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Galusca B, Gay A, Belleton G, Eisinger M, Massoubre C, Lang F, Grouselle D, Estour B, Germain N. Mechanisms and predictors of menses resumption once normal weight is reached in anorexia nervosa. J Eat Disord 2023; 11:172. [PMID: 37773179 PMCID: PMC10543836 DOI: 10.1186/s40337-023-00893-x] [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: 12/02/2022] [Accepted: 09/14/2023] [Indexed: 10/01/2023] Open
Abstract
BACKGROUND In cases of Anorexia Nervosa (AN), achieving weight gain recovery beyond the lower limits set by the World Health Organization and normalizing classical nutritional markers appears to be essential for most patients. However, this is not always adequate to restore menstrual cycles. This discrepancy can cause concern for both patients and healthcare providers, and can impact the medical management of these individuals. Thus, the purpose of this study was to assess the ability of anthropometric and hormonal factors to predict the resumption of menstrual cycles in individuals with anorexia nervosa upon reaching a normal body weight. METHOD Patients with AN who had achieved a normal Body Mass Index but had not yet resumed their menstrual cycles (referred to as ANRec) were evaluated on two occasions: first at visit 1 and then again 6 months later, provided their body weight remained stable over this period (visit 2). Among the 46 ANRec patients who reached visit 2, they were categorized into two groups: 20 with persistent amenorrhea (PA-ANRec) and 26 who had regained their menstrual cycles (RM-ANRec). Anthropometric measurements, several hormone levels, Luteinizing Hormone (LH) pulsatility over a 4-h period, and LH response to gonadotropin-releasing hormone injection (LH/GnRH) were then compared between the two groups at visit 1. RESULTS Patients in the RM-ANRec group exhibited higher levels of follicular stimulating hormone, estradiol, inhibin B, LH/GnRH, and lower levels of ghrelin compared to those in the PA-ANRec group. Analysis of Receiver Operating Characteristic curves indicated that having ≥ 2 LH pulses over a 4-h period, LH/GnRH levels ≥ 33 IU/l, and inhibin B levels > 63 pg/ml predicted the resumption of menstrual cycles with a high degree of specificity (87%, 100%, and 100%, respectively) and sensitivity (82%, 80%, and 79%, respectively). CONCLUSIONS These three hormonal tests, of which two are straightforward to perform, demonstrated a high predictive accuracy for the resumption of menstrual cycles. They could offer valuable support for the management of individuals with AN upon achieving normalized weight. Negative results from these tests could assist clinicians and patients in maintaining their efforts to attain individualized metabolic targets. TRIAL REGISTRATION IORG0004981.
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Affiliation(s)
- Bogdan Galusca
- Division of Endocrinology, Endocrinology Department, University Hospital of Saint-Etienne, 42055, Saint-Étienne Cedex 2, France.
- EA 7423, Eating Disorders, Addictions and Extreme Body Weight Research Group, Saint-Étienne, France.
- Eating Disorder Reference Center of Saint-Etienne, University Hospital of Saint-Etienne, Saint-Étienne, France.
| | - Aurélia Gay
- EA 7423, Eating Disorders, Addictions and Extreme Body Weight Research Group, Saint-Étienne, France
- Eating Disorder Reference Center of Saint-Etienne, University Hospital of Saint-Etienne, Saint-Étienne, France
- Division of Psychiatry, University Hospital of Saint-Etienne, Saint-Étienne, France
| | - Gwenaëlle Belleton
- Division of Endocrinology, Endocrinology Department, University Hospital of Saint-Etienne, 42055, Saint-Étienne Cedex 2, France
- Eating Disorder Reference Center of Saint-Etienne, University Hospital of Saint-Etienne, Saint-Étienne, France
| | - Martin Eisinger
- Division of Endocrinology, Endocrinology Department, University Hospital of Saint-Etienne, 42055, Saint-Étienne Cedex 2, France
- Eating Disorder Reference Center of Saint-Etienne, University Hospital of Saint-Etienne, Saint-Étienne, France
| | - Catherine Massoubre
- EA 7423, Eating Disorders, Addictions and Extreme Body Weight Research Group, Saint-Étienne, France
- Eating Disorder Reference Center of Saint-Etienne, University Hospital of Saint-Etienne, Saint-Étienne, France
- Division of Psychiatry, University Hospital of Saint-Etienne, Saint-Étienne, France
| | - François Lang
- EA 7423, Eating Disorders, Addictions and Extreme Body Weight Research Group, Saint-Étienne, France
- Eating Disorder Reference Center of Saint-Etienne, University Hospital of Saint-Etienne, Saint-Étienne, France
- Division of Psychiatry, University Hospital of Saint-Etienne, Saint-Étienne, France
| | - Dominique Grouselle
- UMR 894 INSERM Psychiatry and Neurosciences Center, Paris Descartes University, Paris, France
