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Jaafar K, Nabhan E, Daoud R, Nasser Z. Prevalence of anxiety and depression among Lebanese women using oral contraceptives: a cross-sectional study. BMC Womens Health 2024; 24:47. [PMID: 38233890 PMCID: PMC10795317 DOI: 10.1186/s12905-024-02897-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2023] [Accepted: 01/10/2024] [Indexed: 01/19/2024] Open
Abstract
BACKGROUND Oral contraceptives (OCs) are used worldwide, including Lebanese women. However, the association between OCs use and anxiety or depression remains unclear. This study aims to assess the prevalence of anxiety and depression among Lebanese women using oral contraceptive pills and investigate the differential impact of combined oral contraceptives (COCs) versus progestogen-only pills (POPs) on mental health outcomes. METHODS A cross-sectional study was conducted among a sample of Lebanese women using OCs between January and March 2023. Nine hundred nighty seven out of the 2051 women who took part in the survey met our criteria and were included in this study. Data on anxiety and depression were collected using validated and reliable scales, the Arabic versions of the Generalized Anxiety Disorder-7 Questionnaire (GAD-7) and the Patient Health Questionnaire-9 (PHQ-9). Statistical analyses, including multivariate analysis, were performed to assess the association between OCs type (COC vs. POP) and anxiety/depression. RESULTS The prevalence of anxiety and depression among Lebanese women taking OCs was found to be 39.9% and 64.3%, respectively. Furthermore, the study revealed that POP users had 2.8 times higher odds of developing anxiety (adjusted odds ratio ORadj = 2.8 with 95% confidence interval CI of 1.770 to 4.435) p-value < 0.001 and 9.2 times higher odds of developing depression (adjusted odds ratio ORadj = 9.2 with 95% confidence interval CI of 5.790 to 14.506) p-value < 0.001 compared to COC users. CONCLUSION The results of this study shed light on the elevated prevalence of anxiety and depression among Lebanese women using OCs and emphasized the varying effects of COCs and POPs on their mental health outcomes. Further research is needed to comprehensively understand this association, considering both the dosage and specific type of oral contraceptive to improve the overall well-being of women using these contraceptives.
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Affiliation(s)
- Kamel Jaafar
- Faculty of Medical Sciences, Department of Obstetrics and Gynecology, Lebanese University, Hadath, Lebanon.
- Neurosciences Research Center, Lebanese University, Hadath, Lebanon.
| | - Elias Nabhan
- Neurosciences Research Center, Lebanese University, Hadath, Lebanon
- Faculty of Medical Sciences, Department of Internal Medicine, Cardiology Division, University of Balamand, Beirut, Lebanon
| | - Rama Daoud
- Faculty of Medical Sciences, Lebanese University, Hadath, Lebanon
| | - Zeina Nasser
- Faculty of Medical Sciences, Neurosciences Research Center, Lebanese University, Hadath, Lebanon
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2
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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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3
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Marecki R, Kałuska J, Kolanek A, Hakało D, Waszkiewicz N. Zuranolone - synthetic neurosteroid in treatment of mental disorders: narrative review. Front Psychiatry 2023; 14:1298359. [PMID: 38116383 PMCID: PMC10729607 DOI: 10.3389/fpsyt.2023.1298359] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/21/2023] [Accepted: 11/13/2023] [Indexed: 12/21/2023] Open
Abstract
With each passing year, the number of people suffering from mental disorders grows at a disturbing speed. Neuroactive steroids are a new promising group of drugs with the potential for use in many diseases like postpartum depression, postnatal psychosis, major depression, insomnia, bipolar disorder, and Parkinson's tremor, due to their ability to modulate the activity of GABAA receptor. Neurosteroids are progesterone metabolites that are synthesized from cholesterol or steroid hormones in various brain regions. They regulate neuronal development, regeneration, and neurotransmission. They are implicated in mood disorders, anxiety disorders, schizophrenia, PTSD, and impulsive aggression. Neurosteroids have been studied for their potential to prevent or treat neurodegenerative diseases such as Alzheimer's disease and HIV-associated dementia. They can promote neurogenesis, neuronal survival, myelination, and memory function. They can also affect the growth and sensitivity of hormone-dependent brain tumors such as gliomas. Zuranolone, a newly registered neurosteroid drug has shown huge flexibility in both clinical and ambulatory treatment thanks to its pharmacokinetic traits, especially the possibility for oral administration, unlike its predecessor Brexanolone. Zuranolone is a synthetic positive allosteric modulator of the GABAA receptor that can be taken orally. The review aims to summarize the current knowledge on zuranolone as a novel neurosteroid drug for various mental disorders, especially for postpartum mental disorders for which this drug was meant originally. It covers studies indexed in the PubMed, Scopus, and Web of Science databases published since 2017. Keywords used in the search, as well as inclusion and exclusion criteria, are given in the aims and methodology section. The review explains the evidence for the role of neurosteroids, especially allopregnanolone, in the pathophysiology and treatment of postpartum depression. It discusses the mechanisms of neurosteroid action, the changes in neurosteroid levels during pregnancy and postpartum, and the clinical trials of brexanolone and zuranolone, two synthetic analogs of allopregnanolone, for postpartum depression. It provides an overview of the biosynthesis and metabolism of neurosteroids in the central and peripheral nervous system. Furthermore, it explains the different sources and pathways of neurosteroid production and the factors that influence their synthesis and regulation, such as stress, hormones, drugs, and genetic variations. The review also explores the potential relevance of neurosteroids for other psychiatric disorders, such as major depression, bipolar disorder, post-traumatic stress disorder (PTSD), schizophrenia, and premenstrual dysphoric disorder. Finally, it highlights the associations between neurosteroid levels and symptom severity and the effects of neurosteroid modulation on mood, cognition, and neuroplasticity.
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4
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Gutiérrez-Rodelo C, Ochoa-López A, Luis Balderas-López J, Reyes-Ramírez A, Millán-Pacheco C, Favela-Rosales F, Navarrete A. "Eritadenine as a regulator of anxiety Disorders: An experimental and docking Approach". Neurosci Lett 2023; 813:137413. [PMID: 37541318 DOI: 10.1016/j.neulet.2023.137413] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2023] [Revised: 06/15/2023] [Accepted: 07/30/2023] [Indexed: 08/06/2023]
Abstract
Uncertainty persists regarding the specific chemical causal factors and their corresponding behavioral effects in anxiety disorders. Commonly employed first-line treatments for anxiety target G protein-coupled receptors (GPCRs), including inhibitors of monoaminergic systems. Alternatively, emerging natural bioactive strategies offer potential for mitigating adverse effects. Recent investigations have implicated adenosine in anxiety-triggering mechanisms, while eritadenine, an adenosine analog derived from Shiitake mushroom, has displayed promising attributes. This study explores eritadenine's potential as a bioactive substance for anxiety disorders in mice, employing behavioral tests, pentobarbital-sleep induction, and molecular docking. Behavioral test results reveal a pronounced anxiolytic and sedative-hypnotic pharmacological effect of eritadenine. Our findings suggest that eritadenine may modulate locomotor functions mediated by adenosine receptors, with a stronger affinity for binding to A2AAR over A1AR, thus eliciting these effects.
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Affiliation(s)
- Citlaly Gutiérrez-Rodelo
- Departamento de Farmacia, Facultad de Química, Universidad Nacional Autónoma de México, Ciudad Universitaria, Coyoacán, Ciudad de México 04510, México.
| | - Aurora Ochoa-López
- Departamento de Farmacia, Facultad de Química, Universidad Nacional Autónoma de México, Ciudad Universitaria, Coyoacán, Ciudad de México 04510, México
| | - José Luis Balderas-López
- Departamento de Farmacia, Facultad de Química, Universidad Nacional Autónoma de México, Ciudad Universitaria, Coyoacán, Ciudad de México 04510, México
| | - Adelfo Reyes-Ramírez
- Unidad Multidisciplinaria de Investigación Experimental, Facultad de Estudios Superiores Zaragoza, Universidad Nacional Autónoma de México, Batalla 5 de mayo s/n esquina Fuerte de Loreto, Ejército de Oriente, Iztapalapa, Ciudad de México 09230, México
| | - Cesar Millán-Pacheco
- Facultad de Farmacia. Universidad Autónoma del Estado de Morelos, Cuernavaca Mor. C.P. 62209, México
| | - Fernando Favela-Rosales
- Departamento de Ciencias Básicas, Tecnológico Nacional de México - ITS Zacatecas Occidente, Sombrerete, Zacatecas 99102, México
| | - Andrés Navarrete
- Departamento de Farmacia, Facultad de Química, Universidad Nacional Autónoma de México, Ciudad Universitaria, Coyoacán, Ciudad de México 04510, México.
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5
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Valencia-Cifuentes V, Cañas CA, Rivas JC. Major depression associated with a levonorgestrel-releasing intrauterine system mimicking frontotemporal dementia: a case report. Front Psychiatry 2023; 14:1266419. [PMID: 37779626 PMCID: PMC10535084 DOI: 10.3389/fpsyt.2023.1266419] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/24/2023] [Accepted: 08/28/2023] [Indexed: 10/03/2023] Open
Abstract
This case illustrates the adverse cognitive and affective effects associated with the use of an intrauterine hormonal contraceptive, which could be confused with symptoms of early onset dementia. We present a case of a 42-year-old woman diagnosed with seronegative spondyloarthropathy who subsequently developed anxiety and depressive symptoms after the implantation of a Levonorgestrel-Releasing Intrauterine System (LNG-IUS). Three years later, she began to experience memory and attentional failures, refractory pain, and severe depression. The progression of psychiatric symptoms led to a diagnosis of bipolar affective disorder and treatment with antidepressants and anxiolytics. Due to cognitive and psychiatric symptoms, autoimmune encephalitis was considered, but no improvement was shown with treatment. Early onset dementia was suspected, and a brain PET scan revealed frontal lobe hypometabolism. An adverse effect of LNG-IUS was considered; after its removal, mood and cognitive function improvements were observed. This case report emphasizes the importance of considering organic causes of unexplained psychiatric manifestations and highlights the potential impact of hormonal interventions on mental health.
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Affiliation(s)
- Valeria Valencia-Cifuentes
- Department of Neurology, Fundación Valle del Lili, Cali, Colombia
- Facultad de Ciencias de la Salud, Universidad Icesi, Cali, Colombia
| | - Carlos A. Cañas
- Facultad de Ciencias de la Salud, Universidad Icesi, Cali, Colombia
- Universidad ICESI, CIRAT: Centro de Investigación en Reumatología, Autoinmunidad y Medicina Traslacional, Cali, Colombia
- Department of Rheumatology, Fundación Valle del Lili, Cali, Colombia
| | - Juan Carlos Rivas
- Facultad de Ciencias de la Salud, Universidad Icesi, Cali, Colombia
- Department of Psychiatry, Fundación Valle del Lili, Cali, Colombia
- Department of Psychiatry, Universidad del Valle, Cali, Colombia
- Hospital Departamental Psiquiátrico, Universitario del Valle, Cali, Colombia
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6
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Beech EL, Riddell N, Murphy MJ, Crewther SG. Sex and stress hormone dysregulation as clinical manifestations of hypothalamic function in migraine disorder: A meta-analysis. Eur J Neurosci 2023; 58:3150-3171. [PMID: 37452646 DOI: 10.1111/ejn.16087] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2022] [Revised: 06/24/2023] [Accepted: 06/28/2023] [Indexed: 07/18/2023]
Abstract
Migraine is a leading cause of disability in young adults. It occurs more frequently in females, often comorbidly with stress disorders, suggesting an association with hypothalamic sex and stress hormonal function and a likely interaction with autonomic nervous system activation. Thus, this study aimed to meta-analyse current literature pertaining to female and male sex hormones (estrogen, progesterone and testosterone concentration), hypothalamic-pituitary-adrenal axis (HPA axis) cortisol responses and heart rate variability (HRV) in migraineurs and controls aged 13-65 years. A systematic search of MEDLINE, Embase, PsycINFO, PubMed, CINAHL and Web of Science databases on 29/08/2022 identified 29 studies for meta-analysis (encompassing 719 migraineur and 592 control participants) that met inclusion and NHLBI risk of bias criteria. Results demonstrated that estrogen concentrations of female migraineurs were reduced (g = -.60, 95% CI [-.91, -.29], p < .001) in the luteal phase of the menstrual cycle, compared to controls. No differences were found in progesterone levels overall in female migraineurs, nor in testosterone levels in male migraineurs compared to controls. Further, early diurnal cortisol concentrations were elevated (g = .32, 95% CI [.00, .63], p = .036) in female and male migraineurs compared to controls, though no differences were found in HRV of female or male migraineurs compared to controls. These findings of dysregulation of estrogen in females and cortisol dysregulation in female and male migraineurs indicate perturbed hypothalamic function and highlight the association of migraine with stress and the need for further rigorous investigation of hypothalamic neuroendocrine functions in migraineurs of both sexes.
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Affiliation(s)
- Erin L Beech
- Department of Psychology, Counselling and Therapy, La Trobe University, Melbourne, Australia
| | - Nina Riddell
- Department of Psychology, Counselling and Therapy, La Trobe University, Melbourne, Australia
| | - Melanie J Murphy
- Department of Psychology, Counselling and Therapy, La Trobe University, Melbourne, Australia
| | - Sheila G Crewther
- Department of Psychology, Counselling and Therapy, La Trobe University, Melbourne, Australia
- Centre for Mental Health and Brain Sciences, Swinburne University of Technology, Melbourne, Australia
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7
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Bäckström T, Bengtsson SKS, Sjöstedt J, Malinina E, Johansson M, Ragagnin G, Ekberg K, Lundgren P. Isoallopregnanolone Inhibits Estrus Cycle-Dependent Aggressive Behavior. Biomolecules 2023; 13:1017. [PMID: 37371597 DOI: 10.3390/biom13061017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2023] [Revised: 06/11/2023] [Accepted: 06/15/2023] [Indexed: 06/29/2023] Open
Abstract
Among female rats, some individuals show estrus cycle-dependent irritability/aggressive behaviors, and these individual rats may be used as a model for premenstrual dysphoric disorder (PMDD). We wanted to investigate if these behaviors are related to the estrus cycle phase containing moderately increased levels of positive GABA-A receptor-modulating steroids (steroid-PAM), especially allopregnanolone (ALLO), and if the adverse behavior can be antagonized. The electrophysiology studies in this paper show that isoallopregnanolone (ISO) is a GABA-A-modulating steroid antagonist (GAMSA), meaning that ISO can antagonize the agonistic effects of positive GABA-A receptor-modulating steroids in both α1β2γ2L and α4β3δ GABA-A receptor subtypes. In this study, we also investigated whether ISO could antagonize the estrus cycle-dependent aggressive behaviors in female Wistar rats using a resident-intruder test. Our results confirmed previous reports of estrus cycle-dependent behaviors in that 42% of the tested rats showed higher levels of irritability/aggression at diestrus compared to those at estrus. Furthermore, we found that, during the treatment with ISO, the aggressive behavior at diestrus was alleviated to a level comparable to that of estrus. We noticed an 89% reduction in the increase in aggressive behavior at diestrus compared to that at estrus. Vehicle treatment in the same animals showed a minimal effect on the diestrus-related aggressive behavior. In conclusion, we showed that ISO can antagonize Steroid-PAM both in α1β2γ2L and α4β3δ GABA-A receptor subtypes and inhibit estrus cycle-dependent aggressive behavior.
