Testosterone reduces functional connectivity during the 'Reading the Mind in the Eyes' Test

An fMRI study on alexithymia and affective state recognition in the Reading the Mind in the Eyes Test

Recognizing others' affective states is essential for successful social interactions. Alexithymia, characterized by difficulties in identifying and describing one's own emotions, has been linked to deficits in recognizing emotions and mental states in others. To investigate how neural correlates of affective state recognition are affected by different facets of alexithymia, we conducted a functional magnetic resonance imaging study with 53 healthy participants (aged 19-36 years, 51% female) using the Reading the Mind in the Eyes Test (RMET) and three different measures of alexithymia [Toronto Structured Interview for Alexithymia (TSIA), Toronto Alexithymia Scale (TAS-20), and Bermond-Vorst Alexithymia Questionnaire]. In addition, we examined brain activity during the RMET and replicated previous findings with task-related brain activation in the inferior frontal and temporal gyri, as well as the insula. No association was found between alexithymia and behavioral performance in the RMET, possibly due to the low number of participants with high alexithymia levels. Region of interest based analyses revealed no associations between alexithymia and amygdala or insula activity during the RMET. At the whole-brain level, both a composite alexithymia score and the unique variance of the alexithymia interview (TSIA) were associated with greater activity in visual processing areas during the RMET. This may indicate that affective state recognition performance in alexithymia relies on a higher compensatory activation in visual areas.

The role of external factors in affect-sharing and their neural bases

Affect-sharing, the ability to vicariously feel another person's emotions, is the primary component of empathy that is typically thought to rely on the observer's capacity to feel the emotions of others. However, external signals, such as the target's physical characteristics, have been demonstrated to influence affect-sharing in the neuroscientific literature that speaks to the underappreciated role of external factors in eliciting affect-sharing. We consider factors that influence affect-sharing, including physical cues, emotional cues, situational factors, and observer-target relationships, as well as the neural circuits involved in these processes. Our review reveals that, while neural network activation is primarily responsible for processing affect-sharing, external factors also co-activate a top-down cognitive processing network to modulate the conscious process of affect-sharing. From this knowledge, an integrative framework of external factor interactions with affect-sharing are explained in detail. Finally, we identify critical areas for future research in social and affective neuroscience, including research gaps and incorporation of ecologically valid paradigms.

Hormonal contraceptive exposure relates to changes in resting state functional connectivity of anterior cingulate cortex and amygdala

Introduction

Hormonal contraceptives (HCs), nowadays one of the most used contraceptive methods, downregulate endogenous ovarian hormones, which have multiple plastic effects in the adult brain. HCs usually contain a synthetic estrogen, ethinyl-estradiol, and a synthetic progestin, which can be classified as androgenic or anti-androgenic, depending on their interaction with androgen receptors. Both the anterior cingulate cortex (ACC) and the amygdala express steroid receptors and have shown differential functionality depending on the hormonal status of the participant and the use of HC. In this work, we investigated for the first time the relationship between ACC and amygdala resting state functional connectivity (rs-FC) and HC use duration, while controlling for progestin androgenicity.

Methods

A total of 231 healthy young women participated in five different magnetic resonance imaging studies and were included in the final analysis. The relation between HC use duration and (i) gray matter volume, (ii) fractional amplitude of low-frequency fluctuations, and (iii) seed-based connectivity during resting state in the amygdalae and ACC was investigated in this large sample of women.

Results

In general, rs-FC of the amygdalae with frontal areas, and between the ACC and temporoparietal areas, decreased the longer the HC exposure and independently of the progestin's androgenicity. The type of HC's progestin did show a differential effect in the gray matter volume of left ACC and the connectivity between bilateral ACC and the right inferior frontal gyrus.