| | - Bruno Estour
- Division of Endocrinology, Endocrinology Department, University Hospital of Saint-Etienne, 42055, Saint-Étienne Cedex 2, France
- EA 7423, Eating Disorders, Addictions and Extreme Body Weight Research Group, Saint-Étienne, France
- Eating Disorder Reference Center of Saint-Etienne, University Hospital of Saint-Etienne, Saint-Étienne, France
| | - Natacha Germain
- EA 7423, Eating Disorders, Addictions and Extreme Body Weight Research Group, Saint-Étienne, France
- Eating Disorder Reference Center of Saint-Etienne, University Hospital of Saint-Etienne, Saint-Étienne, France
- Division of Psychiatry, University Hospital of Saint-Etienne, Saint-Étienne, France
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Wickramasuriya N, Hawkins R, Atwood C, Butler T. The roles of GnRH in the human central nervous system. Horm Behav 2022; 145:105230. [PMID: 35809386 PMCID: PMC9990468 DOI: 10.1016/j.yhbeh.2022.105230] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/25/2021] [Revised: 06/20/2022] [Accepted: 06/21/2022] [Indexed: 11/04/2022]
Abstract
It is widely known that GnRH plays a role in facilitating reproductive function via the HPG axis, and this was once believed to be its only function. However, over the last several decades important neuromodulatory roles of GnRH in multiple brain functions have been elucidated. Multiple GnRH isoforms and receptors have been detected outside the HPG-axis across different species. In this review, we focus on the human CNS where GnRH I and II isoforms and a functional GnRH I receptor have been isolated. We first describe the traditional understanding of GnRH within the hypothalamus and the pituitary and current clinical use of GnRH analogues. We then review the location and function of GnRH-producing neurons and receptors located outside the HPG axis. We next review the GnRH I and II neuron location and quantity and GnRH I receptor gene expression throughout the human brain, using the Allen Brain Map Atlas. This analysis demonstrates a wide expression of GnRH throughout the brain, including prominent expression in the basal forebrain and cerebellum. Lastly, we examine the potential role of GnRH in aging and inflammation and its therapeutic potential for neurodegenerative disease and spinal cord lesions.
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Affiliation(s)
- Nimmi Wickramasuriya
- Weill Cornell Medicine, Department of Radiology, 1305 York Ave #3F, New York, NY 1002, USA
| | - Robert Hawkins
- Weill Cornell Medicine, Department of Radiology, 1305 York Ave #3F, New York, NY 1002, USA
| | - Craig Atwood
- University of Wisconsin, Department of Medicine, 2500 Overlook Tce, Madison, WI 53705, USA
| | - Tracy Butler
- Weill Cornell Medicine, Department of Radiology, 1305 York Ave #3F, New York, NY 1002, USA.
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Vinberg M, Wium-Andersen MK, Wium-Andersen IK, Jørgensen MB, Christensen K, Osler M. Intrauterine testosterone exposure and depression risk in opposite-sex and same-sex twins, a Danish register study. Psychol Med 2021; 52:1-6. [PMID: 33722322 DOI: 10.1017/s003329172100057x] [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] [Indexed: 11/05/2022]
Abstract
BACKGROUND Males have a lower prevalence of depression than females and testosterone may be a contributing factor. A comparison of opposite-sex and same-sex twins can be used indirectly to establish the role of prenatal testosterone exposure and the risk of depression. We therefore aimed to explore differences in depression risk using opposite-sex and same-sex twins. METHODS We included 126 087 opposite-sex and same-sex twins from the Danish Twin Registry followed in nationwide Danish registers. We compared sex-specific incidences of depression diagnosis and prescriptions of antidepressants between opposite-sex and same-sex twins using Cox proportional hazard regression. RESULTS During follow-up, 2664 (2.1%) twins were diagnosed with depression and 19 514 (15.5%) twins had purchased at least one prescription of antidepressants. First, in male twins, we found that the opposite-sex male twins had the same risk of depression compared to the same-sex male twins {hazard ratio (HR) = 1.01 [95% confidence interval (CI) 0.88-1.17)]}. Revealing the risk of use of antidepressants, the opposite-sex male twins had a slightly higher risk of 4% (HR = 1.04 (95% CI 1.00-1.11)) compared with the same-sex male twins. Second, in the female opposite-sex twins, we revealed a slightly higher, however, not statistically significant risk of depression (HR = 1.08 (95% CI 0.97-1.29)) or purchase of antidepressants (HR = 1.01 (95% CI 0.96-1.05)) when compared to the same-sex female twins. CONCLUSIONS We found limited support for the hypothesis that prenatal exposure to testosterone was associated with the risk of depression later in life.
