUniversity of CaliforniaSanta BarbaraCaliforniaUSA
- Neuroscience Research InstituteUniversity of CaliforniaSanta BarbaraCaliforniaUSA
| | - Scott T. Grafton
- Department of Psychological & Brain SciencesUniversity of CaliforniaSanta BarbaraCaliforniaUSA
- Institute for Collaborative BiotechnologiesUniversity of CaliforniaSanta BarbaraCaliforniaUSA
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Lee JK, Raghavan S, Christenson LR, Frank RD, Kantarci K, Rocca WA, Vemuri P, Mielke MM. Longitudinal associations of reproductive factors and exogeneous estrogens with neuroimaging biomarkers of Alzheimer's disease and cerebrovascular disease. Alzheimers Dement 2024; 20:4613-4624. [PMID: 38859736 PMCID: PMC11247693 DOI: 10.1002/alz.13890] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2024] [Revised: 04/02/2024] [Accepted: 04/22/2024] [Indexed: 06/12/2024]
Abstract
INTRODUCTION Female-specific reproductive factors and exogeneous estrogen use are associated with cognition in later life. However, the underlying mechanisms are not understood. The present study aimed to investigate the effect of reproductive factors on neuroimaging biomarkers of Alzheimer's disease (AD) and cerebrovascular pathologies. METHODS We evaluated 389 females (median age of 71.7 years) enrolled in the Mayo Clinic Study of Aging with reproductive history data and longitudinal magnetic resonance imaging (MRI) scans. We used linear mixed effect models to examine the associations between reproductive factors and changes in neuroimaging measures. RESULTS Ever hormonal contraception (HC) use was longitudinally associated with higher fractional anisotropy across the corpus callosum, lower white matter hyperintensity (WMH) volume, and greater cortical thickness in an AD meta-region of interest (ROI). The initiation of menopausal hormone therapy (MHT) > 5 years post menopause was associated with higher WMH volume. DISCUSSION HC use and initiation of MHT >5 years post menopause were generally associated with neuroimaging biomarkers of cerebrovascular pathologies. HIGHLIGHTS Hormonal contraception use was associated with better brain white matter (WM) integrity. Initiation of menopausal hormone therapy >5 years post menopause was associated with worsening brain WM integrity. Hormonal contraception use was associated with greater cortical thickness. Ages at menarche and menopause and number of pregnancies were not associated with imaging measures. There were few associations between reproductive factors or exogenous estrogens and amyloid or tau PET.
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Affiliation(s)
- Jillian K Lee
- Department of Epidemiology and Prevention, Wake Forest University School of Medicine, Winston-Salem, North Carolina, USA
| | | | - Luke R Christenson
- Department of Quantitative Health Sciences, Mayo Clinic, Rochester, Minnesota, USA
| | - Ryan D Frank
- Department of Quantitative Health Sciences, Mayo Clinic, Rochester, Minnesota, USA
| | - Kejal Kantarci
- Department of Radiology, Mayo Clinic, Rochester, Minnesota, USA
| | - Walter A Rocca
- Department of Quantitative Health Sciences, Mayo Clinic, Rochester, Minnesota, USA
- Department of Neurology, Mayo Clinic, Rochester, Minnesota, USA
- Women's Health Research Center, Mayo Clinic, Rochester, Minnesota, USA
| | | | - Michelle M Mielke
- Department of Epidemiology and Prevention, Wake Forest University School of Medicine, Winston-Salem, North Carolina, USA
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Dubol M, Stiernman L, Sundström-Poromaa I, Bixo M, Comasco E. Cortical morphology variations during the menstrual cycle in individuals with and without premenstrual dysphoric disorder. J Affect Disord 2024; 355:470-477. [PMID: 38552916 DOI: 10.1016/j.jad.2024.03.130] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/24/2023] [Revised: 02/16/2024] [Accepted: 03/23/2024] [Indexed: 04/09/2024]
Abstract
BACKGROUND Premenstrual dysphoric disorder (PMDD) is hypothesized to stem from maladaptive neural sensitivity to ovarian steroid hormone fluctuations. Recently, we found thinner cortices in individuals with PMDD, compared to healthy controls, during the symptomatic phase. Here, we aimed at investigating whether such differences illustrate state-like characteristics specific to the symptomatic phase, or trait-like features defining PMDD. METHODS Patients and controls were scanned using structural magnetic resonance imaging during the mid-follicular and late-luteal phase of the menstrual cycle. Group-by-phase interaction effects on cortical architecture metrics (cortical thickness, gyrification index, cortical complexity, and sulcal depth) were assessed using surface-based morphometry. RESULTS Independently of menstrual cycle phase, a main effect of diagnostic group on surface metrics was found, primarily illustrating thinner cortices (0.3 < Cohen's d > 1.1) and lower gyrification indices (0.4 < Cohen's d > 1.0) in patients compared to controls. Furthermore, menstrual cycle-specific effects were detected across all participants, depicting a decrease in cortical thickness (0.4 < Cohen's d > 1.7) and region-dependent changes in cortical folding metrics (0.4 < Cohen's d > 2.2) from the mid-follicular to the late luteal phase. LIMITATIONS Small effects (d = 0.3) require a larger sample size to be accurately characterized. CONCLUSIONS These findings provide initial evidence of trait-like cortical characteristics of the brain of individuals with premenstrual dysphoric disorder, together with indications of menstrual cycle-related variations in cortical architecture in patients and controls. Further investigations exploring whether these differences constitute stable vulnerability markers or develop over the years may help understand PMDD etiology.
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Affiliation(s)
- Manon Dubol
- Department of Women's and Children's Health, Science for Life Laboratory, Uppsala University, Sweden
| | | | | | - Marie Bixo
- Department of Clinical Sciences, Umeå University, Sweden
| | - Erika Comasco
- Department of Women's and Children's Health, Science for Life Laboratory, Uppsala University, Sweden.
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Kim GW, Park K, Kim YH, Jeong GW. Altered brain morphology and functional connectivity in postmenopausal women: automatic segmentation of whole-brain and thalamic subnuclei and resting-state fMRI. Aging (Albany NY) 2024; 16:4965-4979. [PMID: 38526330 PMCID: PMC11006480 DOI: 10.18632/aging.205662] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2023] [Accepted: 02/07/2024] [Indexed: 03/26/2024]
Abstract
The transition to menopause is associated with various physiological changes, including alterations in brain structure and function. However, menopause-related structural and functional changes are poorly understood. The purpose of this study was not only to compare the brain volume changes between premenopausal and postmenopausal women, but also to evaluate the functional connectivity between the targeted brain regions associated with structural atrophy in postmenopausal women. Each 21 premenopausal and postmenopausal women underwent magnetic resonance imaging (MRI). T1-weighted MRI and resting-state functional MRI data were used to compare the brain volume and seed-based functional connectivity, respectively. In statistical analysis, multivariate analysis of variance, with age and whole brain volume as covariates, was used to evaluate surface areas and subcortical volumes between the two groups. Postmenopausal women showed significantly smaller cortical surface, especially in the left medial orbitofrontal cortex (mOFC), right superior temporal cortex, and right lateral orbitofrontal cortex, compared to premenopausal women (p < 0.05, Bonferroni-corrected) as well as significantly decreased functional connectivity between the left mOFC and the right thalamus was observed (p < 0.005, Monte-Carlo corrected). Although postmenopausal women did not show volume atrophy in the right thalamus, the volume of the right pulvinar anterior, which is one of the distinguished thalamic subnuclei, was significantly decreased (p < 0.05, Bonferroni-corrected). Taken together, our findings suggest that diminished brain volume and functional connectivity may be linked to menopause-related symptoms caused by the lower sex hormone levels.
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Affiliation(s)
- Gwang-Won Kim
- Advanced Institute of Aging Science, Chonnam National University, Gwangju 61186, Republic of Korea
| | - Kwangsung Park
- Advanced Institute of Aging Science, Chonnam National University, Gwangju 61186, Republic of Korea
- Department of Urology, Chonnam National University Hospital, Chonnam National University Medical School, Gwangju 61469, Republic of Korea
| | - Yun-Hyeon Kim
- Department of Radiology, Chonnam National University Hospital, Chonnam National University Medical School, Gwangju 61469, Republic of Korea
| | - Gwang-Woo Jeong
- Department of Radiology, Chonnam National University Hospital, Chonnam National University Medical School, Gwangju 61469, Republic of Korea
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Brouillard A, Davignon LM, Turcotte AM, Marin MF. Morphologic alterations of the fear circuitry: the role of sex hormones and oral contraceptives. Front Endocrinol (Lausanne) 2023; 14:1228504. [PMID: 38027091 PMCID: PMC10661904 DOI: 10.3389/fendo.2023.1228504] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/24/2023] [Accepted: 09/27/2023] [Indexed: 12/01/2023] Open
Abstract
Background Endogenous sex hormones and oral contraceptives (OCs) have been shown to influence key regions implicated in fear processing. While OC use has been found to impact brain morphology, methodological challenges remain to be addressed, such as avoiding selection bias between OC users and non-users, as well as examining potential lasting effects of OC intake. Objective We investigated the current and lasting effects of OC use, as well as the interplay between the current hormonal milieu and history of hormonal contraception use on structural correlates of the fear circuitry. We also examined the role of endogenous and exogenous sex hormones within this network. Methods We recruited healthy adults aged 23-35 who identified as women currently using (n = 62) or having used (n = 37) solely combined OCs, women who never used any hormonal contraceptives (n = 40), or men (n = 41). Salivary endogenous sex hormones and current users' salivary ethinyl estradiol (EE) were assessed using liquid chromatography - tandem mass spectrometry. Using structural magnetic resonance imaging, we extracted surface-based gray matter volumes (GMVs) and cortical thickness (CT) for regions of interest of the fear circuitry. Exploratory whole-brain analyses were conducted with surface-based and voxel-based morphometry methods. Results Compared to men, all three groups of women exhibited a larger GMV of the dorsal anterior cingulate cortex, while only current users showed a thinner ventromedial prefrontal cortex. Irrespective of the menstrual cycle phase, never users exhibited a thicker right anterior insular cortex than past users. While associations with endogenous sex hormones remain unclear, we showed that EE dosage in current users had a greater influence on brain anatomy compared to salivary EE levels and progestin androgenicity, with lower doses being associated with smaller cortical GMVs. Discussion Our results highlight a sex difference for the dorsal anterior cingulate cortex GMV (a fear-promoting region), as well as a reduced CT of the ventromedial prefrontal cortex (a fear-inhibiting region) specific to current OC use. Precisely, this finding was driven by lower EE doses. These findings may represent structural vulnerabilities to anxiety and stress-related disorders. We showed little evidence of durable anatomical effects, suggesting that OC intake can (reversibly) affect fear-related brain morphology.
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Affiliation(s)
- Alexandra Brouillard
- Research Center of the Institut Universitaire en Santé Mentale de Montréal, Montreal, QC, Canada
- Department of Psychology, University of Quebec in Montreal, Montreal, QC, Canada
| | - Lisa-Marie Davignon
- Research Center of the Institut Universitaire en Santé Mentale de Montréal, Montreal, QC, Canada
- Department of Psychology, University of Quebec in Montreal, Montreal, QC, Canada
| | | | - Marie-France Marin
- Research Center of the Institut Universitaire en Santé Mentale de Montréal, Montreal, QC, Canada
- Department of Psychology, University of Quebec in Montreal, Montreal, QC, Canada
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Hidalgo-Lopez E, Noachtar I, Pletzer B. Hormonal contraceptive exposure relates to changes in resting state functional connectivity of anterior cingulate cortex and amygdala. Front Endocrinol (Lausanne) 2023; 14:1131995. [PMID: 37522123 PMCID: PMC10374315 DOI: 10.3389/fendo.2023.1131995] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/26/2022] [Accepted: 06/09/2023] [Indexed: 08/01/2023] Open
Abstract
Introduction Hormonal contraceptives (HCs), nowadays one of the most used contraceptive methods, downregulate endogenous ovarian hormones, which have multiple plastic effects in the adult brain. HCs usually contain a synthetic estrogen, ethinyl-estradiol, and a synthetic progestin, which can be classified as androgenic or anti-androgenic, depending on their interaction with androgen receptors. Both the anterior cingulate cortex (ACC) and the amygdala express steroid receptors and have shown differential functionality depending on the hormonal status of the participant and the use of HC. In this work, we investigated for the first time the relationship between ACC and amygdala resting state functional connectivity (rs-FC) and HC use duration, while controlling for progestin androgenicity. Methods A total of 231 healthy young women participated in five different magnetic resonance imaging studies and were included in the final analysis. The relation between HC use duration and (i) gray matter volume, (ii) fractional amplitude of low-frequency fluctuations, and (iii) seed-based connectivity during resting state in the amygdalae and ACC was investigated in this large sample of women. Results In general, rs-FC of the amygdalae with frontal areas, and between the ACC and temporoparietal areas, decreased the longer the HC exposure and independently of the progestin's androgenicity. The type of HC's progestin did show a differential effect in the gray matter volume of left ACC and the connectivity between bilateral ACC and the right inferior frontal gyrus.
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Affiliation(s)
- Esmeralda Hidalgo-Lopez
- Centre for Cognitive Neuroscience, University of Salzburg, Salzburg, Austria
- Department of Psychology, University of Salzburg, Salzburg, Austria
| | - Isabel Noachtar
- Centre for Cognitive Neuroscience, University of Salzburg, Salzburg, Austria
- Department of Psychology, University of Salzburg, Salzburg, Austria
| | - Belinda Pletzer
- Centre for Cognitive Neuroscience, University of Salzburg, Salzburg, Austria
- Department of Psychology, University of Salzburg, Salzburg, Austria
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Segarra I, Menárguez M, Roqué MV. Women's health, hormonal balance, and personal autonomy. Front Med (Lausanne) 2023; 10:1167504. [PMID: 37457571 PMCID: PMC10347535 DOI: 10.3389/fmed.2023.1167504] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2023] [Accepted: 05/30/2023] [Indexed: 07/18/2023] Open
Abstract
Hormone-based contraception disrupts hormonal balance, creating artificial states of anovulation and threatening women's health. We reviewed its main adverse effects and mechanisms on accelerated ovarian aging, mental health (emotional disruptions, depression, and suicide), sexuality (reduced libido), cardiovascular (brain stroke, myocardial infarction, hypertension, and thrombosis), and oncological (breast, cervical, and endometrial cancers). Other "collateral damage" includes negative effects on communication, scientific mistrust, poor physician-patient relationships, increased patient burden, economic drain on the healthcare system, and environmental pollution. Hormone-sensitive tumors present a dilemma owing to their potential dual effects: preventing some cancers vs. higher risk for others remains controversial, with denial or dismissal as non-relevant adverse effects, information avoidance, and modification of scientific criteria. This lack of clinical assessment poses challenges to women's health and their right to autonomy. Overcoming these challenges requires an anthropological integration of sexuality, as the focus on genital bodily union alone fails to encompass the intimate relational expression of individuals, complete sexual satisfaction, and the intertwined feelings of trust, safety, tenderness, and endorsement of women's femininity.