Sex and age interact in reading the mind in the eyes

Social cognition includes understanding the mental states (thoughts, feelings, intentions, desires, and beliefs) of others - so-called 'theory of mind' or 'mindreading'. Recent studies have shown an impact of age and sex. Here, we applied the 'Reading the Mind in the Eyes' Test (RMET) that measures the ability to identify mental states from the eye region of the face. RMET accuracy was measured and analyzed in a large population-based sample (N = 1603) across the whole adult age-range from 19 to 79 years with effect size analyses (Hedges' g). Overall test performance was lower in older than younger women and men, whereas differences between women and men were almost negligible across the whole cohort. In a further analysis focusing on age-specific sex differences, RMET accuracy was higher for women below 45 years compared to men. This sex effect nearly vanished in older people above 45 years of age. Results were verified in a sub-cohort after excluding participants with neurological and psychiatric conditions, and with another cut-off, i.e. 50 years of age. In conclusion, results suggest that mindreading declines with age. Overall sex effects were small and results suggest that age-related hormonal and social factors may impact mental state perception. Future mega-analyses and longitudinal studies including hormonal and social measures are needed to validate the interaction between RMET performance, aging and sex.

Cortisol awakening response and testosterone jointly affect adolescents' theory of mind

Adolescence is a critical period for the maturation of neurobiological processes and hormone secretion. Recent studies on the dual-hormone hypothesis have indicated that basal cortisol and testosterone jointly affect dominant and aggressive behavior among adolescents and adults. Whether this hypothesis applies to prosocial-related understanding of others' mental states remains unclear. The present study investigated associations between basal testosterone, basal cortisol (and cortisol awakening response [CAR]), and the cognitive/affective theory of mind (ToM) in 243 adolescents (67.9 % male, aged 14 to 17 years, M_age = 16.09, standard deviation = 0.62). Cognitive ToM (cToM) and affective ToM (aToM) were assessed with a cartoon story reasoning task: In the cToM condition, participants viewed a comic strip story and needed to predict what would happen based on a character's intentions, and in the aToM condition, they viewed a comic strip of two characters interacting and needed to think about what would make the protagonist feel better. The results showed that basal testosterone and basal cortisol did not interact with each other to affect the performance of ToM, either in terms of ToM accuracy or response speed. However, under the condition of low CAR, testosterone is associated with the fast performance of cToM, although the interaction of testosterone and CAR occurred only in female adolescents. Overall, our data provide new evidence for the dual-hormone hypothesis and further extend the hypothesis to social understanding.

Single-dose testosterone administration modulates instant empathic responses to others' pain: An EEG study

Whether or not testosterone can impair empathy remains unclear in the literature. Given that empathic responses to others' emotional experiences depend strongly upon top-down controlled mechanisms of attention, here we investigated whether the effects of testosterone administration on pain empathy could be modulated by manipulating attention. We used a double-blind, placebo-controlled within-participant design, in which either testosterone or placebo was administrated in separate sessions. Images depicting painful or nonpainful scenes were presented to induce instant empathic responses. Experiment 1 adopted the pain-judgment and hands-counting tasks to direct attention toward painful or nonpainful aspect of the images, respectively. Experiment 2 employed the pain-rating task to estimate affective and cognitive aspects of pain empathy. When discriminating nonpainful aspects of the images in the hands-counting task, accuracies were lower and empathic late positive potential responses were greater in testosterone sessions than in placebo sessions. This suggested that testosterone enhanced empathic responses to task-irrelevant pain-related features, which interfered with task performance. When providing empathic ratings to the images in the pain-rating task, empathic event-related potentials in the early stage were only observed in the testosterone session. This suggested that testosterone facilitated automatic affective reactivity to others' pain when elaborately processing empathic stimuli. Nevertheless, when discriminating painful aspects of the images in the pain-judgment task, we did not observe any significant differences between the two sessions. These results demonstrated that testosterone effects on enhancing brain reactivity to empathic stimuli were dependent upon task demands deploying attention allocation. The enhancement likely arose from the altered brain state (e.g., increased vigilance and arousal levels) after testosterone administration, as evidenced by the reduced amplitude of spontaneous α-oscillation recorded before the onset of the images. It expands our understanding of the neurobiological mechanisms that affect empathy, and highlights the role of testosterone.