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Affiliation(s)
- Torbjörn Bäckström
- Umeå Neurosteroid Research Center, Department of Clinical Science, Umeå University, SE-901 85 Umea, Sweden
| | - Sara K S Bengtsson
- Umeå Neurosteroid Research Center, Department of Clinical Science, Umeå University, SE-901 85 Umea, Sweden
| | - Jessica Sjöstedt
- Umeå Neurosteroid Research Center, Department of Clinical Science, Umeå University, SE-901 85 Umea, Sweden
| | - Evgenya Malinina
- Umeå Neurosteroid Research Center, Department of Clinical Science, Umeå University, SE-901 85 Umea, Sweden
| | - Maja Johansson
- Umeå Neurosteroid Research Center, Department of Clinical Science, Umeå University, SE-901 85 Umea, Sweden
| | - Gianna Ragagnin
- Umeå Neurosteroid Research Center, Department of Clinical Science, Umeå University, SE-901 85 Umea, Sweden
| | - Karin Ekberg
- Asarina Pharma AB, Fogdevreten 2, SE-171 65 Solna, Sweden
| | - Per Lundgren
- Umeå Neurosteroid Research Center, Department of Clinical Science, Umeå University, SE-901 85 Umea, Sweden
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8
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Rudzinskas SA, Mazzu MA, Schiller CE, Meltzer-Brody S, Rubinow DR, Schmidt PJ, Goldman D. Divergent Transcriptomic Effects of Allopregnanolone in Postpartum Depression. Genes (Basel) 2023; 14:1234. [PMID: 37372414 DOI: 10.3390/genes14061234] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2023] [Revised: 06/01/2023] [Accepted: 06/02/2023] [Indexed: 06/29/2023] Open
Abstract
Brexanolone, a formulation of the neurosteroid allopregnanolone (ALLO), is approved for treating postpartum depression (PPD) and is being investigated for therapeutic efficacy across numerous neuropsychiatric disorders. Given ALLO's beneficial effects on mood in women with PPD compared to healthy control women, we sought to characterize and compare the cellular response to ALLO in women with (n = 9) or without (n = 10, i.e., Controls) past PPD, utilizing our previously established patient-derived lymphoblastoid cell lines (LCLs). To mimic in vivo PPD ALLO-treatment, LCLs were exposed to ALLO or DMSO vehicle for 60 h and RNA-sequenced to detect differentially expressed genes (DEGs, pnominal < 0.05). Between ALLO-treated Control and PPD LCLs, 269 DEGs were identified, including Glutamate Decarboxylase 1 (GAD1), which was decreased 2-fold in PPD. Network analysis of PPD:ALLO DEGs revealed enriched terms related to synaptic activity and cholesterol biosynthesis. Within-diagnosis analyses (i.e., DMSO vs. ALLO) detected 265 ALLO-induced DEGs in Control LCLs compared to only 98 within PPD LCLs, with just 11 DEGs overlapping. Likewise, the gene ontologies underlying ALLO-induced DEGs in PPD and Control LCLs were divergent. These data suggest that ALLO may activate unique and opposing molecular pathways in women with PPD, which may be tied to its antidepressant mechanism.
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Affiliation(s)
- Sarah A Rudzinskas
- Behavioral Endocrinology Branch, National Institute of Mental Health (NIMH), NIH, 10 Center Drive MSC 1277, Bethesda, MD 20892, USA
- Laboratory of Neurogenetics, National Institute on Alcohol Abuse and Alcoholism (NIAAA), NIH, Rockville, MD 20855, USA
| | - Maria A Mazzu
- Behavioral Endocrinology Branch, National Institute of Mental Health (NIMH), NIH, 10 Center Drive MSC 1277, Bethesda, MD 20892, USA
- Laboratory of Neurogenetics, National Institute on Alcohol Abuse and Alcoholism (NIAAA), NIH, Rockville, MD 20855, USA
| | | | | | - David R Rubinow
- Department of Psychiatry, University of North Carolina, Chapel Hill, NC 27599, USA
| | - Peter J Schmidt
- Behavioral Endocrinology Branch, National Institute of Mental Health (NIMH), NIH, 10 Center Drive MSC 1277, Bethesda, MD 20892, USA
| | - David Goldman
- Laboratory of Neurogenetics, National Institute on Alcohol Abuse and Alcoholism (NIAAA), NIH, Rockville, MD 20855, USA
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9
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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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Zhang H, Gao Z, Sun Y, Lu T, Wang Z, Gao D, Wang J, Qiao M, Gao M. Profiling GABA(A) Receptor Subunit Expression in the Hippocampus of PMDD Rat Models Based on TCM Theories. Mol Neurobiol 2023:10.1007/s12035-023-03354-3. [PMID: 37103685 DOI: 10.1007/s12035-023-03354-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2022] [Accepted: 04/15/2023] [Indexed: 04/28/2023]
Abstract
γ-Aminobutyric acid type A receptors (GABAARs) play an important role in cognitive and emotional regulation and are related to the hippocampus. However, little is known regarding patterns of hippocampal GABAAR subunit expression in rat models of premenstrual dysphoric disorder (PMDD). This study investigated the above changes by establishing two PMDD rat models based on Traditional Chinese Medicine (TCM) theories, namely, PMDD liver-qi invasion syndrome (PMDD-LIS) and PMDD liver-qi depression syndrome (PMDD-LDS). Behavioral tests were used to detect depression and irritability emotion. Western blot analysis was used to investigate protein levels of GABAAR α1, α2, α4, α5, β2, β3, and δ subunits, whereas ultra-high performance liquid chromatography-tandem mass spectrometry (UHPLC-MS/MS) analysis was performed to determine gamma-aminobutyric acid (GABA) and glutamate (Glu) levels in the hippocampus across each group. Concurrently, behavioral data indicated that the PMDD-LDS and PMDD-LIS rat models had been successfully established. GABAAR α2, α5, β2, and δ subunit was significantly upregulated, whereas α4 was significantly downregulated (P < 0.05) in PMDD-LDS rat models relative to controls. On the other hand, GABAAR α1, α2, and β3 were significantly downregulated while α4 and β2 were significantly upregulated in PMDD-LIS rat models relative to the control group (P < 0.05). Moreover, GABA levels significantly decreased, while Glu and the ratio of glutamate to GABA increased in PMDD-LIS rat models (P < 0.05). Conversely, GABA and Glu levels significantly decreased, whereas the ratio of glutamate to GABA increased in PMDD-LIS rat models (P < 0.05). Conclusively, our results revealed differential expression of GABAAR α1, α2, α4, α5, β2, β3, and δ subunits between PMDD-LIS and PMDD-LDS rat models, suggesting that they may be biomarkers in the pathogenesis of PMDD.
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Affiliation(s)
- Hao Zhang
- Experimental Center, Shandong University of Traditional Chinese Medicine, Jinan, Shandong Province, China
| | - Zhan Gao
- College of Traditional Chinese Medicine, Shandong University of Traditional Chinese Medicine, Jinan, Shandong Province, China
| | - Ya Sun
- Innovation Research Institute of Traditional Chinese Medicine, Shandong University of Traditional Chinese Medicine, Jinan, Shandong Province, China
| | - Tian Lu
- International Exchange and Cooperation Office, Shandong University of Traditional Chinese Medicine, Jinan, Shandong Province, China
| | - Zhenzhen Wang
- Qilu Hospital of Shandong University, Jinan, Shandong Province, China
| | - Dongmei Gao
- College of Traditional Chinese Medicine, Shandong University of Traditional Chinese Medicine, Jinan, Shandong Province, China
| | - Jieqiong Wang
- Office of Academic Research, Shandong University of Traditional Chinese Medicine, Jinan , Shandong Province, China
| | - Mingqi Qiao
- College of Traditional Chinese Medicine, Shandong University of Traditional Chinese Medicine, Jinan, Shandong Province, China
| | - Mingzhou Gao
- Innovation Research Institute of Traditional Chinese Medicine, Shandong University of Traditional Chinese Medicine, Jinan, Shandong Province, China.
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11
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Stefaniak M, Dmoch-Gajzlerska E, Jankowska K, Rogowski A, Kajdy A, Maksym RB. Progesterone and Its Metabolites Play a Beneficial Role in Affect Regulation in the Female Brain. Pharmaceuticals (Basel) 2023; 16:ph16040520. [PMID: 37111278 PMCID: PMC10143192 DOI: 10.3390/ph16040520] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2023] [Revised: 03/25/2023] [Accepted: 03/30/2023] [Indexed: 04/03/2023] Open
Abstract
Premenstrual dysphoric disorder is a female affective disorder that is defined by mood symptoms. The condition is linked to unstable progesterone concentrations. Progestin supplementation is given in cases of threatened or recurrent miscarriage and for luteal phase support. Progesterone is essential for implantation, immune tolerance, and modulation of uterine contractility. For a long time, the administration of progestins was associated with an unfavorable impact on mood, leading to negative affect, and, therefore, was contraindicated in existing mood disorders. Establishing the role of the natural progesterone derivative allopregnanolone in advances in the treatment of postpartum depression has shed new light on the general pathophysiology of mood disorders. Allopregnanolone directly interacts with gamma-aminobutyric acid type A (GABA-A) receptors even at nanomolar concentrations and induces significant anti-depressant, anti-stress, sedative, and anxiolytic effects. Postpartum depression is caused by a rapid drop in hormones and can be instantly reversed by the administration of allopregnanolone. Premenstrual dysphoric disorder can also be considered to result from insufficient neuroactive steroid action due to low progesterone derivative concentration, unstable hormone levels, or decreased receptor sensitivity. The decrease in progesterone levels in perimenopause is also associated with affective symptoms and an exacerbation of some psychosomatic syndromes. Bioidentical progesterone supplementation encounters several obstacles, including limited absorption, first-pass effect, and rapid metabolism. Hence, non-bioidentical progestins with better bioavailability were widely applied. The paradoxical, unfavorable effect of progestins on mood can be explained by the fact that progestins suppress ovulation and disturb the endocrine function of the ovary in the luteal phase. Moreover, their distinct chemical structure prevents their metabolism to neuroactive, mood-improving derivatives. A new understanding of progesterone-related mood disorders can translate the study results from case series and observational studies to cohort studies, clinical trials, and novel, effective treatment protocols being developed.
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Affiliation(s)
- Małgorzata Stefaniak
- Department of Obstetrics and Gynecology Didactics, Medical University of Warsaw, ul. Litewska 14/16, 00-575 Warsaw, Poland
| | - Ewa Dmoch-Gajzlerska
- Department of Obstetrics and Gynecology Didactics, Medical University of Warsaw, ul. Litewska 14/16, 00-575 Warsaw, Poland
| | - Katarzyna Jankowska
- Department of Endocrinology, Centre of Postgraduate Medical Education, ul. Cegłowska 80, 01-809 Warsaw, Poland
| | - Artur Rogowski
- Department of Minimally Invasive and Endoscopic Gynecology, Military Institute of Medicine, ul. Zegrzyńska 8, 05-119 Legionowo, Poland
| | - Anna Kajdy
- 1st Department of Obstetrics and Gynecology, Centre of Postgraduate Medical Education, ul. Żelazna 90, 02-004 Warszawa, Poland
| | - Radosław B. Maksym
- 1st Department of Obstetrics and Gynecology, Centre of Postgraduate Medical Education, ul. Żelazna 90, 02-004 Warszawa, Poland
- Correspondence:
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Brambila-Tapia AJL, Macías-Espinoza F, González-Cantero JO, Martínez-Arriaga RJ, Reyes-Domínguez YA, Ramírez-García ML. Sex Differences in Mental Status and Coping Strategies among Adult Mexican Population: A Cross-Sectional Study. Healthcare (Basel) 2023; 11:healthcare11040514. [PMID: 36833048 PMCID: PMC9957381 DOI: 10.3390/healthcare11040514] [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: 12/28/2022] [Revised: 01/24/2023] [Accepted: 02/07/2023] [Indexed: 02/12/2023] Open
Abstract
We performed a cross-sectional study in order to determine the association between stress coping strategies and stress, depression, and anxiety, in which the Mexican population was invited to answer these variables by an electronic questionnaire. A total of 1283 people were included, of which 64.8% were women. Women presented higher levels of stress, depression, and anxiety than men; likewise, women showed a higher frequency of some maladaptive coping strategies (behavioral disengagement and denial) and lower levels of some adaptive ones (active coping and planning); additionally, maladaptive coping strategies were positively correlated with stress and depression in both sexes: self-blame, behavioral disengagement, denial, substance use, and self-distraction. Likewise, there were negative correlations between stress and depression and the adaptive strategies: planning, active coping, acceptance, and positive reframing. For women, religion presented negative correlations with stress, depression, and anxiety, and humor showed low positive correlations with stress, anxiety, and depression. In conclusion, most adaptive and maladaptive coping strategies are common in both sexes with the exception of religion, which seems to be adaptive in women and neutral in men, and humor, which seems to be adaptive in men and maladaptive in women. In addition, emotional and instrumental support seem to be neutral in both sexes.
