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Pletzer B, Bodenbach H, Hoehn M, Hajdari L, Hausinger T, Noachtar I, Beltz AM. Reproducible stability of verbal and spatial functions along the menstrual cycle. Neuropsychopharmacology 2024; 49:933-941. [PMID: 38267632 PMCID: PMC11039678 DOI: 10.1038/s41386-023-01789-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/16/2023] [Revised: 12/13/2023] [Accepted: 12/19/2023] [Indexed: 01/26/2024]
Abstract
Recent studies have reported brain changes in response to ovarian hormonal fluctuations along the menstrual cycle. However, it remains unclear, whether these brain changes are of an adaptive nature or whether they are linked to changes in behavior along the menstrual cycle, particularly with respect to cognitive performance. To address this knowledge gap, we report results from 3 well-powered behavioral studies with different task designs, leveraging the advantages of each design type. In all three studies we assessed whether verbal or spatial performance (i) differed between cycle phases, (ii) were related to estradiol and / or progesterone levels and (iii) were moderated by individual hormone sensitivity as estimated by premenstrual symptoms. Overall, results of all three studies point towards a null effect of menstrual cycle phase and - to a lesser extent - ovarian hormones on verbal and spatial performance and provided no evidence for a moderation of this effect by individual hormone sensitivity. We conclude that there is substantial consistency in verbal and spatial performance across the menstrual cycle, and that future studies of intra-individual variation are needed.
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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.
| | - Hannah Bodenbach
- Department of Psychology, University of Salzburg, Salzburg, Austria
| | - Marcel Hoehn
- Department of Psychology, University of Salzburg, Salzburg, Austria
| | - Linda Hajdari
- Department of Psychology, University of Salzburg, Salzburg, Austria
| | - Tobias Hausinger
- Department of Psychology, University of Salzburg, Salzburg, Austria
- Centre for Cognitive Neuroscience, University of Salzburg, Salzburg, Austria
| | - Isabel Noachtar
- Department of Psychology, University of Salzburg, Salzburg, Austria
- Centre for Cognitive Neuroscience, University of Salzburg, Salzburg, Austria
| | - Adriene M Beltz
- Department of Psychology, University of Michigan, Ann Arbor, MI, USA
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2
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Di Benedetto MG, Landi P, Mencacci C, Cattaneo A. Depression in Women: Potential Biological and Sociocultural Factors Driving the Sex Effect. Neuropsychobiology 2024; 83:2-16. [PMID: 38272005 PMCID: PMC10871691 DOI: 10.1159/000531588] [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: 05/16/2022] [Accepted: 05/24/2023] [Indexed: 01/27/2024]
Abstract
Important sex-related differences have been observed in the onset, prevalence, and clinical phenotype of depression, based on several epidemiological studies. Social, behavioural, and educational factors have a great role in underlying this bias; however, also several biological factors are extensively involved. Indeed, sexually dimorphic biological systems might represent the underlying ground for these disparities, including cerebral structures and neural correlates, reproductive hormones, stress response pathways, the immune system and inflammatory reaction, metabolism, and fat distribution. Furthermore, in this perspective, it is also important to consider and focus the attention on specific ages and life stages of individuals: indeed, women experience during their life specific periods of reproductive transitional phases, which are not found in men, that represent windows of particular psychological vulnerability. In addition to these, other biologically related risk factors, including the occurrence of sleep disturbances and the exposure to childhood trauma, which are found to differentially affect men and women, are also putative underlying mechanisms of the clinical bias of depression. Overall, by taking into account major differences which characterize men and women it might be possible to improve the diagnostic process, as well as treat more efficiently depressed individuals, based on a more personalized medicine and research.
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Affiliation(s)
- Maria Grazia Di Benedetto
- Department of Pharmacological and Biomolecular Sciences, University of Milan, Milan, Italy,
- Biological Psychiatry Unit, IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy,
| | - Paola Landi
- Department of Neuroscience, ASST Fatebenefratelli Sacco, Milan, Italy
| | - Claudio Mencacci
- Department of Neuroscience, ASST Fatebenefratelli Sacco, Milan, Italy
| | - Annamaria Cattaneo
- Department of Pharmacological and Biomolecular Sciences, University of Milan, Milan, Italy
- Biological Psychiatry Unit, IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy
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3
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Dong P, Dai W, Su M, Wang S, Ma Y, Zhao T, Zheng F, Sun P. The potential role of the orexin system in premenstrual syndrome. Front Endocrinol (Lausanne) 2024; 14:1266806. [PMID: 38292774 PMCID: PMC10824941 DOI: 10.3389/fendo.2023.1266806] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/28/2023] [Accepted: 12/29/2023] [Indexed: 02/01/2024] Open
Abstract
Premenstrual syndrome (PMS) occurs recurrently during the luteal phase of a woman's menstrual cycle and disappears after menstruation ends. It is characterized by abnormal changes in both the body and mood, and in certain cases, severe disruptions in daily life and even suicidal tendencies. Current drugs for treating PMS, such as selective serotonin reuptake inhibitors, do not yield satisfactory results. Orexin, a neuropeptide produced in the lateral hypothalamus, is garnering attention in the treatment of neurological disorders and is believed to modulate the symptoms of PMS. This paper reviews the advancements in research on sleep disturbances, mood changes, and cognitive impairment caused by PMS, and suggests potential pathways for orexin to address these symptoms. Furthermore, it delves into the role of orexin in the molecular mechanisms underlying PMS. Orexin regulates steroid hormones, and the cyclic fluctuations of estrogen and progesterone play a crucial role in the pathogenesis of PMS. Additionally, orexin also modulates the gamma-aminobutyric acid (GABA) system and the inflammatory response involved in coordinating the mechanism of PMS. Unraveling the role of orexin in the pathogenesis of PMS will not only aid in understanding the etiology of PMS but also hold implications for orexin as a novel target for treating PMS.
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Affiliation(s)
- Ping Dong
- School of Traditional Chinese Medicine, Shandong University of Traditional Chinese Medicine, Jinan, China
| | - Weibo Dai
- Department of Pharmacy, Zhongshan Hospital of Traditional Chinese Medicine, Zhong Shan, China
| | - Mengyue Su
- School of Pharmacy, Shandong University of Traditional Chinese Medicine, Jinan, China
| | - Shukun Wang
- School of Pharmacy, Shandong University of Traditional Chinese Medicine, Jinan, China
| | - Yuexiang Ma
- School of Traditional Chinese Medicine, Shandong University of Traditional Chinese Medicine, Jinan, China
| | - Tingting Zhao
- College of Foreign Languages, Shandong University of Traditional Chinese Medicine, Jinan, China
| | - Feng Zheng
- Department of Neurosurgery, The Second Affiliated Hospital of Fujian Medical University, Quanzhou, China
| | - Peng Sun
- Innovation Research Institute of Chinese Medicine, Shandong University of Traditional Chinese Medicine, Jinan, China
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4
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Cary E, Simpson P. Premenstrual disorders and PMDD - a review. Best Pract Res Clin Endocrinol Metab 2024; 38:101858. [PMID: 38182436 DOI: 10.1016/j.beem.2023.101858] [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] [Indexed: 01/07/2024]
Abstract
Defining, diagnosing and managing premenstrual disorders (PMDs) remains a challenge both for general practitioners and specialists. Yet these disorders are common and can have an enormous impact on women. PMDD (premenstrual dysphoric disorder), one severe form of PMD, has a functional impact similar to major depression yet remains under-recognised and poorly treated. The aim of this chapter is to give some clarity to this area, provide a framework for non-specialists to work towards, and to stress the importance of MDT care for severe PMDs, including PMDD.
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Affiliation(s)
- Emily Cary
- GP Mattishall Surgery, 15 Dereham Road, Mattishall, East Dereham, Norfolk NR20 3QA, United Kingdom.
| | - Paul Simpson
- Norfolk and Norwich University Hospital, Colney Lane, Norwich NR4 7UY, United Kingdom.
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Naik SS, Nidhi Y, Kumar K, Grover S. Diagnostic validity of premenstrual dysphoric disorder: revisited. Front Glob Womens Health 2023; 4:1181583. [PMID: 38090047 PMCID: PMC10711063 DOI: 10.3389/fgwh.2023.1181583] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2023] [Accepted: 10/04/2023] [Indexed: 06/30/2024] Open
Abstract
The World Health Organization (WHO) and American Psychiatric Association (APA) have recognised premenstrual dysphoric disorder (PMDD) as an independent diagnostic entity, legitimising the distress and socio-occupational impairment experienced by affected women. However, the biological validity of this diagnosis remains inexplicit. This illness has also been criticised for a feminist-led, sympathetic reaction to the modern cultural challenges of urban, literate, employed, high-functioning women. This article systematically reviews existing literature on PMDD using the criteria established by Robins and Guze for the validity of a psychiatric diagnosis (clinical description, laboratory study, exclusion of other disorders, follow-up study, and family study). Despite the early recognition of premenstrual syndrome (PMS) in the 1950s, the research has encountered challenges due to two groups of proponents viewing it with psychologising bias and medicalising bias. PMDD is currently understood as the most severe form of PMS, characterised by the presence of psychological features. Recent evidence suggests that PMDD perhaps has neurodevelopmental underpinnings (attention deficit hyperactive disorder, adverse childhood experiences) affecting the fronto-limbic circuit that regulates the emotions. In addition, the affected individuals exhibit an increased sensitivity to gonadal hormonal fluctuations as observed during premenstrual, pregnancy, and perimenopausal phases of life. The prevalence is comparable between high-income countries and low- and middle-income countries (LAMIC), refuting the notion that it mostly affects modern women. Instead, a greater prevalence is observed in LAMIC. Despite the fact that educated women possess knowledge regarding the importance of getting help, there is a prevalent issue of inadequate help-seeking behaviour. This can be attributed to the perception of seeking help as an isolating experience, which is influenced by profound internalised stigma and discrimination in the workplace. Future studies must aim to develop culturally validated assessment tools and more research to understand the life course of the illness, in addition to systematically examining for more biological validators (animal models, genetics, imaging, neurotransmitters).
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Liguori F, Saraiello E, Calella P. Premenstrual Syndrome and Premenstrual Dysphoric Disorder's Impact on Quality of Life, and the Role of Physical Activity. MEDICINA (KAUNAS, LITHUANIA) 2023; 59:2044. [PMID: 38004093 PMCID: PMC10673441 DOI: 10.3390/medicina59112044] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/19/2023] [Revised: 11/13/2023] [Accepted: 11/16/2023] [Indexed: 11/26/2023]
Abstract
Most women who menstruate experience various physical, psychological, and behavioral changes during the period between ovulation and menstruation. This study focuses on defining and diagnosing premenstrual disorders, distinguishing between premenstrual symptoms (PS), PMS, and premenstrual dysphoric disorder (PMDD). It highlights the prevalence of these conditions and their impact on women's quality of life, including social, occupational, and psychological aspects. Furthermore, the study examines the role of physical activity, particularly aerobic exercise, in managing premenstrual symptoms. Several systematic reviews are cited, suggesting that regular physical activity can effectively reduce both physical and psychological symptoms associated with PMS. In conclusion, the management of PMS involves a multifaceted approach, with exercises, dietary modifications, stress management, cognitive-behavioral therapy, and medications all playing roles. Physical activity, especially aerobic exercise, has been found to be an effective non-pharmacological therapy for alleviating PMS symptoms and improving overall well-being. However, more research is needed to determine the optimal type and dosage of exercise for individual women with PMS.
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Affiliation(s)
| | | | - Patrizia Calella
- Department of Medical, Movement Sciences and Wellbeing, University of Naples “Parthenope”, 80133 Naples, Italy; (F.L.); (E.S.)
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Sikes-Keilp C, Rubinow DR. GABA-ergic Modulators: New Therapeutic Approaches to Premenstrual Dysphoric Disorder. CNS Drugs 2023; 37:679-693. [PMID: 37542704 DOI: 10.1007/s40263-023-01030-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 07/20/2023] [Indexed: 08/07/2023]
Abstract
Premenstrual dysphoric disorder (PMDD) is characterized by the predictable onset of mood and physical symptoms secondary to gonadal steroid fluctuation during the luteal phase of the menstrual cycle. Although menstrual-related affective dysfunction is responsible for considerable functional impairment and reduction in quality of life worldwide, currently approved treatments for PMDD are suboptimal in their effectiveness. Research over the past two decades has suggested that the interaction between allopregnanolone, a neurosteroid derivative of progesterone, and the gamma-aminobutyric acid (GABA) system represents an important relationship underlying symptom genesis in reproductive-related mood disorders, including PMDD. The objective of this narrative review is to discuss the plausible link between changes in GABAergic transmission secondary to the fluctuation of allopregnanolone during the luteal phase and mood impairment in susceptible individuals. As part of this discussion, we explore promising findings from early clinical trials of several compounds that stabilize allopregnanolone signaling during the luteal phase, including dutasteride, a 5-alpha reductase inhibitor; isoallopregnanolone, a GABA-A modulating steroid antagonist; and ulipristal acetate, a selective progesterone receptor modulator. We then reflect on the implications of these therapeutic advances, including how they may promote our knowledge of affective regulation more generally. We conclude that these and other studies of PMDD may yield critical insight into the etiopathogenesis of affective disorders, considering that (1) symptoms in PMDD have a predictable onset and offset, allowing for examination of affective state kinetics, and (2) GABAergic interventions in PMDD can be used to better understand the relationship between mood states, network regulation, and the balance between excitatory and inhibitory signaling in the brain.