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Affiliation(s)
- Ignacio Segarra
- Department of Pharmacy, Faculty of Pharmacy and Nutrition, Catholic University of Murcia (UCAM), Murcia, Spain
- “Pharmacokinetics, Patient Care and Translational Bioethics” Research Group, Faculty of Pharmacy and Nutrition, Catholic University of Murcia (UCAM), Murcia, Spain
| | - Micaela Menárguez
- Bioethics Chair, Faculty of Medicine, Catholic University of Murcia (UCAM), Murcia, Spain
| | - María Victoria Roqué
- “Pharmacokinetics, Patient Care and Translational Bioethics” Research Group, Faculty of Pharmacy and Nutrition, Catholic University of Murcia (UCAM), Murcia, Spain
- Bioethics Chair, Faculty of Medicine, Catholic University of Murcia (UCAM), Murcia, Spain
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Hidalgo-Lopez E, Engman J, Poromaa IS, Gingnell M, Pletzer B. Triple network model of brain connectivity changes related to adverse mood effects in an oral contraceptive placebo-controlled trial. Transl Psychiatry 2023; 13:209. [PMID: 37328507 PMCID: PMC10276024 DOI: 10.1038/s41398-023-02470-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/16/2022] [Revised: 05/02/2023] [Accepted: 05/12/2023] [Indexed: 06/18/2023] Open
Abstract
Combined oral contraceptives (COC) are among the most commonly used contraceptive methods worldwide, and mood side effects are the major reason for discontinuation of treatment. We here investigate the directed connectivity patterns associated with the mood side effects of an androgenic COC in a double-blind randomized, placebo-controlled trial in women with a history of affective COC side effects (n = 34). We used spectral dynamic causal modeling on a triple network model consisting of the default mode network (DMN), salience network (SN) and executive control network (ECN). Within this framework, we assessed the treatment-related changes in directed connectivity associated with adverse mood side effects. Overall, during COC use, we found a pattern of enhanced connectivity within the DMN and decreased connectivity within the ECN. The dorsal anterior cingulate cortex (SN) mediates an increased recruitment of the DMN by the ECN during treatment. Mood lability was the most prominent COC-induced symptom and also arose as the side effect most consistently related to connectivity changes. Connections that were related to increased mood lability showed increased connectivity during COC treatment, while connections that were related to decreased mood lability showed decreased connectivity during COC treatment. Among these, the connections with the highest effect size could also predict the participants' treatment group above chance.
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Affiliation(s)
- Esmeralda Hidalgo-Lopez
- Department of Psychology, University of Salzburg, Salzburg, Austria.
- Centre for Cognitive Neuroscience, University of Salzburg, Salzburg, Austria.
- Department of Psychology, University of Michigan, Ann Arbor, MI, USA.
- Department of Anesthesiology, Chronic Pain and Fatigue Research Center, University of Michigan, Ann Arbor, MI, USA.
| | - Jonas Engman
- Department of Psychology, Uppsala University, 751 85, Uppsala, Sweden
| | - Inger Sundström Poromaa
- Department of Women's and Children's Health, Uppsala University, 751 85, Uppsala, Sweden
- Centre for Women's Mental Health during the Reproductive Lifespan, Uppsala University, 751 85, Uppsala, Sweden
| | - Malin Gingnell
- Department of Psychology, Uppsala University, 751 85, Uppsala, Sweden
- Department of Women's and Children's Health, Uppsala University, 751 85, Uppsala, Sweden
- Department of Medical Sciences, Uppsala University, 751 85, Uppsala, Sweden
| | - Belinda Pletzer
- Department of Psychology, University of Salzburg, Salzburg, Austria.
- Centre for Cognitive Neuroscience, University of Salzburg, Salzburg, Austria.
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Pletzer B, Winkler-Crepaz K, Hillerer K. Progesterone and contraceptive progestin actions on the brain: A systematic review of animal studies and comparison to human neuroimaging studies. Front Neuroendocrinol 2023; 69:101060. [PMID: 36758768 DOI: 10.1016/j.yfrne.2023.101060] [Citation(s) in RCA: 10] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/30/2022] [Revised: 01/25/2023] [Accepted: 02/03/2023] [Indexed: 02/09/2023]
Abstract
In this review we systematically summarize the effects of progesterone and synthetic progestins on neurogenesis, synaptogenesis, myelination and six neurotransmitter systems. Several parallels between progesterone and older generation progestin actions emerged, suggesting actions via progesterone receptors. However, existing results suggest a general lack of knowledge regarding the effects of currently used progestins in hormonal contraception regarding these cellular and molecular brain parameters. Human neuroimaging studies were reviewed with a focus on randomized placebo-controlled trials and cross-sectional studies controlling for progestin type. The prefrontal cortex, amygdala, salience network and hippocampus were identified as regions of interest for future preclinical studies. This review proposes a series of experiments to elucidate the cellular and molecular actions of contraceptive progestins in these areas and link these actions to behavioral markers of emotional and cognitive functioning. Emotional effects of contraceptive progestins appear to be related to 1) alterations in the serotonergic system, 2) direct/indirect modulations of inhibitory GABA-ergic signalling via effects on the allopregnanolone content of the brain, which differ between androgenic and anti-androgenic progestins. Cognitive effects of combined oral contraceptives appear to depend on the ethinylestradiol dose.
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Affiliation(s)
- Belinda Pletzer
- Department of Psychology & Centre for Cognitive Neuroscience, Paris-Lodron-University Salzburg, Salzburg Austria.
| | | | - Katharina Hillerer
- Department of Gynaecology & Obstetrics, Private Medical University, Salzburg, Austria
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12
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Jensen A, Thériault K, Yilmaz E, Pon E, Davidson PSR. Mental rotation, episodic memory, and executive control: Possible effects of biological sex and oral contraceptive use. Neurobiol Learn Mem 2023; 198:107720. [PMID: 36621560 DOI: 10.1016/j.nlm.2023.107720] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2022] [Revised: 11/02/2022] [Accepted: 01/02/2023] [Indexed: 01/07/2023]
Abstract
Oral contraceptives (OCs) are one of the most common forms of hormonal birth control. A small literature suggests that OC use may affect visuospatial ability, episodic memory, and executive control. However, previous studies have been criticized for small sample sizes and the use of different, single cognitive tests. We investigated the degree to which biological sex and OC use might affect individual mental rotation, episodic memory, and executive control in a large sample of healthy, young adults (N = 155, including 52 OC users, 53 naturally cycling females, and 50 males) tested individually over videoconference. To measure cognition, we used a set of neuropsychological tasks inspired by Glisky and colleagues' two-factor episodic memory and executive control battery, from which two composite scores (based on principal component analysis) were derived for each participant. Our pre-registered analysis revealed a clear female advantage in episodic memory, independent of OC use. In an exploratory analysis, gist memory was elevated in OC users. Interestingly, we found no significant sex-related differences nor effects of OC use on mental rotation or executive control. Duration of OC use was also not related to any of our cognitive measures. These results suggest that the use of combined, monophasic OCs does not lead to many significant changes in cognition in young adults, although young females overall may have better episodic memory than young males. Additional studies, including longitudinal designs and looking in more detail at the menstrual cycle and OC use history, will further clarify the effects of different types of OCs and their duration of use on different aspects of cognition.
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Affiliation(s)
- Adelaide Jensen
- School of Psychology, Faculty of Social Sciences, University of Ottawa, Canada.
| | - Kim Thériault
- School of Psychology, Faculty of Social Sciences, University of Ottawa, Canada
| | - Ece Yilmaz
- School of Psychology, Faculty of Social Sciences, University of Ottawa, Canada
| | - Ethan Pon
- School of Psychology, Faculty of Social Sciences, University of Ottawa, Canada
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13
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Kim TH, Kim B, Kim YR, Jeong CW, Lee YH. Gray matter differences associated with menopausal hormone therapy in menopausal women: a DARTEL-based VBM study. Sci Rep 2023; 13:1401. [PMID: 36697505 PMCID: PMC9877025 DOI: 10.1038/s41598-023-28673-2] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2022] [Accepted: 01/23/2023] [Indexed: 01/26/2023] Open
Abstract
Menopausal hormone therapy (MHT) in women can reduce troublesome menopause symptoms and prevent cognitive decline. This cross-sectional study investigated the MHT-related effect on brain morphology and its association with sex hormones in menopausal women by using an optimized diffeomorphic anatomical registration through exponentiated Lie algebra (DARTEL)-based voxel-based morphometry (VBM) method. Twenty-one menopausal women without MHT (noMHT) and 20 menopausal women with MHT were included in this study. Magnetic resonance imaging data were processed using SPM 12 with DARTEL-based VBM whole brain analysis approach. A 2-sample t-test and analysis of covariance (ANCOVA) adjusting for age and total intracranial volume were used to compare GM volume between noMHT and MHT women. The association between MHT (treatment period, hormones levels) and brain volume variations were analyzed by Spearman correlation. MHT women showed significantly larger volumes of the superior/middle/inferior frontal gyri, hypothalamus, inferior temporal gyrus, parahippocampal gyrus, hippocampus, cerebellar cortex, postcentral gyrus, precuneus, angular gyrus, supplementary motor area, superior occipital gyrus, and precentral gyrus compared to the noMHT women. The volumes of the angular gyrus and hypothalamus in MHT women positively correlated with treatment period. On the other hand, the hypothalamic volume negatively correlated with FSH and LH levels, and the volumes of the inferior frontal gyrus, and angular gyrus negatively correlated with progesterone levels, respectively. MHT-treated women showed larger GM volume than noMHT women. The anatomical structures that showed greater volume in association with MHT included the deep brain areas, frontal, temporal, parietal, and occipital gyri.
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Affiliation(s)
- Tae-Hoon Kim
- Medical Convergence Research Center, Wonkwang University and Hospital, Iksan, 54538, Republic of Korea.
| | - ByoungRyun Kim
- Department of Obstetrics and Gynecology, Wonkwang University Hospital, Iksan, 54538, Republic of Korea
| | - Youe Ree Kim
- Department of Radiology, Wonkwang University School of Medicine, Iksan, 54538, Republic of Korea
| | - Chang-Won Jeong
- Medical Convergence Research Center, Wonkwang University and Hospital, Iksan, 54538, Republic of Korea
| | - Young Hwan Lee
- Department of Radiology, Wonkwang University School of Medicine, Iksan, 54538, Republic of Korea
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14
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Hampson E. Oral contraceptives in the central nervous system: Basic pharmacology, methodological considerations, and current state of the field. Front Neuroendocrinol 2023; 68:101040. [PMID: 36243109 DOI: 10.1016/j.yfrne.2022.101040] [Citation(s) in RCA: 10] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/05/2022] [Revised: 09/19/2022] [Accepted: 10/06/2022] [Indexed: 11/06/2022]
Abstract
Millions of women around the world use combined oral contraceptives (OCs), yet surprisingly little is known about their central nervous system (CNS) effects. This article provides a short overview of the basic pharmacology of OCs, emphasizing features that may be relevant to understanding their effects in the CNS. Historical and recent findings from studies of cognitive function, mood, and negative affect (depressive changes under OC use) are then reviewed. We also present data from an archival dataset from our own laboratory in which we explore dysphoric changes in women using four generations of contraceptive progestins. Current data in the field are consistent with a modest effect of OC use on CNS variables, but conclusions based on current findings must be made very cautiously because of multiple methodological issues in many published studies to date, and inconsistencies in the findings. Directions for future research over the next 10 years are suggested. (150 words).
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Affiliation(s)
- Elizabeth Hampson
- Department of Psychology, University of Western Ontario, London, ON, Canada; Department of Psychiatry, Schulich School of Medicine and Dentistry, University of Western Ontario, London, ON, Canada.
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15
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Velasco ER, Florido A, Perez-Caballero L, Marin I, Andero R. The Impacts of Sex Differences and Sex Hormones on Fear Extinction. Curr Top Behav Neurosci 2023; 64:105-132. [PMID: 37528309 DOI: 10.1007/7854_2023_426] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/03/2023]
Abstract
Fear extinction memories are strongly modulated by sex and hormonal status, but the exact mechanisms are still being discovered. In humans, there are some basal and task-related features in which male and female individuals differ in fear conditioning paradigms. However, analyses considering the effects of sex hormones demonstrate a role for estradiol in fear extinction memory consolidation. Translational studies are taking advantage of the convergent findings between species to understand the brain structures implicated. Nevertheless, the human brain is complex and the transfer of these findings into the clinics remains a challenge. The promising advances in the field together with the standardization of fear extinction methodologies in humans will benefit the design of new personalized therapies.
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Affiliation(s)
- Eric Raul Velasco
- Institut de Neurociències, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Antonio Florido
- Institut de Neurociències, Universitat Autònoma de Barcelona, Barcelona, Spain
- Departament de Psicobiologia i de Metodologia de les Ciències de la Salut, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Laura Perez-Caballero
- Institut de Neurociències, Universitat Autònoma de Barcelona, Barcelona, Spain
- Departament de Psicobiologia i de Metodologia de les Ciències de la Salut, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Ignacio Marin
- Institut de Neurociències, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Raul Andero
- Institut de Neurociències, Universitat Autònoma de Barcelona, Barcelona, Spain.
- Departament de Psicobiologia i de Metodologia de les Ciències de la Salut, Universitat Autònoma de Barcelona, Barcelona, Spain.