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Affiliation(s)
- M Vinberg
- Mental Health Services, Capital Region of Denmark, Psychiatric Centre North Zealand, Hillerød, Denmark
- Institute of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | - M K Wium-Andersen
- Psychiatric Center Copenhagen, Rigshospitalet, Copenhagen, Denmark
- Center for Clinical Research and Prevention, Bispebjerg and Frederiksberg Hospital, Frederiksberg, Denmark
| | - I K Wium-Andersen
- Psychiatric Center Copenhagen, Rigshospitalet, Copenhagen, Denmark
- Center for Clinical Research and Prevention, Bispebjerg and Frederiksberg Hospital, Frederiksberg, Denmark
| | - M B Jørgensen
- Institute of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
- Psychiatric Center Copenhagen, Rigshospitalet, Copenhagen, Denmark
| | - K Christensen
- Department of Public Health, The Danish Aging Research Center and The Danish Twin Registry, University of Southern Denmark, Odense, Denmark
- Department of Psychology, University of Minnesota, Minneapolis, MN, USA
| | - M Osler
- Center for Clinical Research and Prevention, Bispebjerg and Frederiksberg Hospital, Frederiksberg, Denmark
- Department of Public Health, Section of Epidemiology, University of Copenhagen, Copenhagen, Denmark
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Vijayakumar N, Youssef GJ, Allen NB, Anderson V, Efron D, Hazell P, Mundy L, Nicholson JM, Patton G, Seal ML, Simmons JG, Whittle S, Silk T. A longitudinal analysis of puberty-related cortical development. Neuroimage 2020; 228:117684. [PMID: 33385548 DOI: 10.1016/j.neuroimage.2020.117684] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2020] [Revised: 12/08/2020] [Accepted: 12/16/2020] [Indexed: 01/27/2023] Open
Abstract
The brain undergoes extensive structural changes during adolescence, concurrent to puberty-related physical and hormonal changes. While animal research suggests these biological processes are related to one another, our knowledge of brain development in humans is largely based on age-related processes. Thus, the current study characterized puberty-related changes in human brain structure, by combining data from two longitudinal neuroimaging cohorts. Beyond normative changes in cortical thickness, we examined whether individual differences in the rate of pubertal maturation (or "pubertal tempo") was associated with variations in cortical trajectories. Participants (N = 192; scans = 366) completed up to three waves of MRI assessments between 8.5 and 14.5 years of age, as well as questionnaire assessments of pubertal stage at each wave. Generalized additive mixture models were used to characterize trajectories of cortical development. Results revealed widespread linear puberty-related changes across much of the cortex. Many of these changes, particularly within the frontal and parietal cortices, were independent of age-related development. Males exhibiting faster pubertal tempo demonstrated greater thinning in the precuneus and frontal cortices than same-aged and -sex peers. Findings suggest that the unique influence of puberty on cortical development may be more extensive than previously identified, and also emphasize important individual differences in the coupling of these developmental processes.
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Affiliation(s)
| | | | - Nicholas B Allen
- Department of Psychology, University of Oregon, Eugene, USA; Melbourne School of Psychological Sciences, The University of Melbourne, Melbourne, Australia
| | - Vicki Anderson
- Melbourne School of Psychological Sciences, The University of Melbourne, Melbourne, Australia; Clinical Sciences Research, Murdoch Children's Research Institute, Parkville, Australia; Royal Children's Hospital, Melbourne, Australia
| | - Daryl Efron
- Health Services, Murdoch Children's Research Institute, Parkville, Australia; Department of Paediatrics, The University of Melbourne, Melbourne, Australia
| | - Philip Hazell
- Discipline of Psychiatry, The University of Sydney, Sydney, Australia
| | - Lisa Mundy
- Department of Paediatrics, The University of Melbourne, Melbourne, Australia; Centre for Adolescent Health, Murdoch Children's Research Institute, Parkville, Australia
| | - Jan M Nicholson
- Judith Lumley Centre, La Trobe University, Melbourne, Australia
| | - George Patton
- Department of Paediatrics, The University of Melbourne, Melbourne, Australia; Centre for Adolescent Health, Murdoch Children's Research Institute, Parkville, Australia
| | - Marc L Seal
- Department of Paediatrics, The University of Melbourne, Melbourne, Australia; Developmental Imaging, Murdoch Children's Research Institute, Parkville, Australia
| | - Julian G Simmons
- Melbourne School of Psychological Sciences, The University of Melbourne, Melbourne, Australia; Melbourne Neuropsychiatry Centre, Department of Psychiatry, The University of Melbourne, Melbourne, Australia
| | - Sarah Whittle
- Melbourne Neuropsychiatry Centre, Department of Psychiatry, The University of Melbourne, Melbourne, Australia
| | - Tim Silk
- School of Psychology, Deakin University, Melbourne, Australia; Department of Paediatrics, The University of Melbourne, Melbourne, Australia; Developmental Imaging, Murdoch Children's Research Institute, Parkville, Australia
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Vijayakumar N, Op de Macks Z, Shirtcliff EA, Pfeifer JH. Puberty and the human brain: Insights into adolescent development. Neurosci Biobehav Rev 2018; 92:417-436. [PMID: 29972766 PMCID: PMC6234123 DOI: 10.1016/j.neubiorev.2018.06.004] [Citation(s) in RCA: 190] [Impact Index Per Article: 31.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2018] [Revised: 06/03/2018] [Accepted: 06/06/2018] [Indexed: 12/24/2022]
Abstract
Alongside the exponential flourish of research on age-related trajectories of human brain development during childhood and adolescence in the past two decades, there has been an increase in the body of work examining the association between pubertal development and brain maturation. This review systematically examines empirical research on puberty-related structural and functional brain development in humans, with the aim of identifying convergent patterns of associations. We emphasize longitudinal studies, and discuss pervasive but oft-overlooked methodological issues that may be contributing to inconsistent findings and hindering progress (e.g., conflating distinct pubertal indices and different measurement instruments). We also briefly evaluate support for prominent models of adolescent neurodevelopment that hypothesize puberty-related changes in brain regions involved in affective and motivational processes. For the field to progress, replication studies are needed to help resolve current inconsistencies and gain a clearer understanding of pubertal associations with brain development in humans, knowledge that is crucial to make sense of the changes in psychosocial functioning, risk behavior, and mental health during adolescence.