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Affiliation(s)
- Christopher Sikes-Keilp
- Department of Psychiatry, University of North Carolina Hospitals, 101 Manning Drive, Chapel Hill, NC, 27514, USA.
| | - David R Rubinow
- Department of Psychiatry, University of North Carolina Hospitals, 101 Manning Drive, Chapel Hill, NC, 27514, USA
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Hantsoo L, Payne JL. Towards understanding the biology of premenstrual dysphoric disorder: From genes to GABA. Neurosci Biobehav Rev 2023; 149:105168. [PMID: 37059403 PMCID: PMC10176022 DOI: 10.1016/j.neubiorev.2023.105168] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2022] [Revised: 03/10/2023] [Accepted: 04/10/2023] [Indexed: 04/16/2023]
Abstract
Premenstrual dysphoric disorder (PMDD) is a severe mood disorder, with affective symptoms that rise and fall in concert with the hormonal fluctuations of the menstrual cycle. PMDD's pathophysiology is poorly understood. This review describes recent research on potential biological contributors to PMDD, with a focus on neuroactive steroids, genetics, neuroimaging and cellular studies. Studies suggest that a key contributor is abnormal central nervous system (CNS) response to fluctuations in neuroactive steroid hormones. Imaging studies are limited but support alterations in serotonergic and GABA transmission. Genetic studies suggest heritability, yet specific genetic contributors have not been characterized. Finally, recent cutting-edge cellular studies indicate an underlying vulnerability to the effect of sex hormones at a cellular level. Overall the findings across studies do not yet fit together into a complete description of the underlying biology of PMDD. It is possible that PMDD consists of biological subtypes, and future research may benefit from a subtyping approach.
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Affiliation(s)
- Liisa Hantsoo
- Department of Psychiatry & Behavioral Sciences, The Johns Hopkins University School of Medicine, 550 N. Broadway Street, Baltimore, MD 21205, USA.
| | - Jennifer L Payne
- Department of Psychiatry and Neurobehavioral Sciences, University of Virginia, PO Box 800548, Charlottesville, VA 22908, USA
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Kiesner J, Bittoni C, Eisenlohr-Moul T, Komisaruk B, Pastore M. Menstrual cycle-driven vs noncyclical daily changes in sexual desire. J Sex Med 2023; 20:756-765. [PMID: 37037659 DOI: 10.1093/jsxmed/qdad032] [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: 09/17/2022] [Revised: 02/14/2023] [Accepted: 02/21/2023] [Indexed: 04/12/2023]
Abstract
BACKGROUND Past research on the association between sexual desire and the menstrual cycle has provided inconclusive results and has not considered the potential influence of psychological and physical changes that are frequently associated with the menstrual cycle. AIM To test the strength of association between the menstrual cycle (and associated symptoms) and changes in sexual desire. METHODS Prospective daily reports across 2 full menstrual cycles (2 months) from a sample of female university students (n = 213), were analysed. Analyses tested for average effects of the menstrual cycle on sexual desire, individual differences in these effects, and cyclical and noncyclical associations between sexual desire and the 9 menstrual cycle-related changes. Note that data presented in the current article come from a larger study from which other reports have been published. OUTCOMES Target variables were (1) daily change in sexual desire and (2) daily reports of 5 psychological changes and 4 physical changes that are commonly associated with the menstrual cycle. RESULTS Results showed that when considering average effects across participants, the menstrual cycle was associated with a small midcycle increase in sexual desire. However, multilevel analyses showed large individual differences in how the menstrual cycle influences sexual desire. Specifically, some participants showed a midcycle increase, others a perimenstrual increase, and others no change across the menstrual cycle. Moreover, results demonstrated that psychological changes were more important for predicting sexual desire as compared with physical changes. CLINICAL IMPLICATIONS These results suggest that daily measurement of sexual desire across multiple menstrual cycles may be an important tool in the assessment of sexual desire among some females. STRENGTHS AND LIMITATIONS Strengths of this study are the daily assessment of sexual desire and all symptoms for 2 menstrual cycles and multilevel analyses that allow the study of individual differences. Limitations include limited measurement of sexual desire based on only 2 questions and the lack of measures of relationship status and sexual orientation. CONCLUSION Emphasis is placed on the need to apply more rigorous research methods and to abandon simplistic average-effects models that are based on outdated theories and stereotypes.
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Affiliation(s)
- Jeff Kiesner
- Department of Psychology, Università Degli Studi di Padova, Padova 35131, Italy
| | - Celeste Bittoni
- Department of Psychology, Università Degli Studi di Padova, Padova 35131, Italy
| | - Tory Eisenlohr-Moul
- Department of Psychiatry, University of Illinois at Chicago, Chicago, IL 60612, United States
| | - Barry Komisaruk
- Psychology Department, Rutgers University, Newark, NJ 07102, United States
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Kiesner J, Eisenlohr-Moul TA, Vidotto G. Affective Risk Associated With Menstrual Cycle Symptom Change. Front Glob Womens Health 2022; 3:896924. [PMID: 35936817 PMCID: PMC9353132 DOI: 10.3389/fgwh.2022.896924] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2022] [Accepted: 06/16/2022] [Indexed: 11/13/2022] Open
Abstract
In the present study we test whether cyclical changes in affective symptoms of the menstrual cycle are associated with higher mean levels of those same symptoms. Using prospective daily reports across two full menstrual cycles, from two samples of female University students (n = 213; n = 163), we applied both quartic polynomial regressions and cosine regressions to model cyclical change in symptoms, and to test for mean-level differences in symptoms across the resulting trajectory patterns. Counter to prior findings, but consistent with theoretical expectations, these results show that females who experience menstrual cycle-related changes in affect (whether a perimenstrual or mid-cycle increase) are at risk for higher average levels of affective symptoms. These results suggest that the mid-cycle group should be recognized as a target for future research that is associated with increased risk for chronic negative affective symptoms.
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Affiliation(s)
- Jeff Kiesner
- Department of Developmental and Social Psychology, University of Padova, Padua, Italy
- *Correspondence: Jeff Kiesner
| | | | - Giulio Vidotto
- Department of General Psychology, University of Padova, Padua, Italy
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Qu S, Qiao M, Wang J, Gao M, Chen D, Li S, Wei E, Guo Y. Network Pharmacology and Data Mining Approach Reveal the Medication Rule of Traditional Chinese Medicine in the Treatment of Premenstrual Syndrome/Premenstrual Dysphoric Disorder. Front Pharmacol 2022; 13:811030. [PMID: 35800440 PMCID: PMC9253672 DOI: 10.3389/fphar.2022.811030] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2021] [Accepted: 05/09/2022] [Indexed: 12/17/2022] Open
Abstract
Premenstrual syndrome (PMS) is a common disorder that affects women of reproductive age. It is characterized by periodic mental and somatic symptoms such as irritability, depression, and breast pain during the luteal phase. Premenstrual dysphoric disorder (PMDD) is the most severe form of PMS. In recent years, the incidence of PMS/PMDD has been increasing year after year. However, due to the complex symptoms and ambiguous classification of PMS/PMDD, the limitations of present treatments, such as their poor efficacy rate, have become increasingly apparent. With its unique benefits such as syndrome differentiation and high cure rate, traditional Chinese medicine (TCM) has sparked new diagnosing and treating of PMS/PMDD. This study uses data mining methods, and statistical analysis revealed that Xiaoyao San and Chaihu Shugan San were the commonly used TCM to treat PMS/PMDD. A detailed investigation of regularly used single herbs revealed that most TCM is used as cold herbs that penetrate the liver meridian, with predominant bitter, sweet, and pungent flavors. The network pharmacology method analyzes the interactions between diseases, targets, and herbs. Meanwhile, the deep action targets and molecular mechanisms of 10 commonly used herbs for the treatment of PMS/PMDD are studied, revealing that it involves several ingredients, many targets, and different pathways. This interaction provides insight into the mechanism of action of TCM in the synergistic treatment of PMS/PMDD. It is now clear that we can begin treating PMS/PMDD with TCM using the target and mechanism revealed by the abovementioned findings in the future. This serves as an essential reference for future research and clinical application of TCM in the treatment of PMS/PMDD.
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Affiliation(s)
- Songlin Qu
- College of Traditional Chinese Medicine, Shandong University of Traditional Chinese Medicine, Jinan, China
| | - Mingqi Qiao
- College of Traditional Chinese Medicine, Shandong University of Traditional Chinese Medicine, Jinan, China
| | - Jieqiong Wang
- Department of Science and Technology, Shandong University of Traditional Chinese Medicine, Jinan, China
| | - Mingzhou Gao
- College of Traditional Chinese Medicine, Shandong University of Traditional Chinese Medicine, Jinan, China
| | - Dan Chen
- Department of the Graduate Student, Shandong University of Traditional Chinese Medicine, Jinan, China
| | - Shujing Li
- College of Traditional Chinese Medicine, Shandong University of Traditional Chinese Medicine, Jinan, China
| | - Enhua Wei
- College of Traditional Chinese Medicine, Shandong University of Traditional Chinese Medicine, Jinan, China
| | - Yinghui Guo
- College of Traditional Chinese Medicine, Shandong University of Traditional Chinese Medicine, Jinan, China
- Laboratory of Traditional Chinese Medicine Classical Theory, Ministry of Education, Shandong University of Traditional Chinese Medicine, Jinan, China
- *Correspondence: Yinghui Guo,
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12
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Morishita C, Inoue T, Honyashiki M, Ono M, Iwata Y, Tanabe H, Kusumi I, Masuya J. Roles of childhood maltreatment, personality traits, and life stress in the prediction of severe premenstrual symptoms. Biopsychosoc Med 2022; 16:11. [PMID: 35484626 PMCID: PMC9052504 DOI: 10.1186/s13030-022-00240-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/09/2021] [Accepted: 04/07/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND About 3% to 8% of women of fertile age are thought to have premenstrual dysphoric disorder (PMDD), which is regarded as a serious form of premenstrual syndrome (PMS), although the details of this common condition remain unclear. The aim of this study was to analyze the interrelations of childhood maltreatment, personality traits, and life stress in the etiology of PMS/PMDD. METHODS A total of 240 adult female volunteers from a community in Japan were investigated, using the following 5 questionnaires: Patient Health Quesstionaire-9, Child Abuse and Trauma Scale, Temperament and Character Inventory (TCI), Life Experiences Survey, and premenstrual dysphoric disorder (PMDD) scale. The questionnaire data were subjected to path analyses to clarify the association between childhood maltreatment and the severity of premenstrual symptoms, mediated by personality traits and life stress. RESULTS The 2 path analysis models showed that high harm avoidance (HA) on the TCI and low self-directedness (SD) on the TCI had significant direct effects on the severity of premenstrual symptoms. Moreover, childhood maltreatment was associated with the severity of premenstrual symptoms, both directly and indirectly through personality traits. CONCLUSION Our findings suggest that HA on the TCI might be a risk factor for severe premenstrual symptoms among general women and furthermore that SD on the TCI may be a protective factor. In addition, childhood maltreatment is associated with severe premenstrual symptoms both directly and indirectly through personality traits.
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Affiliation(s)
- Chihiro Morishita
- Department of Psychiatry, Tokyo Medical University, 6-7-1 Nishishinjuku, Shinjuku-ku, Tokyo, 160-0023, Japan.
| | - Takeshi Inoue
- Department of Psychiatry, Tokyo Medical University, 6-7-1 Nishishinjuku, Shinjuku-ku, Tokyo, 160-0023, Japan
| | - Mina Honyashiki
- Department of Psychiatry, Tokyo Medical University, 6-7-1 Nishishinjuku, Shinjuku-ku, Tokyo, 160-0023, Japan
| | - Miki Ono
- Department of Psychiatry, Tokyo Medical University, 6-7-1 Nishishinjuku, Shinjuku-ku, Tokyo, 160-0023, Japan
| | - Yoshio Iwata
- Department of Psychiatry, Tokyo Medical University, 6-7-1 Nishishinjuku, Shinjuku-ku, Tokyo, 160-0023, Japan
| | - Hajime Tanabe
- Faculty of Humanities and Social Sciences, Shizuoka University, 836 Ohya, Suruga-ku, Shizuoka, 422-8529, Japan
| | - Ichiro Kusumi
- Department of Psychiatry, Hokkaido University Graduate School of Medicine, North 15, West 7, Kita-ku, Sapporo, Hokkaido, 060-8638, Japan
| | - Jiro Masuya
- Department of Psychiatry, Tokyo Medical University, 6-7-1 Nishishinjuku, Shinjuku-ku, Tokyo, 160-0023, Japan
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13
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Yin W, Zhang J, Guo Y, Wu Z, Diao C, Sun J. Melatonin for premenstrual syndrome: A potential remedy but not ready. Front Endocrinol (Lausanne) 2022; 13:1084249. [PMID: 36699021 PMCID: PMC9868742 DOI: 10.3389/fendo.2022.1084249] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/30/2022] [Accepted: 12/12/2022] [Indexed: 01/11/2023] Open
Abstract
Premenstrual syndrome (PMS), a recurrent and moderate disorder that occurs during the luteal phase of the menstrual cycle and quickly resolves after menstruation, is characterized by somatic and emotional discomfort that can be severe enough to impair daily activities. Current therapeutic drugs for PMS such as selective serotonin reuptake inhibitors are not very satisfying. As a critical pineal hormone, melatonin has increasingly been suggested to modulate PMS symptoms. In this review, we update the latest progress on PMS-induced sleep disturbance, mood changes, and cognitive impairment and provide possible pathways by which melatonin attenuates these symptoms. Moreover, we focus on the role of melatonin in PMS molecular mechanisms. Herein, we show that melatonin can regulate ovarian estrogen and progesterone, of which cyclic fluctuations contribute to PMS pathogenesis. Melatonin also modulates gamma-aminobutyric acid and the brain-derived neurotrophic factor system in PMS. Interpreting the role of melatonin in PMS is not only informative to clarify PMS etiology but also instructive to melatonin and its receptor agonist application to promote female health. As a safe interaction, melatonin treatment can be effective in alleviating symptoms of PMS. However, symptoms such as sleep disturbance, depressive mood, cognitive impairment are not specific and can be easily misdiagnosed. Connections between melatonin receptor, ovarian steroid dysfunction, and PMS are not consistent among past studies. Before final conclusions are drawn, more well-organized and rigorous studies are recommended.