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain.
- Unitat de Neurociència Traslacional, Parc Taulí Hospital Universitari, Institut d'Investigació i Innovació Parc Taulí (I3PT), Institut de Neurociències, Universitat Autònoma de Barcelona, Bellaterra, Spain.
- ICREA, Pg. Lluís Companys 23, Barcelona, Spain.
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16
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Kheloui S, Smith A, Ismail N. Combined oral contraceptives and mental health: Are adolescence and the gut-brain axis the missing links? Front Neuroendocrinol 2023; 68:101041. [PMID: 36244525 DOI: 10.1016/j.yfrne.2022.101041] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/22/2022] [Revised: 09/16/2022] [Accepted: 10/07/2022] [Indexed: 11/05/2022]
Abstract
Combined oral contraceptives (containing synthetic forms of estradiol and progestins) are one of the most commonly used drugs among females. However, their effects on the gut-brain axis have not been investigated to a great extent despite clear evidence that suggest bi-directional interactions between the gut microbiome and endogenous sex hormones. Moreover, oral contraceptives are prescribed during adolescence, a critical period of development during which several brain structures and systems, such as hypothalamic-pituitary-gonadal axis, undergo maturation. Considering that oral contraceptives could impact the developing adolescent brain and that these effects may be mediated by the gut-brain axis, further research investigating the effects of oral contraceptives on the gut-brain axis is imperative. This article briefly reviews evidence from animal and human studies on the effects of combined oral contraceptives on the brain and the gut microbiota particularly during adolescence.
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Affiliation(s)
- Sarah Kheloui
- School of Psychology, Faculty of Social Sciences, University of Ottawa, Ottawa, ON, Canada
| | - Andra Smith
- School of Psychology, Faculty of Social Sciences, University of Ottawa, Ottawa, ON, Canada; uOttawa Brain and Mind Research Institute, Ottawa, ON, Canada
| | - Nafissa Ismail
- School of Psychology, Faculty of Social Sciences, University of Ottawa, Ottawa, ON, Canada; uOttawa Brain and Mind Research Institute, Ottawa, ON, Canada; LIFE Research Institute, Ottawa, ON, Canada.
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17
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Grey matter morphology in women with premenstrual dysphoric disorder treated with a selective progesterone receptor modulator. Eur Neuropsychopharmacol 2022; 65:35-43. [PMID: 36343426 DOI: 10.1016/j.euroneuro.2022.10.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/28/2022] [Revised: 10/05/2022] [Accepted: 10/07/2022] [Indexed: 11/06/2022]
Abstract
Premenstrual dysphoric disorder (PMDD) is characterized by severe cyclic mood symptoms emerging in the luteal phase of the menstrual cycle. The variation in progesterone levels and its metabolites during the luteal phase seems critical to the occurrence of PMDD symptoms. Notably, the efficacy of selective progesterone receptor modulator (SPRM) treatment on the mental symptoms of PMDD has been recently demonstrated. In the present study, structural magnetic resonance imaging was used to assess the effects of SPRM treatment, compared with placebo, on grey matter morphology in women with PMDD. In total, 35 women were scanned during the luteal phase, before and after three months of treatment with SPRM or placebo. Symptom severity was assessed using the Daily Record of Severity of Problems (DRSP), while gonadal hormone levels were measured by liquid chromatography-tandem mass spectrometry. Region-of-interest and whole-brain approaches were employed to perform voxel-based morphometry analyses, subcortical volumetric analyses, and surface-based morphometry analyses. No interaction or main effects of treatment and time were observed on grey matter volume and cortical surface measures (cortical thickness, gyrification index, sulcal depth, and fractal dimension). The relationship between change in brain morphology and symptom severity was also explored but no treatment-dependant grey matter structure change was related to symptom severity change. These findings suggest that SPRM treatment does not impart macrostructural changes onto grey matter structure, at least in the short term.
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18
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Griksiene R, Monciunskaite R, Ruksenas O. What is there to know about the effects of progestins on the human brain and cognition? Front Neuroendocrinol 2022; 67:101032. [PMID: 36029852 DOI: 10.1016/j.yfrne.2022.101032] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/29/2022] [Revised: 07/24/2022] [Accepted: 08/19/2022] [Indexed: 12/27/2022]
Abstract
Progestins are an important component of hormonal contraceptives (HCs) and hormone replacement therapies (HRTs). Despite an increasing number of studies elucidating the effects of HCs and HRTs, little is known about the effects of different types of progestins included in these medications on the brain. Animal studies suggest that various progestins interact differently with sex steroid, mineralocorticoid and glucocorticoid receptors and have specific modulatory effects on neurotransmitter systems and on the expression of neuropeptides, suggesting differential impacts on cognition and behavior. This review focuses on the currently available knowledge from human behavioral and neuroimaging studies pooled with evidence from animal research regarding the effects of progestins on the brain. The reviewed information is highly relevant for improving women's mental health and making informed choices regarding specific types of contraception or treatment.
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Affiliation(s)
- Ramune Griksiene
- Department of Neurobiology and Biophysics, Life Sciences Center, Vilnius University, Lithuania
| | - Rasa Monciunskaite
- Department of Neurobiology and Biophysics, Life Sciences Center, Vilnius University, Lithuania
| | - Osvaldas Ruksenas
- Department of Neurobiology and Biophysics, Life Sciences Center, Vilnius University, Lithuania
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19
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Heller C, Kimmig ACS, Kubicki MR, Derntl B, Kikinis Z. Imaging the human brain on oral contraceptives: A review of structural imaging methods and implications for future research goals. Front Neuroendocrinol 2022; 67:101031. [PMID: 35998859 DOI: 10.1016/j.yfrne.2022.101031] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/14/2022] [Revised: 06/30/2022] [Accepted: 08/15/2022] [Indexed: 12/21/2022]
Abstract
Worldwide over 150 million women use oral contraceptives (OCs), which are the most prescribed form of contraception in both the United States and in European countries. Sex hormones, such as estradiol and progesterone, are important endogenous hormones known for shaping the brain across the life span. Synthetic hormones, which are present in OCs, interfere with the natural hormonal balance by reducing the endogenous hormone levels. Little is known how this affects the brain, especially during the most vulnerable times of brain maturation. Here, we review studies that investigate differences in brain gray and white matter in women using OCs in comparison to naturally cycling women. We focus on two neuroimaging methods used to quantify structural gray and white matter changes, namely structural MRI and diffusion MRI. Finally, we discuss the potential of these imaging techniques to advance knowledge about the effects of OCs on the brain and wellbeing in women.
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Affiliation(s)
- Carina Heller
- Psychiatry Neuroimaging Laboratory, Department of Psychiatry, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA; Department of Psychiatry and Psychotherapy, Jena University Hospital, Germany; Department of Clinical Psychology, Friedrich Schiller University Jena, Germany.
| | - Ann-Christin S Kimmig
- Department of Psychiatry and Psychotherapy, Innovative Neuroimaging, Tübingen Center for Mental Health (TüCMH), University of Tübingen, Tübingen, Germany; Graduate Training Centre of Neuroscience, International Max Planck Research School, University of Tübingen, Tübingen, Germany
| | - Marek R Kubicki
- Psychiatry Neuroimaging Laboratory, Department of Psychiatry, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA; Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Birgit Derntl
- Department of Psychiatry and Psychotherapy, Innovative Neuroimaging, Tübingen Center for Mental Health (TüCMH), University of Tübingen, Tübingen, Germany; Lead Graduate School, University of Tübingen, Tübingen, Germany
| | - Zora Kikinis
- Psychiatry Neuroimaging Laboratory, Department of Psychiatry, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
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20
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Lacasse JM, Gomez-Perales E, Brake WG. Modeling hormonal contraception in female rats: A framework for studies in behavioral neurobiology. Front Neuroendocrinol 2022; 67:101020. [PMID: 35952797 DOI: 10.1016/j.yfrne.2022.101020] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/26/2022] [Revised: 07/19/2022] [Accepted: 08/03/2022] [Indexed: 12/12/2022]
Abstract
Research on hormonal contraceptives (HC) in animal models is lacking, and as a result, so is our understanding of the impact of HC on the brain and behavior. Here, we provide a review of the pharmacology of HC, as well as the methodology and best practices for designing a model of HC in female rats. We outline specific methodological considerations regarding dosing, route of administration, exposure time/timing, and selecting a control group. We also provide a framework outlining important levels of analysis for thinking about the impact of HC on behavioral and neurobiological outcomes. The purpose of this review is to equip researchers with foundational knowledge, and some basic elements of experimental design for future studies investigating the impact of HC on the brain and behavior of female rats.
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Affiliation(s)
- Jesse M Lacasse
- Centre for Studies in Behavioral Neurobiology, Department of Psychology, Concordia University, Montréal H4B 1R6, Canada.
| | - Eamonn Gomez-Perales
- Centre for Studies in Behavioral Neurobiology, Department of Psychology, Concordia University, Montréal H4B 1R6, Canada
| | - Wayne G Brake
- Centre for Studies in Behavioral Neurobiology, Department of Psychology, Concordia University, Montréal H4B 1R6, Canada.
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21
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Jett S, Schelbaum E, Jang G, Boneu Yepez C, Dyke JP, Pahlajani S, Diaz Brinton R, Mosconi L. Ovarian steroid hormones: A long overlooked but critical contributor to brain aging and Alzheimer's disease. Front Aging Neurosci 2022; 14:948219. [PMID: 35928995 PMCID: PMC9344010 DOI: 10.3389/fnagi.2022.948219] [Citation(s) in RCA: 18] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2022] [Accepted: 06/28/2022] [Indexed: 01/19/2023] Open
Abstract
Ovarian hormones, particularly 17β-estradiol, are involved in numerous neurophysiological and neurochemical processes, including those subserving cognitive function. Estradiol plays a key role in the neurobiology of aging, in part due to extensive interconnectivity of the neural and endocrine system. This aspect of aging is fundamental for women's brains as all women experience a drop in circulating estradiol levels in midlife, after menopause. Given the importance of estradiol for brain function, it is not surprising that up to 80% of peri-menopausal and post-menopausal women report neurological symptoms including changes in thermoregulation (vasomotor symptoms), mood, sleep, and cognitive performance. Preclinical evidence for neuroprotective effects of 17β-estradiol also indicate associations between menopause, cognitive aging, and Alzheimer's disease (AD), the most common cause of dementia affecting nearly twice more women than men. Brain imaging studies demonstrated that middle-aged women exhibit increased indicators of AD endophenotype as compared to men of the same age, with onset in perimenopause. Herein, we take a translational approach to illustrate the contribution of ovarian hormones in maintaining cognition in women, with evidence implicating menopause-related declines in 17β-estradiol in cognitive aging and AD risk. We will review research focused on the role of endogenous and exogenous estrogen exposure as a key underlying mechanism to neuropathological aging in women, with a focus on whether brain structure, function and neurochemistry respond to hormone treatment. While still in development, this research area offers a new sex-based perspective on brain aging and risk of AD, while also highlighting an urgent need for better integration between neurology, psychiatry, and women's health practices.
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Affiliation(s)
- Steven Jett
- Department of Neurology, Weill Cornell Medical College, New York, NY, United States
| | - Eva Schelbaum
- Department of Neurology, Weill Cornell Medical College, New York, NY, United States
| | - Grace Jang
- Department of Neurology, Weill Cornell Medical College, New York, NY, United States
| | - Camila Boneu Yepez
- Department of Neurology, Weill Cornell Medical College, New York, NY, United States
| | - Jonathan P. Dyke
- Department of Radiology, Weill Cornell Medical College, New York, NY, United States
| | - Silky Pahlajani
- Department of Neurology, Weill Cornell Medical College, New York, NY, United States
- Department of Radiology, Weill Cornell Medical College, New York, NY, United States
| | - Roberta Diaz Brinton
- Department of Pharmacology, University of Arizona, Tucson, AZ, United States
- Department of Neurology, University of Arizona, Tucson, AZ, United States
| | - Lisa Mosconi
- Department of Neurology, Weill Cornell Medical College, New York, NY, United States
- Department of Radiology, Weill Cornell Medical College, New York, NY, United States
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22
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Concas A, Serra M, Porcu P. How hormonal contraceptives shape brain and behavior: A review of preclinical studies. Front Neuroendocrinol 2022; 66:101017. [PMID: 35843303 DOI: 10.1016/j.yfrne.2022.101017] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/09/2022] [Revised: 06/13/2022] [Accepted: 07/12/2022] [Indexed: 12/12/2022]
Abstract
Steroid hormones influence different aspects of brain function, including development, neurogenesis, neuronal excitability, and plasticity, thus affecting emotional states, cognition, sociality, and reward. In women, their levels fluctuate across the lifespan and through the reproductive stages but are also altered by exogenous administration of hormonal contraceptives (HC). HC are widely used by women throughout their fertile life both for contraceptive and therapeutic benefits. However, awareness of their effects on brain function and behavior is still poorly appreciated, despite the emerging evidence of their action at the level of the central nervous system. Here, we summarize results obtained in preclinical studies, mostly conducted in intact female rodents, aimed at investigating the neurobiological effects of HC. HC can alter neuroactive hormones, neurotransmitters, neuropeptides, as well as emotional states, cognition, social and sexual behaviors. Animal studies provide insights into the neurobiological effects of HC with the aim to improve women's health and well-being.
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Affiliation(s)
- Alessandra Concas
- Department of Life and Environment Sciences, Section of Neuroscience and Anthropology, University of Cagliari, Cagliari, Italy
| | - Mariangela Serra
- Department of Life and Environment Sciences, Section of Neuroscience and Anthropology, University of Cagliari, Cagliari, Italy
| | - Patrizia Porcu
- Neuroscience Institute, National Research Council of Italy (CNR), Cagliari, Italy.