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Owens SJ, Murphy CE, Purves-Tyson TD, Weickert TW, Shannon Weickert C. Considering the role of adolescent sex steroids in schizophrenia. J Neuroendocrinol 2018; 30. [PMID: 28941299 DOI: 10.1111/jne.12538] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/02/2017] [Revised: 09/06/2017] [Accepted: 09/20/2017] [Indexed: 12/29/2022]
Abstract
Schizophrenia is a disabling illness that is typically first diagnosed during late adolescence to early adulthood. It has an unremitting course and is often treatment-resistant. Many clinical aspects of the illness suggest that sex steroid-nervous system interactions may contribute to the onset, course of symptoms and the cognitive impairment displayed by men and women with schizophrenia. Here, we discuss the actions of oestrogen and testosterone on the brain during adolescent development and in schizophrenia from the perspective of experimental studies in animals, human post-mortem studies, magnetic resonance imaging studies in living humans and clinical trials of sex steroid-based treatments. We present evidence of potential beneficial, as well as detrimental, effects of both testosterone and oestrogen. We provide a rationale for the necessity to further elucidate sex steroid mechanisms of action at different ages, sexes and brain regions to more fully understand the role of testosterone and oestrogen in the pathophysiology of schizophrenia. The weight of the evidence suggests that sex steroid hormones influence mammalian brain function, including both cognition and emotion, and that pharmaceutical agents aimed at sex steroid receptors appear to provide a novel treatment avenue to reduce symptoms and improve cognition in men and women with schizophrenia.
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Affiliation(s)
- S J Owens
- Schizophrenia Research Laboratory, Neuroscience Research Australia, Randwick, NSW, Australia
- Faculty of Medicine, School of Psychiatry, University of New South Wales, Sydney, NSW, Australia
| | - C E Murphy
- Schizophrenia Research Laboratory, Neuroscience Research Australia, Randwick, NSW, Australia
- Faculty of Medicine, School of Psychiatry, University of New South Wales, Sydney, NSW, Australia
| | - T D Purves-Tyson
- Schizophrenia Research Laboratory, Neuroscience Research Australia, Randwick, NSW, Australia
- Faculty of Medicine, School of Psychiatry, University of New South Wales, Sydney, NSW, Australia
| | - T W Weickert
- Schizophrenia Research Laboratory, Neuroscience Research Australia, Randwick, NSW, Australia
- Faculty of Medicine, School of Psychiatry, University of New South Wales, Sydney, NSW, Australia
| | - C Shannon Weickert
- Schizophrenia Research Laboratory, Neuroscience Research Australia, Randwick, NSW, Australia
- Faculty of Medicine, School of Psychiatry, University of New South Wales, Sydney, NSW, Australia
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Ramanathan S, Miewald J, Montrose D, Keshavan MS. Can age at sexual maturity act as a predictive biomarker for prodromal negative symptoms? Schizophr Res 2015; 164:35-9. [PMID: 25778616 PMCID: PMC4411182 DOI: 10.1016/j.schres.2015.02.019] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/18/2014] [Revised: 02/21/2015] [Accepted: 02/22/2015] [Indexed: 11/25/2022]
Abstract
BACKGROUND Puberty and reproductive hormones have been identified as having a potential role in schizophrenia. Earlier reports have suggested associations between later age at puberty and schizophrenia in males. Similarly, associations have been reported between testosterone levels and psychotic symptoms. In this report, we examined the association between age at puberty and prodromal symptoms of psychosis. METHODS 58 child or adolescent family members of individuals with schizophrenia were interviewed using the Scale of Prodromal Symptoms and the Tanner Maturational Scale. Age at Tanner pubertal stage was determined and regression analyses were used to explore associations between prodromal symptoms and age at puberty. RESULTS Among males, delayed age at puberty was associated with greater severity of prodromal symptoms; the association between negative prodromal symptoms and delayed age was significant (p=0.001). In females, the association was not statistically significant. CONCLUSIONS Our results suggest that delayed age at puberty may be associated with negative prodromal symptoms of schizophrenia in males. Our findings suggest that delayed age at puberty could potentially be a predictive biomarker for psychopathology in males at risk for schizophrenia.