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Affiliation(s)
- Wei Yin
- Shandong Key Laboratory of Mental Disorders, Department of Anatomy and Neurobiology, Shandong University, Jinan, Shandong, China
| | - Jie Zhang
- Department of Neurosurgery, Laizhou City People’s Hospital, Laizhou, Shandong, China
| | - Yao Guo
- Department of Psychiatry, Shandong Provincial Mental Health Center, Jinan, Shandong, China
| | - Zhibing Wu
- Department of Anatomy, Changzhi Medical College, Changzhi, Shanxi, China
| | - Can Diao
- School of Basic Medical Sciences, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, China
| | - Jinhao Sun
- Shandong Key Laboratory of Mental Disorders, Department of Anatomy and Neurobiology, Shandong University, Jinan, Shandong, China
- *Correspondence: Jinhao Sun,
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Xue H, Wu Z, Long X, Ullah A, Chen S, Mat WK, Sun P, Gao MZ, Wang JQ, Wang HJ, Li X, Sun WJ, Qiao MQ. Copy number variation profile-based genomic typing of premenstrual dysphoric disorder in Chinese. J Genet Genomics 2021; 48:1070-1080. [PMID: 34530168 DOI: 10.1016/j.jgg.2021.08.012] [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: 03/10/2021] [Revised: 08/13/2021] [Accepted: 08/13/2021] [Indexed: 11/16/2022]
Abstract
Premenstrual dysphoric disorder (PMDD) affects nearly 5% women of reproductive age. Symptomatic heterogeneity, together with largely unknown genetics, have greatly hindered its effective treatment. In the present study, analysis of genomic sequencing-based copy-number-variations (CNVs) called from 100-kb white blood cell DNA sequence windows by means of semi-supervised clustering led to the segregation of patient genomes into the D and V groups, which correlated with the depression and invasion clinical types respectively with 89.0% consistency. Application of diagnostic CNV features selected using the correlation-based machine-learning method enabled the classification of the CNVs obtained into the D group, V group, total-patient group and control group with an average accuracy of 83.0%. The power of the diagnostic CNV features was 0.98 on average, suggesting that these CNV features could be employed for the molecular diagnosis of the major clinical types of PMDD. This demonstrated concordnce between the CNV profiles and clinical types of PMDD supported the validity of symptom-based diagnosis of PMDD for differentiating between its two major clinical types, as well as the predominanly genetic nature of PMDD with a host of overlaps between multiple susceptibility genes/pathways and the diagnostic CNV features as indicators of involvement in PMDD etiology.
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Affiliation(s)
- Hong Xue
- Shandong University of Traditional Chinese Medicine, Jinan, Shandong, 250355, China; Division of Life Science and Applied Genomics Center, Hong Kong University of Science and Technology, Hong Kong, China; School of Basic Medicine and Clinical Pharmacy, China Pharmaceutical University, Nanjing, Jiangsu, 210009, China; HKUST Shenzhen Research Institute, 9 Yuexing First Road, Nanshan, Shenzhen, China; Guangzhou HKUST Fok Ying Tung Research Institute, Science and Technology Building, Nansha Information Technology Park, Nansha, Guangzhou, 511458, China.
| | - Zhenggang Wu
- Division of Life Science and Applied Genomics Center, Hong Kong University of Science and Technology, Hong Kong, China; School of Basic Medicine and Clinical Pharmacy, China Pharmaceutical University, Nanjing, Jiangsu, 210009, China; HKUST Shenzhen Research Institute, 9 Yuexing First Road, Nanshan, Shenzhen, China; Guangzhou HKUST Fok Ying Tung Research Institute, Science and Technology Building, Nansha Information Technology Park, Nansha, Guangzhou, 511458, China
| | - Xi Long
- Division of Life Science and Applied Genomics Center, Hong Kong University of Science and Technology, Hong Kong, China; School of Basic Medicine and Clinical Pharmacy, China Pharmaceutical University, Nanjing, Jiangsu, 210009, China; HKUST Shenzhen Research Institute, 9 Yuexing First Road, Nanshan, Shenzhen, China; Guangzhou HKUST Fok Ying Tung Research Institute, Science and Technology Building, Nansha Information Technology Park, Nansha, Guangzhou, 511458, China
| | - Ata Ullah
- Division of Life Science and Applied Genomics Center, Hong Kong University of Science and Technology, Hong Kong, China
| | - Si Chen
- Division of Life Science and Applied Genomics Center, Hong Kong University of Science and Technology, Hong Kong, China
| | - Wai-Kin Mat
- Division of Life Science and Applied Genomics Center, Hong Kong University of Science and Technology, Hong Kong, China
| | - Peng Sun
- Shandong University of Traditional Chinese Medicine, Jinan, Shandong, 250355, China
| | - Ming-Zhou Gao
- Shandong University of Traditional Chinese Medicine, Jinan, Shandong, 250355, China
| | - Jie-Qiong Wang
- Shandong University of Traditional Chinese Medicine, Jinan, Shandong, 250355, China
| | - Hai-Jun Wang
- Shandong University of Traditional Chinese Medicine, Jinan, Shandong, 250355, China
| | - Xia Li
- Shandong University of Traditional Chinese Medicine, Jinan, Shandong, 250355, China
| | - Wen-Jun Sun
- Shandong University of Traditional Chinese Medicine, Jinan, Shandong, 250355, China
| | - Ming-Qi Qiao
- Shandong University of Traditional Chinese Medicine, Jinan, Shandong, 250355, China.
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15
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Neural basis for estrous cycle-dependent control of female behaviors. Neurosci Res 2021; 176:1-8. [PMID: 34331974 DOI: 10.1016/j.neures.2021.07.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2021] [Revised: 06/25/2021] [Accepted: 07/12/2021] [Indexed: 01/30/2023]
Abstract
Females display changes in distinct behaviors along the estrous cycle. Levels of circulating ovarian sex steroid hormones peak around ovulation, which occur around estrus phase of the cycle. This increase of sex hormones is thought to be important for changes in behaviors, however, neural circuit mechanisms of periodic behavioral changes in females are not understood well. Different lines of research indicate sex hormonal effects on several forms of neuronal plasticity. This review provides an overview of behavioral and plastic changes that occur in an estrous cycle-dependent manner and explores the current research linking these changes to understand neural circuit mechanisms that control female behaviors.
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16
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Zeitoun T, Dehghan Noudeh N, Garcia-Bailo B, El-Sohemy A. Genetics of Iron Metabolism and Premenstrual Symptoms: A Mendelian Randomization Study. J Nutr 2021; 151:1747-1754. [PMID: 33758941 DOI: 10.1093/jn/nxab048] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2020] [Revised: 01/16/2021] [Accepted: 02/10/2021] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Many women of reproductive age experience adverse psychological and physiological premenstrual symptoms. These symptoms may last for most of the reproductive years and can negatively affect the quality of life of many women. Some studies have examined the role of micronutrients in premenstrual symptoms, but the research on iron has been limited. OBJECTIVES The objective of this study was to evaluate the effects of genetic predictors of iron overload and low iron status on premenstrual symptoms using Mendelian randomization. METHODS We examined 254 White females aged 20-29 y from the Toronto Nutrigenomics and Health Study. DNA was isolated from peripheral white blood cells and genotyped for the homeostatic regulatory iron gene (HFE; rs1800562 and rs1799945), transmembrane protease serine 6 (TMPRSS6; rs482026), transferrin receptor 2 (TFR2; rs3811647), and transferrin (TF; rs738584) polymorphisms. Risk of iron overload or low iron status was determined based on combined genotypes. Binomial logistic regressions were carried out to examine the association between genetic risk of iron overload or low iron status and the presence of premenstrual symptoms. RESULTS Compared with participants with typical risk of iron overload, those with an elevated risk of iron overload were less likely to experience premenstrual symptoms of confusion (OR: 0.13; 95% CI: 0.02, 1.00), headaches (OR: 0.28; 95% CI: 0.08, 0.98), and nausea (OR: 0.13; 95% CI: 0.02, 0.99) after adjusting for BMI, age, and vitamin C and calcium intake. No associations were seen with the other symptoms. There were also no associations between low iron status genotypes and premenstrual symptoms. CONCLUSIONS This Mendelian randomization study demonstrates that women with an elevated risk of iron overload may have a lower risk of experiencing some premenstrual symptoms (headache, confusion, and nausea), suggesting that iron status could impact the risk of certain premenstrual symptoms.
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Affiliation(s)
- Tara Zeitoun
- Department of Nutritional Sciences, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Negar Dehghan Noudeh
- Department of Nutritional Sciences, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Bibiana Garcia-Bailo
- Department of Nutritional Sciences, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Ahmed El-Sohemy
- Department of Nutritional Sciences, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
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Dilbaz B, Aksan A. Premenstrual syndrome, a common but underrated entity: review of the clinical literature. J Turk Ger Gynecol Assoc 2021; 22:139-148. [PMID: 33663193 PMCID: PMC8187976 DOI: 10.4274/jtgga.galenos.2021.2020.0133] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2020] [Accepted: 01/06/2021] [Indexed: 02/06/2023] Open
Abstract
Premenstrual syndrome (PMS) and premenstrual dysphoric disorder (PMDD) are characterized by somatic and psychologic symptoms that arise at the luteal phase of the menstrual cycle and subside with menstruation. For definitive diagnosis prospectively self-reported symptoms should demonstrate a cyclic pattern and other psychological pathologies and thyroid dysfunction, that may present with similar symptoms, should be excluded. Both entities affect millions of women at reproductive age as the prevalence of PMS is given as 10-98% while PMDD affects 2-8%. Sex steroids and neurotransmitters have a central role in the etiology. The role of vitamins and minerals in the etiology and treatment of PMS and PMDD is open to discussion. Drugs that suppress ovarian sex steroid production, such as combined oral contraceptives or selective serotonin re-uptake inhibitors enhancing central serotonin delivery are used for treatment. Life-style changes and regular exercise also have a positive effect in milder cases. Tricyclic antidepressants and gonadotropin-releasing hormone analogues can be used in selected cases.
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Affiliation(s)
- Berna Dilbaz
- Department of Obstetrics and Gynecology, University of Health Sciences Turkey, Etlik Zübeyde Hanım Women’s Health and Research Center, Ankara, Turkey
| | - Alperen Aksan
- Department of Obstetrics and Gynecology, University of Health Sciences Turkey, Etlik Zübeyde Hanım Women’s Health and Research Center, Ankara, Turkey
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18
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Schweizer-Schubert S, Gordon JL, Eisenlohr-Moul TA, Meltzer-Brody S, Schmalenberger KM, Slopien R, Zietlow AL, Ehlert U, Ditzen B. Steroid Hormone Sensitivity in Reproductive Mood Disorders: On the Role of the GABA A Receptor Complex and Stress During Hormonal Transitions. Front Med (Lausanne) 2021; 7:479646. [PMID: 33585496 PMCID: PMC7873927 DOI: 10.3389/fmed.2020.479646] [Citation(s) in RCA: 35] [Impact Index Per Article: 11.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2019] [Accepted: 08/20/2020] [Indexed: 12/16/2022] Open
Abstract
Women worldwide are two to three times more likely to suffer from depression in their lifetime than are men. Female risk for depressive symptoms is particularly high during the reproductive years between menarche and menopause. The term “Reproductive Mood Disorders” refers to depressive disorders triggered by hormonal fluctuations during reproductive transitions including the perimenarchal phase, the pre-menstrual phase, pregnancy, the peripartum period and the perimenopausal transition. Here we focus on reproductive mood disorders manifesting in adult life. We propose a research agenda that draws together several reproductive mood disorders and investigates which genetic, endocrinological, neural, and psychosocial factors can explain depressive symptoms during phases of hormonal transitions in women. Based on current research it is assumed that some women experience an increased sensitivity to not only fluctuations in reproductive steroids (estrogen and progesterone), but also stress-related steroids. We integrate both dynamics into the concept of “steroid hormone sensitivity,” expanding on the concept of “reproductive hormone sensitivity.” We suggest that a differential response of the stress steroid system including corticosteroids, neurosteroids, like allopregnanolone and the GABA-A Receptor complex, as well as a differential (epi)genetic risk in serotonergic and GABAergic signaling, are moderators or mediators between changes in the reproductive steroid system and the physiological, affective, and cognitive outcomes manifesting in reproductive mood disorders. We point to the lack of research on the role of psychosocial factors in increasing a woman's stress level and at some point also the sensitivity of her stress steroid system within the etiology of Reproductive Mood Disorders. Drawing together the evidence on various reproductive mood disorders we seek to present a basis for the development of more effective pharmacological, social, and psychological treatment interventions and prevention strategies for women susceptible to these disorders. This could pave the way for new research as well as medical and psychological teaching and practice- such as a new type of Practice for Gynecological Psychoneuroendocrinology- with the aim of working on and ultimately offering more integrative forms of support not yet available to women suffering from depression during hormonal transitions. In medical history women have been left alone with this integrative challenge.