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Affiliation(s)
- Aniel Jessica Leticia Brambila-Tapia
- Departamento de Psicología Básica, Centro Universitario de Ciencias de la Salud (CUCS), Universidad de Guadalajara, Guadalajara 44340, Jalisco, Mexico
- Correspondence: (A.J.L.B.-T.); (F.M.-E.)
| | - Fabiola Macías-Espinoza
- Departamento de Psicología Aplicada, Centro Universitario de Ciencias de la Salud (CUCS), Universidad de Guadalajara, Guadalajara 44340, Jalisco, Mexico
- Correspondence: (A.J.L.B.-T.); (F.M.-E.)
| | - Joel Omar González-Cantero
- Departamento de Ciencias del Comportamiento, Centro Universitario de los Valles (CUVALLES), Universidad de Guadalajara, Guadalajara 46600, Jalisco, Mexico
| | - Reyna Jazmín Martínez-Arriaga
- Clínicas de Salud Mental, Centro Universitario de Ciencias de la Salud (CUCS), Universidad de Guadalajara, Guadalajara 44340, Jalisco, Mexico
| | - Yesica Arlae Reyes-Domínguez
- Maestría en Psicología de la Salud, Centro Universitario de Ciencias de la Salud (CUCS), Universidad de Guadalajara, Guadalajara 44340, Jalisco, Mexico
| | - María Luisa Ramírez-García
- Maestría en Psicología de la Salud, Centro Universitario de Ciencias de la Salud (CUCS), Universidad de Guadalajara, Guadalajara 44340, Jalisco, Mexico
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13
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Barendse MEA, Lara GA, Guyer AE, Swartz JR, Taylor SL, Shirtcliff EA, Lamb ST, Miller C, Ng J, Yu G, Tully LM. Sex and pubertal influences on the neurodevelopmental underpinnings of schizophrenia: A case for longitudinal research on adolescents. Schizophr Res 2023; 252:231-241. [PMID: 36682313 PMCID: PMC10725041 DOI: 10.1016/j.schres.2022.12.011] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/04/2022] [Revised: 11/08/2022] [Accepted: 12/10/2022] [Indexed: 01/21/2023]
Abstract
Sex is a significant source of heterogeneity in schizophrenia, with more negative symptoms in males and more affective symptoms and internalizing comorbidity in females. In this narrative review, we argue that there are likely sex differences in the pathophysiological mechanisms of schizophrenia-spectrum disorders (SZ) that originate during puberty and relate to the sex-specific impacts of pubertal maturation on brain development. Pubertal maturation might also trigger underlying (genetic or other) vulnerabilities in at-risk individuals, influencing brain development trajectories that contribute to the emergence of SZ. This review is the first to integrate links between pubertal development and neural development with cognitive neuroscience research in SZ to form and evaluate these hypotheses, with a focus on the frontal-striatal and frontal-limbic networks and their hypothesized contribution to negative and mood symptoms respectively. To test these hypotheses, longitudinal research with human adolescents is needed that examines the role of sex and pubertal development using large cohorts or high risk samples. We provide recommendations for such studies, which will integrate the fields of psychiatry, developmental cognitive neuroscience, and developmental endocrinology towards a more nuanced understanding of the role of pubertal factors in the hypothesized sex-specific pathophysiological mechanisms of schizophrenia.
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Affiliation(s)
- M E A Barendse
- Department of Psychiatry and Behavioral Sciences, UC Davis, CA, USA
| | - G A Lara
- Department of Psychiatry and Behavioral Sciences, UC Davis, CA, USA
| | - A E Guyer
- Department of Human Ecology, UC Davis, CA, USA; Center for Mind and Brain, UC Davis, CA, USA
| | - J R Swartz
- Center for Mind and Brain, UC Davis, CA, USA
| | - S L Taylor
- Division of Biostatistics, Department of Public Health Sciences, UC Davis, CA, USA
| | - E A Shirtcliff
- Human Development and Family Studies, Iowa State University, Ames, IA, USA
| | - S T Lamb
- Department of Psychiatry and Behavioral Sciences, UC Davis, CA, USA
| | - C Miller
- Department of Psychiatry and Behavioral Sciences, UC Davis, CA, USA
| | - J Ng
- Department of Psychiatry and Behavioral Sciences, UC Davis, CA, USA
| | - G Yu
- Department of Psychiatry and Behavioral Sciences, UC Davis, CA, USA
| | - L M Tully
- Department of Psychiatry and Behavioral Sciences, UC Davis, CA, USA.
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14
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Detlefsen AJ, Paulukinas RD, Penning TM. Germline Mutations in Steroid Metabolizing Enzymes: A Focus on Steroid Transforming Aldo-Keto Reductases. Int J Mol Sci 2023; 24:1873. [PMID: 36768194 PMCID: PMC9915212 DOI: 10.3390/ijms24031873] [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] [Subscribe] [Scholar Register] [Received: 11/09/2022] [Revised: 01/15/2023] [Accepted: 01/16/2023] [Indexed: 01/20/2023] Open
Abstract
Steroid hormones synchronize a variety of functions throughout all stages of life. Importantly, steroid hormone-transforming enzymes are ultimately responsible for the regulation of these potent signaling molecules. Germline mutations that cause dysfunction in these enzymes cause a variety of endocrine disorders. Mutations in SRD5A2, HSD17B3, and HSD3B2 genes that lead to disordered sexual development, salt wasting, and other severe disorders provide a glimpse of the impacts of mutations in steroid hormone transforming enzymes. In a departure from these established examples, this review examines disease-associated germline coding mutations in steroid-transforming members of the human aldo-keto reductase (AKR) superfamily. We consider two main categories of missense mutations: those resulting from nonsynonymous single nucleotide polymorphisms (nsSNPs) and cases resulting from familial inherited base pair substitutions. We found mutations in human AKR1C genes that disrupt androgen metabolism, which can affect male sexual development and exacerbate prostate cancer and polycystic ovary syndrome (PCOS). Others may be disease causal in the AKR1D1 gene that is responsible for bile acid deficiency. However, given the extensive roles of AKRs in steroid metabolism, we predict that with expanding publicly available data and analysis tools, there is still much to be uncovered regarding germline AKR mutations in disease.
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Affiliation(s)
- Andrea J. Detlefsen
- Department of Biochemistry & Biophysics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA
| | - Ryan D. Paulukinas
- Department of Systems Pharmacology & Translational Therapeutics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA
- Center of Excellence in Environmental Toxicology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA
| | - Trevor M. Penning
- Department of Systems Pharmacology & Translational Therapeutics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA
- Center of Excellence in Environmental Toxicology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA
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15
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Velasco ER, Florido A, Perez-Caballero L, Marin I, Andero R. The Impacts of Sex Differences and Sex Hormones on Fear Extinction. Curr Top Behav Neurosci 2023; 64:105-132. [PMID: 37528309 DOI: 10.1007/7854_2023_426] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/03/2023]
Abstract
Fear extinction memories are strongly modulated by sex and hormonal status, but the exact mechanisms are still being discovered. In humans, there are some basal and task-related features in which male and female individuals differ in fear conditioning paradigms. However, analyses considering the effects of sex hormones demonstrate a role for estradiol in fear extinction memory consolidation. Translational studies are taking advantage of the convergent findings between species to understand the brain structures implicated. Nevertheless, the human brain is complex and the transfer of these findings into the clinics remains a challenge. The promising advances in the field together with the standardization of fear extinction methodologies in humans will benefit the design of new personalized therapies.
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Affiliation(s)
- Eric Raul Velasco
- Institut de Neurociències, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Antonio Florido
- Institut de Neurociències, Universitat Autònoma de Barcelona, Barcelona, Spain
- Departament de Psicobiologia i de Metodologia de les Ciències de la Salut, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Laura Perez-Caballero
- Institut de Neurociències, Universitat Autònoma de Barcelona, Barcelona, Spain
- Departament de Psicobiologia i de Metodologia de les Ciències de la Salut, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Ignacio Marin
- Institut de Neurociències, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Raul Andero
- Institut de Neurociències, Universitat Autònoma de Barcelona, Barcelona, Spain.
- Departament de Psicobiologia i de Metodologia de les Ciències de la Salut, Universitat Autònoma de Barcelona, Barcelona, Spain.
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain.
- Unitat de Neurociència Traslacional, Parc Taulí Hospital Universitari, Institut d'Investigació i Innovació Parc Taulí (I3PT), Institut de Neurociències, Universitat Autònoma de Barcelona, Bellaterra, Spain.
- ICREA, Pg. Lluís Companys 23, Barcelona, Spain.
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Şahin İ, Say GN, Avcı B, Kesim N. Low serum allopregnanolone levels in children with attention deficit hyperactivity disorder. Psychoneuroendocrinology 2022; 146:105923. [PMID: 36152454 DOI: 10.1016/j.psyneuen.2022.105923] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/28/2022] [Revised: 09/06/2022] [Accepted: 09/07/2022] [Indexed: 11/17/2022]
Abstract
Attention deficit hyperactivity disorder (ADHD) has increasing evidence for the role of neurohormones in its etiopathogenesis. It has been suggested that the effects of neurosteroids on the brain in the early developmental period may predispose to neurodevelopmental pathologies. In our study, we examined serum dehydroepiandrosterone (DHEA), dehydroepiandrosterone sulfate (DHEA-S), and allopregnanolone levels in children with ADHD and whether these neurosteroids differ in the presence of specific learning disorder (SLD) and oppositional defiant disorder (ODD) comorbidities (ADHD+SLD and ADHD+ODD). We also investigated the relationship between neurosteroid levels and the severity of ADHD symptoms. Thirty-five prepubertal children with ADHD and 33 prepubertal healthy children, all aged 6-10 years, were included in this study. The severity of ADHD symptoms was assessed with the parent-rated and teacher-rated Turgay DSM-IV Disruptive Behavior Disorders Rating Scale (T-DSM-IV-S). Serum allopregnanolone levels were significantly lower in the ADHD group compared to healthy controls. When analyzed according to comorbidity status, serum allopregnanolone levels were lower in ADHD+SLD and ADHD+ODD groups compared to healthy controls. However, when compared to healthy children, serum DHEA and DHEA-S levels in children with ADHD were not significantly different. Serum allopregnanolone levels were negatively associated with teacher-rated T-DSM-IV-S hyperactivity/impulsivity scores for all participants only. These findings suggest that allopregnanolone may play a role in the pathophysiology of ADHD, especially in the presence of ODD and SLD comorbidities.
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Affiliation(s)
- İrem Şahin
- Ondokuz Mayıs University, School of Medicine, Department of Child and Adolescent Psychiatry, Samsun, Turkey.
| | - Gökçe Nur Say
- Ondokuz Mayıs University, School of Medicine, Department of Child and Adolescent Psychiatry, Samsun, Turkey
| | - Bahattin Avcı
- Ondokuz Mayıs University, School of Medicine, Department of Medical Biochemistry, Samsun, Turkey
| | - Neriman Kesim
- Ondokuz Mayıs University, School of Medicine, Department of Child and Adolescent Psychiatry, Samsun, Turkey
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17
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Novick AM, Duffy KA, Johnson RL, Sammel MD, Cao W, Strasser AA, Sofuoglu M, Kuzma A, Loughead J, Epperson CN. Progesterone Increases Nicotine Withdrawal and Anxiety in Male but Not Female Smokers During Brief Abstinence. Nicotine Tob Res 2022; 24:1898-1905. [PMID: 35713950 PMCID: PMC9653080 DOI: 10.1093/ntr/ntac146] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2021] [Revised: 05/08/2022] [Accepted: 06/14/2022] [Indexed: 01/03/2023]
Abstract
INTRODUCTION Although exogenous progesterone may hold promise as a treatment for nicotine use disorders, it is unclear whether it is similarly effective in males and females. This study examined the effects of progesterone on nicotine use disorder comprehensively using behavioral, psychological, and neural measures in male and female smokers exposed to brief abstinence. AIMS AND METHODS Thirty-three male and 33 female non-treatment-seeking smokers participated in a double-blind, randomized, placebo-controlled crossover study of 200 mg of progesterone or placebo daily over a four-day abstinence period. Smoking behavior and subjective effects of nicotine were assessed at baseline and after final drug administration. Nicotine withdrawal, smoking urges, mood states, and neural response to smoking cues were measured at baseline, after the first drug administration, and after the final drug administration. RESULTS No main effect of drug (progesterone vs. placebo) emerged for any outcome. Significant sex by drug interactions emerged for nicotine withdrawal (p = .020), perceived strength of nicotine (p = .040), and perceived bad effects of nicotine (p = .029). Males receiving progesterone reported worse nicotine withdrawal (p = .046) and a trend towards decreased bad effects of nicotine (p = .070). Males on progesterone also reported greater tension and anxiety relative to placebo (p = .021). Females on progesterone perceived nicotine's effects as being stronger relative to placebo (p = .046). CONCLUSIONS Progesterone causes sex-dependent effects on smoking-related outcomes during brief abstinence. Specifically, progesterone in males may increase rather than decrease nicotine withdrawal and negative affect during abstinence, potentially hindering efforts to quit smoking. IMPLICATIONS In male and female smokers undergoing a brief period of abstinence, we examined the effects of progesterone on smoking outcomes. While progesterone had limited effects in female smokers, in males, it worsened nicotine withdrawal and negative affect. Our findings emphasize the importance of analyzing sex differences in future studies examining progesterone as a potential treatment and suggest that progesterone in males could potentially exacerbate aspects of nicotine dependence. CLINICALTRIALS.GOV REGISTRATION NCT01954966. https://clinicaltrials.gov/ct2/show/NCT01954966.
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Affiliation(s)
- Andrew M Novick
- Corresponding Author: Andrew M. Novick, MD, PhD, Department of Psychiatry, University of Colorado-Anschutz Medical Campus, 13001 E 17th Pl, Aurora, CO 80045, USA. Telephone: 303-724-5656; Fax: 844-886-1892; E-mail:
| | - Korrina A Duffy
- Department of Psychiatry, School of Medicine, University of Colorado-Anschutz Medical Campus, Aurora, CO, USA
| | - Rachel L Johnson
- Department of Biostatistics and Informatics, Colorado School of Public Health, University of Colorado-Anschutz Medical Campus, Aurora, CO, USA
| | - Mary D Sammel
- Department of Psychiatry, School of Medicine, University of Colorado-Anschutz Medical Campus, Aurora, CO, USA
- Department of Biostatistics and Informatics, Colorado School of Public Health, University of Colorado-Anschutz Medical Campus, Aurora, CO, USA
| | - Wen Cao
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Andrew A Strasser
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Mehmet Sofuoglu
- Department of Psychiatry, Yale School of Medicine, Yale University, New Haven, CT, USA
| | - Alexandra Kuzma
- Larner College of Medicine, University of Vermont, Burlington, VM, USA
| | - James Loughead
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - C Neill Epperson
- Department of Psychiatry, School of Medicine, University of Colorado-Anschutz Medical Campus, Aurora, CO, USA
- Department of Family Medicine, School of Medicine, University of Colorado-Anschutz Medical Campus, Aurora, CO, USA
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18
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Kaps M, Lutzer A, Gautier C, Nagel C, Aurich J, Aurich C. Altrenogest treatment reduces the stress response of three-year-old warmblood mares during their initial equestrian training. Domest Anim Endocrinol 2022; 80:106728. [PMID: 35421809 DOI: 10.1016/j.domaniend.2022.106728] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/02/2022] [Revised: 03/13/2022] [Accepted: 03/16/2022] [Indexed: 11/25/2022]
Abstract
Horse mares are frequently treated with the progestin altrenogest with the aim to suppress estrous behavior and its negative impact on equestrian performance. Progestogens, however, also have sedative effects in males, and females of different species. The aim of our study was therefore to investigate altrenogest-induced changes in the stress response of female horses during initial equestrian training. Three-yr-old Warmblood mares were randomly assigned to treatment with altrenogest (ALT; 0.044 mg/kg once daily; n = 6) or sunflower oil (CON; n = 5) for 12 wk during training. At predefined steps of the training program (free movement, lunging without and with side reins, lunging with saddle, mounting of a rider, free riding, riding by an unfamiliar rider) salivary cortisol concentration, and heart rate were determined from 60 min before to 120 min after training. The same procedures were performed during repeated gynecologic examinations and 2 novel object tests. Bodyweight and body condition scores (BCS) were assessed at 4-wk intervals. During all training units, salivary cortisol concentration and heart rate increased (P < 0.001), but the increase was smaller in group ALT mares (time x treatment P < 0.001). Gynecologic examinations and novel object tests induced a much smaller increase in cortisol and heart rate (P < 0.001) than equestrian training with no difference between groups ALT and CON. Initially, bodyweight, and BCS decreased during training. The subsequent increase was larger in group ALT vs CON (time x treatment P < 0.05). In conclusion, altrenogest reduced the stress response of 3-yr-old mares to equestrian training. The use of altrenogest during equestrian competitions should therefore be reconsidered.