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Affiliation(s)
| | - Jean Miewald
- Western Psychiatric Institute and Clinic, University of Pittsburgh School of Medicine, Pittsburgh, PA
| | - Debra Montrose
- Western Psychiatric Institute and Clinic, University of Pittsburgh School of Medicine, Pittsburgh, PA
| | - Matcheri S Keshavan
- Western Psychiatric Institute and Clinic, University of Pittsburgh School of Medicine, Pittsburgh, PA, United States; Beth Israel Deaconess Medical Center, Boston, MA, United States; Department of Psychiatry, Harvard Medical School, Boston, MA, United States.
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8
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Chiang HL, Liu CJ, Hu YW, Chen SC, Hu LY, Shen CC, Yeh CM, Chen TJ, Gau SSF. Risk of cancer in children, adolescents, and young adults with autistic disorder. J Pediatr 2015; 166:418-23.e1. [PMID: 25453246 DOI: 10.1016/j.jpeds.2014.10.029] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/02/2014] [Revised: 09/02/2014] [Accepted: 10/13/2014] [Indexed: 01/26/2023]
Abstract
OBJECTIVES To investigate whether individuals with autism have an increased risk for cancer relative to the general population. STUDY DESIGN We enrolled patients with autistic disorder from the Taiwan National Health Insurance database in years 1997-2011. A total of 8438 patients diagnosed with autism were retrieved from the Registry for Catastrophic Illness Patients database. The diagnosis of cancers was also based on the certificate of catastrophic illness, which requires histological confirmation. The risk of cancer among the autism cohort was determined with a standardized incidence ratio (SIR). RESULTS During the observation period, cancer occurred in 20 individuals with autism, which was significantly higher than a total number of expected cancers with a SIR estimate of 1.94 (95% CI 1.18-2.99). The number of cancer in males was greater than the expected number with a SIR of 1.95 (1.11-3.16), but no excess risk was found for females with a SIR of 1.91 (0.52-4.88). Cancer developed more than expected in individuals age 15-19 years with the SIR of 3.58 (1.44-7.38), but did not differ in other age range groups. The number of cancers of genitourinary system was significantly in excess of the expected number (SIR 4.15; 95% CI 1.13-10.65), and increased risk was found in ovarian cancer with SIR of 9.21 (1.12-33.29). CONCLUSIONS Our study demonstrated that patients with autistic disorder have an increased risk of cancer.
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Affiliation(s)
- Huey-Ling Chiang
- Department of Psychiatry, National Taiwan University Hospital and College of Medicine, Taipei, Taiwan; Graduate Institute of Clinical Medicine, College of Medicine, National Taiwan University, Taipei, Taiwan; Department of Psychiatry, Far Eastern Memorial Hospital, New Taipei City, Taiwan
| | - Chia-Jen Liu
- Division of Hematology and Oncology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan; School of Medicine, National Yang-Ming University, Taipei, Taiwan; Institute of Public Health, National Yang-Ming University, Taipei, Taiwan
| | - Yu-Wen Hu
- School of Medicine, National Yang-Ming University, Taipei, Taiwan; Institute of Public Health, National Yang-Ming University, Taipei, Taiwan; Cancer Center, Taipei Veterans General Hospital, Taipei, Taiwan
| | - San-Chi Chen
- Division of Hematology and Oncology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Li-Yu Hu
- Institute of Public Health, National Yang-Ming University, Taipei, Taiwan; Department of Psychiatry, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan
| | - Cheng-Che Shen
- Department of Psychiatry, Chiayi Branch, Taichung Veterans General Hospital, Chiayi, Taiwan
| | - Chiu-Mei Yeh
- Department of Family Medicine, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Tzeng-Ji Chen
- School of Medicine, National Yang-Ming University, Taipei, Taiwan; Department of Family Medicine, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Susan Shur-Fen Gau
- Department of Psychiatry, National Taiwan University Hospital and College of Medicine, Taipei, Taiwan; Graduate Institute of Clinical Medicine, College of Medicine, National Taiwan University, Taipei, Taiwan.