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Affiliation(s)
- Sophie Schweizer-Schubert
- Center for Psychosocial Medicine, Institute of Medical Psychology, University Hospital Heidelberg, Heidelberg, Germany.,Practice for Psychoendocrinology and Psychotherapy, Heilbronn, Germany
| | | | - Tory A Eisenlohr-Moul
- Women's Mental Health Research Program, Department of Psychiatry, University of Illinois at Chicago, Chicago, IL, United States
| | | | - Katja M Schmalenberger
- Center for Psychosocial Medicine, Institute of Medical Psychology, University Hospital Heidelberg, Heidelberg, Germany
| | - Radoslaw Slopien
- Department of Gynecological Endocrinology, Poznan University of Medical Sciences, Poznan, Poland
| | - Anna-Lena Zietlow
- Center for Psychosocial Medicine, Institute of Medical Psychology, University Hospital Heidelberg, Heidelberg, Germany
| | - Ulrike Ehlert
- Department of Psychology, University of Zurich, Zurich, Switzerland
| | - Beate Ditzen
- Center for Psychosocial Medicine, Institute of Medical Psychology, University Hospital Heidelberg, Heidelberg, Germany
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19
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Ullah A, Long X, Mat WK, Hu T, Khan MI, Hui L, Zhang X, Sun P, Gao M, Wang J, Wang H, Li X, Sun W, Qiao M, Xue H. Highly Recurrent Copy Number Variations in GABRB2 Associated With Schizophrenia and Premenstrual Dysphoric Disorder. Front Psychiatry 2020; 11:572. [PMID: 32695026 PMCID: PMC7338560 DOI: 10.3389/fpsyt.2020.00572] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/26/2019] [Accepted: 06/03/2020] [Indexed: 01/03/2023] Open
Abstract
OBJECTIVE Although single-nucleotide polymorphisms in GABRB2, the gene encoding for GABAA receptors β2 subunit, have been associated with schizophrenia (SCZ), it is unknown whether there is any association of copy number variations (CNVs) in this gene with either SCZ or premenstrual dysphoric disorder (PMDD). METHODS In this study, the occurrences of the recurrent CNVs esv2730987 in Intron 6 and nsv1177513 in Exon 11 of GABRB2 in Chinese and German SCZ, and Chinese PMDD patients were compared to controls of same ethnicity and gender by quantitative PCR (qPCR). RESULTS The results demonstrated that copy-number-gains were enriched in both SCZ and PMDD patients with significant odds ratios (OR). For combined-gender SCZ patients versus controls, about two-fold increases were observed in both ethnic groups at both esv2730987 (OR = 2.15, p = 5.32E-4 in Chinese group; OR = 2.79, p = 8.84E-3 in German group) and nsv1177513 (OR = 3.29, p = 1.28E-11 in Chinese group; OR = 2.44, p = 6.17E-5 in German group). The most significant copy-number-gains were observed in Chinese females at nsv1177513 (OR = 3.41), and German females at esv2730987 (OR=3.96). Copy-number-gains were also enriched in Chinese PMDD patients versus controls at esv2730987 (OR = 10.53, p = 4.34E-26) and nsv1177513 (OR = 2.39, p = 3.19E-5). CONCLUSION These findings established for the first time the association of highly recurrent CNVs with SCZ and PMDD, suggesting the presence of an overlapping genetic basis with shared biomarkers for these two common psychiatric disorders.
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Affiliation(s)
- Ata Ullah
- Applied Genomics Center and State Key Laboratory of Molecular Neuroscience, Hong Kong University of Science and Technology, Division of Life Science, Hong Kong, Hong Kong
| | - Xi Long
- Applied Genomics Center and State Key Laboratory of Molecular Neuroscience, Hong Kong University of Science and Technology, Division of Life Science, Hong Kong, Hong Kong
| | - Wai-Kin Mat
- Applied Genomics Center and State Key Laboratory of Molecular Neuroscience, Hong Kong University of Science and Technology, Division of Life Science, Hong Kong, Hong Kong
| | - Taobo Hu
- Applied Genomics Center and State Key Laboratory of Molecular Neuroscience, Hong Kong University of Science and Technology, Division of Life Science, Hong Kong, Hong Kong
| | - Muhammad Ismail Khan
- Applied Genomics Center and State Key Laboratory of Molecular Neuroscience, Hong Kong University of Science and Technology, Division of Life Science, Hong Kong, Hong Kong
| | - Li Hui
- Suzhou Guangji Hospital, The Affiliated Guangji Hospital of Soochow University, Suzhou, China
| | - Xiangyang Zhang
- Institute of Psychology, Chinese Academy of Sciences, Beijing, China
| | - Peng Sun
- School of Basic Medicine, Shandong University of Traditional Chinese Medicine, Jinan, China
| | - Mingzhou Gao
- School of Basic Medicine, Shandong University of Traditional Chinese Medicine, Jinan, China
| | - Jieqiong Wang
- School of Basic Medicine, Shandong University of Traditional Chinese Medicine, Jinan, China
| | - Haijun Wang
- School of Basic Medicine, Shandong University of Traditional Chinese Medicine, Jinan, China
| | - Xia Li
- School of Basic Medicine, Shandong University of Traditional Chinese Medicine, Jinan, China
| | - Wenjun Sun
- School of Basic Medicine, Shandong University of Traditional Chinese Medicine, Jinan, China
| | - Mingqi Qiao
- School of Basic Medicine, Shandong University of Traditional Chinese Medicine, Jinan, China
| | - Hong Xue
- Applied Genomics Center and State Key Laboratory of Molecular Neuroscience, Hong Kong University of Science and Technology, Division of Life Science, Hong Kong, Hong Kong
- School of Basic Medicine, Shandong University of Traditional Chinese Medicine, Jinan, China
- School of Basic Medicine and Clinical Pharmacy, China Pharmaceutical University, Nanjing, China
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20
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Bellofiore N, Cousins F, Temple-Smith P, Evans J. Altered exploratory behaviour and increased food intake in the spiny mouse before menstruation: a unique pre-clinical model for examining premenstrual syndrome. Hum Reprod 2020; 34:308-322. [PMID: 30561655 DOI: 10.1093/humrep/dey360] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2018] [Accepted: 11/20/2018] [Indexed: 01/01/2023] Open
Abstract
STUDY QUESTION Does the newly discovered menstruating spiny mouse exhibit behavioural and metabolic changes in correlation with premenstrual phases of the menstrual cycle? SUMMARY ANSWER This is the first report of cycle variability in the exploratory and interactive behaviour, and food consumption in menstruating spiny mice, and demonstrates that physiological changes are also dependent on within-subject variation. WHAT IS KNOWN ALREADY Premenstrual syndrome (PMS) is a prominent cyclic disorder that affects millions of women worldwide. More than 70% of women endure symptoms of impending menstruation, such as bloating, abdominal cramping and nausea to some degree. Consequently, ~8% of women experience recurrent physical and emotional symptoms which are extreme enough to disrupt daily life and seek intervention. Due to a lack of an appropriate animal model, the mechanisms underlying PMS are poorly understood, and subsequently, effective treatments are limited. STUDY DESIGN, SIZE, DURATION This study analyses the changes in behavioural responses to the investigator during vaginal lavage (n = 14), exploratory behaviour (n = 11) and metabolism (n = 20) across the menstrual cycle in the spiny mouse (Acomys cahirinus). PARTICIPANTS/MATERIALS, SETTING, METHODS We performed vaginal lavages on virgin spiny mice (6-8 months of age) and subjected each cohort of females to repeated measures for vaginal lavage, exploratory behaviour and metabolism. Stages of the menstrual cycle were designated as early follicular, late follicular, early luteal, late luteal, early menstrual and late menstrual, with the late luteal and early menstrual phases considered as premenstrual phases and analysed using generalized estimating equations. For vaginal lavage, the behavioural responses to researcher handling were scored on an increasing scale of severity during the lavage process (e.g. restraint, frequency of vocalizations, total handling time). For exploratory behaviour, exploration, memory and sociability were assessed through subjection to Open Field (OF), Novel Object Recognition (NORT), Social Novelty (SN) and Elevated Plus Maze (EPM) tests. For metabolism, physiological changes were measured over a 24-h period in metabolic cages. Results are mean ± SD with statistical significance set to P < 0.05. MAIN RESULTS AND THE ROLE OF CHANCE Qualitative behavioural assessment showed that compared to early follicular controls, during premenstrual phases, cycling females had significantly increased probability of: manifesting difficulties during restraint (4×, P < 0.01), vocalizing (8×, P < 0.01) and exhibiting isolation in the cage (40×, P = 0.041). We saw significant increases in handling time during the premenstrual phase in cycling females (76 ± 16 s) compared to controls (55 ± 7 s, P < 0.001). For exploratory behaviour, cycling females in their early menstrual phase travelled significantly less distance in the outer zone of the OF arena (13.3 ± 9.0 m) than females in their early luteal phase (22.3 ± 9.9 m, P = 0.038) and at significantly reduced velocities (40.2 ± 10.5 mm/s and 78.8 ± 31.0 mm/s, respectively, P = 0.006). These females also had fewer entries into the EPM open arms during the same phases (9.6 ± 6.1 and versus 20.0 ± 7.2, respectively, P = 0.030) and travelled less distance (3.2 ± 2.8 m versus 7.0 ± 5.5 m, respectively, P = 0.026). No differences were observed in NORT or SN across the cycle. In the metabolism studies, spiny mice demonstrated a significant increase in food consumption (percentage of body weight) during the early follicular and late luteal phases (3.9 ± 2.4% and 3.8 ± 2.1%, respectively) compared to the late follicular phase (2.3 ± 2.6%, P = 0.015). LARGE SCALE DATA N/A. LIMITATIONS, REASONS FOR CAUTION This is an observational study to determine fundamental changes in behaviour and metabolism in a novel species, and as such, lacks commercially available laboratory reagents and protocols specific to the spiny mouse. WIDER IMPLICATIONS OF THE FINDINGS The timing of these behavioural and physiological changes suggests that spiny mice exhibit symptoms analogous to PMS in higher order primates, thus providing a pre-clinical model for testing novel interventions to alleviate premenstrual symptoms and overcoming many limitations associated with this research area. STUDY FUNDING/COMPETING INTEREST(S) N.B. is supported by a Research Training Program stipend through Monash University. J.E. is supported by a Fellowship awarded by the Peter Fielding Foundation. The Hudson Institute of Medical Research is supported by the Victorian Government Operational Research Infrastructure Support. The authors declare no conflicts of interest.
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Affiliation(s)
- Nadia Bellofiore
- The Ritchie Centre, Hudson Institute of Medical Research, Clayton, Australia.,Obstetrics and Gynaecology, Monash University, Clayton, Australia
| | - Fiona Cousins
- The Ritchie Centre, Hudson Institute of Medical Research, Clayton, Australia.,Obstetrics and Gynaecology, Monash University, Clayton, Australia
| | | | - Jemma Evans
- Centre for Reproductive Health, Hudson Institute of Medical Research, Clayton, Australia
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Kiesner J, Eisenlohr-Moul T, Mendle J. Evolution, the Menstrual Cycle, and Theoretical Overreach. PERSPECTIVES ON PSYCHOLOGICAL SCIENCE 2020; 15:1113-1130. [PMID: 32539582 DOI: 10.1177/1745691620906440] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
A considerable amount of recent psychological research has attributed a variety of menstrual-cycle-related changes in social behavior to evolutionarily adaptive functions. Although these studies often draw interesting and unusual conclusions about female emotion and behavior within evolutionary theory, their significant limitations have not yet been addressed. In this article, we outline several methodological and conceptual issues related to the menstrual cycle that constitute threats to the internal validity and theoretical integrity of these studies. We recommend specific guidelines to address these issues and emphasize the need to apply more comprehensive and sophisticated theoretical structures when considering menstrual-cycle-related changes in emotion and behavior.