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Affiliation(s)
- M Kaps
- Department for Small Animals and Horses, Artificial Insemination and Embryo Transfer, Vetmeduni Vienna, Veterinärplatz 1, 1210, Vienna, Austria
| | - Anne Lutzer
- Graf Lehndorff Institute for Equine Science, Vetmeduni Vienna, Hauptgestüt 10, 16845, Neustadt (Dosse), Germany
| | - C Gautier
- Department for Small Animals and Horses, Artificial Insemination and Embryo Transfer, Vetmeduni Vienna, Veterinärplatz 1, 1210, Vienna, Austria
| | - C Nagel
- Graf Lehndorff Institute for Equine Science, Vetmeduni Vienna, Hauptgestüt 10, 16845, Neustadt (Dosse), Germany
| | - J Aurich
- Department for Small Animals and Horses, Gynecology, Obstetrics and Andrology, Vetmeduni Vienna, Veterinärplatz 1, 1210, Vienna, Austria
| | - C Aurich
- Department for Small Animals and Horses, Artificial Insemination and Embryo Transfer, Vetmeduni Vienna, Veterinärplatz 1, 1210, Vienna, Austria; Graf Lehndorff Institute for Equine Science, Vetmeduni Vienna, Hauptgestüt 10, 16845, Neustadt (Dosse), Germany.
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Gilfarb RA, Leuner B. GABA System Modifications During Periods of Hormonal Flux Across the Female Lifespan. Front Behav Neurosci 2022; 16:802530. [PMID: 35783228 PMCID: PMC9245048 DOI: 10.3389/fnbeh.2022.802530] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2021] [Accepted: 02/21/2022] [Indexed: 01/10/2023] Open
Abstract
The female lifespan is marked by periods of dramatic hormonal fluctuation. Changes in the ovarian hormones estradiol and progesterone, in addition to the progesterone metabolite allopregnanolone, are among the most significant and have been shown to have widespread effects on the brain. This review summarizes current understanding of alterations that occur within the GABA system during the major hormonal transition periods of puberty, the ovarian cycle, pregnancy and the postpartum period, as well as reproductive aging. The functional impacts of altered inhibitory activity during these times are also discussed. Lastly, avenues for future research are identified, which, if pursued, can broaden understanding of the GABA system in the female brain and potentially lead to better treatments for women experiencing changes in brain function at each of these hormonal transition periods.
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Affiliation(s)
- Rachel A. Gilfarb
- Neuroscience Graduate Program, The Ohio State University, Columbus, OH, United States
| | - Benedetta Leuner
- Department of Psychology, The Ohio State University, Columbus, OH, United States
- Department of Neuroscience, The Ohio State University, Columbus, OH, United States
- *Correspondence: Benedetta Leuner,
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20
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Stewart SA, Peltier MR, Roys MR, Copeland AL. The association between hormonal contraceptive use and smoking, negative affect, and cessation attempts in college females. DRUG AND ALCOHOL DEPENDENCE REPORTS 2022; 3:100063. [PMID: 36845992 PMCID: PMC9948877 DOI: 10.1016/j.dadr.2022.100063] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/27/2021] [Revised: 03/11/2022] [Accepted: 05/09/2022] [Indexed: 11/30/2022]
Abstract
Exogenous and endogenous female hormones influence nicotine use and cessation, potentially through mechanisms such as anxiety and negative affect. In the present study, college females using all types of hormonal contraceptives (HC) were compared to those not using HC to determine the potential influence on current smoking, negative affect, and current and past cessation attempts. Differences between progestin-only and combination HC were also examined. Of the 1,431 participants, 53.2% (n = 761) reported current HC use, and 12.3% (n = 176) of participants endorsed current smoking. Women currently using HC were significantly more likely to smoke (13.5%; n = 103) compared to women not using HC (10.9%; n = 73), p = .04. There was a significant main effect of HC use being associated with lower anxiety levels (p = .005), as well as a significant HC use by smoking status interaction, such that women who smoke using HC reported the lowest levels of anxiety among participants (p = .01). Participants using HC were more likely to be making a current attempt to quit smoking than those not using HC (p = .04) and were more likely to have made past quit attempts (p = .04). No significant differences were observed across women using progestin-only, combined estrogen and progestin, and women not using HC. These findings provide evidence that exogenous hormones may be an advantageous treatment target and that they warrant additional study.
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Affiliation(s)
- Shelby A. Stewart
- Department of Psychology, Louisiana State University Baton Rouge, LA 70803, USA
| | - MacKenzie R. Peltier
- Department of Psychiatry, Yale School of Medicine, USA
- Psychology Service, VA Connecticut Healthcare System, USA
| | - Melanie R. Roys
- Department of Psychology, Louisiana State University Baton Rouge, LA 70803, USA
| | - Amy L. Copeland
- Department of Psychology, Louisiana State University Baton Rouge, LA 70803, USA
- Pennington Biomedical Research Center, USA
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21
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Koebele SV, Poisson ML, Palmer JM, Berns-Leone C, Northup-Smith SN, Peña VL, Strouse IM, Bulen HL, Patel S, Croft C, Bimonte-Nelson HA. Evaluating the Cognitive Impacts of Drospirenone, a Spironolactone-Derived Progestin, Independently and in Combination With Ethinyl Estradiol in Ovariectomized Adult Rats. Front Neurosci 2022; 16:885321. [PMID: 35692432 PMCID: PMC9177129 DOI: 10.3389/fnins.2022.885321] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2022] [Accepted: 04/14/2022] [Indexed: 11/15/2022] Open
Abstract
Oral contraceptives and hormone therapies require a progestogen component to prevent ovulation, curtail uterine hyperplasia, and reduce gynecological cancer risk. Diverse classes of synthetic progestogens, called progestins, are used as natural progesterone alternatives due to progesterone’s low oral bioavailability. Progesterone and several synthetic analogs can negatively impact cognition and reverse some neuroprotective estrogen effects. Here, we investigate drospirenone, a spironolactone-derived progestin, which has unique pharmacological properties compared to other clinically-available progestins and natural progesterone, for its impact on spatial memory, anxiety-like behavior, and brain regions crucial to these cognitive tasks. Experiment 1 assessed three drospirenone doses in young adult, ovariectomized rats, and found that a moderate drospirenone dose benefited spatial memory. Experiment 2 investigated this moderate drospirenone dose with and without concomitant ethinyl estradiol (EE) treatment, the most common synthetic estrogen in oral contraceptives. Results demonstrate that the addition of EE to drospirenone administration reversed the beneficial working memory effects of drospirenone. The hippocampus, entorhinal cortex, and perirhinal cortex were then probed for proteins known to elicit estrogen- and progestin- mediated effects on learning and memory, including glutamate decarboxylase (GAD)65, GAD67, and insulin-like growth factor receptor protein expression, using western blot. EE increased GAD expression in the perirhinal cortex. Taken together, results underscore the necessity to consider the distinct cognitive and neural impacts of clinically-available synthetic estrogen and progesterone analogs, and why they produce unique cognitive profiles when administered together compared to those observed when each hormone is administered separately.
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Affiliation(s)
- Stephanie V. Koebele
- Department of Psychology, Arizona State University, Tempe, AZ, United States
- Arizona Alzheimer’s Consortium, Phoenix, AZ, United States
| | - Mallori L. Poisson
- Department of Psychology, Arizona State University, Tempe, AZ, United States
- Arizona Alzheimer’s Consortium, Phoenix, AZ, United States
| | - Justin M. Palmer
- Department of Psychology, Arizona State University, Tempe, AZ, United States
- Arizona Alzheimer’s Consortium, Phoenix, AZ, United States
| | - Claire Berns-Leone
- Department of Psychology, Arizona State University, Tempe, AZ, United States
- Arizona Alzheimer’s Consortium, Phoenix, AZ, United States
| | - Steven N. Northup-Smith
- Department of Psychology, Arizona State University, Tempe, AZ, United States
- Arizona Alzheimer’s Consortium, Phoenix, AZ, United States
| | - Veronica L. Peña
- Department of Psychology, Arizona State University, Tempe, AZ, United States
- Arizona Alzheimer’s Consortium, Phoenix, AZ, United States
| | - Isabel M. Strouse
- Department of Psychology, Arizona State University, Tempe, AZ, United States
- Arizona Alzheimer’s Consortium, Phoenix, AZ, United States
| | - Haidyn L. Bulen
- Department of Psychology, Arizona State University, Tempe, AZ, United States
- Arizona Alzheimer’s Consortium, Phoenix, AZ, United States
| | - Shruti Patel
- Department of Psychology, Arizona State University, Tempe, AZ, United States
- Arizona Alzheimer’s Consortium, Phoenix, AZ, United States
| | - Corissa Croft
- Department of Psychology, Arizona State University, Tempe, AZ, United States
- Arizona Alzheimer’s Consortium, Phoenix, AZ, United States
| | - Heather A. Bimonte-Nelson
- Department of Psychology, Arizona State University, Tempe, AZ, United States
- Arizona Alzheimer’s Consortium, Phoenix, AZ, United States
- *Correspondence: Heather A. Bimonte-Nelson,
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22
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Premenstrual Syndrome and Premenstrual Dysphoric Disorder as Centrally Based Disorders. ENDOCRINES 2022. [DOI: 10.3390/endocrines3010012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Premenstrual syndrome (PMS) and premenstrual dysphoric disorder (PMDD) encompass a variety of symptoms that occur during the luteal phase of the menstrual cycle and impair daily life activities and relationships. Depending on the type and severity of physical, emotional or behavioral symptoms, women of reproductive age followed for at least two prospective menstrual cycles may receive one of the two diagnoses. PMDD is the most severe form of PMS, predominantly characterized by emotional and behavioral symptoms not due to another psychiatric disorder. PMS and PMDD are common neuro-hormonal gynecological disorders with a multifaceted etiology. Gonadal steroid hormones and their metabolites influence a plethora of biological systems involved in the occurrence of specific symptoms, but there is no doubt that PMS/PMDD are centrally based disorders. A more sensitive neuroendocrine threshold to cyclical variations of estrogens and progesterone under physiological and hormonal therapies is present. Moreover, altered brain sensitivity to allopregnanolone, a metabolite of progesterone produced after ovulation potentiating GABA activity, along with an impairment of opioid and serotoninergic systems, may justify the occurrence of emotional and behavioral symptoms. Even neuro-inflammation expressed via the GABAergic system is under investigation as an etiological factor of PMS/PMDD. Pharmacological management aims to stabilize hormonal fluctuations and to restore the neuroendocrine balance. The rationale of suppressing ovulation supports prescription of combined hormonal contraception (CHC). Its effect on mood is highly variable and depends on biochemical characteristics of exogenous steroids and on type and severity of symptoms. Hormonal regimens reducing the estrogen-free interval or suppressing menstruation seem better choices. Psychoactive agents, such as serotonin reuptake inhibitors (SSRIs), are effective in reducing the symptoms of PMS/PMDD and may be prescribed continuously or only during the luteal phase. Novel therapeutic approaches include inhibition of progesterone receptors in the brain, i.e., with ulipristal acetate, reduced conversion of progesterone with dutasteride, and modulation of the action of allopregnanolone on the brain GABAergic system with sepranolone.
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23
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Chan JH, Lo C, Hsu CD, Chiu CC, Huang MC, Liao SC, Chen IM, Chen WY, Chen HC, Kuo PH. Premenstrual dysphoric symptoms and lifetime suicide experiences in patients with mood disorder. Gen Hosp Psychiatry 2021; 71:82-87. [PMID: 33965699 DOI: 10.1016/j.genhosppsych.2021.04.009] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/21/2020] [Revised: 04/27/2021] [Accepted: 04/28/2021] [Indexed: 10/21/2022]
Abstract
BACKGROUND Premenstrual dysphoric symptoms (PMDS) commonly co-occurred with mood disorders and correlated with suicide experiences in women. This study aims to examine the associations between PMDS and lifetime suicide experiences in patients with mood disorders. METHODS Participants were recruited from outpatient settings of two medical centers and one psychiatric hospital in Taiwan. Women aged 18-65 in non-acute state of major depressive disorder or bipolar affective disorder were recruited. PMDS and lifetime suicide experiences were defined by the Schedule for Affective Disorder and Schizophrenia-Lifetime. Lifetime suicide experiences were defined as no suicide experience, suicide plans only and suicide attempts. RESULTS A total of 383 women participated in this study (54.8% of them were diagnosed with major depressive disorder), and 13.8% were diagnosed with PMDS. The prevalence of patients with lifetime suicide plans only and lifetime suicide attempts were 15.9% and 39.7%, respectively. In the univariate analysis, PMDS was correlated with lifetime suicide experience. After controlling for covariates, PMDS was a risk indicator for lifetime suicide attempts (OR: 3.46, 95% CI: 1.43-8.38) but not for suicide plans only (OR: 0.93, 95% CI: 0.28-3.11). CONCLUSIONS PMDS correlated with lifetime suicide experiences in women with non-acute mood disorders. In particular, PMDS exhibited as an independent correlate for lifetime suicide attempts.