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The influence of sex steroids on structural brain maturation in adolescence. PLoS One 2014; 9:e83929. [PMID: 24416184 PMCID: PMC3885531 DOI: 10.1371/journal.pone.0083929] [Citation(s) in RCA: 86] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2013] [Accepted: 11/08/2013] [Indexed: 11/24/2022] Open
Abstract
Puberty reflects a period of hormonal changes, physical maturation and structural brain reorganization. However, little attention has been paid to what extent sex steroids and pituitary hormones are associated with the refinement of brain maturation across adolescent development. Here we used high-resolution structural MRI scans from 215 typically developing individuals between ages 8–25, to examine the association between cortical thickness, surface area and (sub)cortical brain volumes with luteinizing hormone, testosterone and estradiol, and pubertal stage based on self-reports. Our results indicate sex-specific differences in testosterone related influences on gray matter volumes of the anterior cingulate cortex after controlling for age effects. No significant associations between subcortical structures and sex hormones were found. Pubertal stage was not a stronger predictor than chronological age for brain anatomical differences. Our findings indicate that sex steroids are associated with cerebral gray matter morphology in a sex specific manner. These hormonal and morphological differences may explain in part differences in brain development between boys and girls.
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van Rijn S, Aleman A, de Sonneville L, Sprong M, Ziermans T, Schothorst P, van Engeland H, Swaab H. Neuroendocrine markers of high risk for psychosis: salivary testosterone in adolescent boys with prodromal symptoms. Psychol Med 2011; 41:1815-1822. [PMID: 21251344 DOI: 10.1017/s0033291710002576] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
BACKGROUND The peak in age of onset of psychotic disorders such as schizophrenia during puberty and early adulthood suggests a relationship between the expression of psychopathology and the changes in the brain and body that take place during this dynamic maturational period, including a dramatic increase in circulating oestrogens and androgens. This study examined levels of salivary testosterone and oestradiol in adolescents with prepsychotic, prodromal symptoms, as this may mediate risk for psychosis by having an impact on brain development. METHOD In 21 male adolescents with prodromal symptoms and 21 male non-clinical controls levels of testosterone and oestradiol were measured in saliva. Tanner pubertal stage and prodromal symptoms were also assessed. RESULTS Levels of testosterone were significantly lower in adolescents with prodromal symptoms as compared with non-clinical controls. No group differences in oestradiol were found. In the total sample, level of testosterone was significantly correlated with age and Tanner pubertal stage. CONCLUSIONS Our observations are in line with current hypotheses stressing the role of neuroendocrine factors during adolescence in the expression of psychotic symptoms. From a developmental perspective, susceptibility to psychotic disorders increases during adolescence. Our data suggest that testosterone might, in part, mediate this increased vulnerability. Further research is needed to assess the mediating, neural, mechanisms through which testosterone may have an impact on the development of psychotic symptoms. In the search for early risk markers for psychosis, studying neuroendocrine factors might increase our understanding of 'at-risk' developmental pathways.
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Affiliation(s)
- S van Rijn
- Leiden University, Clinical Child and Adolescent Studies, Leiden, The Netherlands.
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Weigle DS, Breen PA, Matthys CC, Callahan HS, Meeuws KE, Burden VR, Purnell JQ. A high-protein diet induces sustained reductions in appetite, ad libitum caloric intake, and body weight despite compensatory changes in diurnal plasma leptin and ghrelin concentrations. Am J Clin Nutr 2005. [DOI: 10.1093/ajcn/82.1.41] [Citation(s) in RCA: 486] [Impact Index Per Article: 25.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- David S Weigle
- From the University of Washington School of Medicine, Seattle, WA (DSW, PAB, CCM, and HSC), and the Oregon Health and Science University, Portland, OR (KEM, VRB, and JQP)
| | - Patricia A Breen
- From the University of Washington School of Medicine, Seattle, WA (DSW, PAB, CCM, and HSC), and the Oregon Health and Science University, Portland, OR (KEM, VRB, and JQP)
| | - Colleen C Matthys
- From the University of Washington School of Medicine, Seattle, WA (DSW, PAB, CCM, and HSC), and the Oregon Health and Science University, Portland, OR (KEM, VRB, and JQP)
| | - Holly S Callahan
- From the University of Washington School of Medicine, Seattle, WA (DSW, PAB, CCM, and HSC), and the Oregon Health and Science University, Portland, OR (KEM, VRB, and JQP)
| | - Kaatje E Meeuws
- From the University of Washington School of Medicine, Seattle, WA (DSW, PAB, CCM, and HSC), and the Oregon Health and Science University, Portland, OR (KEM, VRB, and JQP)
| | - Verna R Burden
- From the University of Washington School of Medicine, Seattle, WA (DSW, PAB, CCM, and HSC), and the Oregon Health and Science University, Portland, OR (KEM, VRB, and JQP)
| | - Jonathan Q Purnell
- From the University of Washington School of Medicine, Seattle, WA (DSW, PAB, CCM, and HSC), and the Oregon Health and Science University, Portland, OR (KEM, VRB, and JQP)
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Walker EF, Sabuwalla Z, Huot R. Pubertal neuromaturation, stress sensitivity, and psychopathology. Dev Psychopathol 2005; 16:807-24. [PMID: 15704816 DOI: 10.1017/s0954579404040027] [Citation(s) in RCA: 99] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
Normal adolescent development is often accompanied by transient emotional and behavioral problems. For most individuals with postpubertal-onset adjustment problems, there is a resolution by early adulthood and relative stability through the adult life span. But for a minority, adjustment problems escalate during adolescence and portend the development of serious mental illness in adulthood. In this article, we explore adolescent behavioral changes and neurodevelopmental processes that might contribute to stress sensitivity and vulnerability for the emergence of the mental disorders. Of particular interest is the role that hormonal changes might play in the expression of genetic vulnerabilities for psychopathology. Drawing on recent findings from clinical research and behavioral neuroscience, we describe the ways in which postpubertal hormones might alter brain function and, thereby, behavior. It is concluded that there are both activational and organization effects of hormones on the adolescent brain, and these contribute to developmental discontinuities in behavioral adjustment. Implications for adult psychopathology and preventive intervention are discussed.