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Affiliation(s)
- Jeff Kiesner
- Department of Social and Developmental Psychology, University of Padua
| | | | - Jane Mendle
- Department of Human Development, Cornell University
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22
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The prevalence of premenstrual dysphoric disorder among adolescents in Ethiopia: a systematic review and meta-analysis. Ir J Med Sci 2020; 190:419-427. [PMID: 32506277 DOI: 10.1007/s11845-020-02275-7] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2020] [Accepted: 05/30/2020] [Indexed: 10/24/2022]
Abstract
The rates of prevalence of premenstrual dysphoric disorder (PMDD) in Ethiopia were high and inconsistent across studies. However, there was no previous systematic reviews and meta-analysis conducted on this topic. Therefore, this review aimed to systematically review previous studies on the topic and summarize the prevalence of PMDD among students in Ethiopia and formulate recommendations for future clinical services. The preferred reporting items for systematic review and meta-analysis (PRISMA) guidelines were used to conduct this systematic review and meta-analysis. Popular databases such as PubMed, EMBASE, Psych-INFO, SCOPUS, Google Scholar, African Index Medicus, and African Journals Online (AJOL) were searched for relevant studies. We used a Comprehensive Meta-Analysis software version 3.0 (CMA-3.0) to conduct a meta-analysis. The random-effects model was used to estimate the pooled prevalence. The magnitude of statistical heterogeneity between the eligible articles was checked by Cochrane Q and the I2 statistics. The funnel plot and Egger's regression tests were used to assess potential publication bias. A total of 12 studies that were published between 2003 and 2019 was included in our systematic review and meta-analysis. The pooled estimated prevalence of premenstrual dysphoric disorder among female students in Ethiopia was 54.5% (95% CI 40.8-67.6). The pooled estimated prevalence of premenstrual dysphoric disorder was approximately similar for both studies that recruited study participants from either high school or higher education. Further, the pooled estimated prevalence of premenstrual dysphoric disorder was ranging from 51.2 to 57.2% in leave-one-out sensitivity analysis, suggesting that the removal of one study did not affect the overall prevalence estimate. The pooled estimated prevalence of premenstrual dysphoric disorder among female students in Ethiopia was high. Early screening and appropriate interventions at primary healthcare settings are warranted.
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Dubol M, Epperson CN, Lanzenberger R, Sundström-Poromaa I, Comasco E. Neuroimaging premenstrual dysphoric disorder: A systematic and critical review. Front Neuroendocrinol 2020; 57:100838. [PMID: 32268180 DOI: 10.1016/j.yfrne.2020.100838] [Citation(s) in RCA: 36] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/31/2020] [Revised: 03/26/2020] [Accepted: 03/31/2020] [Indexed: 01/29/2023]
Abstract
Endocrine organizational and activational influences on cognitive and affective circuits are likely critical to the development of premenstrual dysphoric disorder (PMDD), a sex-specific hormone-dependent mood disorder. An overview of the anatomical and functional neural characterization of this disorder is presented here by means of neuroimaging correlates, identified from eighteen publications (n = 361 subjects). While white matter integrity remains uninvestigated, greater cerebellar grey matter volume and metabolism were observed in patients with PMDD, along with altered serotonergic and GABAergic neurotransmission. Differential corticolimbic activation in response to emotional stimuli distinguishes the PMDD brain, namely enhanced amygdalar and diminished fronto-cortical function. Thus far, the emotional distress and dysregulation linked to PMDD seem to be defined by structural, chemical and functional brain signatures; however, their characterization remains sparsely studied and somewhat inconsistent. Clear and well-replicated neurobiological features of PMDD are needed to promote timely diagnoses and inform development of prevention and treatment strategies.
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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, United States
| | - 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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Association of genetic variants in Estrogen receptor (ESR)1 and ESR2 with susceptibility to recurrent pregnancy loss in Tunisian women: A case control study. Gene 2020; 736:144406. [PMID: 32007580 DOI: 10.1016/j.gene.2020.144406] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2019] [Revised: 01/19/2020] [Accepted: 01/27/2020] [Indexed: 02/07/2023]
Abstract
Estrogen receptor (ER) signaling is key regulator for maintaining successful pregnancy. Several research suggested that genetic variation in ER genes (ESR)1 and ESR2 is associated with the susceptibility to unexplained recurrent pregnancy loss (RPL), often with inconclusive results. In this study, we investigate the relationship between ESR1 and ESR2 polymorphisms and idiopathic RPL. A total of 444 patients with RPL, defined as three or more consecutive pregnancy losses of unknown etiology, and 446 control women were recruited to the study and their genotypes for ESR1-rs2234693, ESR1-rs3020314, and ESR2-rs928554 variants were determined using allelic exclusion method on real-time polymerase chain reaction. Minor allele frequencies (MAF) of tagging SNPs ESR1 rs2234693 and rs3020314, and ESR2 rs928554 were not significantly different between RPL cases and control women. Considerable higher frequencies of homozygous (2/2) ESR1 rs2234693 genotype carriers were seen between patients vs. control women, which maintained after controlling for age, body mass index (BMI), and menarche. ESR1 haplotype analysis demonstrated two common haplotype (rs2234693-rs3020314) with no linkage disequilibrium between both polymorphisms, and no 2-locus haplotype linked with RPL risk was revealed. The present study confirmed a significant association of specific ESR1 variant (rs2234693) with an increased risk of RPL, further supporting a role for ESR1 as an important candidate locus inducing RPL.
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Talarowska ME, Szemraj J, Kuan-Pin S. Expression of ESR1 and ESR2 oestrogen receptor encoding gene and personality traits - preliminary study. PRZEGLAD MENOPAUZALNY = MENOPAUSE REVIEW 2019; 18:133-140. [PMID: 31975979 PMCID: PMC6970415 DOI: 10.5114/pm.2019.90804] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 09/29/2019] [Accepted: 11/03/2019] [Indexed: 12/24/2022]
Abstract
INTRODUCTION The main objective of the study is to examine the hypothesis claiming a correlation between personality traits measured with the use of the Minnesota Multiphasic Personality Inventory (MMPI-2) personality questionnaire and the expression of the ERα (ESR1) and ERβ (ESR2) encoding gene in patients suffering from depression. MATERIAL AND METHODS The experiment was carried out on a group of 44 individuals with depression. The Polish variant of the MMPI-2 was applied with the aim of assessing personality traits. Furthermore, the authors evaluated the expression of the genes encoding the oestrogen receptors (ERα and ERβ) at the mRNA level and protein level in the studied population. RESULTS No significant differences in the expression of ERα and ERβ encoding genes were found and confirmed in the patients with the first episode of depression and those suffering from subsequent episodes of the disease. No differences were found between women and men, either. In women a positive relationship was found between the scale of psychopathy (p = 0.04), paranoia (p = 0.01), and mania (p = 0.03) and expression for the ERα encoding gene at the mRNA level. A negative relationship was found between the mania scale and ERβ encoding gene expression at mRNA (p = 0.03) and protein (p = 0.04) levels. In males a positive relationship between anxiety as a personality trait and expression of the ERβ receptor encoding gene at mRNA level (p = 0.03) and protein level (p = 0.03) was found. CONCLUSIONS Personality traits may be linked with the expression of genes encoding oestrogen receptors (ERα and ERβ) among patients with depressive disorders.
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Affiliation(s)
- Monika E. Talarowska
- Department of Personality and Individual Differences, Institute of Psychology, University of Lodz, Poland
| | - Janusz Szemraj
- Department of Medical Biochemistry, Medical University of Lodz, Poland
| | - Su Kuan-Pin
- Department of General Psychiatry, China Medical University Hospital, Taichung City, Taiwan
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Schmalenberger KM, Eisenlohr-Moul TA, Würth L, Schneider E, Thayer JF, Ditzen B, Jarczok MN. A Systematic Review and Meta-Analysis of Within-Person Changes in Cardiac Vagal Activity across the Menstrual Cycle: Implications for Female Health and Future Studies. J Clin Med 2019; 8:jcm8111946. [PMID: 31726666 PMCID: PMC6912442 DOI: 10.3390/jcm8111946] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2019] [Revised: 11/01/2019] [Accepted: 11/04/2019] [Indexed: 12/11/2022] Open
Abstract
Interest in cardiac vagal activity (CVA; e.g., parasympathetically-mediated heart rate variability) as a biomarker of physical and mental health has increased exponentially in recent years. However, the understanding of sources of within-person change (i.e., intra-individual variance) in CVA is lagging behind. This systematic review and meta-analysis summarizes and quantifies current empirical evidence of within-person changes in measures of CVA across the menstrual cycle in naturally-cycling premenopausal females. We conducted an extensive literature search following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement in five databases to identify observational studies with repeated measures of CVA in at least two menstrual cycle phases. A broad meta-analysis (nstudies = 37; nindividuals = 1,004) revealed a significant CVA decrease from the follicular to luteal phase (d = −0.39, 95% CI (−0.67, −0.11)). Furthermore, 21 studies allowed for finer-grained comparisons between each of two cycle phases (menstrual, mid-to-late follicular, ovulatory, early-to-mid luteal, and premenstrual). Significant decreases in CVA were observed from the menstrual to premenstrual (nstudies = 5; nindividuals = 200; d = −1.17, 95% CI (−2.18, −0.17)) and from the mid-to-late follicular to premenstrual phases (nstudies = 8; nindividuals = 280; d = −1.32, 95% CI (−2.35, −0.29)). In conclusion, meta-analyses indicate the presence of CVA fluctuations across the menstrual cycle. Future studies involving CVA should control for cycle phase. Recommendations for covarying or selecting cycle phase are provided.
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Affiliation(s)
- Katja M. Schmalenberger
- Institute of Medical Psychology, Center for Psychosocial Medicine, University Hospital Heidelberg, 69115 Heidelberg, Germany; (L.W.); (E.S.); (B.D.)
- Correspondence: (K.M.S.); (M.N.J.); Tel.: +49-6221-56-8148 (K.M.S.); +49-731-500-61810 (M.N.J.)
| | - Tory A. Eisenlohr-Moul
- Women’s Mental Health Research Program, Department of Psychiatry, University of Illinois at Chicago, Chicago, IL 60612, USA;
| | - Lena Würth
- Institute of Medical Psychology, Center for Psychosocial Medicine, University Hospital Heidelberg, 69115 Heidelberg, Germany; (L.W.); (E.S.); (B.D.)
| | - Ekaterina Schneider
- Institute of Medical Psychology, Center for Psychosocial Medicine, University Hospital Heidelberg, 69115 Heidelberg, Germany; (L.W.); (E.S.); (B.D.)
| | - Julian F. Thayer
- Department of Psychological Science, School of Social Ecology, University of California Irvine, Irvine, CA 92697-7085, USA
| | - Beate Ditzen
- Institute of Medical Psychology, Center for Psychosocial Medicine, University Hospital Heidelberg, 69115 Heidelberg, Germany; (L.W.); (E.S.); (B.D.)
| | - Marc N. Jarczok
- Clinic for Psychosomatic Medicine and Psychotherapy, Ulm University Medical Center, 89081 Ulm, Germany
- Correspondence: (K.M.S.); (M.N.J.); Tel.: +49-6221-56-8148 (K.M.S.); +49-731-500-61810 (M.N.J.)
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Yen JY, Lin HC, Lin PC, Liu TL, Long CY, Ko CH. Early- and Late-Luteal-Phase Estrogen and Progesterone Levels of Women with Premenstrual Dysphoric Disorder. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16224352. [PMID: 31703451 PMCID: PMC6888463 DOI: 10.3390/ijerph16224352] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/02/2019] [Revised: 11/01/2019] [Accepted: 11/06/2019] [Indexed: 01/11/2023]
Abstract
Objective/introduction: The dynamics of ovarian hormone fluctuations during the luteal phase of the menstruation cycle were previously suggested to contribute to the development of premenstrual dysphoric disorder (PMDD) symptoms, but adequate empirical evidence has not been obtained from hormone concentration studies. We prospectively evaluated estrogen and progesterone levels in the early luteal (EL) and late luteal (LL) phases in women with PMDD and the association of these levels with PMDD symptom severity. Methods: 63 women with PMDD and 53 controls without such severe symptoms were evaluated for the estrogen and progesterone levels, and PMDD severity in the EL and LL phases. Results: The results demonstrated that the women with PMDD had a lower EL-phase estrogen level than the controls. Covariant analysis demonstrated that the interaction term between EL-phase estrogen and EL-phase progesterone level was associated with PMDD severity. Among women with lower EL estrogen levels, higher EL-phase progesterone was observed among the women with PMDD versus controls. These results suggest that low EL-phase estrogen level could moderate the provoking effect of EL progesterone in women with PMDD. Overall, these data suggest a possible role of estrogen and progesterone in the development of PMDD symptoms.
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Affiliation(s)
- Ju-Yu Yen
- Department of Psychiatry, Kaohsiung Municipal Ta-Tung Hospital, Kaohsiung Medical University, Kaohsiung 801, Taiwan; (J.-Y.Y.); (P.-C.L.)
- Department of Psychiatry, Faculty of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung 807, Taiwan;
- Department of Psychiatry, Kaohsiung Medical University Hospital, Kaohsiung 807, Taiwan;
| | - Huang-Chi Lin
- Department of Psychiatry, Faculty of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung 807, Taiwan;
- Department of Psychiatry, Kaohsiung Medical University Hospital, Kaohsiung 807, Taiwan;
| | - Pai-Cheng Lin
- Department of Psychiatry, Kaohsiung Municipal Ta-Tung Hospital, Kaohsiung Medical University, Kaohsiung 801, Taiwan; (J.-Y.Y.); (P.-C.L.)
| | - Tai-Ling Liu
- Department of Psychiatry, Kaohsiung Medical University Hospital, Kaohsiung 807, Taiwan;
| | - Cheng-Yu Long
- Department of Obstetrics and Gynecology, Kaohsiung Municipal Siaogang Hospital, Kaohsiung Medical University, Kaohsiung 812, Taiwan;
| | - Chih-Hung Ko
- Department of Psychiatry, Faculty of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung 807, Taiwan;
- Department of Psychiatry, Kaohsiung Medical University Hospital, Kaohsiung 807, Taiwan;
- Department of Psychiatry, Kaohsiung Municipal Siaogang Hospital, Kaohsiung Medical University, Kaohsiung 812, Taiwan
- Research Center for Environmental Medicine, Kaohsiung Medical University, Kaohsiung 807, Taiwan
- Correspondence: ; Tel.: +886-975-357-342
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Amiel Castro R, Pataky E, Ehlert U. Associations between premenstrual syndrome and postpartum depression: A systematic literature review. Biol Psychol 2019; 147:107612. [DOI: 10.1016/j.biopsycho.2018.10.014] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2018] [Revised: 10/24/2018] [Accepted: 10/24/2018] [Indexed: 12/17/2022]
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Abstract
Premenstrual dysphoric disorder (PMDD) comprises emotional and physical symptoms and functional impairment that lie on the severe end of the continuum of premenstrual symptoms. Women with PMDD have a differential response to normal hormonal fluctuations. This susceptibility may involve the serotonin system, altered sensitivity of the GABAA receptor to the neurosteroid allopregnanalone, and altered brain circuitry involving emotional and cognitive functions. Serotonin reuptake inhibitors are considered the first-line treatment. Second-line treatments include oral contraceptives containing drospirenone, other ovulation suppression methods, calcium, chasteberry, and cognitive-behavioral therapy.