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Affiliation(s)
- Jen-Hui Chan
- Department of Psychiatry, National Taiwan University Hospital Hsin-Chu Branch, No.25, Lane 442, Sec.1, Jingguo Rd., Hsinchu City 300, Taiwan
| | - Chen Lo
- Department of Psychiatry, National Taiwan University Hospital, No.7 Chung San South Road, Taipei 10002, Taiwan
| | - Cheng-Dien Hsu
- Department of Psychosomatic Medicine, Taiwan Adventist Hospital, No.424, Sec. 2, Bade Rd., Songshan District, Taipei City 10556, Taiwan
| | - Chih-Chiang Chiu
- Department of Psychiatry, Taipei City Psychiatric Center, Taipei City Hospital, No. 309, Songde Rd., Xinyi Dist., Taipei City 110, Taiwan; Department of Psychiatry, School of Medicine, Taipei Medical University, No. 250, Wuxing St., Xinyi Dist., Taipei City 110, Taiwan
| | - Ming-Chyi Huang
- Department of Psychiatry, Taipei City Psychiatric Center, Taipei City Hospital, No. 309, Songde Rd., Xinyi Dist., Taipei City 110, Taiwan
| | - Shih-Cheng Liao
- Department of Psychiatry, National Taiwan University Hospital, No.7 Chung San South Road, Taipei 10002, Taiwan; Department of Psychiatry, National Taiwan University Medical College, No.1 Jen Ai road section 1, Taipei 100233, Taiwan
| | - I-Ming Chen
- Department of Psychiatry, National Taiwan University Hospital, No.7 Chung San South Road, Taipei 10002, Taiwan
| | - Wen-Yin Chen
- Department of Psychiatry, Taipei City Psychiatric Center, Taipei City Hospital, No. 309, Songde Rd., Xinyi Dist., Taipei City 110, Taiwan
| | - Hsi-Chung Chen
- Department of Psychiatry, National Taiwan University Hospital, No.7 Chung San South Road, Taipei 10002, Taiwan.
| | - Po-Hsiu Kuo
- Department of Psychiatry, National Taiwan University Hospital, No.7 Chung San South Road, Taipei 10002, Taiwan; Graduate Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, No. 17 Xuzhou Road, Taipei 100, Taiwan
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24
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The regulatory roles of progesterone and estradiol on emotion processing in women. COGNITIVE AFFECTIVE & BEHAVIORAL NEUROSCIENCE 2021; 21:1026-1038. [PMID: 33982247 DOI: 10.3758/s13415-021-00908-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 04/21/2021] [Indexed: 12/28/2022]
Abstract
Emotion processing is known to interact with memory. Ovarian steroid hormones, such as progesterone and estradiol, modulate emotion processing and memory. However, it is unclear how these hormones influence brain activity when emotion processing is integrated with working memory (WM). Therefore, the objective of this study was to examine the relationship between endogenous hormonal concentration and brain activity during emotion processing in the context of a WM n-back task in 74 young women using functional magnetic resonance imaging (fMRI). Results show that positive emotion processing activates reward-related areas, such as the caudate and putamen, whereas negative emotion processing activates a corticolimbic network, including the amygdala and hippocampus. Furthermore, our findings provide evidence that progesterone modulates more bottom-up brain activation during both positive and negative emotion processing, whereas estradiol activates lateralized, top-down regulation. These findings provide insight on the neural correlates of emotion processing during an n-back task in young women and highlight how important it is to consider women's endogenous hormonal concentration in neurobiological and cognition research.
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25
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Zhu Y, Wu X, Zhou R, Sie O, Niu Z, Wang F, Fang Y. Hypothalamic-Pituitary-End-Organ Axes: Hormone Function in Female Patients with Major Depressive Disorder. Neurosci Bull 2021; 37:1176-1187. [PMID: 33909242 DOI: 10.1007/s12264-021-00689-6] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2020] [Accepted: 11/27/2020] [Indexed: 12/27/2022] Open
Abstract
Classic hypothalamic-pituitary-end-organ feedback loops - the hypothalamic-pituitary-adrenal axis (HPAA), hypothalamic-pituitary-thyroidal axis (HPTA), and hypothalamic-pituitary-gonadal axis (HPGA) - are associated with the neuroendocrine and immune systems in major depressive disorder (MDD). Female patients with MDD present with evident neuroendocrine and immunological changes. Glucocorticoid, thyroid hormone, and reproductive steroid levels fluctuate with menstrual cycles, which might lead to glucocorticoid receptor resistance, impairment of triiodothyronine conversion, and sex hormone secretion disorders. In this review, we summarize the independent and interactive functions of these three axes in female MDD patients. The similar molecular structure of steroids implies an interrelationship between the hypothalamic-pituitary-end-organ axes and the competitive inhibitory effects at the receptor level, especially when considering the HPAA and HPGA.
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Affiliation(s)
- Yuncheng Zhu
- Division of Mood Disorders, Shanghai Hongkou Mental Health Center, Shanghai, 200083, China.,Clinical Research Center, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, 200030, China
| | - Xiaohui Wu
- Clinical Research Center, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, 200030, China
| | - Rubai Zhou
- Clinical Research Center, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, 200030, China
| | - Oliver Sie
- Shanghai Medical College, Fudan University, Shanghai, 200032, China
| | - Zhiang Niu
- Clinical Research Center, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, 200030, China
| | - Fang Wang
- Shanghai Yangpu Mental Health Center, Shanghai, 200093, China.
| | - Yiru Fang
- Clinical Research Center, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, 200030, China. .,CAS Center for Excellence in Brain Science and Intelligence Technology, Shanghai, 200031, China. .,Shanghai Key Laboratory of Psychotic Disorders, Shanghai, 201108, China.
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26
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Prado RCR, Silveira R, Kilpatrick MW, Pires FO, Asano RY. Menstrual Cycle, Psychological Responses, and Adherence to Physical Exercise: Viewpoint of a Possible Barrier. Front Psychol 2021; 12:525943. [PMID: 33679501 PMCID: PMC7929979 DOI: 10.3389/fpsyg.2021.525943] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2020] [Accepted: 01/12/2021] [Indexed: 11/29/2022] Open
Affiliation(s)
- Raul Cosme Ramos Prado
- Women's Science Studies and Research Academy, São Paulo, Brazil.,Exercise Psychophysiology Research Group, School of Arts, Sciences and Humanities, University of São Paulo, São Paulo, Brazil
| | - Rodrigo Silveira
- School of Physical Education and Sport, University of São Paulo, São Paulo, Brazil
| | | | - Flávio Oliveira Pires
- Exercise Psychophysiology Research Group, School of Arts, Sciences and Humanities, University of São Paulo, São Paulo, Brazil
| | - Ricardo Yukio Asano
- Exercise Psychophysiology Research Group, School of Arts, Sciences and Humanities, University of São Paulo, São Paulo, Brazil
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27
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Jensen MCH, Jørgensen L, Gemzell-Danielsson K, Sundström Poromaa I, Schroll JB. Hormonal contraceptive use and depression. Hippokratia 2021. [DOI: 10.1002/14651858.cd013838] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Affiliation(s)
| | | | | | - Inger Sundström Poromaa
- Women's and Children's Health, Research Group; Reproductive Health; Uppsala University; Hvidovre Denmark
| | - Jeppe B Schroll
- Department of Obstetrics and Gynaecology; Copenhagen University Hospital Hvidovre; Hvidovre Denmark
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28
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Schmalenberger KM, Tauseef HA, Barone JC, Owens SA, Lieberman L, Jarczok MN, Girdler SS, Kiesner J, Ditzen B, Eisenlohr-Moul TA. How to study the menstrual cycle: Practical tools and recommendations. Psychoneuroendocrinology 2021; 123:104895. [PMID: 33113391 PMCID: PMC8363181 DOI: 10.1016/j.psyneuen.2020.104895] [Citation(s) in RCA: 109] [Impact Index Per Article: 36.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/14/2020] [Revised: 09/02/2020] [Accepted: 10/02/2020] [Indexed: 02/08/2023]
Abstract
Despite decades of research on the physiological and psychological effects of the menstrual cycle, studies have not sufficiently adopted consistent methods for operationalizing the menstrual cycle. This has resulted in substantial confusion in the literature and limited possibilities to conduct systematic reviews and meta-analyses. In order to facilitate more rapid accumulation of knowledge on cycle effects, the present paper offers a set of integrative guidelines and standardized tools for studying the menstrual cycle as an independent variable. We begin with (1) an overview of the menstrual cycle and (2) premenstrual disorders, followed by (3) recommendations and tools regarding data collection in cycle studies. These recommendations address selecting the appropriate study design and sampling strategy, managing demand characteristics, identifying a sample of naturally-cycling individuals, and measuring menstrual bleeding dates, ovarian hormones, and ovulation. We proceed with suggestions for (4) data preparation and coding of cycle day and phases, as well as (5) data visualization, statistical modeling, and interpretation of menstrual cycle associations. We also provide (6) recommendations for using menses start day and ovulation testing to schedule visits in laboratory studies and end with a (7) comprehensive summary and conclusion. Regardless of whether the influence of the menstrual cycle is of central interest in a study or should be controlled to accurately assess the effects of another variable, the use of these recommendations and tools will help make study results more meaningful and replicable.
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Affiliation(s)
- Katja M Schmalenberger
- Institute of Medical Psychology, Center for Psychosocial Medicine, Heidelberg University Hospital, Heidelberg University, Heidelberg, Germany.
| | - Hafsah A Tauseef
- Women's Mental Health Research Program, Department of Psychiatry, University of Illinois at Chicago, Chicago, IL, USA.
| | - Jordan C Barone
- Women's Mental Health Research Program, Department of Psychiatry, University of Illinois at Chicago, Chicago, IL, USA.
| | - Sarah A Owens
- Department of Psychology and Neuroscience, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
| | - Lynne Lieberman
- Women's Mental Health Research Program, Department of Psychiatry, University of Illinois at Chicago, Chicago, IL, USA.
| | - Marc N Jarczok
- Department of Psychosomatic Medicine and Psychotherapy, Ulm University Medical Center, Ulm, Germany.
| | - Susan S Girdler
- Department of Psychiatry, University of North Carolina at chapel Hill, Chapel Hill, NC, USA.
| | - Jeff Kiesner
- Department of General Psychology, University of Padua, Padua, Italy.
| | - Beate Ditzen
- Institute of Medical Psychology, Center for Psychosocial Medicine, Heidelberg University Hospital, Heidelberg University, Heidelberg, Germany.
| | - Tory A Eisenlohr-Moul
- Women's Mental Health Research Program, Department of Psychiatry, University of Illinois at Chicago, Chicago, IL, USA.
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29
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Roe AH, Kumar-Kaparaboyna P, Nathan M, Dutton C. Effects of Hormonal Contraception on Mood. CURRENT OBSTETRICS AND GYNECOLOGY REPORTS 2020. [DOI: 10.1007/s13669-020-00295-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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30
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Standeven LR, McEvoy KO, Osborne LM. Progesterone, reproduction, and psychiatric illness. Best Pract Res Clin Obstet Gynaecol 2020; 69:108-126. [PMID: 32723604 DOI: 10.1016/j.bpobgyn.2020.06.001] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2020] [Revised: 05/14/2020] [Accepted: 06/04/2020] [Indexed: 12/26/2022]
Abstract
Mood and anxiety disorders are vastly overrepresented in women, and one important contributor to these differences is the fluctuation in sex steroids in women during the reproductive years. Considerable evidence supports a role for abnormal sensitivity to these hormonal fluctuations for some women, who develop mood symptoms associated with reproductive transitions. This chapter presents evidence of the role of endogenous progesterone and its metabolites in such mood symptoms, and then goes on to cover the evidence concerning exogenous progesterone's effects on mood. Overall, the literature does not support an association between exogenous progesterone and negative mood in the general population, but does indicate that subset of women may be vulnerable to such effects. Research is lacking on women with psychiatric illness.
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Affiliation(s)
- Lindsay R Standeven
- Department of Psychiatry & Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | | | - Lauren M Osborne
- Department of Psychiatry & Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, USA; Department of Gynecology and Obstetrics, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
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31
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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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32
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Menstrual Cycle Changes in Vagally-Mediated Heart Rate Variability are Associated with Progesterone: Evidence from Two Within-Person Studies. J Clin Med 2020; 9:jcm9030617. [PMID: 32106458 PMCID: PMC7141121 DOI: 10.3390/jcm9030617] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2019] [Revised: 02/12/2020] [Accepted: 02/13/2020] [Indexed: 02/07/2023] Open
Abstract
A recent meta-analysis revealed that cardiac vagal activity (mostly indicated by vagally-mediated heart rate variability; HRV) decreases significantly from the follicular to luteal menstrual cycle phase in naturally-cycling participants. However, the question remains as to whether cyclical changes in estradiol (E2), progesterone (P4), or both are responsible for HRV fluctuations. We present the first studies to use repeated measures of E2, P4, and HRV across the cycle to model both the unique and interactive effects of person-centered E2 and P4 on HRV in multilevel models. In study one, 40 naturally-cycling participants were assessed weekly across four weeks, and were blind to the cycle focus of the study. In study two, 50 naturally-cycling participants were examined in three precisely defined cycle phases via ovulation testing. Both studies revealed that only P4 was correlated with HRV, such that higher-than-usual P4 significantly predicted lower-than-usual HRV within a given participant. In line with this, cycle phase comparisons revealed lower HRV in the mid-luteal phase (characterized by elevated P4) than in other phases. No significant main or interactive effects of E2 on HRV were found. Future female health studies should investigate individual differences in these effects and potential consequences of cyclical HRV changes on daily functioning.
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33
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Pelegrina LT, de Los Ángeles Sanhueza M, Ramona Cáceres AR, Cuello-Carrión D, Rodriguez CE, Laconi MR. Effect of progesterone and first evidence about allopregnanolone action on the progression of epithelial human ovarian cancer cell lines. J Steroid Biochem Mol Biol 2020; 196:105492. [PMID: 31614205 DOI: 10.1016/j.jsbmb.2019.105492] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/15/2019] [Revised: 08/20/2019] [Accepted: 10/01/2019] [Indexed: 01/22/2023]
Abstract
Ovarian carcinoma is one of the most common cause of death by gynecologic cancer. Several epidemiological and in vitro studies have shown controversial data about progesterone effects in ovarian cancer. Progesterone can be converted in its active metabolite, allopregnanolone, its effects in ovarian cancer are still unknown. Previously, we demonstrated that allopregnanolone modifies ovarian morphophysiology, being able to alter critical process of tumor development such as proliferation, apoptosis and angiogenesis. Taking into account these antecedents, we investigated the effect of progesterone and allopregnanolone on proliferation, apoptosis, clonogenic capacity and migration on two epithelial human ovarian cancer cell lines, IGROV-1 and SKOV-3. To this end, IGROV-1 and SKOV-3 cells were exposed to a range of progesterone and allopregnanolone concentrations (10-11 to 10-5 M) for 72 h. Proliferation was analyzed by MTT and Ki67 expression. Apoptosis was measured by immunocytochemistry of cleaved caspase 3. Clonogenic capacity was evaluated by counting colonies. Migration was analyzed by wound assay. We found that allopregnanolone increased proliferation and Ki67 expression respect to control on IGROV-1 cells, while expression of cleaved caspase 3 did not change in any cell line studied. IGROV-1 clonogenic capacity was also increased by allopregnanolone treatment. Both steroids, progesterone and allopregnanolone, increased IGROV-1 migration in a concentration dependent manner. None of the steroids tested modified SKOV-3 biological behavior analized. This is the first evidence that allopregnanolone, a progesterone metabolite, affects critical events in tumor development of human epithelial ovarian cancer. These results could have an impact in the future in clinic diagnosis, prognosis and treatment of ovarian cancer patients. The regulation of progesterone and allopregnanolone steroideogenesis and their molecular mechanisms might be considered as potential therapeutic tool in ovarian cancer.