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23
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Jett S, Malviya N, Schelbaum E, Jang G, Jahan E, Clancy K, Hristov H, Pahlajani S, Niotis K, Loeb-Zeitlin S, Havryliuk Y, Isaacson R, Brinton RD, Mosconi L. Endogenous and Exogenous Estrogen Exposures: How Women's Reproductive Health Can Drive Brain Aging and Inform Alzheimer's Prevention. Front Aging Neurosci 2022; 14:831807. [PMID: 35356299 PMCID: PMC8959926 DOI: 10.3389/fnagi.2022.831807] [Citation(s) in RCA: 40] [Impact Index Per Article: 20.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2021] [Accepted: 02/07/2022] [Indexed: 01/14/2023] Open
Abstract
After advanced age, female sex is the major risk factor for late-onset Alzheimer's disease (AD), the most common cause of dementia affecting over 24 million people worldwide. The prevalence of AD is higher in women than in men, with postmenopausal women accounting for over 60% of all those affected. While most research has focused on gender-combined risk, emerging data indicate sex and gender differences in AD pathophysiology, onset, and progression, which may help account for the higher prevalence in women. Notably, AD-related brain changes develop during a 10-20 year prodromal phase originating in midlife, thus proximate with the hormonal transitions of endocrine aging characteristic of the menopause transition in women. Preclinical evidence for neuroprotective effects of gonadal sex steroid hormones, especially 17β-estradiol, strongly argue for associations between female fertility, reproductive history, and AD risk. The level of gonadal hormones to which the female brain is exposed changes considerably across the lifespan, with relevance to AD risk. However, the neurobiological consequences of hormonal fluctuations, as well as that of hormone therapies, are yet to be fully understood. Epidemiological studies have yielded contrasting results of protective, deleterious and null effects of estrogen exposure on dementia risk. In contrast, brain imaging studies provide encouraging evidence for positive associations between greater cumulative lifetime estrogen exposure and lower AD risk in women, whereas estrogen deprivation is associated with negative consequences on brain structure, function, and biochemistry. Herein, we review the existing literature and evaluate the strength of observed associations between female-specific reproductive health factors and AD risk in women, with a focus on the role of endogenous and exogenous estrogen exposures as a key underlying mechanism. Chief among these variables are reproductive lifespan, menopause status, type of menopause (spontaneous vs. induced), number of pregnancies, and exposure to hormonal therapy, including hormonal contraceptives, hormonal therapy for menopause, and anti-estrogen treatment. As aging is the greatest risk factor for AD followed by female sex, understanding sex-specific biological pathways through which reproductive history modulates brain aging is crucial to inform preventative and therapeutic strategies for AD.
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Affiliation(s)
- Steven Jett
- Department of Neurology, Weill Cornell Medical College, New York, NY, United States
| | - Niharika Malviya
- Department of Neurology, Weill Cornell Medical College, New York, NY, United States
| | - Eva Schelbaum
- Department of Neurology, Weill Cornell Medical College, New York, NY, United States
| | - Grace Jang
- Department of Neurology, Weill Cornell Medical College, New York, NY, United States
| | - Eva Jahan
- Department of Neurology, Weill Cornell Medical College, New York, NY, United States
| | - Katherine Clancy
- Department of Neurology, Weill Cornell Medical College, New York, NY, United States
| | - Hollie Hristov
- Department of Neurology, Weill Cornell Medical College, New York, NY, United States
| | - Silky Pahlajani
- Department of Neurology, Weill Cornell Medical College, New York, NY, United States
- Department of Radiology, Weill Cornell Medical College, New York, NY, United States
| | - Kellyann Niotis
- Department of Neurology, Weill Cornell Medical College, New York, NY, United States
| | - Susan Loeb-Zeitlin
- Department of Obstetrics and Gynecology, Weill Cornell Medical College, New York, NY, United States
| | - Yelena Havryliuk
- Department of Obstetrics and Gynecology, Weill Cornell Medical College, New York, NY, United States
| | - Richard Isaacson
- Department of Neurology, Weill Cornell Medical College, New York, NY, United States
| | - Roberta Diaz Brinton
- Department of Pharmacology, University of Arizona, Tucson, AZ, United States
- Department of Neurology, University of Arizona, Tucson, AZ, United States
| | - Lisa Mosconi
- Department of Neurology, Weill Cornell Medical College, New York, NY, United States
- Department of Radiology, Weill Cornell Medical College, New York, NY, United States
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24
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Schmidt NM, Hennig J, Munk AJL. Event-Related Potentials in Women on the Pill: Neural Correlates of Positive and Erotic Stimulus Processing in Oral Contraceptive Users. Front Neurosci 2022; 15:798823. [PMID: 35058744 PMCID: PMC8764149 DOI: 10.3389/fnins.2021.798823] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2021] [Accepted: 12/09/2021] [Indexed: 11/13/2022] Open
Abstract
Background/Aims: Exposure toward positive emotional cues with - and without - reproductive significance plays a crucial role in daily life and regarding well-being as well as mental health. While possible adverse effects of oral contraceptive (OC) use on female mental and sexual health are widely discussed, neural processing of positive emotional stimuli has not been systematically investigated in association with OC use. Considering reported effects on mood, well-being and sexual function, and proposed associations with depression, it was hypothesized that OC users showed reduced neural reactivity toward positive and erotic emotional stimuli during early as well as later stages of emotional processing and also rated these stimuli as less pleasant and less arousing compared to naturally cycling (NC) women. Method: Sixty-two female subjects (29 NC and 33 OC) were assessed at three time points across the natural menstrual cycle and corresponding time points of the OC regimen. Early (early posterior negativity, EPN) and late (late positive potential, LPP) event-related potentials in reaction to positive, erotic and neutral stimuli were collected during an Emotional Picture Stroop Paradigm (EPSP). At each appointment, subjects provided saliva samples for analysis of gonadal steroid concentration. Valence and arousal ratings were collected at the last appointment. Results: Oral contraceptive users had significantly lower endogenous estradiol and progesterone concentrations compared to NC women. No significant group differences in either subjective stimulus evaluations or neural reactivity toward positive and erotic emotional stimuli were observed. For the OC group, LPP amplitudes in reaction to erotic vs. neutral pictures differed significantly between measurement times across the OC regimen. Discussion: In this study, no evidence regarding alterations of neural reactivity toward positive and erotic stimuli in OC users compared to NC was found. Possible confounding factors and lines for future research are elaborated and discussed.
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Affiliation(s)
- Norina M. Schmidt
- Department of Differential and Biological Psychology, University of Giessen, Giessen, Germany
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25
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Lewis CA, Kimmig ACS, Kroemer NB, Pooseh S, Smolka MN, Sacher J, Derntl B. No Differences in Value-Based Decision-Making Due to Use of Oral Contraceptives. Front Endocrinol (Lausanne) 2022; 13:817825. [PMID: 35528016 PMCID: PMC9075610 DOI: 10.3389/fendo.2022.817825] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/18/2021] [Accepted: 03/11/2022] [Indexed: 12/17/2022] Open
Abstract
Fluctuating ovarian hormones have been shown to affect decision-making processes in women. While emerging evidence suggests effects of endogenous ovarian hormones such as estradiol and progesterone on value-based decision-making in women, the impact of exogenous synthetic hormones, as in most oral contraceptives, is not clear. In a between-subjects design, we assessed measures of value-based decision-making in three groups of women aged 18 to 29 years, during (1) active oral contraceptive intake (N = 22), (2) the early follicular phase of the natural menstrual cycle (N = 20), and (3) the periovulatory phase of the natural menstrual cycle (N = 20). Estradiol, progesterone, testosterone, and sex-hormone binding globulin levels were assessed in all groups via blood samples. We used a test battery which measured different facets of value-based decision-making: delay discounting, risk-aversion, risk-seeking, and loss aversion. While hormonal levels did show the expected patterns for the three groups, there were no differences in value-based decision-making parameters. Consequently, Bayes factors showed conclusive evidence in support of the null hypothesis. We conclude that women on oral contraceptives show no differences in value-based decision-making compared to the early follicular and periovulatory natural menstrual cycle phases.
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Affiliation(s)
- Carolin A. Lewis
- Department of Psychiatry and Psychotherapy, Tübingen Center for Mental Health (TüCMH), University of Tuebingen, Tuebingen, Germany
- Emotion Neuroimaging Lab, Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany
- International Max Planck Research School on Neuroscience of Communication: Function, Structure, and Plasticity, Leipzig, Germany
- *Correspondence: Carolin A. Lewis,
| | - Ann-Christin S. Kimmig
- Department of Psychiatry and Psychotherapy, Tübingen Center for Mental Health (TüCMH), University of Tuebingen, Tuebingen, Germany
- International Max Planck Research School for Cognitive and Systems Neuroscience, University of Tuebingen, Tuebingen, Germany
| | - Nils B. Kroemer
- Department of Psychiatry and Psychotherapy, Tübingen Center for Mental Health (TüCMH), University of Tuebingen, Tuebingen, Germany
| | - Shakoor Pooseh
- Department of Psychiatry, Technische Universität Dresden, Dresden, Germany
- Freiburg Center for Data Analysis and Modeling, Albert-Ludwigs-Universität Freiburg, Freiburg, Germany
| | - Michael N. Smolka
- Department of Psychiatry, Technische Universität Dresden, Dresden, Germany
| | - Julia Sacher
- Emotion Neuroimaging Lab, Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany
- Clinic for Cognitive Neurology, University of Leipzig, Leipzig, Germany
| | - Birgit Derntl
- Department of Psychiatry and Psychotherapy, Tübingen Center for Mental Health (TüCMH), University of Tuebingen, Tuebingen, Germany
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26
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Hidalgo-Lopez E, Zeidman P, Harris T, Razi A, Pletzer B. Spectral dynamic causal modelling in healthy women reveals brain connectivity changes along the menstrual cycle. Commun Biol 2021; 4:954. [PMID: 34376799 PMCID: PMC8355156 DOI: 10.1038/s42003-021-02447-w] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2020] [Accepted: 07/01/2021] [Indexed: 01/01/2023] Open
Abstract
Longitudinal menstrual cycle studies allow to investigate the effects of ovarian hormones on brain organization. Here, we use spectral dynamic causal modelling (spDCM) in a triple network model to assess effective connectivity changes along the menstrual cycle within and between the default mode, salience and executive control networks (DMN, SN, and ECN). Sixty healthy young women were scanned three times along their menstrual cycle, during early follicular, pre-ovulatory and mid-luteal phase. Related to estradiol, right before ovulation the left insula recruits the ECN, while the right middle frontal gyrus decreases its connectivity to the precuneus and the DMN decouples into anterior/posterior parts. Related to progesterone during the mid-luteal phase, the insulae (SN) engage to each other, while decreasing their connectivity to parietal ECN, which in turn engages the posterior DMN. When including the most confident connections in a leave-one out cross-validation, we find an above-chance prediction of the left-out subjects' cycle phase. These findings corroborate the plasticity of the female brain in response to acute hormone fluctuations and may help to further understand the neuroendocrine interactions underlying cognitive changes along the menstrual cycle.
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Affiliation(s)
- Esmeralda Hidalgo-Lopez
- Department of Psychology and Centre for Cognitive Neuroscience, University of Salzburg, Salzburg, Austria.
| | - Peter Zeidman
- The Wellcome Centre for Human Neuroimaging, University College London, London, UK
| | - TiAnni Harris
- Department of Psychology and Centre for Cognitive Neuroscience, University of Salzburg, Salzburg, Austria
| | - Adeel Razi
- The Wellcome Centre for Human Neuroimaging, University College London, London, UK
- Turner Institute for Brain and Mental Health, Monash University, Clayton, VIC, Australia
| | - Belinda Pletzer
- Department of Psychology and Centre for Cognitive Neuroscience, University of Salzburg, Salzburg, Austria.
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27
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Chen KX, Worley S, Foster H, Edasery D, Roknsharifi S, Ifrah C, Lipton ML. Oral contraceptive use is associated with smaller hypothalamic and pituitary gland volumes in healthy women: A structural MRI study. PLoS One 2021; 16:e0249482. [PMID: 33882080 PMCID: PMC8059834 DOI: 10.1371/journal.pone.0249482] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2020] [Accepted: 03/18/2021] [Indexed: 11/19/2022] Open
Abstract
The effects of hormonal contraceptives on structural features of the hypothalamus and pituitary are incompletely understood. One prior study reported microstructural changes in the hypothalamus with oral contraceptive pill (OCP) use. However, effects on hypothalamic volume have not been reported. One prior study reported volumetric changes in the pituitary. However, this study was limited by including participants evaluated for neurological symptoms. We sought to determine if OCP use is associated with alteration of hypothalamic or pituitary volume. High-resolution 3T MRI was performed for a prospective cohort of 50 healthy women from 2016 to 2018, which comprised 21 OCP users (age, 19-29) and 29 naturally cycling women (age, 18-36). Participants were excluded if they were pregnant or had significant medical conditions including neurological, psychiatric, and endocrine disorders. After confirming reliability of the image analysis techniques, 5 raters independently performed manual segmentation of the hypothalamus and semi-automated intensity threshold-based segmentation of the pituitary using ITK-SNAP. Total intracranial volume was estimated using FreeSurfer. A general linear model tested the association of OCP use with hypothalamic and pituitary volumes. Hypothalamic (B = -81.2 ± 24.9, p = 0.002) and pituitary (B = -81.2 ± 38.7, p = 0.04) volumes in OCP users were smaller than in naturally cycling women. These findings may be related to interference with known trophic effects of sex hormones and suggest a structural correlate of central OCP effects.