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Affiliation(s)
- Teresa Lanza di Scalea
- Assistant Professor of Psychiatry and Women's Health, Dell Medical School, University of Texas at Austin, Austin, TX, USA.
| | - Teri Pearlstein
- Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, Women's Behavioral Medicine, Women's Medicine Collaborative, Miriam Hospital, 146 West River Street, Providence, RI 02904, USA
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Abstract
Introduction: Premenstrual dysphoric disorder (PMDD) is a distressing disorder amongst women of reproductive age group with significant implication in the productivity and quality of life of women who suffer from it. It is generally neglected as it is mostly undifferentiated from premenstrual symptoms—milder presentation of the same spectrum of problem but of lesser intensity and impairment. Objective: Here, in this article, we aim to highlight various studies and the research done on PMDD in the context of Indian women. Method: Reviewing the last 40 years’ database including Medline (PUBMED), Cochrane Library, EMBASE, Trip, Psych INFO, CINAHL, the Allied and Complementary Medicine Database (AMED), and the British Nursing Index. Results: PMDD is a troublesome disorder, often underdiagnosed. A thorough history including menstrual and sexual history, conducting a thorough physical examination, assessing the comorbidities, and finally using a proper and structured treatment protocol for managing the condition are recommended. Sertraline is the most widely studied drug which is found to be effective in PMDD.
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Affiliation(s)
- Dahuja Malvika
- Shaikh-ul-Hind Maulana Mahmood Hasan Medical College, Saharanpur, Uttar Pradesh, India
| | - Agarwal Supriya
- Netaji Subhash Chandra Bose Subharti Medical College, Swami Vivekanand Subharti University, Meerut, Uttar Pradesh, India
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Abstract
PURPOSE OF REVIEW Risk for suicidal behavior may fluctuate across the menstrual cycle. Here, we use the RDoC framework to review potential mechanisms by which the cycle may increase acute suicide risk. RECENT FINDINGS The menstrual cycle impacts the majority of RDoC constructs linked to suicide risk, particularly among hormone-sensitive women, such as those with premenstrual dysphoric disorder or premenstrual exacerbation of a psychiatric disorder. Despite this, there are no published studies examining suicidal ideation, planning, or behavior longitudinally across the cycle. More work is needed to understand how hormone sensitivity may relate to both trait and state suicide risk. Intensive multilevel investigations of cyclical hormone effects on suicide risk through specific RDoC mechanisms are suggested. This is a fertile research area and may provide key insights regarding the mechanisms of acute suicide risk.
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Affiliation(s)
- Sarah A Owens
- Department of Psychology, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Tory Eisenlohr-Moul
- Department of Psychiatry, Women's Mental Health Research Program, University of Illinois at Chicago, 912 S Wood St., South Tower, Room 335, Chicago, IL, 60612, USA.
- Department of Psychology, University of Illinois at Chicago, Chicago, IL, 60612, USA.
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Yen JY, Wang PW, Su CH, Liu TL, Long CY, Ko CH. Estrogen levels, emotion regulation, and emotional symptoms of women with premenstrual dysphoric disorder: The moderating effect of estrogen receptor 1α polymorphism. Prog Neuropsychopharmacol Biol Psychiatry 2018; 82:216-223. [PMID: 29146473 DOI: 10.1016/j.pnpbp.2017.11.013] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/14/2017] [Revised: 11/03/2017] [Accepted: 11/09/2017] [Indexed: 12/21/2022]
Abstract
BACKGROUND This study evaluated the association between estrogen levels, emotion regulation, depression, anxiety, and stress of women with premenstrual dysphoric disorder (PMDD). We also evaluated the moderating effect of estrogen receptor (ESR) α-Xbal polymorphism on the aforementioned association. METHODS A total of 100 women were diagnosed with PMDD based on psychiatric interviews and a prospective investigation of 3 menstrual cycles. A total of 96 normal individuals were recruited as controls. Their estrogen levels, depression, anxiety, stress, and ESR α-Xbal polymorphism in both premenstrual and follicular phases were assessed, and these data were included in the final analysis. RESULTS The PMDD group had high depression, anxiety, and stress and low emotional adjusting and tolerating in the premenstrual phase. Emotional adjustment was negatively associated with depression, anxiety and stress. No association was observed between PMDD and estrogen level. However, premenstrual estrogen level was negatively correlated with anxiety and stress in women with PMDD. The association was only significant in G carriers of ESR α-Xbal, as was the difference in premenstrual emotion regulation between the PMDD and control groups. CONCLUSIONS The results demonstrate the association between estrogen and anxiety in PMDD, supporting the claim that women with PMDD differ in their responses to normal estrogen levels. Furthermore, this association and dysfunctional emotional regulation in PMDD existed only among the G carriers of ESR α-Xbal polymorphism. Future studies should investigate the effect of estrogen on brain functions involving emotional regulation in women with PMDD, stratified by ESR α-Xbal polymorphism.
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Affiliation(s)
- Ju-Yu Yen
- Department of Psychiatry, Kaohsiung Municipal Ta-Tung Hospital, Kaohsiung, Taiwan; Department of Psychiatry, Faculty of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan; Department of Psychiatry, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
| | - Peng-Wei Wang
- Department of Psychiatry, Faculty of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan; Department of Psychiatry, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan; Graduate Institute of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Chen-Hsiang Su
- Department of Psychiatry, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
| | - Tai-Ling Liu
- Department of Psychiatry, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
| | - Cheng-Yu Long
- Department of Obstetrics and Gynecology, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
| | - Chih-Hung Ko
- Department of Psychiatry, Faculty of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan; Department of Psychiatry, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan; Graduate Institute of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan; Department of Psychiatry, Kaohsiung Municipal Hsiao-Kang Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan.
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McEvoy K, Osborne LM, Nanavati J, Payne JL. Reproductive Affective Disorders: a Review of the Genetic Evidence for Premenstrual Dysphoric Disorder and Postpartum Depression. Curr Psychiatry Rep 2017; 19:94. [PMID: 29082433 DOI: 10.1007/s11920-017-0852-0] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
PURPOSE OF REVIEW The purpose of this study is to review and summarize the literature exploring the genetic basis for premenstrual dysphoric disorder (PMDD) and postpartum depression (PPD). RECENT FINDINGS There is more evidence for a genetic basis for PPD than for PMDD, but only when PPD is defined as beginning in the immediate postpartum time period. Familial, genome-wide linkage and association studies, and candidate gene studies, most in the past 10 years, have examined the genetic etiology of reproductive affective disorders, including PMDD and PPD. The most commonly studied genes include SERT, COMT, MAOA, BDNF, and ESR1 and 2. This qualitative review of the recent literature finds limited evidence so far for the genetic basis for PMDD, with both familial and candidate gene studies having negative or conflicting results. Evidence is stronger for the genetic basis for PPD, with positive associations found in family studies and in several genes associated with major depression as well as genes involved in estrogen signaling but only when PPD onset is shortly after delivery. Epigenetic biomarkers on genes responsive to estrogen have also been found to predict PPD. Our findings underscore the need for additional studies with larger samples, as well as the crucial importance of timing in the definition of PPD for genetic studies.
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Affiliation(s)
- Katherine McEvoy
- Department of Psychiatry, Women's Mood Disorders Center, Johns Hopkins School of Medicine, 550 N. Broadway, Suite 305, Baltimore, MD, 21205, USA
| | - Lauren M Osborne
- Department of Psychiatry, Women's Mood Disorders Center, Johns Hopkins School of Medicine, 550 N. Broadway, Suite 305, Baltimore, MD, 21205, USA
| | - Julie Nanavati
- Department of Psychiatry, Women's Mood Disorders Center, Johns Hopkins School of Medicine, 550 N. Broadway, Suite 305, Baltimore, MD, 21205, USA
| | - Jennifer L Payne
- Department of Psychiatry, Women's Mood Disorders Center, Johns Hopkins School of Medicine, 550 N. Broadway, Suite 305, Baltimore, MD, 21205, USA.
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Maney DL. Polymorphisms in sex steroid receptors: From gene sequence to behavior. Front Neuroendocrinol 2017; 47:47-65. [PMID: 28705582 PMCID: PMC6312198 DOI: 10.1016/j.yfrne.2017.07.003] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/24/2017] [Revised: 07/05/2017] [Accepted: 07/08/2017] [Indexed: 01/09/2023]
Abstract
Sex steroid receptors have received much interest as potential mediators of human behaviors and mental disorders. Candidate gene association studies have identified about 50 genetic variants of androgen and estrogen receptors that correlate with human behavioral phenotypes. Because most of these polymorphisms lie outside coding regions, discerning their effect on receptor function is not straightforward. Thus, although discoveries of associations improve our ability to predict risk, they have not greatly advanced our understanding of underlying mechanisms. This article is intended to serve as a starting point for psychologists and other behavioral biologists to consider potential mechanisms. Here, I review associations between polymorphisms in sex steroid receptors and human behavioral phenotypes. I then consider ways in which genetic variation can affect processes such as mRNA transcription, splicing, and stability. Finally, I suggest ways that hypotheses about mechanism can be tested, for example using in vitro assays and/or animal models.
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Affiliation(s)
- Donna L Maney
- Department of Psychology, 36 Eagle Row, Emory University, Atlanta, GA 30322, USA.
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Dubey N, Hoffman JF, Schuebel K, Yuan Q, Martinez PE, Nieman LK, Rubinow DR, Schmidt PJ, Goldman D. The ESC/E(Z) complex, an effector of response to ovarian steroids, manifests an intrinsic difference in cells from women with premenstrual dysphoric disorder. Mol Psychiatry 2017; 22:1172-1184. [PMID: 28044059 PMCID: PMC5495630 DOI: 10.1038/mp.2016.229] [Citation(s) in RCA: 51] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/22/2016] [Revised: 10/19/2016] [Accepted: 10/31/2016] [Indexed: 12/21/2022]
Abstract
Clinical evidence suggests that mood and behavioral symptoms in premenstrual dysphoric disorder (PMDD), a common, recently recognized, psychiatric condition among women, reflect abnormal responsivity to ovarian steroids. This differential sensitivity could be due to an unrecognized aspect of hormonal signaling or a difference in cellular response. In this study, lymphoblastoid cell line cultures (LCLs) from women with PMDD and asymptomatic controls were compared via whole-transcriptome sequencing (RNA-seq) during untreated (ovarian steroid-free) conditions and following hormone treatment. The women with PMDD manifested ovarian steroid-triggered behavioral sensitivity during a hormone suppression and addback clinical trial, and controls did not, leading us to hypothesize that women with PMDD might differ in their cellular response to ovarian steroids. In untreated LCLs, our results overall suggest a divergence between mRNA (for example, gene transcription) and protein (for example, RNA translation in proteins) for the same genes. Pathway analysis of the LCL transcriptome revealed, among others, over-expression of ESC/E(Z) complex genes (an ovarian steroid-regulated gene silencing complex) in untreated LCLs from women with PMDD, with more than half of these genes over-expressed as compared with the controls, and with significant effects for MTF2, PHF19 and SIRT1 (P<0.05). RNA and protein expression of the 13 ESC/E(Z) complex genes were individually quantitated. This pattern of increased ESC/E(Z) mRNA expression was confirmed in a larger cohort by qRT-PCR. In contrast, protein expression of ESC/E(Z) genes was decreased in untreated PMDD LCLs with MTF2, PHF19 and SIRT1 all significantly decreased (P<0.05). Finally, mRNA expression of several ESC/E(Z) complex genes were increased by progesterone in controls only, and decreased by estradiol in PMDD LCLs. These findings demonstrate that LCLs from women with PMDD manifest a cellular difference in ESC/E(Z) complex function both in the untreated condition and in response to ovarian hormones. Dysregulation of ESC/E(Z) complex function could contribute to PMDD.