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Affiliation(s)
- Laura Tatiana Pelegrina
- Laboratorio de Fisio-patología ovárica, Instituto de Medicina y Biología Experimental (IMBECU)- Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), Mendoza, Argentina; Facultad de Ciencias Médicas y Facultad de Ingeniería, Universidad de Mendoza, Mendoza, Argentina; Universidad Juan Agustín Maza, Mendoza, Argentina.d- Hospital de Oncología Angel Roffo. CONICET, Buenos Aires, Argentina
| | - María de Los Ángeles Sanhueza
- Laboratorio de Fisio-patología ovárica, Instituto de Medicina y Biología Experimental (IMBECU)- Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), Mendoza, Argentina
| | - Antonella Rosario Ramona Cáceres
- Laboratorio de Fisio-patología ovárica, Instituto de Medicina y Biología Experimental (IMBECU)- Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), Mendoza, Argentina; Facultad de Ciencias Médicas y Facultad de Ingeniería, Universidad de Mendoza, Mendoza, Argentina; Universidad Juan Agustín Maza, Mendoza, Argentina.d- Hospital de Oncología Angel Roffo. CONICET, Buenos Aires, Argentina
| | - Dario Cuello-Carrión
- Laboratorio de Fisio-patología ovárica, Instituto de Medicina y Biología Experimental (IMBECU)- Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), Mendoza, Argentina
| | - Cristina Elisa Rodriguez
- Universidad Juan Agustín Maza, Mendoza, Argentina.d- Hospital de Oncología Angel Roffo. CONICET, Buenos Aires, Argentina
| | - Myriam Raquel Laconi
- Laboratorio de Fisio-patología ovárica, Instituto de Medicina y Biología Experimental (IMBECU)- Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), Mendoza, Argentina; Facultad de Ciencias Médicas y Facultad de Ingeniería, Universidad de Mendoza, Mendoza, Argentina.
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34
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Sepede G, Brunetti M, Di Giannantonio M. Comorbid Premenstrual Dysphoric Disorder in Women with Bipolar Disorder: Management Challenges. Neuropsychiatr Dis Treat 2020; 16:415-426. [PMID: 32103961 PMCID: PMC7020916 DOI: 10.2147/ndt.s202881] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/29/2019] [Accepted: 01/30/2020] [Indexed: 12/16/2022] Open
Abstract
Bipolar disorder (BD) and premenstrual dysphoric disorder (PMDD) are two cyclic mood illnesses, sometimes presenting together. Their comorbidity appears to be linked to common biological mechanisms and usually results in more severity of mood symptoms and a poorer long-term outcome. Nevertheless, the management of comorbid PMDD/BD has been scarcely studied. Therefore, the aim of the present paper was to review the published literature on the treatment of comorbid PMDD/BD and to provide point-by-point hypotheses to address these complex clinical cases. We searched PubMed to identify the studies focused on the treatment and management of comorbid PMDD/BD using the following search words, alone and in combination: premenstrual dysphoric disorder, bipolar disorder, comorbid, treatment, management, pharmacotherapy, psychotherapy. The search was conducted on the 1st of June 2019 and yielded 55 records. Four papers met our inclusion/exclusion criteria and were therefore included in our qualitative synthesis. Integrating the few data pertaining to the treatment of comorbid PMDD/BD with the large amount of published data on the two conditions separately, we can suggest that the management of comorbid PMDD/BD needs as a first step to stabilize the bipolar symptoms by means of optimal dosages of mood stabilizers. Then, in euthymic BD patients, the PMDD symptoms could be treated with estroprogestins (first-line treatment). On the contrary, during acute phases of BD, antidepressants (for major depressive episodes) and atypical antipsychotics/hormonal modulators (for manic episodes) could be considered as promising add-on treatments to mood stabilizers. In case of resistant PMDD/BD symptoms, combined strategies should be taken into account, as well as alternative treatments, such as lifestyle changes. In conclusion, RCTs on comorbid PMDD/BD are still lacking. The management of this complex condition is therefore challenging and it requires a tailored treatment.
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Affiliation(s)
- Gianna Sepede
- Department of Neuroscience, Imaging, and Clinical Sciences, University "G. d'Annunzio", Chieti, Italy
| | - Marcella Brunetti
- Department of Neuroscience, Imaging, and Clinical Sciences, University "G. d'Annunzio", Chieti, Italy
| | - Massimo Di Giannantonio
- Department of Neuroscience, Imaging, and Clinical Sciences, University "G. d'Annunzio", Chieti, Italy.,Department of Mental Health - Chieti, National Health Trust, Chieti, Italy
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35
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Estrada-Camarena E, Sollozo-Dupont I, Islas-Preciado D, González-Trujano ME, Carro-Juárez M, López-Rubalcava C. Anxiolytic- and anxiogenic-like effects of Montanoa tomentosa (Asteraceae): Dependence on the endocrine condition. JOURNAL OF ETHNOPHARMACOLOGY 2019; 241:112006. [PMID: 31153863 DOI: 10.1016/j.jep.2019.112006] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/11/2019] [Revised: 05/28/2019] [Accepted: 05/29/2019] [Indexed: 06/09/2023]
Abstract
ETHNOPHARMACOLOGICAL RELEVANCE Montanoa tomentosa Cerv. (MT) is a native plant from Mexico used in traditional medicine as a remedy for reproductive impairments and relaxing effects. In previous studies, it has been shown that the endocrine state could modify the antianxiety-like actions of anxiolytic compounds. Although women are the primary user of MT, no studies have evaluated the potential impact of the endocrine milieu on its anti-anxiety actions. AIMS OF THE STUDY Ascertain the antianxiety effects of M. tomentosa in rats with different hormonal conditions, and to analyze the participation of the GABAA receptor in ovariectomized rats treated with MT. MATERIALS AND METHODS The animal model of anxiety used was the elevated plus-maze (EPM). Rats' endocrine conditions were: a) Low hormone levels (rats in diestrus I and II phases); b) High hormone levels (proestrus/estrus phases); c) No hormones (ovariectomized rats); and d) Rats under progesterone withdrawal (PW). To evaluate the participation of the GABAA receptor in the anxiolytic-like action of MT the antagonist picrotoxin was used. RESULTS Results showed that MT induced dose-dependent anxiolytic-like actions in rats with low hormone level conditions. Also, MT reduced anxiety-like behavior in female rats under PW, in contrast to diazepam which was ineffective. MT's anxiolytic-like effect was blocked by picrotoxin, suggesting the participation of the GABAA receptor complex. However, increased anxiety-like behavior was observed in rats with a high hormone level condition and low doses of MT. CONCLUSIONS Beneficial anxiolytic-like actions of MT are observed under low hormone conditions, particularly in the PW challenge (a condition that can be related to a premenstrual period). Furthermore, the participation of the GABAA receptor is evidenced. However, hormonal variations could induce the opposite effects, hence women should be cautious.
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Affiliation(s)
- Erika Estrada-Camarena
- Laboratorio de Neuropsicofarmacología, Dirección de Neurociencias, Instituto Nacional de Psiquiatría "Ramón de la Fuente Muñíz", Calzada México Xochimilco 101, Col San Lorenzo Huipulco, Delegación Tlalpan, Ciudad de México, Mexico.
| | - Isabel Sollozo-Dupont
- Departamento de Farmacobiología, CINVESTAV-Sede Sur. Calzada de los Tenorios 235, Col Granjas Coapa, Delegación Tlalpan, Ciudad de México, Mexico.
| | - Dannia Islas-Preciado
- Laboratorio de Neuropsicofarmacología, Dirección de Neurociencias, Instituto Nacional de Psiquiatría "Ramón de la Fuente Muñíz", Calzada México Xochimilco 101, Col San Lorenzo Huipulco, Delegación Tlalpan, Ciudad de México, Mexico.
| | - María Eva González-Trujano
- Laboratorio de Neurofarmacología de Productos Naturales, Dirección de Neurociencias, Instituto Nacional de Psiquiatría "Ramón de la Fuente Muñíz", Calzada México, Xochimilco 101, Col San Lorenzo Huipulco, Delegación Tlalpan, Ciudad de México, Mexico.
| | | | - Carolina López-Rubalcava
- Departamento de Farmacobiología, CINVESTAV-Sede Sur. Calzada de los Tenorios 235, Col Granjas Coapa, Delegación Tlalpan, Ciudad de México, Mexico.
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Monciunskaite R, Malden L, Lukstaite I, Ruksenas O, Griksiene R. Do oral contraceptives modulate an ERP response to affective pictures? Biol Psychol 2019; 148:107767. [PMID: 31509765 DOI: 10.1016/j.biopsycho.2019.107767] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2019] [Revised: 08/23/2019] [Accepted: 09/06/2019] [Indexed: 12/22/2022]
Abstract
Indications exist that use of oral contraceptives affects women's socio-emotional behaviour, brain function and, cognitive abilities, but the information is still scarce and ambiguous. We aimed to examine affective processing of visual stimuli between oral contraceptive users (OC, n = 33) and naturally cycling women (NC, n = 37) using the event-related potential (ERP) method. The main findings are: (i) emotionally arousing stimuli elicited significantly enlarged late positive potential (LPP) amplitudes compared to neutral stimuli, (ii) anti-androgenic OC users demonstrated diminished brain reactivity to visual stimuli, and (iii) significantly blunted reaction to highly unpleasant images. In addition, a positive relationship between GFP evoked by the highly unpleasant and highly pleasant visual emotional stimuli and progesterone was observed in NC women, while OC users demonstrated a trend of negative relationship between GFP and progesterone level. These findings suggest possible modulations of affective processing of visual stimuli when hormonal contraceptives are used.
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Affiliation(s)
- R Monciunskaite
- Institute of Biosciences, Life Sciences Center, Vilnius University, Vilnius, Lithuania.
| | - L Malden
- Institute of Biosciences, Life Sciences Center, Vilnius University, Vilnius, Lithuania
| | - I Lukstaite
- Institute of Biosciences, Life Sciences Center, Vilnius University, Vilnius, Lithuania
| | - O Ruksenas
- Institute of Biosciences, Life Sciences Center, Vilnius University, Vilnius, Lithuania
| | - R Griksiene
- Institute of Biosciences, Life Sciences Center, Vilnius University, Vilnius, Lithuania
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Lobmaier JS, Probst F, Lory V, Meyer AH, Meinlschmidt G. Increased sensitivity to social exclusion during the luteal phase: Progesterone as resilience factor buffering against ostracism? Psychoneuroendocrinology 2019; 107:217-224. [PMID: 31152968 DOI: 10.1016/j.psyneuen.2019.05.019] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/07/2018] [Revised: 05/10/2019] [Accepted: 05/14/2019] [Indexed: 01/29/2023]
Abstract
A woman's social behaviour reportedly varies across the menstrual cycle. In this study, we estimated changes in sensitivity to social exclusion across the menstrual cycle and scrutinized the related role of progesterone. Forty-nine naturally cycling women played a virtual ball-tossing game (Cyberball) to manipulate social inclusion. All participants underwent inclusion and exclusion conditions during the late follicular and the luteal phase. We assessed salivary progesterone concentrations at each cycle phase. After each Cyberball session we measured positive/negative mood using the Multidimensional Mood State Questionnaire (MDMQ). Multilevel analyses indicated that women showed worse mood following exclusion as compared to inclusion conditions (p = 0.014). Notably, this exclusion effect was more pronounced during the luteal phase than the late follicular phase (p = 0.029). As expected, progesterone concentrations were higher during the luteal phase as compared to the late follicular phase, but interestingly, progesterone concentrations were negatively associated with exclusion effects. When accounting for mediation via progesterone, direct cycle-phase related differences in social exclusion effects even increased as compared to the model without mediator. These findings suggest that progesterone may function as buffer against negative feelings that result from being socially excluded. The relevance of these findings for Premenstrual Dysphoric Disorder (PMDD) are discussed, and we conclude that social exclusion may represent an important research domain criterion (RDoC) of relevance for PMDD, with progesterone pointing to new potential pharmacological targets.
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Affiliation(s)
| | - Fabian Probst
- Institute of Psychology, University of Bern, Bern, Switzerland
| | - Vanda Lory
- Institute of Psychology, University of Bern, Bern, Switzerland
| | - Andrea H Meyer
- Division of Clinical Psychology and Epidemiology, Department of Psychology, University of Basel, Basel, Switzerland
| | - Gunther Meinlschmidt
- Division of Clinical Psychology and Epidemiology, Department of Psychology, University of Basel, Basel, Switzerland; International Psychoanalytic University, Division of Clinical Psychology and Cognitive Behavioral Therapy, Berlin, Germany; Department of Psychosomatic Medicine, University Hospital Basel and University of Basel, Switzerland
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38
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Velasco ER, Florido A, Milad MR, Andero R. Sex differences in fear extinction. Neurosci Biobehav Rev 2019; 103:81-108. [PMID: 31129235 DOI: 10.1016/j.neubiorev.2019.05.020] [Citation(s) in RCA: 70] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2018] [Revised: 03/08/2019] [Accepted: 05/19/2019] [Indexed: 12/18/2022]
Abstract
Despite the exponential increase in fear research during the last years, few studies have included female subjects in their design. The need to include females arises from the knowledge gap of mechanistic processes underlying the behavioral and neural differences observed in fear extinction. Moreover, the exact contribution of sex and hormones in relation to learning and behavior is still largely unknown. Insights from this field could be beneficial as fear-related disorders are twice as prevalent in women compared to men. Here, we review an up-to-date summary of animal and human studies in adulthood that report sex differences in fear extinction from a structural and functional approach. Furthermore, we describe how these factors could contribute to the observed sex differences in fear extinction during normal and pathological conditions.
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Affiliation(s)
- E R Velasco
- Institut de Neurociències, Universitat Autònoma de Barcelona, Spain
| | - A Florido
- Institut de Neurociències, Universitat Autònoma de Barcelona, Spain
| | - M R Milad
- Department of Psychiatry, University of Illinois at Chicago, USA
| | - R Andero
- Institut de Neurociències, Universitat Autònoma de Barcelona, Spain; CIBERSAM, Corporació Sanitaria Parc Taulí, Sabadell, Spain; Department of Psychobiology and Methodology of Health Sciences, Universitat Autònoma de Barcelona, Spain.