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Affiliation(s)
- Elaine F Walker
- Department of Psychology, Emory University, Atlanta, GA 30322, USA.
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Veldhuis JD, Roemmich JN, Richmond EJ, Rogol AD, Lovejoy JC, Sheffield-Moore M, Mauras N, Bowers CY. Endocrine control of body composition in infancy, childhood, and puberty. Endocr Rev 2005; 26:114-46. [PMID: 15689575 DOI: 10.1210/er.2003-0038] [Citation(s) in RCA: 273] [Impact Index Per Article: 14.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
Abstract
Body composition exhibits marked variations across the early human lifetime. The precise physiological mechanisms that drive such developmental adaptations are difficult to establish. This clinical challenge reflects an array of potentially confounding factors, such as marked intersubject differences in tissue compartments; the incremental nature of longitudinal intrasubject variations in body composition; technical limitations in quantitating the unobserved mass of mineral, fat, water, and muscle ad seriatim; and the multifold contributions of genetic, dietary, environmental, hormonal, nutritional, and behavioral signals to physical and sexual maturation. From an endocrine perspective (reviewed here), gonadal sex steroids and GH/IGF-I constitute prime determinants of evolving body composition. The present critical review examines hormonal regulation of body composition in infancy, childhood, and puberty.
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Affiliation(s)
- Johannes D Veldhuis
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Mayo Medical and Graduate Schools of Medicine, General Clinical Research Center, Mayo Clinic, Rochester, Minnesota 55905, USA.
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14
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Abstract
Puberty accelerates microvascular complications of diabetes mellitus, including nephropathy. Animal studies confirm a different renal hypertrophic response to diabetes before and after puberty, probably due to differences in the production of transforming growth factor-beta (TGF-beta). Many of the complex physiological changes during puberty could affect potentially pathogenic mechanisms of diabetic kidney disease. Increased blood pressure, activation of the growth hormone-insulin-like growth factor I axis, and production of sex steroids could all play a role in pubertal susceptibility to diabetic renal hypertrophy and nephropathy. These factors may influence the effects of hyperglycemia and several systems that ultimately control TGF-beta production, including the renin-angiotensin system, cellular redox systems, the polyol pathway, and protein kinase C. These phenomena may also explain gender differences in kidney function and incidence of end-stage renal disease. Normal changes during puberty, when coupled with diabetes and superimposed on a genetically susceptible milieu, are capable of accelerating diabetic hypertrophy and microvascular lesions. A better understanding of these processes may lead to new treatments to prevent renal failure in diabetes mellitus.
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Affiliation(s)
- Pascale H Lane
- Department of Pediatrics, University of Nebraska Medical Center, Omaha 68198-2169, USA.
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15
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Sprinkle RH. The missing politics and unsettled science of the trend toward earlier puberty. Politics Life Sci 2001; 20:43-66. [PMID: 16859323 DOI: 10.1017/s0730938400005177] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/11/2023]
Abstract
The age of puberty in many populations has declined steeply over recent centuries and may be declining still. Consequently, today's children tend to experience the hormonal stresses of rapid development at younger ages than did their ancestors, around whose later, if not more gradual, maturation traditional behavioral expectations formed. Little has been made of this "rush to puberty" outside the life sciences. This article reviews its historical documentation, scholarly appreciation, epidemiological correlations, putative physiological and environmental explanations, sociological implications, and largely latent politics.