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Affiliation(s)
| | | | | | | | | | - Lynnette K. Nieman
- Intramural Research Program on Reproductive and Adult Endocrinology, The Eunice Kennedy Shriver National Institute of Child Health and Human Development, NIH, DHSS
| | - David R. Rubinow
- Department of Psychiatry, University of North Carolina, Chapel Hill, NC
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Farahmand M, Ramezani Tehrani F, Khalili D, Amin G, Negarandeh R. Factors associated with the severity of premenstrual syndrome among Iranian college students. J Obstet Gynaecol Res 2017; 43:1726-1731. [PMID: 28737241 DOI: 10.1111/jog.13439] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2016] [Revised: 05/15/2017] [Accepted: 05/28/2017] [Indexed: 11/28/2022]
Abstract
AIM Premenstrual syndrome (PMS) is characterized by physical, cognitive, and behavioral symptoms that occur cyclically, from several days to 2 weeks before menses, which resolve either quickly or during the early days of menstruation. The aim of this study was to determine the factors associated with the severity of PMS in Iranian college students. METHODS The cross-sectional study was performed among 298 college students (aged 18-35 years) with PMS, of whom, 271 college students completed the Iranian version of the Premenstrual Symptoms Screening Tool questionnaire to determine the severity of PMS. Factors associated with PMS severity were identified using linear regression analysis with a stepwise method. RESULTS Factors associated with severity of PMS were age (years), family income (low vs high income), marital status (unmarried vs married), and familial history of dysmenorrhea or PMS after adjustment for dysmenorrheal severity with β (95% confidence interval) of 0.31 (0.45-0.57), 11.6 (1.2-23.54), 3.2 (0.4-5.2), and 2.22 (0.04-4.4), respectively. CONCLUSION In this study, factors associated with severity of PMS were age, marital status, family income, and familial history of PMS. We observed that some outcomes were consistent with some previously reported results, which indicates the need for further studies.
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Affiliation(s)
- Maryam Farahmand
- Nursing and Midwifery Care Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Fahimeh Ramezani Tehrani
- Reproductive Endocrinology Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Davood Khalili
- Prevention of Metabolic Disorders Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Gholamreza Amin
- Department of Pharmacognosy, Faculty of Pharmacy, Tehran University of Medical Sciences, Tehran, Iran
| | - Reza Negarandeh
- Nursing and Midwifery Care Research Center, Tehran University of Medical Sciences, Tehran, Iran
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Pinsonneault JK, Frater JT, Kompa B, Mascarenhas R, Wang D, Sadee W. Intronic SNP in ESR1 encoding human estrogen receptor alpha is associated with brain ESR1 mRNA isoform expression and behavioral traits. PLoS One 2017; 12:e0179020. [PMID: 28617822 PMCID: PMC5472281 DOI: 10.1371/journal.pone.0179020] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2016] [Accepted: 05/23/2017] [Indexed: 01/07/2023] Open
Abstract
Genetic variants of ESR1 have been implicated in multiple diseases, including behavioral disorders, but causative variants remain uncertain. We have searched for regulatory variants affecting ESR1 expression in human brain, measuring allelic ESR1 mRNA expression in human brain tissues with marker SNPs in exon4 representing ESR1-008 (or ESRα-36), and in the 3'UTR of ESR1-203, two main ESR1 isoforms in brain. In prefrontal cortex from subjects with bipolar disorder, schizophrenia, and controls (n = 35 each; Stanley Foundation brain bank), allelic ESR1 mRNA ratios deviated from unity up to tenfold at the exon4 marker SNP, with large allelic ratios observed primarily in bipolar and schizophrenic subjects. SNP scanning and targeted sequencing identified rs2144025, associated with large allelic mRNA ratios (p = 1.6E10-6). Moreover, rs2144025 was significantly associated with ESR1 mRNA levels in the Brain eQTL Almanac and in brain regions in the Genotype-Tissue Expression project. In four GWAS cohorts, rs2104425 was significantly associated with behavioral traits, including: hypomanic episodes in female bipolar disorder subjects (GAIN bipolar disorder study; p = 0.0004), comorbid psychological symptoms in both males and females with attention deficit hyperactivity disorder (GAIN ADHD, p = 0.00002), psychological diagnoses in female children (eMERGE study of childhood health, subject age ≥9, p = 0.0009), and traits in schizophrenia (e.g., grandiose delusions, GAIN schizophrenia, p = 0.0004). The first common ESR1 variant (MAF 12-33% across races) linked to regulatory functions, rs2144025 appears conditionally to affect ESR1 mRNA expression in the brain and modulate traits in behavioral disorders.
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Affiliation(s)
- Julia K. Pinsonneault
- Center for Pharmacogenomics, Department of Cancer Biology and Genetics, College of Medicine and Public Health, Ohio State University, Columbus, Ohio, United States of America
| | - John T. Frater
- Center for Pharmacogenomics, Department of Cancer Biology and Genetics, College of Medicine and Public Health, Ohio State University, Columbus, Ohio, United States of America
| | - Benjamin Kompa
- Center for Pharmacogenomics, Department of Cancer Biology and Genetics, College of Medicine and Public Health, Ohio State University, Columbus, Ohio, United States of America
| | - Roshan Mascarenhas
- Center for Pharmacogenomics, Department of Cancer Biology and Genetics, College of Medicine and Public Health, Ohio State University, Columbus, Ohio, United States of America
| | - Danxin Wang
- Center for Pharmacogenomics, Department of Cancer Biology and Genetics, College of Medicine and Public Health, Ohio State University, Columbus, Ohio, United States of America
| | - Wolfgang Sadee
- Center for Pharmacogenomics, Department of Cancer Biology and Genetics, College of Medicine and Public Health, Ohio State University, Columbus, Ohio, United States of America
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Abstract
Premenstrual dysphoric disorder (PMDD) comprises emotional and physical symptoms and functional impairment that lie on the severe end of the continuum of premenstrual symptoms. Women with PMDD have a differential response to normal hormonal fluctuations. This susceptibility may involve the serotonin system, altered sensitivity of the GABAA receptor to the neurosteroid allopregnanalone, and altered brain circuitry involving emotional and cognitive functions. Serotonin reuptake inhibitors are considered the first-line treatment. Second-line treatments include oral contraceptives containing drospirenone, other ovulation suppression methods, calcium, chasteberry, and cognitive-behavioral therapy.
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Affiliation(s)
- Teresa Lanza di Scalea
- Department of Psychiatry, Rhode Island Hospital and Miriam Hospital, 593 Eddy Street, Providence, RI 02903, USA.
| | - Teri Pearlstein
- Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, Women's Behavioral Medicine, Women's Medicine Collaborative, Miriam Hospital, 146 West River Street, Providence, RI 02904, USA
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Sy JL, Tomarken AJ, Patel V, Blake R. The time course of binocular rivalry during the phases of the menstrual cycle. J Vis 2016; 16:22. [PMID: 28006072 PMCID: PMC5221672 DOI: 10.1167/16.15.22] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2016] [Accepted: 10/30/2016] [Indexed: 11/28/2022] Open
Abstract
Binocular rivalry occurs when markedly different inputs to the two eyes initiate alternations in perceptual dominance between the two eyes' views. A link between individual differences in perceptual dynamics of rivalry and concentrations of GABA, a prominent inhibitory neurotransmitter in the brain, has highlighted binocular rivalry as a potential tool to investigate inhibitory processes in the brain. The present experiment investigated whether previously reported fluctuations of GABA concentrations in a healthy menstrual cycle (Epperson et al., 2002) also are associated with measurable changes in rivalry dynamics within individuals. We obtained longitudinal measures of alternation rate, dominance, and mixture durations in 300 rivalry tracking blocks measured over 5 weeks from healthy female participants who monitored the start of the follicular and luteal phases of their cycle. Although we demonstrate robust and stable individual differences in rivalry dynamics, across analytic approaches and dependent measures, we found no significant change or even trends across menstrual phases in the temporal dynamics of dominance percepts. We found only sparse between-phase differences in skew and kurtosis on mixture percepts when data were pooled across sessions and blocks. These results suggest a complex dynamic between hormonal steroids, binocular rivalry, and GABAeric signaling in the brain and thus implicate the need to consider a systemic perspective when linking GABA with perceptual alternations in binocular rivalry.
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Affiliation(s)
- Jocelyn L Sy
- Department of Psychology, Vanderbilt University, Nashville, TN,
| | | | - Vaama Patel
- Department of Psychology, Vanderbilt University, Nashville, TN,
| | - Randolph Blake
- Department of Psychology, Vanderbilt University, Nashville, TN,
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Kiesner J, Granger DA. A lack of consistent evidence for cortisol dysregulation in premenstrual syndrome/premenstrual dysphoric disorder. Psychoneuroendocrinology 2016; 65:149-64. [PMID: 26789492 DOI: 10.1016/j.psyneuen.2015.12.009] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/22/2015] [Revised: 12/03/2015] [Accepted: 12/14/2015] [Indexed: 11/17/2022]
Abstract
Although decades of research has examined the association between cortisol regulation and premenstrual syndrome/premenstrual dysphoric disorder (PMS/PMDD), no review exists to provide a general set of conclusions from the extant research. In the present review we summarize and interpret research that has tested for associations between PMS/PMDD and cortisol levels and reactivity (n=38 original research articles). Three types of studies are examined: correlational studies, environmental-challenge studies, and pharmacological-challenge studies. Overall, there was very little evidence that women with and without PMS/PMDD demonstrate systematic and predictable mean-level differences in cortisol, or differences in cortisol response/reactivity to challenges. Methodological differences in sample size, the types of symptoms used for diagnosis (physical and psychological vs. only affective), or the type of cortisol measure used (serum vs. salivary), did not account for differences between studies that did and did not find significant effects. Caution is recommended before accepting the conclusion of null effects, and recommendations are made that more rigorous research be conducted, considering symptom-specificity, within-person analyses, and multiple parameters of cortisol regulation, before final conclusions are drawn.
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Affiliation(s)
- Jeff Kiesner
- Department of Psychology, Università Degli Studi di Padova, Italy.
| | - Douglas A Granger
- Institute for Interdisciplinary Salivary Bioscience Research (IISBR), Arizona State University, United States; Johns Hopkins University School of Nursing, Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University School of Medicine, United States
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Ryu A, Kim TH. Premenstrual syndrome: A mini review. Maturitas 2015; 82:436-40. [DOI: 10.1016/j.maturitas.2015.08.010] [Citation(s) in RCA: 74] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2015] [Revised: 08/10/2015] [Accepted: 08/21/2015] [Indexed: 02/06/2023]
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Abstract
Recently designated as a disorder in the DSM-5, premenstrual dysphoric disorder (PMDD) presents an array of avenues for further research. PMDD's profile, characterized by cognitive-affective symptoms during the premenstruum, is unique from that of other affective disorders in its symptoms and cyclicity. Neurosteroids may be a key contributor to PMDD's clinical presentation and etiology, and represent a potential avenue for drug development. This review will present recent literature on potential contributors to PMDD's pathophysiology, including neurosteroids and stress, and explore potential treatment targets.
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Affiliation(s)
- Liisa Hantsoo
- Department of Psychiatry, Penn Center for Women's Behavioral Wellness, 3535 Market Street, 3rd Floor, Philadelphia, PA, 19104, USA.
| | - C. Neill Epperson
- Department of Psychiatry, Penn Center for Women's Behavioral Wellness, 3535 Market Street, 3rd Floor, Philadelphia, PA 19104, USA
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Janda C, Kues JN, Kleinstäuber M, Weise C. Wie kann man den Umgang mit prämenstruellen Symptomen verändern? Ein modularisiertes Behandlungsprogramm. VERHALTENSTHERAPIE 2015. [DOI: 10.1159/000439336] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
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Barth C, Villringer A, Sacher J. Sex hormones affect neurotransmitters and shape the adult female brain during hormonal transition periods. Front Neurosci 2015; 9:37. [PMID: 25750611 PMCID: PMC4335177 DOI: 10.3389/fnins.2015.00037] [Citation(s) in RCA: 368] [Impact Index Per Article: 40.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2014] [Accepted: 01/26/2015] [Indexed: 12/21/2022] Open
Abstract
Sex hormones have been implicated in neurite outgrowth, synaptogenesis, dendritic branching, myelination and other important mechanisms of neural plasticity. Here we review the evidence from animal experiments and human studies reporting interactions between sex hormones and the dominant neurotransmitters, such as serotonin, dopamine, GABA and glutamate. We provide an overview of accumulating data during physiological and pathological conditions and discuss currently conceptualized theories on how sex hormones potentially trigger neuroplasticity changes through these four neurochemical systems. Many brain regions have been demonstrated to express high densities for estrogen- and progesterone receptors, such as the amygdala, the hypothalamus, and the hippocampus. As the hippocampus is of particular relevance in the context of mediating structural plasticity in the adult brain, we put particular emphasis on what evidence could be gathered thus far that links differences in behavior, neurochemical patterns and hippocampal structure to a changing hormonal environment. Finally, we discuss how physiologically occurring hormonal transition periods in humans can be used to model how changes in sex hormones influence functional connectivity, neurotransmission and brain structure in vivo.