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Machado Figueiredo R, de Carvalho MC, Brandão ML, Lovick TA. Short-term, low-dose fluoxetine prevents oestrous cycle-linked increase in anxiety-like behaviour in female rats. J Psychopharmacol 2019; 33:548-557. [PMID: 31012390 DOI: 10.1177/0269881119841833] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
BACKGROUND AND AIMS We sought a robust behavioural test that evoked increased anxiety-like behaviour during the late dioestrus phase of the oestrous cycle (similar to the premenstrual period in women) and tested whether this could be prevented by acute low-dose fluoxetine (FLX). METHODS Female Wistar rats in different stages of their cycle were exposed to four different tests of anxiety-like behaviour. RESULTS No oestrous cycle differences were detected in fear potentiated startle or conditioned freezing to an aversive context. In a light switch-off test where rats move from one compartment of a shuttle-box to the other to turn off an aversive light, females displayed enhanced responding in late dioestrus. During isolation restraint stress females in late dioestrus emitted three times more 22 kHz ultrasound vocalisations (USV) than at other cycle stages. Using the USV test, short-term administration of low-dose FLX (1.75 mg kg-1, i.p.) designed to blunt the sharp fall in brain allopregnanolone concentration during late dioestrus but without affecting 5-HT systems, prevented the increase in isolation stress-evoked USVs. CONCLUSIONS The light switch-off and isolation restraint-induced USV tests evoke unconditioned adverse emotional responses that are ethologically relevant and sensitive to oestrous cycle stage. The USV test fulfils many criteria required of a model for premenstrual syndrome in women. Using the USV test, short-term administration of FLX to increase brain allopregnanolone concentration without affecting 5-HT systems prevented the increased USV responding in late dioestrus. Short-term low-dose FLX treatment may have potential to alleviate development of adverse premenstrual symptoms in women.
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Affiliation(s)
- Rebeca Machado Figueiredo
- 1 Laboratório de Neuropsicofarmacologia, FFCLRP, Universidade de São Paulo, Campus USP, Ribeirão Preto, SP, Brazil.,2 Instituto de Neurociências e Comportamento, Avenida do Café 2450, Ribeirão Preto, SP, Brazil
| | - Milene Cristina de Carvalho
- 1 Laboratório de Neuropsicofarmacologia, FFCLRP, Universidade de São Paulo, Campus USP, Ribeirão Preto, SP, Brazil.,2 Instituto de Neurociências e Comportamento, Avenida do Café 2450, Ribeirão Preto, SP, Brazil
| | - Marcus Lira Brandão
- 1 Laboratório de Neuropsicofarmacologia, FFCLRP, Universidade de São Paulo, Campus USP, Ribeirão Preto, SP, Brazil.,2 Instituto de Neurociências e Comportamento, Avenida do Café 2450, Ribeirão Preto, SP, Brazil
| | - Thelma Anderson Lovick
- 2 Instituto de Neurociências e Comportamento, Avenida do Café 2450, Ribeirão Preto, SP, Brazil.,3 School of Physiology, Pharmacology and Neuroscience, University of Bristol, Bristol, UK
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40
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Soyer-Gobillard MO, Gaspari L, Courtet P, Puillandre M, Paris F, Sultan C. Neurodevelopmental disorders in children exposed in utero to synthetic progestins: analysis from the national cohort of the Hhorages Association. Gynecol Endocrinol 2019; 35:247-250. [PMID: 30626235 DOI: 10.1080/09513590.2018.1512968] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
The medical and scientific communities have not yet fully acknowledged the undesirable effects of the synthetic hormones that have been administered to pregnant women for decades. The somatic effects of in utero exposure to diethylstilbestrol (DES), such as genital malformations, infertility, and cancer, have long been recognized but this has not been the case concerning psychiatric disorders. The progestins used in contraception and hormone replacement therapy are known to affect the adult brain, but no data exist on their effects due to in utero exposure of children. The Hhorages Association, a national patient support group, has assembled a cohort of 1200 women who took synthetic hormones during pregnancy. These women had a combined 1934 children. We obtained full questionnaire responses from 46 women treated with progestins only - and not an estrogenic cocktail - who gave birth to 115 children. Three groups were observed: Group 1 (n = 18): firstborn unexposed children, Group 2 (n = 62): children exposed in utero to synthetic progestins, and Group 3 (n = 35): children born after a previous pregnancy treated with progestins. No psychiatric disorders were reported in Group 1 and the incidence of psychiatric disorders was drastically elevated in Group 2. Our work shows a striking increase in psychiatric disorders among children exposed in utero to progestins and strongly suggests that prenatal exposure is associated with a high risk of psychiatric disorders in adolescence and adulthood, whether accompanied or not by disorders of sex development.
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Affiliation(s)
- Marie-Odile Soyer-Gobillard
- a Centre National de la Recherche Scientifique, Sorbonne University, Université P. et M. Curie (Paris 6) , France
- b Association HHORAGES-France (Halte aux HORmones Artificielles pour les GrossessES) , Asnières sur Oise , France
| | - Laura Gaspari
- c Service de Pédiatrie I , Unité d'endocrinologie et gynécologie pédiatrique , Université de Montpellier , France
| | - Philippe Courtet
- d Département d'urgence et Post urgence Psychiatrique , CHU Montpellier and Université de Montpellier , Montpellier , France
| | - Mauricette Puillandre
- b Association HHORAGES-France (Halte aux HORmones Artificielles pour les GrossessES) , Asnières sur Oise , France
| | - Françoise Paris
- c Service de Pédiatrie I , Unité d'endocrinologie et gynécologie pédiatrique , Université de Montpellier , France
| | - Charles Sultan
- c Service de Pédiatrie I , Unité d'endocrinologie et gynécologie pédiatrique , Université de Montpellier , France
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Stickel S, Wagels L, Wudarczyk O, Jaffee S, Habel U, Schneider F, Chechko N. Neural correlates of depression in women across the reproductive lifespan - An fMRI review. J Affect Disord 2019; 246:556-570. [PMID: 30605874 DOI: 10.1016/j.jad.2018.12.133] [Citation(s) in RCA: 37] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/25/2018] [Revised: 10/19/2018] [Accepted: 12/26/2018] [Indexed: 01/12/2023]
Abstract
INTRODUCTION Depressive disorders in women emerge largely during transitions in their reproductive aging cycle, which can be attributed to internal endocrine possesses that affect emotion-associated brain circuits. A review was performed to outline the neural basis in depression during female puberty, premenstrual dysphoric disorder (PMDD), postpartum depression disorder (PPD) and perimenopausal depression disorder. METHODS For this review, Web of science, Pubmed and PsychInfo databases were searched for functional brain imaging studies addressing reproductive cycle-related mood disorder. The results are summarized and discussed within a broader theoretical framework of major depression disorder (MDD) to determine how reproductive-sensitive phases contribute to affective symptoms and how they relate to the neurobiology of MDD. RESULTS Neural activation patterns of all depressive disorders related to female reproductive cycle, except for puberty depression, differ from these observed in MDD. While the PMDD results are widely divergent, the activation patterns in PPD show general hypoactivation in all respects. LIMITATIONS Systematic comparisons between the diverse depression disorders are impeded by the heterogeneous experimental protocols used on different samples, reproductive aging stages and depression types. CONCLUSION Given that hormonal fluctuations strongly influence the development of a reproductive cycle-related depression, it is possible that the hormonal and neural patterns are indicative of distinct mood disorder with phase specific biotypes, that only show behavioral similarities to MDD. Understanding the similarities and differences in the neural functioning of female cycle-related mood disorders evaluated against MDD might help elucidate the role of neuroendocrine involvement in development of depression in women, and potentially facilitate the search for prevention and treatment approaches for women' reproductive-related depressions.
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Affiliation(s)
- Susanne Stickel
- Department of Psychiatry, Psychotherapy and Psychosomatics, Medical Faculty, Uniklinik RWTH Aachen University, Pauwelstraße 30, 52074 Aachen, Germany; Institute of Neuroscience and Medicine: JARA-Institute Brain Structure Function Relationship (INM 10), Research Center Jülich, Jülich, Germany.
| | - Lisa Wagels
- Department of Psychiatry, Psychotherapy and Psychosomatics, Medical Faculty, Uniklinik RWTH Aachen University, Pauwelstraße 30, 52074 Aachen, Germany; Institute of Neuroscience and Medicine: JARA-Institute Brain Structure Function Relationship (INM 10), Research Center Jülich, Jülich, Germany
| | - Olga Wudarczyk
- Department of Psychiatry, Psychotherapy and Psychosomatics, Medical Faculty, Uniklinik RWTH Aachen University, Pauwelstraße 30, 52074 Aachen, Germany; Institute of Neuroscience and Medicine: JARA-Institute Brain Structure Function Relationship (INM 10), Research Center Jülich, Jülich, Germany
| | - Sara Jaffee
- Department of Psychology, University of Pennsylvania, Philadelphia, USA
| | - Ute Habel
- Department of Psychiatry, Psychotherapy and Psychosomatics, Medical Faculty, Uniklinik RWTH Aachen University, Pauwelstraße 30, 52074 Aachen, Germany; Institute of Neuroscience and Medicine: JARA-Institute Brain Structure Function Relationship (INM 10), Research Center Jülich, Jülich, Germany
| | - Frank Schneider
- Department of Psychiatry, Psychotherapy and Psychosomatics, Medical Faculty, Uniklinik RWTH Aachen University, Pauwelstraße 30, 52074 Aachen, Germany; University Hospital, Heinrich Heine University Düsseldorf, Düsseldorf, Germany
| | - Natalia Chechko
- Department of Psychiatry, Psychotherapy and Psychosomatics, Medical Faculty, Uniklinik RWTH Aachen University, Pauwelstraße 30, 52074 Aachen, Germany; Institute of Neuroscience and Medicine: JARA-Institute Brain Structure Function Relationship (INM 10), Research Center Jülich, Jülich, Germany
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Depression as a Neuroendocrine Disorder: Emerging Neuropsychopharmacological Approaches beyond Monoamines. Adv Pharmacol Sci 2019; 2019:7943481. [PMID: 30719038 PMCID: PMC6335777 DOI: 10.1155/2019/7943481] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2018] [Revised: 11/27/2018] [Accepted: 12/05/2018] [Indexed: 01/26/2023] Open
Abstract
Depression is currently recognized as a crucial problem in everyday clinical practice, in light of ever-increasing rates of prevalence, as well as disability, morbidity, and mortality related to this disorder. Currently available antidepressant drugs are notoriously problematic, with suboptimal remission rates and troubling side-effect profiles. Their mechanisms of action focus on the monoamine hypothesis for depression, which centers on the disruption of serotonergic, noradrenergic, and dopaminergic neurotransmission in the brain. Nevertheless, views on the pathophysiology of depression have evolved notably, and the comprehension of depression as a complex neuroendocrine disorder with important systemic implications has sparked interest in a myriad of novel neuropsychopharmacological approaches. Innovative pharmacological targets beyond monoamines include glutamatergic and GABAergic neurotransmission, brain-derived neurotrophic factor, various endocrine axes, as well as several neurosteroids, neuropeptides, opioids, endocannabinoids and endovanilloids. This review summarizes current knowledge on these pharmacological targets and their potential utility in the clinical management of depression.
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Espin L, Villada C, Hidalgo V, Salvador A. Effects of sex and menstrual cycle phase on cardiac response and alpha- amylase levels in psychosocial stress. Biol Psychol 2018; 140:141-148. [PMID: 30552951 DOI: 10.1016/j.biopsycho.2018.12.002] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2018] [Revised: 10/30/2018] [Accepted: 12/04/2018] [Indexed: 11/19/2022]
Abstract
The impact of sex and the menstrual cycle phase on the autonomic response to psychosocial stress remains controversial. This study explored autonomic nervous system activity through salivary alpha-amylase, heart rate, and heart rate variability responses to the Trier Social Stress Test (TSST) in healthy young people. The sample was composed of 25 men, 26 women in the luteal phase, and 25 women in the follicular phase, from 18 to 25 years of age. Participants were exposed to the TSST or a control condition. The results indicate that women in their follicular phase showed a blunted alpha-amylase response to stress compared to men and women in the luteal phase. In addition, men showed higher sympatho-vagal activity in the stress condition compared to the two groups of women. These results confirm that sex and the menstrual cycle phase are potential modulators of autonomic nervous system reactivity to psychosocial stress.
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Affiliation(s)
- Laura Espin
- Department of Human Anatomy and Psychobiology, University of Murcia, 30100 Murcia, Spain; Laboratory of Social Cognitive Neuroscience, IDOCAL, Department of Psychobiology, University of Valencia, 46010 Valencia, Spain.
| | - Carolina Villada
- Laboratory of Social Cognitive Neuroscience, IDOCAL, Department of Psychobiology, University of Valencia, 46010 Valencia, Spain; Department of Cognitive and Behavioral Neurobiology, Institute of Neurobiology, National Autonomous University of Mexico, Juriquilla, Querétaro, Mexico
| | - Vanesa Hidalgo
- Laboratory of Social Cognitive Neuroscience, IDOCAL, Department of Psychobiology, University of Valencia, 46010 Valencia, Spain; IIS Aragón, Department of Psychology and Sociology, Area of Psychobiology, University of Zaragoza, Teruel, Spain
| | - Alicia Salvador
- Laboratory of Social Cognitive Neuroscience, IDOCAL, Department of Psychobiology, University of Valencia, 46010 Valencia, Spain
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Wei S, Sun P, Guo Y, Chen J, Wang J, Song C, Li Z, Xue L, Qiao M. Gene Expression in the Hippocampus in a Rat Model of Premenstrual Dysphoric Disorder After Treatment With Baixiangdan Capsules. Front Psychol 2018; 9:2065. [PMID: 30483168 PMCID: PMC6242977 DOI: 10.3389/fpsyg.2018.02065] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2018] [Accepted: 10/08/2018] [Indexed: 12/18/2022] Open
Abstract
Objective: To explore the targets, signal regulatory networks and mechanisms involved in Baixiangdan (BXD) capsule regulation of premenstrual dysphoric disorder (PMDD) at the gene transcription level, since the etiology and pathogenesis of PMDD are not well understood. Methods: The PMDD rat model was prepared using the resident-intruder paradigm. The rats were tested for aggressive behavior, and those with scores in the lowest 30% were used as controls, while rats with scores in the highest 30% were divided into a PMDD model group, BXD administration group and fluoxetine administration group, which were evaluated with open-field tests and aggressive behavior tests. We also analyzed gene expression profiles in the hippocampus for each group, and verified differential expression of genes by real-time PCR. Results: Before and after BXD or fluoxetine administration, scores in the open-field test exhibited no significant differences. The aggressive behavior of the PMDD model rats was improved to a degree after administration of both substances. Gene chip data indicated that 715 genes were differentially expressed in the control and BXD groups. Other group-to-group comparisons exhibited smaller numbers of differentially expressed genes. The effective targets of both drugs included the Htr2c, Cdh3, Serpinb1a, Ace, Trpv4, Cacna1a, Mapk13, Mapk8, Cyp2c13, and Htr1a genes. The results of real-time PCR tests were in accordance with the gene chip data. Based on the target genes and signaling pathway network analysis, we have elaborated the impact and likely mechanism of BXD in treating PMDD and premenstrual irritability. Conclusion: Our work contributes to the understanding of PMDD pathogenesis and the mechanisms of BXD treatment. We speculate that the differentially expressed genes could participate in neuroactive ligand-receptor interactions, mitogen-activated protein kinase, calcium, and gamma-aminobutyric acid signal transduction.