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Affiliation(s)
- Ke Xun Chen
- Department of Radiology, Albert Einstein College of Medicine and Montefiore Health, Bronx, NY, United States of America
| | - Sandie Worley
- Department of Neurology, New York University School of Medicine, New York, NY, United States of America
| | - Henry Foster
- Gruss Magnetic Resonance Research Center, Albert Einstein College of Medicine and Montefiore Health, Bronx, NY, United States of America
| | - David Edasery
- Department of Radiology, Albert Einstein College of Medicine and Montefiore Health, Bronx, NY, United States of America
| | - Shima Roknsharifi
- Department of Radiology, Albert Einstein College of Medicine and Montefiore Health, Bronx, NY, United States of America
| | - Chloe Ifrah
- Gruss Magnetic Resonance Research Center, Albert Einstein College of Medicine and Montefiore Health, Bronx, NY, United States of America
| | - Michael L. Lipton
- Department of Radiology, Albert Einstein College of Medicine and Montefiore Health, Bronx, NY, United States of America
- Gruss Magnetic Resonance Research Center, Albert Einstein College of Medicine and Montefiore Health, Bronx, NY, United States of America
- Department of Psychiatry and Behavioral Sciences, Albert Einstein College of Medicine and Montefiore Health, Bronx, NY, United States of America
- Dominick P. Purpura Department of Neuroscience, Albert Einstein College of Medicine and Montefiore Health, Bronx, NY, United States of America
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28
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Hidalgo-Lopez E, Pletzer B. Fronto-striatal changes along the menstrual cycle during working memory: Effect of sex hormones on activation and connectivity patterns. Psychoneuroendocrinology 2021; 125:105108. [PMID: 33516121 DOI: 10.1016/j.psyneuen.2020.105108] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/09/2019] [Revised: 09/24/2020] [Accepted: 12/08/2020] [Indexed: 12/18/2022]
Abstract
Frontal and striatal areas are the neuroanatomical basis for working memory (WM), as well as targets for sex steroids. However, up to date little is known regarding menstrual cycle (MC) effects on brain activation and connectivity patterns during verbal WM. To the best of our knowledge, this is the first longitudinal dataset to study dorsolateral prefrontal cortex, putamen and caudate activation and connectivity patterns during a verbal WM task along the natural MC. Thirty-nine naturally cycling healthy women were scanned three times locked to their MC (menses, pre-ovulatory and luteal phase). They performed an N-back task with two trial types, targets and lures, assessing (i) updating and (ii) inhibitory process respectively. Distinct patterns of fronto-striatal activation and connectivity changes were observed for each process. (i) For targets, we observed decreased connectivity between left striatum- and inferior frontal and parietal areas, the circuit underlying phonological WM, in response to elevated progesterone during the luteal phase. Simultaneously, we observed an alleviation of inhibition from fronto-striatal areas on areas related to higher cognitive effort and the salience network. (ii) For lures, negative inter-hemispheric connectivity between fronto-parietal areas during the pre-ovulatory phase, as well as increased connectivity between bilateral dorsolateral prefrontal cortex and posteromedial structures during the luteal phase. Overall, we corroborated a hormone mediated inter-hemispheric decoupling, enhanced frontal activity and disinhibition of the salience brain network and striatum during the luteal phase. In summary, we interpret these results in relation to a differential top-down regulation in higher hormone levels phases and hyperactive bottom-up network during the luteal phase, which could explain the vulnerability of this phase to MC associated disorders.
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Affiliation(s)
- Esmeralda Hidalgo-Lopez
- Department of Psychology and Centre for Cognitive Neuroscience, University of Salzburg, Hellbrunnerstr. 34, 5020 Salzburg, Austria.
| | - Belinda Pletzer
- Department of Psychology and Centre for Cognitive Neuroscience, University of Salzburg, Hellbrunnerstr. 34, 5020 Salzburg, Austria.
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29
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Effects of oral contraceptive pills on mood and magnetic resonance imaging measures of prefrontal cortical thickness. Mol Psychiatry 2021; 26:917-926. [PMID: 33420480 PMCID: PMC7914152 DOI: 10.1038/s41380-020-00990-2] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/06/2020] [Revised: 11/23/2020] [Accepted: 12/07/2020] [Indexed: 01/29/2023]
Abstract
Gonadal hormones influence neuronal organization and plasticity. Yet the consequences of altering their concentrations by administering contraceptive agents, which are used by most reproductive-age women in the United States, are unclear. Cross-sectional studies have found both larger and smaller cortical regions alongside a variety of mood alterations in women who use oral contraceptive pills (OCPs) compared to naturally-cycling women. The goal of this study, therefore, was to determine whether there is an effect of OCPs on MRI measures of prefrontal cortical brain structure that may influence regulation of mood. We performed a double-blind, placebo-controlled, randomized crossover study comparing effects of OCPs (0.15 mg levonorgestrel + 0.30 μg ethinyl estradiol) vs placebo (N = 26) on MRI measures of prefrontal cortical thickness and on mood, as indicated by self-report on the Daily Record of Severity of Problems, which also includes one item related to somatic symptoms. MRI measures that reflect cortical thickness were smaller bilaterally in the pars triangularis and in the pars opercularis and frontal pole of the right hemisphere during the OCP arm vs. placebo. Only the effect in the right pars triangularis survived multiple comparisons correction. Right pars triangularis MRI measures of cortical thickness were not related to mood symptoms, but negatively correlated across conditions with severity of somatic symptoms on the DSRP. The somatic symptoms and MRI measures may be independently related to the actions of steroid hormones in OCPs, with OCPs simultaneously inducing both more effects on MRI measures of cortical thickness and somatic symptoms.
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30
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Dubol M, Epperson CN, Sacher J, Pletzer B, Derntl B, Lanzenberger R, Sundström-Poromaa I, Comasco E. Neuroimaging the menstrual cycle: A multimodal systematic review. Front Neuroendocrinol 2021; 60:100878. [PMID: 33098847 DOI: 10.1016/j.yfrne.2020.100878] [Citation(s) in RCA: 66] [Impact Index Per Article: 22.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/31/2020] [Revised: 09/29/2020] [Accepted: 10/15/2020] [Indexed: 12/15/2022]
Abstract
Increasing evidence indicates that ovarian hormones affect brain structure, chemistry and function of women in their reproductive age, potentially shaping their behavior and mental health. Throughout the reproductive years, estrogens and progesterone levels fluctuate across the menstrual cycle and can modulate neural circuits involved in affective and cognitive processes. Here, we review seventy-seven neuroimaging studies and provide a comprehensive and data-driven evaluation of the accumulating evidence on brain plasticity associated with endogenous ovarian hormone fluctuations in naturally cycling women (n = 1304). The results particularly suggest modulatory effects of ovarian hormones fluctuations on the reactivity and structure of cortico-limbic brain regions. These findings highlight the importance of performing multimodal neuroimaging studies on neural correlates of systematic ovarian hormone fluctuations in naturally cycling women based on careful menstrual cycle staging.
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Affiliation(s)
- Manon Dubol
- Department of Neuroscience, Science for Life Laboratory, Uppsala University, Sweden
| | - C Neill Epperson
- Department of Psychiatry, Department of Family Medicine, University of Colorado School of Medicine-Anschutz Medical Campus, USA
| | - Julia Sacher
- Emotion Neuroimaging Lab, Max Planck Institute for Human Cognitive and Brain Sciences, Germany
| | - Belinda Pletzer
- Department of Psychology, Centre for Cognitive Neuroscience, University of Salzburg, Austria
| | - Birgit Derntl
- Department of Psychiatry and Psychotherapy, University of Tuebingen, Germany
| | - Rupert Lanzenberger
- Department of Psychiatry and Psychotherapy, Medical University of Vienna, Austria
| | | | - Erika Comasco
- Department of Neuroscience, Science for Life Laboratory, Uppsala University, Sweden; Department of Psychiatry and Psychotherapy, Medical University of Vienna, Austria.
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31
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Rehbein E, Hornung J, Sundström Poromaa I, Derntl B. Shaping of the Female Human Brain by Sex Hormones: A Review. Neuroendocrinology 2021; 111:183-206. [PMID: 32155633 DOI: 10.1159/000507083] [Citation(s) in RCA: 64] [Impact Index Per Article: 21.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/14/2020] [Accepted: 03/09/2020] [Indexed: 12/26/2022]
Abstract
Traditionally sex hormones have been associated with reproductive and developmental processes only. Since the 1950s we know that hormones can have organizational effects on the developing brain and initiate hormonal transition periods such as puberty. However, recent evidence shows that sex hormones additionally structure the brain during important hormonal transition periods across a woman's life including short-term fluctuations during the menstrual cycle. However, a comprehensive review focusing on structural changes during all hormonal transition phases of women is still missing. Therefore, in this review structural changes across hormonal transition periods (i.e., puberty, menstrual cycle, oral contraceptive intake, pregnancy and menopause) were investigated in a structured way and correlations with sex hormones evaluated. Results show an overall reduction in grey matter and region-specific decreases in prefrontal, parietal and middle temporal areas during puberty. Across the menstrual cycle grey matter plasticity in the hippocampus, the amygdala as well as temporal and parietal regions were most consistently reported. Studies reporting on pre- and post-pregnancy measurements revealed volume reductions in midline structures as well as prefrontal and temporal cortices. During perimenopause, the decline in sex hormones was paralleled with a reduction in hippocampal and parietal cortex volume. Brain volume changes were significantly correlated with estradiol, testosterone and progesterone levels in some studies, but directionality remains inconclusive between studies. These results indicate that sex hormones play an important role in shaping women's brain structure during different transition periods and are not restricted to specific developmental periods.
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Affiliation(s)
- Elisa Rehbein
- Department of Psychiatry and Psychotherapy, Innovative Neuroimaging, University of Tübingen, Tübingen, Germany,
| | - Jonas Hornung
- Department of Psychiatry and Psychotherapy, Innovative Neuroimaging, University of Tübingen, Tübingen, Germany
| | | | - Birgit Derntl
- Department of Psychiatry and Psychotherapy, Innovative Neuroimaging, University of Tübingen, Tübingen, Germany
- Werner Reichardt Centre for Integrative Neuroscience, University of Tübingen, Tübingen, Germany
- Lead Graduate School, University of Tübingen, Tübingen, Germany
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32
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Taylor CM, Pritschet L, Jacobs EG. The scientific body of knowledge - Whose body does it serve? A spotlight on oral contraceptives and women's health factors in neuroimaging. Front Neuroendocrinol 2021; 60:100874. [PMID: 33002517 PMCID: PMC7882021 DOI: 10.1016/j.yfrne.2020.100874] [Citation(s) in RCA: 41] [Impact Index Per Article: 13.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/12/2020] [Revised: 09/22/2020] [Accepted: 09/23/2020] [Indexed: 12/13/2022]
Abstract
Women constitute half of the world's population, yet neuroscience research does not serve the sexes equally. Fifty years of preclinical animal evidence documents the tightly-coupled relationship between our endocrine and nervous systems, yet human neuroimaging studies rarely consider how endocrine factors shape the structural and functional architecture of the human brain. Here, we quantify several blind spots in neuroimaging research, which overlooks aspects of the human condition that impact women's health (e.g. the menstrual cycle, hormonal contraceptives, pregnancy, menopause). Next, we illuminate potential consequences of this oversight: today over 100 million women use oral hormonal contraceptives, yet relatively few investigations have systematically examined whether disrupting endogenous hormone production impacts the brain. We close by presenting a roadmap for progress, highlighting the University of California Women's Brain Initiative which is addressing unmet needs in women's health research.
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Affiliation(s)
- Caitlin M Taylor
- Department of Psychological and Brain Sciences, University of California, Santa Barbara, United States.
| | - Laura Pritschet
- Department of Psychological and Brain Sciences, University of California, Santa Barbara, United States
| | - Emily G Jacobs
- Department of Psychological and Brain Sciences, University of California, Santa Barbara, United States; Neuroscience Research Institute, University of California, Santa Barbara, United States.
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33
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Brain structural correlates of insomnia severity in 1053 individuals with major depressive disorder: results from the ENIGMA MDD Working Group. Transl Psychiatry 2020; 10:425. [PMID: 33293520 PMCID: PMC7723989 DOI: 10.1038/s41398-020-01109-5] [Citation(s) in RCA: 28] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/08/2020] [Revised: 11/04/2020] [Accepted: 11/17/2020] [Indexed: 12/20/2022] Open
Abstract
It has been difficult to find robust brain structural correlates of the overall severity of major depressive disorder (MDD). We hypothesized that specific symptoms may better reveal correlates and investigated this for the severity of insomnia, both a key symptom and a modifiable major risk factor of MDD. Cortical thickness, surface area and subcortical volumes were assessed from T1-weighted brain magnetic resonance imaging (MRI) scans of 1053 MDD patients (age range 13-79 years) from 15 cohorts within the ENIGMA MDD Working Group. Insomnia severity was measured by summing the insomnia items of the Hamilton Depression Rating Scale (HDRS). Symptom specificity was evaluated with correlates of overall depression severity. Disease specificity was evaluated in two independent samples comprising 2108 healthy controls, and in 260 clinical controls with bipolar disorder. Results showed that MDD patients with more severe insomnia had a smaller cortical surface area, mostly driven by the right insula, left inferior frontal gyrus pars triangularis, left frontal pole, right superior parietal cortex, right medial orbitofrontal cortex, and right supramarginal gyrus. Associations were specific for insomnia severity, and were not found for overall depression severity. Associations were also specific to MDD; healthy controls and clinical controls showed differential insomnia severity association profiles. The findings indicate that MDD patients with more severe insomnia show smaller surfaces in several frontoparietal cortical areas. While explained variance remains small, symptom-specific associations could bring us closer to clues on underlying biological phenomena of MDD.
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34
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Sharma R, Fang Z, Smith A, Ismail N. Oral contraceptive use, especially during puberty, alters resting state functional connectivity. Horm Behav 2020; 126:104849. [PMID: 32971138 DOI: 10.1016/j.yhbeh.2020.104849] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/12/2020] [Revised: 09/04/2020] [Accepted: 09/05/2020] [Indexed: 10/23/2022]
Abstract
Millions of women worldwide use oral contraceptives (OCs), often starting during puberty/adolescence. It is, however, unknown how OC use during this critical period of development affects the brain. The objective of the current study was to examine resting state functional connectivity (FC) in the default mode network (DMN), central executive network (CEN), salience network (SN), reward network (RN), and subcortical limbic network of the brain using independent component analysis (ICA) between pubertal- and adult-onset OC users (n = 27) and naturally cycling women (n = 48). It was hypothesized that OC use would result in network-specific increases and decreases in FC and that pubertal-onset OC use would result in differences to the aforementioned networks compared to adult-onset OC use. Pubertal-onset OC use is related to heightened FC in the SN compared to adult-onset OC users. In general, OC use also increases connectivity in the SN, CEN, RN, and subcortical limbic network compared to NC women. No significant differences in connectivity were observed in the DMN between OC users and NC women. These findings provide a mechanistic insight for the altered executive functioning and emotion/reward processing previously seen in OC users, which may then increase their vulnerability to mental health conditions.
