Differential trait and state frontal alpha asymmetry in women with premenstrual syndrome

Electroencephalography findings in menstrually-related mood disorders: A critical review

The female reproductive years are characterized by fluctuations in ovarian hormones across the menstrual cycle, which have the potential to modulate neurophysiological and behavioral dynamics. Menstrually-related mood disorders (MRMDs) comprise cognitive-affective or somatic symptoms that are thought to be triggered by the rapid fluctuations in ovarian hormones in the luteal phase of the menstrual cycle. MRMDs include premenstrual syndrome (PMS), premenstrual dysphoric disorder (PMDD), and premenstrual exacerbation (PME) of other psychiatric disorders. Electroencephalography (EEG) non-invasively records in vivo synchronous activity from populations of neurons with high temporal resolution. The present overview sought to systematically review the current state of task-related and resting-state EEG investigations on MRMDs. Preliminary evidence indicates lower alpha asymmetry at rest being associated with MRMDs, while one study points to the effect being luteal-phase specific. Moreover, higher luteal spontaneous frontal brain activity (slow/fast wave ratio as measured by the delta/beta power ratio) has been observed in persons with MRMDs, while sleep architecture results point to potential circadian rhythm disturbances. In this review, we discuss the quality of study designs as well as future perspectives and challenges of supplementing the diagnostic and scientific toolbox for MRMDs with EEG.

Women with more severe premenstrual syndrome have an enhanced anticipatory reward processing: a magnetoencephalography study

Laboratory studies reveal that young women with premenstrual syndrome (PMS) often exhibit decreased reward processing during the late luteal phase. However, studies based on the self-reports find opposite results (e.g., higher craving for high-sweet-fat food). These differences may lie in the difference between the stimulus used and measuring the different aspects of the reward. The present study was designed to expand previous work by using a classic monetary reward paradigm, simultaneously examining the motivational (i.e., reward anticipation, "wanting") and emotional (i.e., reward outcome, "liking") components of reward processing in women with high premenstrual symptoms (High PMS). College female students in their early twenties with High PMS (n = 20) and low premenstrual symptoms (Low PMS, n = 20) completed a monetary incentive delay task during their late luteal phase when the premenstrual symptoms typically peak. Brain activities in the reward anticipation phase and outcome phase were recorded using the magnetoencephalographic (MEG) imaging technique. No group differences were found in various behavioral measurements. For the MEG results, in the anticipation phase, when High PMS participants were presented with cues that predicted the upcoming monetary gains, they showed higher event-related magnetic fields (ERFs) than when they were presented with neutral non-reward cues. This pattern was reversed in Low PMS participants, as they showed lower reward cue-elicited ERFs than non-reward cue-elicited ones (cluster mass = 2560, cluster size = 891, p = .03, corrected for multiple comparisons), mainly in the right medial orbitofrontal and lateral orbitofrontal cortex (cluster mass = 375, cluster size = 140, p = .03, corrected for multiple comparisons). More importantly, women with High PMS had an overall significantly higher level of ERFs than women with Low PMS (cluster mass = 8039, cluster size = 2937, p = .0009, corrected for multiple comparisons) in the bilateral precentral gyrus, right postcentral gyrus, and left superior temporal gyrus (right: cluster mass = 410, cluster size = 128, p = .03; left: cluster mass = 352, cluster size = 98, p = .05; corrected for multiple comparisons). In the outcome phase, women with High PMS showed significantly lower theta power than the Low PMS ones for the expected non-reward feedback in the bilateral temporal-parietal regions (cluster mass = 47620, cluster size = 18308, p = .01, corrected for multiple comparisons). These findings reveal that the severity of PMS might alter reward anticipation. Specifically, women with High PMS displayed increased brain activities to reward-predicting cues and increased action preparation after the cues appear.

Premenstrual syndrome is associated with an altered spontaneous electroencephalographic delta/beta power ratio across the menstrual cycle

Premenstrual syndrome is associated with altered spontaneous brain activity in the late luteal phase, but the fluctuation patterns of brain activity throughout the menstrual cycle have not been revealed. Furthermore, it is also unknown whether the altered spontaneous brain activity during the whole menstrual cycle is further associated with their habitual use of maladaptive emotion regulation strategies. Based on the two reasons, electroencephalogram data and cognitive emotion regulation questionnaire from 32 women with high premenstrual symptoms (HPMS) and 33 women with low premenstrual symptoms (LPMS) were measured in the late luteal and follicular phases. Delta power, theta power, beta power, and the slow/fast wave ratios (SW/FW, including theta/beta power ratio [TBR] and delta/beta power ratio [DBR]) were calculated using both fixed frequency bands and individually adjusted frequency bands (based on the individual alpha peak frequency). The results showed that for the frontal and central DBR, as assessed both with fixed and individualized frequency bands, there was no difference between the two phases of the LPMS group, whereas there was a difference between the two phases of the HPMS group with a higher DBR in the late luteal phase than in the follicular phase. Further correlation results revealed that for women with HPMS in the late luteal phase, the frontal and central DBR values, as assessed both with fixed and individualized frequency bands, were positively correlated with self-blame and rumination. Consequently, HPMS was characterized by a fluctuation across the menstrual cycle in the DBR, which was further associated with maladaptive emotion regulation.