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Abstract
Given the tight, temporal coupling between growth and reproductive development, the idea that a common signal may regulate both adolescent growth and the initiation of puberty has been the focus of much research. Since the rate-limiting step for the onset of puberty is the appropriate hypothalamic secretion of gonadotropin-releasing hormone (GnRH), any factor important for the initiation of puberty must affect GnRH pulsatility. This review examines the hypothesis that GH and/or IGF-I are growth-related signals that regulate the release of GnRH, initiating puberty. By extension, this review also addresses the hypothesis that the GH axis also impacts GnRH and gonadotropin secretion in post-pubertal individuals and, thus, affects the maintenance of fertility in adults. The review examines data from a range of animal models employing a number of different strategies which directly manipulate the activity of either GH or IGF-I. The success of these strategies for producing the desired effects on the GH-IGF-I axis is somewhat variable. Although IGF-I may only play a permissive role in the maintenance of adult fertility, acting at the level of the gonad to increase sensitivity to gonadotropin stimulation, the data indicate that IGF-I is essential for reproductive maturation. However, in addition to its well-documented effects on the gonad, the specific mode of action of IGF-I on the neuroendocrine hypothalamus and GnRH pulsatility remains to be determined. Available evidence suggests that such action by IGF-I may be mediated through neurotransmitter effects on GnRH neurons, changing the availability of metabolic substrates for neuronal activity, or remodeling of synaptic input into GnRH neurons.
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Affiliation(s)
- M E Wilson
- Yerkes Regional Primate Research Center, Emory University, Atlanta, GA 30329, USA.
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Dawes MA, Antelman SM, Vanyukov MM, Giancola P, Tarter RE, Susman EJ, Mezzich A, Clark DB. Developmental sources of variation in liability to adolescent substance use disorders. Drug Alcohol Depend 2000; 61:3-14. [PMID: 11064179 DOI: 10.1016/s0376-8716(00)00120-4] [Citation(s) in RCA: 74] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
This review provides a synthesis of the literature on the complex sequence of maturational, psychosocial, and neuroadaptive processes that lead to substance use disorders (SUD) in adolescence. A brief overview introduces the concepts of liability to SUD and epigenesis. A theory is presented explaining how affective, cognitive, and behavioral dysregulation in late childhood is exacerbated during early and middle adolescence by family and peer factors, as well as puberty, leading to substance use. Continued exacerbation of the three components of dysregulation by drug and non-drug stressors during late adolescence is posited to result in neuroadaptations that increase the likelihood of developing SUD, particularly in high-risk individuals. Implications for etiologic research as well as clinical and preventive interventions are discussed.
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Affiliation(s)
- M A Dawes
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA 15213, USA
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Giustina A, Veldhuis JD. Pathophysiology of the neuroregulation of growth hormone secretion in experimental animals and the human. Endocr Rev 1998; 19:717-97. [PMID: 9861545 DOI: 10.1210/edrv.19.6.0353] [Citation(s) in RCA: 211] [Impact Index Per Article: 8.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
Abstract
During the last decade, the GH axis has become the compelling focus of remarkably active and broad-ranging basic and clinical research. Molecular and genetic models, the discovery of human GHRH and its receptor, the cloning of the GHRP receptor, and the clinical availability of recombinant GH and IGF-I have allowed surprisingly rapid advances in our knowledge of the neuroregulation of the GH-IGF-I axis in many pathophysiological contexts. The complexity of the GHRH/somatostatin-GH-IGF-I axis thus commends itself to more formalized modeling (154, 155), since the multivalent feedback-control activities are difficult to assimilate fully on an intuitive scale. Understanding the dynamic neuroendocrine mechanisms that direct the pulsatile secretion of this fundamental growth-promoting and metabolic hormone remains a critical goal, the realization of which is challenged by the exponentially accumulating matrix of experimental and clinical data in this arena. To the above end, we review here the pathophysiology of the GHRH somatostatin-GH-IGF-I feedback axis consisting of corresponding key neurotransmitters, neuromodulators, and metabolic effectors, and their cloned receptors and signaling pathways. We propose that this system is best viewed as a multivalent feedback network that is exquisitely sensitive to an array of neuroregulators and environmental stressors and genetic restraints. Feedback and feedforward mechanisms acting within the intact somatotropic axis mediate homeostatic control throughout the human lifetime and are disrupted in disease. Novel effectors of the GH axis, such as GHRPs, also offer promise as investigative probes and possible therapeutic agents. Further understanding of the mechanisms of GH neuroregulation will likely allow development of progressively more specific molecular and clinical tools for the diagnosis and treatment of various conditions in which GH secretion is regulated abnormally. Thus, we predict that unexpected and enriching insights in the domain of the neuroendocrine pathophysiology of the GH axis are likely be achieved in the succeeding decades of basic and clinical research.
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Affiliation(s)
- A Giustina
- Department of Internal Medicine, University of Brescia, Italy
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