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Affiliation(s)
- Rupali Sharma
- Neuroimmunology, Stress and Endocrinology (NISE) Lab, School of Psychology, Faculty of Social Science, University of Ottawa, 136 Jean-Jacques Lussier, K1N 6N5 Ottawa, ON, Canada
| | - Zhuo Fang
- Brain Imaging Group (BIG) Lab, School of Psychology, Faculty of Social Science, University of Ottawa, 136 Jean-Jacques Lussier, K1N 6N5 Ottawa, ON, Canada; Brain and Mind Research Institute, Faculty of Medicine, University of Ottawa, 451 Smyth Road, K1H 8M5 Ottawa, ON, Canada
| | - Andra Smith
- Brain Imaging Group (BIG) Lab, School of Psychology, Faculty of Social Science, University of Ottawa, 136 Jean-Jacques Lussier, K1N 6N5 Ottawa, ON, Canada; Brain and Mind Research Institute, Faculty of Medicine, University of Ottawa, 451 Smyth Road, K1H 8M5 Ottawa, ON, Canada
| | - Nafissa Ismail
- Neuroimmunology, Stress and Endocrinology (NISE) Lab, School of Psychology, Faculty of Social Science, University of Ottawa, 136 Jean-Jacques Lussier, K1N 6N5 Ottawa, ON, Canada; Brain and Mind Research Institute, Faculty of Medicine, University of Ottawa, 451 Smyth Road, K1H 8M5 Ottawa, ON, Canada.
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35
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Woelfer M, Li M, Colic L, Liebe T, Di X, Biswal B, Murrough J, Lessmann V, Brigadski T, Walter M. Ketamine-induced changes in plasma brain-derived neurotrophic factor (BDNF) levels are associated with the resting-state functional connectivity of the prefrontal cortex. World J Biol Psychiatry 2020; 21:696-710. [PMID: 31680600 DOI: 10.1080/15622975.2019.1679391] [Citation(s) in RCA: 28] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
OBJECTIVES Synaptic plasticity and brain-derived neurotrophic factor (BDNF) signalling are proposed to play key roles in antidepressant drug action. Ketamine, an N-methyl-D-aspartate receptor antagonist and putative antidepressant, may increase synaptic plasticity in prefrontal cortex through higher expression of BDNF. Furthermore, ketamine was shown to change resting-state functional connectivity (RSFC) of dorsomedial prefrontal cortex (dmPFC). METHODS In a randomised, placebo-controlled study, we investigated acutely (100 min) and at 24 h following subanesthetic ketamine infusion which dmPFC seeded RSFC changes are most strongly associated with plasma BDNF level changes in 53 healthy participants (21 females, age: 24.4 ± 2.9 years) using 7 T-fMRI. RESULTS We observed higher relative levels of BDNF 2 h and 24 h after ketamine compared to placebo. Whole-brain regression revealed that the change in BDNF after 24 h was associated with RSFC decreases from dmPFC to posterior cingulate cortex and ventromedial PFC at 24 h and exploratively also at the 100 min measurement point. Follow-up analyses revealed that RSFC reductions following ketamine were restricted to subjects showing increased BDNF levels at 24 h. CONCLUSIONS Our findings indicate BDNF level dynamics following ketamine are related to acute and 24 h RSFC changes. Particularly when BDNF increases are observed after ketamine infusion, a disconnection from dmPFC after 24 h is seen and may reflect synaptic plasticity effects.
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Affiliation(s)
- Marie Woelfer
- Clinical Affective Neuroimaging Laboratory (CANLAB), Magdeburg, Germany.,Leibniz Institute for Neurobiology, Magdeburg, Germany.,Department of Biomedical Engineering, New Jersey Institute of Technology, Newark, NJ, USA
| | - Meng Li
- Clinical Affective Neuroimaging Laboratory (CANLAB), Magdeburg, Germany.,Department of Psychiatry and Psychotherapy, University Tuebingen, Tuebingen, Germany
| | - Lejla Colic
- Clinical Affective Neuroimaging Laboratory (CANLAB), Magdeburg, Germany.,Leibniz Institute for Neurobiology, Magdeburg, Germany
| | - Thomas Liebe
- Clinical Affective Neuroimaging Laboratory (CANLAB), Magdeburg, Germany
| | - Xin Di
- Department of Biomedical Engineering, New Jersey Institute of Technology, Newark, NJ, USA
| | - Bharat Biswal
- Department of Biomedical Engineering, New Jersey Institute of Technology, Newark, NJ, USA.,School of Life Sciences and Technology, University of Electronic Science and Technology of China, Chengdu, China
| | - James Murrough
- Depression and Anxiety Center for Discovery and Treatment, Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA.,Department of Neuroscience, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Volkmar Lessmann
- Institute of Physiology, Otto-von-Guericke-University, Magdeburg, Germany.,Center for Behavioral Brain Sciences (CBBS), Magdeburg, Germany
| | - Tanja Brigadski
- Institute of Physiology, Otto-von-Guericke-University, Magdeburg, Germany.,Department of Informatics and Microsystems Technology, University of Applied Science Kaiserslautern, Zweibrücken, Germany
| | - Martin Walter
- Clinical Affective Neuroimaging Laboratory (CANLAB), Magdeburg, Germany.,Department of Psychiatry and Psychotherapy, University Tuebingen, Tuebingen, Germany.,Center for Behavioral Brain Sciences (CBBS), Magdeburg, Germany
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36
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Brønnick MK, Økland I, Graugaard C, Brønnick KK. The Effects of Hormonal Contraceptives on the Brain: A Systematic Review of Neuroimaging Studies. Front Psychol 2020; 11:556577. [PMID: 33224053 PMCID: PMC7667464 DOI: 10.3389/fpsyg.2020.556577] [Citation(s) in RCA: 45] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2020] [Accepted: 09/25/2020] [Indexed: 12/23/2022] Open
Abstract
Background: Hormonal contraceptive drugs are being used by adult and adolescent women all over the world. Convergent evidence from animal research indicates that contraceptive substances can alter both structure and function of the brain, yet such effects are not part of the public discourse or clinical decision-making concerning these drugs. We thus conducted a systematic review of the neuroimaging literature to assess the current evidence of hormonal contraceptive influence on the human brain. Methods: The review was registered in PROSPERO and conducted in accordance with the PRISMA criteria for systematic reviews. Structural and functional neuroimaging studies concerning the use of hormonal contraceptives, indexed in Embase, PubMed and/or PsycINFO until February 2020 were included, following a comprehensive and systematic search based on predetermined selection criteria. Results: A total of 33 articles met the inclusion criteria. Ten of these were structural studies, while 23 were functional investigations. Only one study investigated effects on an adolescent sample. The quality of the articles varied as many had methodological challenges as well as partially unfounded theoretical claims. However, most of the included neuroimaging studies found functional and/or structural brain changes associated with the use of hormonal contraceptives. Conclusion: The included studies identified structural and functional changes in areas involved in affective and cognitive processing, such as the amygdala, hippocampus, prefrontal cortex and cingulate gyrus. However, only one study reported primary research on a purely adolescent sample. Thus, there is a need for further investigation of the implications of these findings, especially with regard to adolescent girls.
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Affiliation(s)
- Marita Kallesten Brønnick
- Center for Clinical Research in Psychosis (TIPS), Stavanger University Hospital, Stavanger, Norway.,Department of Clinical Medicine, Center for Sexology Research, Aalborg University, Aalborg, Denmark
| | - Inger Økland
- Department of Obstetrics and Gynecology, Stavanger University Hospital, Stavanger, Norway.,Department for Caring and Ethics, Faculty of Health Sciences, University of Stavanger, Stavanger, Norway
| | - Christian Graugaard
- Department of Clinical Medicine, Center for Sexology Research, Aalborg University, Aalborg, Denmark
| | - Kolbjørn Kallesten Brønnick
- SESAM, Department of Psychiatry, Stavanger University Hospital, Stavanger, Norway.,Department of Public Health, Faculty of Health Sciences, University of Stavanger, Stavanger, Norway
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37
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Larsen SV, Köhler‐Forsberg K, Dam VH, Poulsen AS, Svarer C, Jensen PS, Knudsen GM, Fisher PM, Ozenne B, Frokjaer VG. Oral contraceptives and the serotonin 4 receptor: a molecular brain imaging study in healthy women. Acta Psychiatr Scand 2020; 142:294-306. [PMID: 33314049 PMCID: PMC7586815 DOI: 10.1111/acps.13211] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 06/25/2020] [Indexed: 12/13/2022]
Abstract
OBJECTIVE Sex steroid hormones potently shape brain functions, including those critical to maintain mental health such as serotonin signaling. Use of oral contraceptives (OCs) profoundly changes endogenous sex steroid hormone levels and dynamics. Recent register-based studies show that starting an OC is associated with increased risk of developing depression. Here, we investigate whether use of OCs in healthy women is associated with a marker of the serotonin system in terms of serotonin 4 receptor (5-HT4R) brain imaging. METHODS [11C]SB207145-PET imaging data on 53 healthy women, of whom 16 used OCs, were available from the Cimbi database. We evaluated global effects of OC use on 5-HT4R binding in a latent variable model based on 5-HT4R binding across cortical and subcortical regions. RESULTS We demonstrate that OC users have 9-12% lower global brain 5-HT4R binding potential compared to non-users. Univariate region-based analyses (pallidostriatum, caudate, hippocampus, amygdala, anterior cingulate cortex, and neocortex) supported the global effect of OC use with the largest difference present in the hippocampus (-12.8% (95% CI [-21.0; -3.9], Pcorrected = 0.03). CONCLUSION We show that women who use OCs have markedly lower brain 5-HT4R binding relative to non-users, which constitutes a plausible molecular link between OC use and increased risk of depressive episodes. We propose that this reflects a reduced 5-HT4R gene expression, possibly related to a blunted ovarian hormone state among OC users.
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Affiliation(s)
- S. V. Larsen
- Neurobiology Research UnitRigshospitaletCopenhagenDenmark
| | - K. Köhler‐Forsberg
- Neurobiology Research UnitRigshospitaletCopenhagenDenmark
- Faculty of Health and Medical SciencesUniversity of CopenhagenCopenhagenDenmark
- Mental health services in the Capital Region of DenmarkCopenhagenDenmark
| | - V. H. Dam
- Neurobiology Research UnitRigshospitaletCopenhagenDenmark
- Faculty of Health and Medical SciencesUniversity of CopenhagenCopenhagenDenmark
| | - A. S. Poulsen
- Neurobiology Research UnitRigshospitaletCopenhagenDenmark
| | - C. Svarer
- Neurobiology Research UnitRigshospitaletCopenhagenDenmark
| | - P. S. Jensen
- Neurobiology Research UnitRigshospitaletCopenhagenDenmark
| | - G. M. Knudsen
- Neurobiology Research UnitRigshospitaletCopenhagenDenmark
- Faculty of Health and Medical SciencesUniversity of CopenhagenCopenhagenDenmark
| | - P. M. Fisher
- Neurobiology Research UnitRigshospitaletCopenhagenDenmark
| | - B. Ozenne
- Neurobiology Research UnitRigshospitaletCopenhagenDenmark
- Department of Public HealthSection of BiostatisticsUniversity of CopenhagenCopenhagen KDenmark
| | - V. G. Frokjaer
- Neurobiology Research UnitRigshospitaletCopenhagenDenmark
- Faculty of Health and Medical SciencesUniversity of CopenhagenCopenhagenDenmark
- Mental health services in the Capital Region of DenmarkCopenhagenDenmark
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38
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Peyrot C, Brouillard A, Morand-Beaulieu S, Marin MF. A review on how stress modulates fear conditioning: Let's not forget the role of sex and sex hormones. Behav Res Ther 2020; 129:103615. [PMID: 32334278 DOI: 10.1016/j.brat.2020.103615] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2019] [Revised: 03/27/2020] [Accepted: 04/05/2020] [Indexed: 12/12/2022]
Abstract
Stress and fear are two fields of research that have evolved simultaneously. It was not until the eighties that these domains converged in order to better characterize the impact of stress on fear memory formation. Here, we reviewed the effects of stress occurring before fear acquisition on the main phases of fear conditioning protocols (acquisition training, extinction training, extinction retention test), with a specific focus on sex and sex hormones. We also paid close attention to methodological aspects in order to better understand and characterize discrepant findings across studies. In men, stress appears to potentiate fear acquisition at a physiological level but induces lower activations of fear-related brain regions. In women, results are inconsistent. Although some studies have shown that stress lowers physiological fear responses and heightens brain activations in women during fear acquisition, many studies report no significant effects. Irrespective of sex, pre-acquisition stress seems to induce fear extinction learning resistance. Overall, few studies have taken into account sex hormones, despite their impact on both the fear and stress brain networks. As methodological variability makes it complex to draw strong conclusions, several methodological aspects are discussed with the aim of orienting future research.
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Affiliation(s)
- Clémence Peyrot
- Research Center, Institut universitaire en santé mentale de Montréal, 7331 Hochelaga Street, Montreal, Quebec, Canada, H1N 3J4; Department of Psychiatry and Addictology, Université de Montréal, 2900 Édouard-Montpetit Boulevard, Montreal, Quebec, Canada, H3T 1J4.
| | - Alexandra Brouillard
- Research Center, Institut universitaire en santé mentale de Montréal, 7331 Hochelaga Street, Montreal, Quebec, Canada, H1N 3J4; Department of Psychology, Université du Québec à Montréal, 100 Sherbrooke Street W, Montreal, Quebec, Canada, H2X 2P3.
| | - Simon Morand-Beaulieu
- Research Center, Institut universitaire en santé mentale de Montréal, 7331 Hochelaga Street, Montreal, Quebec, Canada, H1N 3J4; Department of Neuroscience, Université de Montréal, 2960 de la Tour Rd, Montreal, Quebec, Canada, H3T 1J4; Currently with the Child Study Center, Yale University School of Medicine, 230 S Frontage Rd, New Haven, CT, 06519, USA.
| | - Marie-France Marin
- Research Center, Institut universitaire en santé mentale de Montréal, 7331 Hochelaga Street, Montreal, Quebec, Canada, H1N 3J4; Department of Psychiatry and Addictology, Université de Montréal, 2900 Édouard-Montpetit Boulevard, Montreal, Quebec, Canada, H3T 1J4; Department of Psychology, Université du Québec à Montréal, 100 Sherbrooke Street W, Montreal, Quebec, Canada, H2X 2P3.