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Affiliation(s)
- Sheng Wei
- Lab of Traditional Chinese Medicine Classical Theory, Ministry of Education, Shandong University of Traditional Chinese Medicine, Jinan, China.,Behavioral Phenotyping Core Facility, Shandong University of Traditional Chinese Medicine, Jinan, China
| | - Peng Sun
- Lab of Traditional Chinese Medicine Classical Theory, Ministry of Education, Shandong University of Traditional Chinese Medicine, Jinan, China
| | - Yinghui Guo
- Lab of Traditional Chinese Medicine Classical Theory, Ministry of Education, Shandong University of Traditional Chinese Medicine, Jinan, China
| | - Jingxuan Chen
- Lab of Traditional Chinese Medicine Classical Theory, Ministry of Education, Shandong University of Traditional Chinese Medicine, Jinan, China.,Behavioral Phenotyping Core Facility, Shandong University of Traditional Chinese Medicine, Jinan, China
| | - Jieqiong Wang
- Lab of Traditional Chinese Medicine Classical Theory, Ministry of Education, Shandong University of Traditional Chinese Medicine, Jinan, China
| | - Chunhong Song
- Lab of Traditional Chinese Medicine Classical Theory, Ministry of Education, Shandong University of Traditional Chinese Medicine, Jinan, China
| | - Zifa Li
- Behavioral Phenotyping Core Facility, Shandong University of Traditional Chinese Medicine, Jinan, China
| | - Ling Xue
- Lab of Traditional Chinese Medicine Classical Theory, Ministry of Education, Shandong University of Traditional Chinese Medicine, Jinan, China
| | - Mingqi Qiao
- Lab of Traditional Chinese Medicine Classical Theory, Ministry of Education, Shandong University of Traditional Chinese Medicine, Jinan, China
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Reynolds TA, Makhanova A, Marcinkowska UM, Jasienska G, McNulty JK, Eckel LA, Nikonova L, Maner JK. Progesterone and women's anxiety across the menstrual cycle. Horm Behav 2018; 102:34-40. [PMID: 29673619 DOI: 10.1016/j.yhbeh.2018.04.008] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/28/2017] [Revised: 04/10/2018] [Accepted: 04/13/2018] [Indexed: 12/22/2022]
Abstract
Animal models and a few human investigations suggest progesterone may be associated with anxiety. Progesterone naturally fluctuates across the menstrual cycle, offering an opportunity to understand how within-person increases in progesterone and average progesterone levels across the cycle correspond to women's anxiety. Across two longitudinal studies, we simultaneously modeled the between- and within-person associations between progesterone and anxiety using multilevel modeling. In Study 1, 100 Polish women provided saliva samples and reported their anxiety at three phases of the menstrual cycle: follicular, peri-ovulatory, and luteal. A significant between-person effect emerged, revealing that women with higher average progesterone levels across their cycles reported higher levels of anxiety than women with lower progesterone cycles. This effect held controlling for estradiol. In Study 2, 61 American women provided saliva samples and reported their attachment anxiety during laboratory sessions during the same three cycle phases. A significant between-person and within-person association emerged: women with higher average progesterone levels reported higher levels of attachment anxiety, and as women's progesterone levels increased across their cycles, so too did their attachment anxiety. These effects held controlling for cortisol. In sum, both studies provide support for a link between menstrual cycle progesterone levels and subjective anxiety.
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Affiliation(s)
- Tania A Reynolds
- Department of Psychology, Florida State University, 1107 W. Call St., Tallahassee, FL 32304, United States.
| | - Anastasia Makhanova
- Department of Psychology, Florida State University, 1107 W. Call St., Tallahassee, FL 32304, United States.
| | - Urszula M Marcinkowska
- Department of Environmental Health, Faculty of Health Sciences, Jagiellonian University Medical College, Grzegórzecka 20, Krakow, Poland.
| | - Grazyna Jasienska
- Department of Environmental Health, Faculty of Health Sciences, Jagiellonian University Medical College, Grzegórzecka 20, Krakow, Poland.
| | - James K McNulty
- Department of Psychology, Florida State University, 1107 W. Call St., Tallahassee, FL 32304, United States.
| | - Lisa A Eckel
- Department of Psychology, Florida State University, 1107 W. Call St., Tallahassee, FL 32304, United States.
| | - Larissa Nikonova
- Department of Psychology, Florida State University, 1107 W. Call St., Tallahassee, FL 32304, United States.
| | - Jon K Maner
- Department of Psychology, Florida State University, 1107 W. Call St., Tallahassee, FL 32304, United States.
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Kornfield SL, Hantsoo L, Epperson CN. What Does Sex Have to Do with It? The Role of Sex as a Biological Variable in the Development of Posttraumatic Stress Disorder. Curr Psychiatry Rep 2018; 20:39. [PMID: 29777319 PMCID: PMC6354938 DOI: 10.1007/s11920-018-0907-x] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
PURPOSE OF REVIEW This review highlights the neurobiological aspects of sex differences in posttraumatic stress disorder (PTSD), specifically focusing on the physiological responses to trauma and presents evidence supporting hormone and neurosteroid/peptide differences from both preclinical and clinical research. RECENT FINDINGS While others have suggested that trauma type or acute emotional reaction are responsible for women's disproportionate risk to PTSD, neither of these explanations fully accounts for the sex differences in PTSD. Sex differences in brain neurocircuitry, anatomy, and neurobiological processes, such as those involved in learning and memory, are discussed as they have been implicated in risk and resilience for the development of PTSD. Gonadal and stress hormones have been found to modulate sex differences in the neurocircuitry and neurochemistry underlying fear learning and extinction. Preclinical research has not consistently controlled for hormonal and reproductive status of rodents nor have clinical studies consistently examined these factors as potential moderators of risk for PTSD. Sex as a biological variable (SABV) should be considered, in addition to the endocrine and reproductive status of participants, in all stress physiology and PTSD research.
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Affiliation(s)
- Sara L Kornfield
- Department of Psychiatry, Perelman School of Medicine at the University of Pennsylvania, 3535 Market Street, Room 3005, Philadelphia, PA, 19104, USA.
| | - Liisa Hantsoo
- Department of Psychiatry, Perelman School of Medicine at the University of Pennsylvania, 3535 Market Street, Room 3005, Philadelphia, PA, 19104, USA
| | - C Neill Epperson
- Department of Psychiatry, Perelman School of Medicine at the University of Pennsylvania, 3535 Market Street, Room 3005, Philadelphia, PA, 19104, USA
- Department of Obstetrics and Gynecology, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA
- Penn PROMOTES Research on Sex and Gender in Health, University of Pennsylvania, Philadelphia, PA, USA
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Shojaee A, Taherianfard M. Effects of Gonadectomy and Avoidance Learning on the GABAAα1 Receptor Density in the Prefrontal Cortex of Male and Female Rats. NEUROPHYSIOLOGY+ 2018. [DOI: 10.1007/s11062-018-9693-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Zettermark S, Perez Vicente R, Merlo J. Hormonal contraception increases the risk of psychotropic drug use in adolescent girls but not in adults: A pharmacoepidemiological study on 800 000 Swedish women. PLoS One 2018; 13:e0194773. [PMID: 29566064 PMCID: PMC5864056 DOI: 10.1371/journal.pone.0194773] [Citation(s) in RCA: 54] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2017] [Accepted: 03/11/2018] [Indexed: 12/18/2022] Open
Abstract
The burden of depression and anxiety disorders is greater in women, and female sex hormones have been shown to affect mood. Psychological side effects of hormonal contraception (HC) are also a common complaint in the clinic, but few previous studies have investigated this subject. We therefore wanted to investigate whether use of HC was associated with adverse psychological health outcomes, and whether this association was modified by age. All women aged 12–30 years on 31 December 2010, residing in Sweden for at least four years and with no previous psychiatric morbidity (n = 815 662), were included. We followed the women from their first HC use (or 31 December 2010, if they were non-users) at baseline, until a prescription fill of psychotropic drugs or the end of the one-year follow-up. We performed age-stratified logistic regression models and estimated odds ratios (OR) to measure the association between different HC methods and psychotropic drug use, as well as the area under the receiver operating curve to estimate discriminatory accuracy of HC in relation to psychotropic drugs. Overall, we found an association between HC and psychotropic drugs (adjusted OR 1.34, 95% confidence interval [CI] 1.30–1.37). In the age-stratified analysis, the strongest association was found in adolescent girls (adjusted OR 3.46, 95% CI 3.04–4.94 for age 12 to 14 years), while it was non-existent for adult women. We conclude that hormonal contraception is associated with psychotropic drug use among adolescent girls, suggesting an adverse effect of HC on psychological health in this population.
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Affiliation(s)
- Sofia Zettermark
- Unit of Social Epidemiology, Department of Clinical Sciences, Lund University, Clinical Research Center, Malmö, Sweden
- * E-mail:
| | - Raquel Perez Vicente
- Unit of Social Epidemiology, Department of Clinical Sciences, Lund University, Clinical Research Center, Malmö, Sweden
| | - Juan Merlo
- Unit of Social Epidemiology, Department of Clinical Sciences, Lund University, Clinical Research Center, Malmö, Sweden
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Girit N, Tugrul I, Demirci B, Bozkurt O, Dost T, Birincioglu M, Tanriverdi HA. Drug exposure in early pregnancy might be related to the effects of increased maternal progesterone in implantation period. J Psychosom Obstet Gynaecol 2018. [PMID: 28635531 DOI: 10.1080/0167482x.2017.1289370] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
Abstract
AIM This short communication aims to evaluate the relation in between drug exposure time and early pregnancy regarding gestational weeks. METHODS The study covers the referrals made to the Department of Pharmacology for a teratogenic consultation in a 3-year period. From the recordings of pregnant women, the last menstrual period and the starting date of medication were used to determine the time of prescription with regard to gestational weeks. RESULTS In all of the three years, potentially teratogenic medication was prescribed more frequently in the 3rd, 4th and 5th gestational weeks (in between 15-35 days of pregnancy). Approximately 75% of the pregnant women in the study were prescribed with drugs, most frequently with analgesics, antibiotics, gastrointestinal drugs and antidepressants, in these gestational weeks. CONCLUSIONS The timing of prescriptions in early pregnancy frequently coincides with the increased levels of maternal progesterone in implantation period. Progesterone may lead to negative mood symptoms of an increased pain perception, anxiety, irritability and aggression in some of the pregnant women and therefore causes an increased stress condition which in turn may result in pain, infection and inflammation in the individual. Taking the frequently used medications into consideration, the reason for prescriptions in this period might be related to the symptoms originating from the effects of progesterone. Future studies are needed to better demonstrate this association of drug exposure and effects of maternal progesterone in early pregnancy.
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Affiliation(s)
- Necip Girit
- a Department of Medical Pharmacology, Faculty of Medicine , Adnan Menderes University , Aydın , Turkey
| | - Ibrahim Tugrul
- a Department of Medical Pharmacology, Faculty of Medicine , Adnan Menderes University , Aydın , Turkey
| | - Buket Demirci
- a Department of Medical Pharmacology, Faculty of Medicine , Adnan Menderes University , Aydın , Turkey
| | - Ozlem Bozkurt
- b Department of Biophysics, Faculty of Medicine , Adnan Menderes University , Aydın , Turkey
| | - Turhan Dost
- a Department of Medical Pharmacology, Faculty of Medicine , Adnan Menderes University , Aydın , Turkey
| | - Mustafa Birincioglu
- a Department of Medical Pharmacology, Faculty of Medicine , Adnan Menderes University , Aydın , Turkey
| | - H Alper Tanriverdi
- c Department of Obstetrics and Gynecolgy, Perinataology Unit, Faculty of Medicine , Adnan Menderes University , Aydın , Turkey
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Caruso S, Cianci S, Vitale SG, Fava V, Cutello S, Cianci A. Sexual function and quality of life of women adopting the levonorgestrel-releasing intrauterine system (LNG-IUS 13.5 mg) after abortion for unintended pregnancy. EUR J CONTRACEP REPR 2018; 23:24-31. [PMID: 29436865 DOI: 10.1080/13625187.2018.1433824] [Citation(s) in RCA: 54] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
PURPOSE The aim of the study was to investigate the impact of the long-acting reversible contraception (LARC) levonorgestrel-releasing intrauterine system (LNG-IUS 13.5 mg) on sexual function and quality of life (QoL) in women after having undergone abortion for unintended pregnancy. METHODS In a prospective controlled study, 128 women aged 16-35 years received counseling to adopt LNG-IUS contraception after termination of pregnancy. The Visual Analog Scale (VAS), the Short Form-36 questionnaire (SF-36), the Female Sexual Function Index (FSFI) and the Female Sexual Distress Scale (FSDS) were used to investigate, respectively, pelvic pain levels, QoL, sexual function and sexual distress of these women at baseline (T0) and at 6 (T1) and 12 (T2) months after LNG-IUS placement. RESULTS Sixty-six (51.6%) women adopted a SARC method, mainly because of the cost of the LNG-IUS. They constituted the control group. The study group consisted of 62 (48.4%) women. Improvement of QoL was observed at T1 (p < .05) and T2 (p < .01). Moreover, sexual function improved and dyspareunia decreased over the study period compared to baseline (p < .001). Dysmenorrhea measured by VAS improved at T1 and at T2 (p < .001). The women of the control group did not experience statistically significant changes at T1 and T2 compared to T0 (p = NS). CONCLUSIONS Women who underwent termination of pregnancy experienced positive changes in QoL and sexual function during LNG-IUS use. These results have to be confirmed in larger studies. However, not all women could adopt the LNG-IUS because of the cost of the contraceptive.
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Affiliation(s)
- Salvatore Caruso
- a Department of General Surgery and Medical Surgical Specialties , Gynecological Clinic, Research Group for Sexology, University of Catania , Catania , Italy
| | - Stefano Cianci
- a Department of General Surgery and Medical Surgical Specialties , Gynecological Clinic, Research Group for Sexology, University of Catania , Catania , Italy
| | - Salvatore Giovanni Vitale
- a Department of General Surgery and Medical Surgical Specialties , Gynecological Clinic, Research Group for Sexology, University of Catania , Catania , Italy
| | - Valentina Fava
- a Department of General Surgery and Medical Surgical Specialties , Gynecological Clinic, Research Group for Sexology, University of Catania , Catania , Italy
| | - Silvia Cutello
- a Department of General Surgery and Medical Surgical Specialties , Gynecological Clinic, Research Group for Sexology, University of Catania , Catania , Italy
| | - Antonio Cianci
- a Department of General Surgery and Medical Surgical Specialties , Gynecological Clinic, Research Group for Sexology, University of Catania , Catania , Italy
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