Individual differences in frontal alpha asymmetry moderate the relationship between acute stress responsivity and state and trait anxiety in adolescents

Stress is a risk factor in the development and maintenance of psychopathology, particularly anxiety. Despite theory suggesting differences in stress responsivity may explain heterogeneity in anxiety, findings remain contradictory. This may be due to failure to account for individuals' neurobiological states and outdated methodologic analyses which confound conceptually and biologically distinct stress response pathways. In 145 adolescents, this study examined whether individual differences in neural activation underlying motivational states, indexed by resting frontal alpha asymmetry (FAA) before and after the Trier Social Stress Test (TSST), moderate the relationship between stress responsivity (measured by cortisol) and anxiety. Adolescents with rightward FAA activation (indexed by changes in resting FAA pre-to-post TSST) and high trait anxiety showed blunted cortisol reactivities while those with leftward FAA activation and high state anxiety showed prolonged cortisol recoveries. Our work reveals individual differences in vulnerability to psychosocial stressors and is the first study to show that FAA activation moderates the relationships between anxiety and distinct phases of the stress response in adolescents.

Patterns of premenstrual syndrome and depression symptoms in Chinese female university students: Results of a latent profile analysis

BACKGROUND

Premenstrual syndrome (PMS) and depression co-occur frequently; however, their relationship remains controversial. This study was conducted primarily to discern heterogeneous patterns of such co-occurring symptoms in Chinese female university students, using a latent profile analysis (LPA), a person-centered statistical approach.

METHODS

The PMS Scale and Beck Depression Inventory were used to examine self-reported PMS and depression symptoms in 701 Chinese female university students. LPA, multinomial logistical regression, and analyses of variance were adopted to investigate latent profiles and their validity.

RESULTS

The LPA results indicated that a four-class solution characterized by low symptoms (57.2%), predominantly PMS (11.3%), predominantly depression (23.7%), and combined PMS-depression (7.8%) patterns fitted the data best. Age, first menstrual experience, and personality factors were associated with differences in nonparallel profiles characteristic of menstrual attitude.

LIMITATIONS

Use of self-report measures can lead to response biases; the cross-sectional design at a single time point limits the examination of changes in symptom characteristics and members within the category over time; and the specific age group limits the generalizability of results.

CONCLUSION

These results confirm that PMS is independent from depression, rather than a variant of depression, and can be used to resolve the controversy regarding the relationship between PMS and depression. The current findings highlight the need for identifying women at high risk for PMS and depression, and promoting interventions individually tailored to their symptom presentations.

Major Depression and Brain Asymmetry in a Decision-Making Task with Negative and Positive Feedback

Depressed patients are characterized by hypoactivity of the left and hyperactivity of the right frontal areas during the resting state. Depression is also associated with impaired decision-making, which reflects multiple cognitive, affective, and attentional processes, some of which may be lateralized. The aim of this study was to investigate brain asymmetry during a decision-making task performed in negative and positive feedback conditions in patients with Major Depressive Disorder (MDD) in comparison to healthy control participants. The electroencephalogram (EEG) was recorded from 60 MDD patients and 60 healthy participants while performing a multi-stage decision-making task. Frontal, central, and parietal alpha asymmetry were analyzed with EEGlab/ERPlab software. Evoked potential responses (ERPs) showed general lateralization suggestive of an initial right dominance developing into a more complex pattern of asymmetry across different scalp areas as information was processed. The MDD group showed impaired mood prior to performance, and decreased confidence during performance in comparison to the control group. The resting state frontal alpha asymmetry showed lateralization in the healthy group only. Task-induced alpha power and ERP P100 and P300 amplitudes were more informative biomarkers of depression during decision making. Asymmetry coefficients based on task alpha power and ERP amplitudes showed consistency in the dynamical changes during the decision-making stages. Depression was characterized by a lack of left dominance during the resting state and left hypoactivity during the task baseline and subsequent decision-making process. Findings add to understanding of the functional significance of lateralized brain processes in depression.

Reduced Reward Responsiveness in Women With Moderate - to - Severe Premenstrual Syndrome: Evidence From a Probabilistic Reward Task

Nearly 50% of women of reproductive age worldwide experience premenstrual syndrome (PMS). Women with PMS exhibit low positive affect and low frontal electroencephalography asymmetry scores, both of which are associated with reward processing. These findings suggest that women with PMS may exhibit deficiencies in reward processing. A probabilistic reward task based on signal detection approach was used to assess reward responsiveness in 30 women with moderate-to-severe PMS and 31 controls without PMS. The results revealed that in the late luteal phase, the women with moderate-to-severe PMS exhibited lower response bias and lower hit rate toward more frequently rewarded stimuli (rich stimuli) than the controls. By contrast, the response bias and hit rate did not differ between the two groups in the follicular phase. The group differences still remained after controlling for anhedonic symptoms. Furthermore, trial-by-trial probability analyses revealed that women with moderate-to-severe PMS exhibited a trend of having a higher miss rate for rich stimuli than the controls. In particular, when a rich stimulus was preceded by an infrequently rewarded stimulus (a rewarded lean stimulus), participants in the PMS group exhibited a trend for higher miss rate than those in the control group in the late luteal and follicular phases. However, group differences in the probability analyses were nonsignificant after controlling for anhedonic symptoms. These results provide preliminary evidence that women with moderate-to-severe PMS exhibit dysfunctional reward responsiveness and impaired ability to modulate their behavior as a function of prior reinforcement.