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39
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Shirazi TN, Rosenfield KA, Cárdenas RA, Breedlove SM, Puts DA. No evidence that hormonal contraceptive use or circulating sex steroids predict complex emotion recognition. Horm Behav 2020; 119:104647. [PMID: 31778719 PMCID: PMC8496674 DOI: 10.1016/j.yhbeh.2019.104647] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/19/2019] [Revised: 11/17/2019] [Accepted: 11/20/2019] [Indexed: 12/27/2022]
Abstract
Relatively little is known about the effects of endogenous and exogenous steroid hormones on ecologically relevant behavioral and cognitive phenotypes in women, such as emotion recognition, despite the widespread use of steroid hormone-altering hormonal contraceptives (HCs). Though some previous studies have examined the effect of HC use, estradiol, progesterone, and testosterone on emotion recognition in women, they have been limited by cross-sectional designs, small sample sizes (total n < 100), and compromised statistical power to detect significant effects. Using data from two test sessions in a large sample of naturally cycling women (NC; n = 192) and women on HCs (n = 203), we found no group differences in emotion recognition; further, the lack of group differences in emotion recognition was not modulated by item difficulty or emotional valence. Among NC women who provided saliva samples across two sessions that were assayed for estradiol and progesterone concentrations, we found no compelling evidence across models that between-subject differences and within-subject fluctuations in these ovarian hormones predicted emotion recognition accuracy, with the exception that between-subjects estradiol negatively predicted emotion recognition for emotions of neutral valence (p = .042). Among HC women who provided saliva samples across two sessions that were assayed for testosterone, we found no compelling evidence that between-subjects differences and within-subject fluctuations in testosterone predicted emotion recognition accuracy. Overall, our analyses provide little support for the idea that circulating endogenous or exogenous ovarian hormones influence emotion recognition in women.
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Affiliation(s)
- Talia N Shirazi
- Department of Anthropology, Pennsylvania State University, University Park, PA, 16802, United States of America
| | - Kevin A Rosenfield
- Department of Anthropology, Pennsylvania State University, University Park, PA, 16802, United States of America
| | - Rodrigo A Cárdenas
- Department of Psychology, Pennsylvania State University, University Park, PA, 16802, United States of America
| | - S Marc Breedlove
- Department of Neuroscience, Michigan State University, East Lansing, MI 48824, United States of America
| | - David A Puts
- Department of Anthropology, Pennsylvania State University, University Park, PA, 16802, United States of America.
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40
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Bradshaw HK, Mengelkoch S, Hill SE. Hormonal contraceptive use predicts decreased perseverance and therefore performance on some simple and challenging cognitive tasks. Horm Behav 2020; 119:104652. [PMID: 31812533 DOI: 10.1016/j.yhbeh.2019.104652] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/17/2019] [Revised: 10/29/2019] [Accepted: 11/28/2019] [Indexed: 12/18/2022]
Abstract
A growing body of research suggests that hormonal contraceptive (HC) use may be associated with lower self-control, as well as structural and functional differences in women's brains that could contribute to differences in perseverance on tasks requiring cognitive control. Here, we sought to extend this research by examining the relationship between HC use and college-aged women's perseverance (i.e., time spent) and performance on tasks requiring cognitive control. Across two studies, we find that, compared to naturally-cycling women, women using HCs display less perseverance on both simple (i.e., a spot-the-difference game) and challenging (i.e., Graduate Record Examination quantitative problems) tasks. Moreover, these differences in perseverance were found to predict performance decrements across tasks, with women taking HCs performing worse because they spent less time on the tasks. By demonstrating how HC use may influence perseverance and thereby performance, these results contribute to a growing body of research examining the unintended implications of HC use on cognition, learning, and memory.
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Affiliation(s)
- Hannah K Bradshaw
- Department of Psychology, Texas Christian University, United States of America.
| | - Summer Mengelkoch
- Department of Psychology, Texas Christian University, United States of America
| | - Sarah E Hill
- Department of Psychology, Texas Christian University, United States of America
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41
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Griksiene R, Arnatkeviciute A, Monciunskaite R, Koenig T, Ruksenas O. Mental rotation of sequentially presented 3D figures: sex and sex hormones related differences in behavioural and ERP measures. Sci Rep 2019; 9:18843. [PMID: 31827215 PMCID: PMC6906480 DOI: 10.1038/s41598-019-55433-y] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2019] [Accepted: 11/20/2019] [Indexed: 11/24/2022] Open
Abstract
Mental rotation of 3D objects demonstrates one of the largest sex differences. We investigated sex and sex hormones-related differences in behaviour and event related potentials (ERP) using a modified Shepard and Metzler task composed of sequentially presented 3D figures in 29 men and 32 women. We demonstrated a significant increase in response time and decrease in both accuracy and positivity of the parietal ERP with increasing angular disparity between the figures. Higher angular disparity evoked an increase of global field power (GFP) from 270 to 460 ms and different activation topographies from 470 to 583 ms with lower parietal, but higher left frontal positivity. Flatter slopes in higher angular disparity condition suggest distinct strategies being implemented depending on the difficulty of the rotation. Men performed the task more accurately than women. Performance accuracy in women tended to be negatively related to estradiol while the response time tended to increase with increasing progesterone. There were no associations with testosterone. Women demonstrated higher GFP and an increased positivity over the parietal scalp area, while men showed higher activation in the left frontal cortex. Together these findings indicate dynamic angular disparity- and sex-related differences in brain activity during mental rotation of 3D figures.
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Affiliation(s)
- Ramune Griksiene
- Department of Neurobiology and Biophysics, Vilnius University, Vilnius, Lithuania.
| | | | - Rasa Monciunskaite
- Department of Neurobiology and Biophysics, Vilnius University, Vilnius, Lithuania
| | - Thomas Koenig
- Translational Research Center, University Hospital of Psychiatry, Bern, Switzerland
| | - Osvaldas Ruksenas
- Department of Neurobiology and Biophysics, Vilnius University, Vilnius, Lithuania
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42
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Lewis CA, Kimmig ACS, Zsido RG, Jank A, Derntl B, Sacher J. Effects of Hormonal Contraceptives on Mood: A Focus on Emotion Recognition and Reactivity, Reward Processing, and Stress Response. Curr Psychiatry Rep 2019; 21:115. [PMID: 31701260 PMCID: PMC6838021 DOI: 10.1007/s11920-019-1095-z] [Citation(s) in RCA: 68] [Impact Index Per Article: 13.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
PURPOSE OF REVIEW We review recent research investigating the relationship of hormonal contraceptives and mood with a focus on relevant underlying mechanisms, such as emotion recognition and reactivity, reward processing, and stress response. RECENT FINDINGS Adverse effects of hormonal contraceptives (HCs) on mood seem most consistent in women with a history of depressive symptoms and/or previous negative experience with HC-intake. Current evidence supports a negativity bias in emotion recognition and reactivity in HC-users, although inconsistent to some extent. Some data, however, do indicate a trend towards a blunted reward response and a potential dysregulation of the stress response in some HC-users. HC-effects on psychological and neurophysiological mechanisms underlying mood are likely context-dependent. We provide suggestions on how to address some of the contributing factors to this variability in future studies, such as HC-dose, timing, administration-mode, and individual risk. A better understanding of how and when HCs affect mood is critical to provide adequate contraceptive choices to women worldwide.
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Affiliation(s)
- Carolin A Lewis
- Emotion Neuroimaging Lab, Max Planck Institute for Human Cognitive and Brain Sciences, Stephanstr. 1A, 04103, Leipzig, Germany.
- International Max Planck Research School on Neuroscience of Communication: Function, Structure, and Plasticity, Leipzig, Germany.
- Department of Psychiatry and Psychotherapy, University of Tuebingen, Calwerstr, 14, 72076, Tuebingen, Germany.
| | - Ann-Christin S Kimmig
- Department of Psychiatry and Psychotherapy, University of Tuebingen, Calwerstr, 14, 72076, Tuebingen, Germany
- International Max Planck Research School for Cognitive and Systems Neuroscience, University of Tuebingen, Tuebingen, Germany
| | - Rachel G Zsido
- Emotion Neuroimaging Lab, Max Planck Institute for Human Cognitive and Brain Sciences, Stephanstr. 1A, 04103, Leipzig, Germany
- International Max Planck Research School on Neuroscience of Communication: Function, Structure, and Plasticity, Leipzig, Germany
- Department of Neurology, Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany
| | - Alexander Jank
- Department of Obstetrics, University Hospital Leipzig, Leipzig, Germany
| | - Birgit Derntl
- Department of Psychiatry and Psychotherapy, University of Tuebingen, Calwerstr, 14, 72076, Tuebingen, Germany
- Werner Reichardt Center for Integrative Neuroscience, University of Tuebingen, Tuebingen, Germany
- LEAD Research School and Graduate Network, University of Tuebingen, Tuebingen, Germany
| | - Julia Sacher
- Emotion Neuroimaging Lab, Max Planck Institute for Human Cognitive and Brain Sciences, Stephanstr. 1A, 04103, Leipzig, Germany
- Department of Neurology, Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany
- Clinic for Cognitive Neurology, University of Leipzig, Leipzig, Germany
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Monciunskaite R, Malden L, Lukstaite I, Ruksenas O, Griksiene R. Do oral contraceptives modulate an ERP response to affective pictures? Biol Psychol 2019; 148:107767. [PMID: 31509765 DOI: 10.1016/j.biopsycho.2019.107767] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2019] [Revised: 08/23/2019] [Accepted: 09/06/2019] [Indexed: 12/22/2022]
Abstract
Indications exist that use of oral contraceptives affects women's socio-emotional behaviour, brain function and, cognitive abilities, but the information is still scarce and ambiguous. We aimed to examine affective processing of visual stimuli between oral contraceptive users (OC, n = 33) and naturally cycling women (NC, n = 37) using the event-related potential (ERP) method. The main findings are: (i) emotionally arousing stimuli elicited significantly enlarged late positive potential (LPP) amplitudes compared to neutral stimuli, (ii) anti-androgenic OC users demonstrated diminished brain reactivity to visual stimuli, and (iii) significantly blunted reaction to highly unpleasant images. In addition, a positive relationship between GFP evoked by the highly unpleasant and highly pleasant visual emotional stimuli and progesterone was observed in NC women, while OC users demonstrated a trend of negative relationship between GFP and progesterone level. These findings suggest possible modulations of affective processing of visual stimuli when hormonal contraceptives are used.
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Affiliation(s)
- R Monciunskaite
- Institute of Biosciences, Life Sciences Center, Vilnius University, Vilnius, Lithuania.
| | - L Malden
- Institute of Biosciences, Life Sciences Center, Vilnius University, Vilnius, Lithuania
| | - I Lukstaite
- Institute of Biosciences, Life Sciences Center, Vilnius University, Vilnius, Lithuania
| | - O Ruksenas
- Institute of Biosciences, Life Sciences Center, Vilnius University, Vilnius, Lithuania
| | - R Griksiene
- Institute of Biosciences, Life Sciences Center, Vilnius University, Vilnius, Lithuania
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44
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Burunat E. Love is a physiological motivation (like hunger, thirst, sleep or sex). Med Hypotheses 2019; 129:109225. [PMID: 31371074 DOI: 10.1016/j.mehy.2019.05.011] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2018] [Revised: 04/17/2019] [Accepted: 05/12/2019] [Indexed: 10/26/2022]
Abstract
The multitude of terms associated with love has given rise to a false perception of love. In this paper, only maternal and romantic love are considered. Love is usually regarded as a feeling, motivation, addiction, passion, and, above all, an emotion. This confusion has consequences in the lives of human beings, leading not only to divorces, suicides, femicides but possibly also to a number of mental illnesses and suffering. Therefore, it is crucial to first clarify what is meant by emotion, motivation and love. This work aims to finally place love within the category of physiological motivations, such as hunger, thirst, sleep, or sex, on the basis that love is also essential for human survival, especially in childhood. Love is presented from an evolutionary perspective. Some other similarities between love and other physiological motivations are pointed out, such as its importance for appropriate human development, both its ontogeny and its permanence, and the long-lasting consequences of abuse and neglect. There are summarized reasons that account for this, such as the fact that physiological motivations are essential for survival and that love is an essential motivation for the survival of human offspring. Other reasons are that minimum changes in the quantity and quality of love alters development, that there can be a variety of neurophysiological and behavioural states within a motivation, and that motivations (also love) appear and change throughout development. Also, motivations and love sometimes may lead to an addictive behaviour. Finally, it is recognized that once physiological motivations (and love) appear, they become permanent. In a third section, some potential social, cultural, clinical and scientific consequences of the proposed consideration of love as a motivation are discussed. Accordingly, love's recognition as a motivation in the clinical field would imply a better understanding of its disorders and its inclusion in classifications manuals such as The Diagnostic and Statistical Manual of Mental Disorders (DSM), or in the International Classification of Diseases (ICD). Considering love as a motivation rather than an emotion could also impact the results of scientific research (an example is included). A comprehensive understanding of these questions could potentially allow for a new therapeutic approach in the treatment of mental illness, while offering an all-inclusive evolutionary explanation of cultural phenomena such as the origin and diffusion of both language and art. Love should be understood as a physiological motivation, like hunger, sleep or sex, and not as an emotion as it is commonly considered.
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Affiliation(s)
- Enrique Burunat
- School of Health Sciences/School of Psychology, Department of Clinical Psychology, Psychobiology and Methodology, University of La Laguna, P.O. Box 456, 38200 Santa Cruz de Tenerife, Canary Islands, Spain.