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Affiliation(s)
- Claudia Barth
- Department of Neurology, Max Planck Institute for Human Cognitive and Brain Sciences Leipzig, Germany
| | - Arno Villringer
- Department of Neurology, Max Planck Institute for Human Cognitive and Brain Sciences Leipzig, Germany ; Clinic of Cognitive Neurology, University of Leipzig Leipzig, Germany ; Leipzig Research Center for Civilization Diseases, University of Leipzig Leipzig, Germany ; Integrated Research and Treatment Center Adiposity Diseases, University of Leipzig Leipzig, Germany ; Berlin School of Mind and Brain, Mind and Brain Institute Berlin, Germany
| | - Julia Sacher
- Department of Neurology, Max Planck Institute for Human Cognitive and Brain Sciences Leipzig, Germany ; Clinic of Cognitive Neurology, University of Leipzig Leipzig, Germany
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Soydas EA, Albayrak Y, Sahin B. Increased childhood abuse in patients with premenstrual dysphoric disorder in a Turkish sample: a cross-sectional study. Prim Care Companion CNS Disord 2015; 16:14m01647. [PMID: 25664213 DOI: 10.4088/pcc.14m01647] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2014] [Accepted: 04/11/2014] [Indexed: 10/25/2022] Open
Abstract
OBJECTIVE Abuse is considered to have a place in the etiology of various psychiatric disorders. Premenstrual dysphoric disorder (PMDD) is one of the psychiatric disorders for which abuse could be an etiologic factor; however, few studies have investigated the relationship between abuse and PMDD. In this study, our aim was to investigate childhood abuse in patients with PMDD and compare them with healthy female subjects. METHOD This cross-sectional study included 70 women with PMDD (DSM-IV-TR criteria) who were admitted to the outpatient psychiatry clinic of Ankara Yenimahalle State Hospital, Ankara, Turkey, between December 2012 and December 2013. Additionally, 78 healthy controls were included in the study. Sociodemographic, familial, and reproductive period characteristics of the women were recorded. All subjects were administered the Premenstrual Syndrome Scale (PMSS) and the Childhood Trauma Questionnaire (CTQ). RESULTS Among the sociodemographic characteristics, being a university graduate (76.9%) and being a public servant (70.5%) were significantly higher in the healthy control group (P = .01 and P = .01, respectively). A family history of PMDD (31.4%), a history of postpartum psychiatric disorders (11.4%), and a history of attempted suicide (7.1%) were higher in the PMDD group compared with the healthy control group (P = .001, P = .003, and P = .024, respectively). Significant differences were also found between PMDD and healthy controls in PMSS score (P ≤ .001), CTQ total scores (P = .002), and subscale scores including emotional abuse and emotional neglect (P = .004), physical abuse (P = .009), and sexual abuse (P = .012). CONCLUSIONS To our knowledge, the present study is the first to investigate associations between PMDD and childhood abuse from Turkey. More comprehensive studies on this topic with larger sample sizes are required to enrich the literature and enable practitioners to be more effective in clinical practice.
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Affiliation(s)
- Esra Akyol Soydas
- Department of Psychiatry, Yenimahalle State Hospital, Ankara (Dr Soydas); Department of Psychiatry, Namik Kemal University, Tekirdag (Dr Albayrak); and Department of Psychiatry, Canakkale State Hospital, Canakkale (Dr Sahin), Turkey
| | - Yakup Albayrak
- Department of Psychiatry, Yenimahalle State Hospital, Ankara (Dr Soydas); Department of Psychiatry, Namik Kemal University, Tekirdag (Dr Albayrak); and Department of Psychiatry, Canakkale State Hospital, Canakkale (Dr Sahin), Turkey
| | - Basak Sahin
- Department of Psychiatry, Yenimahalle State Hospital, Ankara (Dr Soydas); Department of Psychiatry, Namik Kemal University, Tekirdag (Dr Albayrak); and Department of Psychiatry, Canakkale State Hospital, Canakkale (Dr Sahin), Turkey
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Smith SB, Reenilä I, Männistö PT, Slade GD, Maixner W, Diatchenko L, Nackley AG. Epistasis between polymorphisms in COMT, ESR1, and GCH1 influences COMT enzyme activity and pain. Pain 2014; 155:2390-9. [PMID: 25218601 DOI: 10.1016/j.pain.2014.09.009] [Citation(s) in RCA: 55] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2014] [Revised: 07/29/2014] [Accepted: 09/04/2014] [Indexed: 01/19/2023]
Abstract
Abnormalities in the enzymatic activity of catechol-O-methyltransferase (COMT) contribute to chronic pain conditions, such as temporomandibular disorders (TMD). Thus, we sought to determine the effects of polymorphisms in COMT and functionally related pain genes in the COMT pathway (estrogen receptor 1 [ESR1], guanosine-5-triphosphate cyclohydrolase 1 [GCH1], methylenetetrahydrofolate reductase [MTHFR]) on COMT enzymatic activity, musculoskeletal pain, and pain-related intermediate phenotypes among TMD cases and healthy control subjects. Results show that the COMT rs4680 (val(158)met) polymorphism is most strongly associated with outcome measures, such that individuals with the minor A allele (met) exhibit reduced COMT activity, increased TMD risk, and increased musculoskeletal pain. Epistatic interactions were observed between the COMT rs4680 polymorphism and polymorphisms in GCH1 and ESR1. Among individuals with the COMT met allele, those with 2 copies of the GCH1 rs10483639 minor G allele exhibit normalized COMT activity and increased mechanical pain thresholds. Among individuals with the COMT val allele, those with 2 copies of the ESR1 rs3020377 minor A allele exhibit reduced COMT activity, increased bodily pain, and poorer self-reported health. These data reveal that the GCH1 minor G allele confers a protective advantage among met carriers, whereas the ESR1 minor A allele is disadvantageous among val carriers. Furthermore, these data suggest that the ability to predict the downstream effects of genetic variation on COMT activity is critically important to understanding the molecular basis of chronic pain conditions.
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Affiliation(s)
- Shad B Smith
- Center for Pain Research and Innovation, School of Dentistry, University of North Carolina, Chapel Hill, NC, USA
| | - Ilkka Reenilä
- Division of Pharmacology and Toxicology, University of Helsinki, Helsinki, Finland
| | - Pekka T Männistö
- Division of Pharmacology and Toxicology, University of Helsinki, Helsinki, Finland
| | - Gary D Slade
- Center for Pain Research and Innovation, School of Dentistry, University of North Carolina, Chapel Hill, NC, USA
| | - William Maixner
- Center for Pain Research and Innovation, School of Dentistry, University of North Carolina, Chapel Hill, NC, USA
| | - Luda Diatchenko
- Center for Pain Research and Innovation, School of Dentistry, University of North Carolina, Chapel Hill, NC, USA; Alan Edwards Pain Centre For Research on Pain, McGill University, Montreal, Canada
| | - Andrea G Nackley
- Center for Pain Research and Innovation, School of Dentistry, University of North Carolina, Chapel Hill, NC, USA.
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Allopregnanolone as a mediator of affective switching in reproductive mood disorders. Psychopharmacology (Berl) 2014; 231:3557-67. [PMID: 24846476 PMCID: PMC4135022 DOI: 10.1007/s00213-014-3599-x] [Citation(s) in RCA: 68] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/18/2013] [Accepted: 04/14/2014] [Indexed: 01/15/2023]
Abstract
RATIONALE Reproductive mood disorders, including premenstrual dysphoria (PMD) and postpartum depression (PPD), are characterized by affective dysregulation that occurs during specific reproductive states. The occurrence of illness onset during changes in reproductive endocrine function has generated interest in the role of gonadal steroids in the pathophysiology of reproductive mood disorders, yet the mechanisms by which the changing hormone milieu triggers depression in susceptible women remain poorly understood. OBJECTIVES This review focuses on one of the neurosteroid metabolites of progesterone - allopregnanolone (ALLO) - that acutely regulates neuronal function and may mediate affective dysregulation that occurs concomitant with changes in reproductive endocrine function. We describe the role of the "neuroactive" steroids estradiol and progesterone in reproductive endocrine-related mood disorders to highlight the potential mechanisms by which ALLO might contribute to their pathophysiology. Finally, using existing data, we test the hypothesis that changes in ALLO levels may trigger affective dysregulation in susceptible women. RESULTS Although there is no reliable evidence that basal ALLO levels distinguish those with PMD or PPD from those without, existing animal models suggest potential mechanisms by which specific reproductive states may unmask susceptibility to affective dysregulation. Consistent with these models, initially euthymic women with PMD and those with a history of PPD show a negative association between depressive symptoms and circulating ALLO levels following progesterone administration. CONCLUSIONS Existing animal models and our own preliminary data suggest that ALLO may play an important role in the pathophysiology of reproductive mood disorders by triggering affective dysregulation in susceptible women.
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Gillings MR. Were there evolutionary advantages to premenstrual syndrome? Evol Appl 2014; 7:897-904. [PMID: 25469168 PMCID: PMC4211719 DOI: 10.1111/eva.12190] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2014] [Accepted: 07/01/2014] [Indexed: 01/24/2023] Open
Abstract
Premenstrual syndrome (PMS) affects up to 80% of women, often leading to significant personal, social and economic costs. When apparently maladaptive states are widespread, they sometimes confer a hidden advantage, or did so in our evolutionary past. We suggest that PMS had a selective advantage because it increased the chance that infertile pair bonds would dissolve, thus improving the reproductive outcomes of women in such partnerships. We confirm predictions arising from the hypothesis: PMS has high heritability; gene variants associated with PMS can be identified; animosity exhibited during PMS is preferentially directed at current partners; and behaviours exhibited during PMS may increase the chance of finding a new partner. Under this view, the prevalence of PMS might result from genes and behaviours that are adaptive in some societies, but are potentially less appropriate in modern cultures. Understanding this evolutionary mismatch might help depathologize PMS, and suggests solutions, including the choice to use cycle-stopping contraception.
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Affiliation(s)
- Michael R Gillings
- Department of Biological Sciences, Macquarie University Sydney, NSW, Australia
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Deveci EO, Incebiyik A, Selek S, Camuzcuoglu A, Hilali NG, Camuzcuoglu H, Erdal ME, Vural M. Is catechol-o-methyltransferase gene polymorphism a risk factor in the development of premenstrual syndrome? Clin Exp Reprod Med 2014; 41:62-7. [PMID: 25045629 PMCID: PMC4102691 DOI: 10.5653/cerm.2014.41.2.62] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2014] [Revised: 05/20/2014] [Accepted: 05/21/2014] [Indexed: 11/23/2022] Open
Abstract
Objective The objective of this study was to investigate whether there was a correlation between catechol-o-methyltransferase (COMT) gene polymorphism, which is believed to play a role in the etiology of psychotic disorders, and premenstrual syndrome (PMS). Methods Fifty-three women with regular menstrual cycles, aged between 18 and 46 years and diagnosed with PMS according to the American Congress of Obstetrics and Gynecology criteria were included in this study as the study group, and 53 healthy women having no health problems were selected as the controls. Venous blood was collected from all patients included in the study and kept at -18℃ prior to analysis. Results There was no significant difference between the groups in terms of demographic features such as age, body mass index, number of pregnancies, parity, and number of children. No statistically significant difference was observed in terms of COMT gene polymorphism (p=0.61) between women in the PMS and the control groups. However, a significant difference was found between arthralgia, which is an indicator of PMS, and low-enzyme activity COMT gene (Met/Met) polymorphism (p=0.04). Conclusion These results suggested that there was no significant relationship between PMS and COMT gene polymorphism. Since we could not find a direct correlation between the COMT gene polymorphism and PMS, further studies including alternative neurotransmitter pathways are needed to find an effective treatment for this disease.
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Affiliation(s)
- Esma Ozturk Deveci
- Department of Gynecology and Obstetrics, Faculty of Medicine, Harran University, Sanliurfa, Turkey
| | - Adnan Incebiyik
- Department of Gynecology and Obstetrics, Faculty of Medicine, Harran University, Sanliurfa, Turkey
| | - Salih Selek
- Psychiatry Department, Faculty of Medicine, Istanbul Medeniyet University, Istanbul, Turkey
| | - Aysun Camuzcuoglu
- Department of Gynecology and Obstetrics, Faculty of Medicine, Harran University, Sanliurfa, Turkey
| | - Nese Gul Hilali
- Department of Gynecology and Obstetrics, Faculty of Medicine, Harran University, Sanliurfa, Turkey
| | - Hakan Camuzcuoglu
- Department of Gynecology and Obstetrics, Faculty of Medicine, Harran University, Sanliurfa, Turkey
| | - Mehmet Emin Erdal
- Medical Faculty, Department of Medical Biology and Genetics, Mersin University, Mersin, Turkey
| | - Mehmet Vural
- Department of Gynecology and Obstetrics, Faculty of Medicine, Harran University, Sanliurfa, Turkey
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Abstract
Microglia, the resident innate immune cells in the brain, have long been understood to be crucial to maintenance in the nervous system, by clearing debris, monitoring for infiltration of infectious agents, and mediating the brain's inflammatory and repair response to traumatic injury, stroke, or neurodegeneration. A wave of new research has shown that microglia are also active players in many basic processes in the healthy brain, including cell proliferation, synaptic connectivity, and physiology. Microglia, both in their capacity as phagocytic cells and via secretion of many neuroactive molecules, including cytokines and growth factors, play a central role in early brain development, including sexual differentiation of the brain. In this review, we present the vast roles microglia play in normal brain development and how perturbations in the normal neuroimmune environment during development may contribute to the etiology of brain-based disorders. There are notable differences between microglia and neuroimmune signaling in the male and female brain throughout the life span, and these differences may contribute to the vast differences in the incidence of neuropsychiatric and neurological disorders between males and females.
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Affiliation(s)
- Kathryn M Lenz
- Department of Psychology and Department of Neuroscience, The Ohio State University, Columbus, OH, USA
| | - Margaret M McCarthy
- Department of Pharmacology and Program in Neuroscience, The University of Maryland School of Medicine, Baltimore, MD, USA
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