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45
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Pletzer B, Harris T, Hidalgo-Lopez E. Previous contraceptive treatment relates to grey matter volumes in the hippocampus and basal ganglia. Sci Rep 2019; 9:11003. [PMID: 31358839 PMCID: PMC6662764 DOI: 10.1038/s41598-019-47446-4] [Citation(s) in RCA: 30] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2018] [Accepted: 07/17/2019] [Indexed: 12/30/2022] Open
Abstract
Oral contraceptive (OC) effects on the brain have gained increasing interest, but are highly controversial. Previous studies suggest that OC users have larger hippocampi, parahippocampi, fusiform gyri and Cerebelli. Preliminary evidence from one of those studies even suggests an effect of previous contraceptive use on the hippocampi of women who are not current users of OCs. Furthermore, more recent studies postulate an involvement of previous OC treatment in later development of mood disorders. To address the question whether previous OC treatment affects women’s brain structure later in life, high resolution structural images were obtained from 131 naturally cycling women. Among them, 52 women had never used OC before, 52 had previously used one OC for a continuous time period and 27 had previously used multiple contraceptives. The groups did not differ in gray matter volumes. Since endogenous sex hormones modulate gray matter volumes of the hippocampus and basal ganglia along the menstrual cycle, we hypothesize effects of OC use on these areas. Specifically, we hypothesize that a longer duration of previous OC treatment is related to larger hippocampi and larger basal ganglia. Indeed we found the duration of previous OC use to be positively correlated to hippocampal and basal ganglia volumes bilaterally. For the hippocampus, but not for the basal ganglia, this association disappeared after controlling for the time since discontinuation. These results suggest that for the hippocampus, but not for the basal ganglia, effects of previous contraceptive treatment are reversed after a time period comparable to treatment duration. These data question the immediate reversibility of OC effects on brain structure. Accordingly, some changes in the brain due to long-term contraceptive use, while subtle, may be long-lasting.
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Affiliation(s)
- Belinda Pletzer
- Department of Psychology & Centre for Cognitive Neuroscience, University of Salzburg, Salzburg, Austria.
| | - TiAnni Harris
- Department of Psychology & Centre for Cognitive Neuroscience, University of Salzburg, Salzburg, Austria
| | - Esmeralda Hidalgo-Lopez
- Department of Psychology & Centre for Cognitive Neuroscience, University of Salzburg, Salzburg, Austria
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Taylor CM, Pritschet L, Yu S, Jacobs EG. Applying a Women's Health Lens to the Study of the Aging Brain. Front Hum Neurosci 2019; 13:224. [PMID: 31333434 PMCID: PMC6625223 DOI: 10.3389/fnhum.2019.00224] [Citation(s) in RCA: 29] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2019] [Accepted: 06/18/2019] [Indexed: 11/15/2022] Open
Abstract
A major challenge in neuroscience is to understand what happens to a brain as it ages. Such insights could make it possible to distinguish between individuals who will undergo typical aging and those at risk for neurodegenerative disease. Over the last quarter century, thousands of human brain imaging studies have probed the neural basis of age-related cognitive decline. "Aging" studies generally enroll adults over the age of 65, a historical precedent rooted in the average age of retirement. A consequence of this research tradition is that it overlooks one of the most significant neuroendocrine changes in a woman's life: the transition to menopause. The menopausal transition is marked by an overall decline in ovarian sex steroid production-up to 90% in the case of estradiol-a dramatic endocrine change that impacts multiple biological systems, including the brain. Despite sex differences in the risk for dementia, the influence that biological sex and sex hormones have on the aging brain is historically understudied, leaving a critical gap in our understanding of the aging process. In this Perspective article, we highlight the influence that endocrine factors have on the aging brain. We devote particular attention to the neural and cognitive changes that unfold in the middle decade of life, as a function of reproductive aging. We then consider emerging evidence from animal and human studies that other endocrine factors occurring earlier in life (e.g., pregnancy, hormonal birth control use) also shape the aging process. Applying a women's health lens to the study of the aging brain will advance knowledge of the neuroendocrine basis of cognitive aging and ensure that men and women get the full benefit of our research efforts.
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Affiliation(s)
- Caitlin M. Taylor
- Department of Psychological and Brain Sciences, University of California, Santa Barbara, Santa Barbara, CA, United States
- The Sage Center for the Study of the Mind, University of California, Santa Barbara, Santa Barbara, CA, United States
| | - Laura Pritschet
- Department of Psychological and Brain Sciences, University of California, Santa Barbara, Santa Barbara, CA, United States
| | - Shuying Yu
- Department of Psychological and Brain Sciences, University of California, Santa Barbara, Santa Barbara, CA, United States
| | - Emily G. Jacobs
- Department of Psychological and Brain Sciences, University of California, Santa Barbara, Santa Barbara, CA, United States
- Neuroscience Research Institute, University of California, Santa Barbara, Santa Barbara, CA, United States
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Pletzer B. Sex Hormones and Gender Role Relate to Gray Matter Volumes in Sexually Dimorphic Brain Areas. Front Neurosci 2019; 13:592. [PMID: 31275099 PMCID: PMC6591487 DOI: 10.3389/fnins.2019.00592] [Citation(s) in RCA: 36] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2019] [Accepted: 05/23/2019] [Indexed: 12/21/2022] Open
Abstract
The present study investigates the relationship of circulating sex hormone levels and gender role to gray matter volumes in sexually dimorphic brain areas and explores, whether these relationships are modulated by biological sex (as assigned at birth based on sexual anatomy) or oral contraceptive (OC) use. It was hypothesized that testosterone and masculinity relate positively to gray matter volumes in areas that are typically larger in men, like the hippocampus or cerebellum, while estradiol/progesterone and femininity relate positively to gray matter volumes in the frontal cortex. To that end, high resolution structural MRI scans, sex hormone levels and gender role self-assessments were obtained in a large sample 89 men, 89 naturally cycling (NC) women, and 60 OC users. Men showed larger regional gray matter volumes than women in the cerebellum and bilateral clusters spanning the putamen and parts of the hippocampi/parahippocampi and fusiform gyri. In accordance with our hypotheses, a significant positive association of testosterone to hippocampal volumes was observed in women irrespective of OC use. Participant's self-reported femininity was significantly positively associated with gray matter volumes in the left middle frontal gyrus (MFG) in men. In addition several differences between OC-users and NC women were identified.
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Affiliation(s)
- Belinda Pletzer
- Department of Psychology, University of Salzburg, Salzburg, Austria
- Centre for Cognitive Neuroscience, University of Salzburg, Salzburg, Austria
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Nowosielski K, Kurpisz J, Kowalczyk R. Sexual self-schema: a cognitive schema and its relationship to choice of contraceptive method among Polish women. EUR J CONTRACEP REPR 2019; 24:280-287. [PMID: 31094585 DOI: 10.1080/13625187.2019.1615617] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
Objectives: The aim of the study was to examine sexual self-schema in women using different methods of contraception. Methods: Women (N = 560) aged 18-55 years were divided into two groups: those who used hormonal contraception (n = 285) and those who used non-hormonal contraception (n = 275). Participants were assessed using the Sexual Self-Schema Scale (SSSS), the Well-Matched Marriage Questionnaire and the Hospital Anxiety and Depression Scale and were also asked to fill in a structured questionnaire, giving information on their socioeconomic status, reproductive and medical history, sexual behaviours, psychosexual orientation, sexual experience and type of contraception used. Results: Women in the hormonal group scored lower on romantic, passionate and direct subscales of the SSSS, compared with women in the non-hormonal group. Of the total sample, 35% were classified as positive schematic. Women in the hormonal group were found to be more negative schematic and aschematic as well as less co-schematic compared with women in the non-hormonal group. Furthermore, women in the hormonal group were significantly less religious and perceived their self-evaluated weight to be higher compared with women in the non-hormonal group. Logistic regression revealed that negative schematic (odds ratio [OR] 6.6) and aschematic women (OR 3.7), as well as women with more deliveries (OR 1.6), were more likely to choose hormonal contraception. Conclusion: A sexual self-schema might be a relevant factor affecting the choice of contraceptive method. All women seeking hormonal contraception who are aschematic or negative schematic should consult with a sexual medicine specialist, because those individuals may have more profound reasons underlying their need for this type of contraception.
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Affiliation(s)
| | - Jacek Kurpisz
- b Department and Clinic of Psychiatry , Pomeranian Medical University , Szczecin , Poland
| | - Robert Kowalczyk
- c Department of Sexology , Andrzej Frycz Modrzewski Kraków University , Cracow , Poland
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Allen AM, Weinberger AH, Wetherill RR, Howe CL, McKee SA. Oral Contraceptives and Cigarette Smoking: A Review of the Literature and Future Directions. Nicotine Tob Res 2019; 21:592-601. [PMID: 29165663 PMCID: PMC6468133 DOI: 10.1093/ntr/ntx258] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2017] [Accepted: 11/16/2017] [Indexed: 01/08/2023]
Abstract
INTRODUCTION Evidence continues to mount indicating that endogenous sex hormones (eg, progesterone and estradiol) play a significant role in smoking-related outcomes. Although approximately one out of four premenopausal smokers use oral contraceptives (OCs), which significantly alter progesterone and estradiol levels, relatively little is known about how OCs may influence smoking-related outcomes. Thus, the goal of this review article is to describe the state of the literature and offer recommendations for future directions. METHODS In March 2017, we searched seven databases, with a restriction to articles written in English, using the following keywords: nicotine, smoker(s), smoking, tobacco, cigarettes, abstinence, withdrawal, and craving(s). We did not restrict on the publication date, type, or study design. RESULTS A total of 13 studies were identified. Three studies indicated faster nicotine metabolism in OC users compared to nonusers. Five of six laboratory studies that examined physiological stress response noted heightened response in OC users compared to nonusers. Three studies examined cessation-related symptomatology (eg, craving) with mixed results. One cross-sectional study observed greater odds of current smoking among OC users, and no studies have explored the relationship between OC use and cessation outcomes. CONCLUSIONS Relatively few studies were identified on the role of OCs in smoking-related outcomes. Future work could explore the relationship between OC use and mood, stress, weight gain, and brain function/connectivity, as well as cessation outcomes. Understanding the role of OC use in these areas may lead to the development of novel smoking cessation interventions for premenopausal women. IMPLICATIONS This is the first review of the relationship between oral contraceptives (OCs) and smoking-related outcomes. The existing literature suggests that the use of OCs is related to increased nicotine metabolism and physiological stress response. However, the relationship between OC use and smoking-related symptoms (eg, craving) is mixed. Further, no published data were available on OC use and smoking cessation outcomes. Therefore, we recommend additional research be conducted to characterize the relationship between OC use and smoking cessation outcomes, perhaps as a function of the effect of OC use on mood, stress, weight gain, and brain function/connectivity.
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Affiliation(s)
- Alicia M Allen
- Family & Community Medicine Department, College of Medicine, University of Arizona, Tucson, AZ, USA
| | - Andrea H Weinberger
- Ferkauf Graduate School of Psychology, Yeshiva University, New York, NY, USA
- Department of Epidemiology & Population Health, Albert Einstein College of Medicine, Bronx, USA
| | - Reagan R Wetherill
- Department of Psychiatry, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA
| | - Carol L Howe
- University of Arizona Health Sciences Library, University of Arizona, Tucson, AZ
| | - Sherry A McKee
- Department of Psychiatry, Yale School of Medicine, New Haven, CT
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Raymond C, Marin MF, Juster RP, Leclaire S, Bourdon O, Cayer-Falardeau S, Lupien SJ. Increased frequency of mind wandering in healthy women using oral contraceptives. Psychoneuroendocrinology 2019; 101:121-127. [PMID: 30453124 DOI: 10.1016/j.psyneuen.2018.11.005] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/06/2018] [Revised: 11/01/2018] [Accepted: 11/01/2018] [Indexed: 01/12/2023]
Abstract
Oral contraceptive (OC) is the most common type of contraceptive method used in industrialized countries. A recent epidemiological study showed that OC use was associated with the onset of depression in young women. Mind wandering, a cognitive process associated with spontaneous thoughts unrelated to the task at-hand, has previously been associated with depressive thinking. Consequently, mind wandering might be a precursor for cognitive vulnerability in individuals who are at-risk for mood disorders. The purpose of this study was to examine the frequency and nature of mind wandering in women using OC in comparison to two control groups: naturally cycling women and men. We recruited 71 participants (28 women currently using OC, 14 naturally cycling women in the luteal phase of their menstrual cycle and 29 men) aged between 18 and 35 years, and measured the frequency and nature (guilt/fear oriented and positive) of mind wandering using the short version of the Imaginal Process Inventory. In all analyses, we controlled for depressive symptoms to delineate the unique association between OC use and mind wandering. We also measured estradiol, progesterone and testosterone to confirm expected group differences in sex hormones concentrations. Results show that women using OC presented increased frequency of mind wandering when compared to naturally cycling women and men who did not differ between each other. The three groups did not differ in terms of the nature of mind wandering. These results show that OC use is associated with increased frequency of mind wandering and suggest that the association between OC use and dysphoric mood described in previous studies may be partially explained by the impact of OC use on cognitive processes underlying mind wandering.
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Affiliation(s)
- Catherine Raymond
- Centre for Studies on Human Stress, Institut universitaire en santé mentale de Montréal, Research Centre, CIUSSS East, Montréal, Québec, Canada; Department of Neurosciences, Université de Montréal.
| | - Marie-France Marin
- Centre for Studies on Human Stress, Institut universitaire en santé mentale de Montréal, Research Centre, CIUSSS East, Montréal, Québec, Canada; Department of Psychology, Université du Québec à Montréal
| | - Robert-Paul Juster
- Centre for Studies on Human Stress, Institut universitaire en santé mentale de Montréal, Research Centre, CIUSSS East, Montréal, Québec, Canada; Department of Psychiatry and Addiction, Université de Montréal
| | - Sarah Leclaire
- Centre for Studies on Human Stress, Institut universitaire en santé mentale de Montréal, Research Centre, CIUSSS East, Montréal, Québec, Canada; Department of Neurosciences, Université de Montréal
| | - Olivier Bourdon
- Centre for Studies on Human Stress, Institut universitaire en santé mentale de Montréal, Research Centre, CIUSSS East, Montréal, Québec, Canada
| | - Sophia Cayer-Falardeau
- Centre for Studies on Human Stress, Institut universitaire en santé mentale de Montréal, Research Centre, CIUSSS East, Montréal, Québec, Canada
| | - Sonia J Lupien
- Centre for Studies on Human Stress, Institut universitaire en santé mentale de Montréal, Research Centre, CIUSSS East, Montréal, Québec, Canada; Department of Psychiatry and Addiction, Université de Montréal
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