Reading language of the eyes

The need for assessment of social skills in clinical and neurotypical populations has led to the widespread, and still increasing use of the 'Reading the Mind in the Eyes Test' (RMET) developed more than two decades ago by Simon Baron-Cohen and colleagues for evaluation of social cognition in autism. By analyzing most recent clinical and brain imaging data, we illuminate a set of factors decisive for using the RMET. Converging evidence indicates: (i) In neurotypical individuals, RMET scores are tightly correlated with other social skills (empathy, emotional intelligence, and body language reading); (ii) The RMET assesses recognition of facial affect, but also heavily relies on receptive language skills, semantic knowledge, and memory; (iii) RMET performance is underwritten by the large-scale ensembles of neural networks well-outside the social brain; (iv) The RMET is limited in its capacity to differentiate between neuropsychiatric conditions as well as between stages and severity of a single disorder, though it reliably distinguishes individuals with altered social cognition or elevated pathological traits from neurotypical persons; (v) Merely gender (as a social construct) rather than neurobiological sex influences performance on the RMET; (vi) RMET scores do not substantially decline in healthy aging, and they are higher with higher education level, cognitive abilities, literacy, and mental well-being; (vii) Accuracy on the RMET, and engagement of the social brain, are greater when emotions are expressed and recognized by individuals with similar cultural/ethnic background. Further research is required to better inform usage of the RMET as a tool for swift and reliable examination of social cognition. In light of comparable visual input from the RMET images and faces covered by masks due to COVID-19 regulations, the analysis is of value for keeping efficient social interaction during the current pandemic, in particular, in professional settings related to social communication.

Testosterone administration does not alter the brain activity supporting cognitive and affective empathy

Although there is evidence that testosterone has deteriorating effects on cognitive and affective empathy, whether testosterone administration influences both routes to understanding others has not yet been simultaneously investigated. We conducted a functional magnetic resonance imaging (fMRI) pharmacological study using a within-subjects, randomized, placebo-controlled, double-blind crossover design to examine the effects of 100 mg transdermal testosterone administration on brain activation during a task that examines affective and cognitive empathy simultaneously in a sample of 23 healthy right-handed adult men. Relative to placebo, testosterone did not alter affective or cognitive empathy functional brain networks. Instead, the task yielded activation in the canonical networks associated with both types of empathy. Affective empathy yielded activation in the inferior and middle frontal gyri, inferior temporal gyri, and the cingulate cortex. Cognitive empathy was associated with activation of the temporoparietal junction, medial prefrontal cortex, middle and inferior temporal gyri, and temporal pole. Behaviourally, testosterone administration decreased error rates and increased participants' confidence in their responses regardless of response accuracy. Independent of testosterone administration, participants reported higher affective responses during emotionally negative scenarios. Even though our results provide further evidence that testosterone administration in healthy men does not alter brain activity underlying cognitive and affective empathy, testosterone administration does influence the empathic concern and hence socio-cognitive processes. The reproducibility and variability of the current and previous findings should nevertheless be addressed in upcoming studies.

Nandrolone Supplementation Promotes AMPK Activation and Divergent 18[FDG] PET Brain Connectivity in Adult and Aged Mice

Decreased anabolic androgen levels are followed by impaired brain energy support and sensing with loss of neural connectivity during physiological aging, providing a neurobiological basis for hormone supplementation. Here, we investigated whether nandrolone decanoate (ND) administration mediates hypothalamic AMPK activation and glucose metabolism, thus affecting metabolic connectivity in brain areas of adult and aged mice. Metabolic interconnected brain areas of rodents can be detected by positron emission tomography using ¹⁸FDG-mPET. Albino CF1 mice at 3 and 18 months of age were separated into 4 groups that received daily subcutaneous injections of either ND (15 mg/kg) or vehicle for 15 days. At the in vivo baseline and on the 14th day, brain ¹⁸FDG-microPET scans were performed. Hypothalamic pAMPK^T172/AMPK protein levels were assessed, and basal mitochondrial respiratory states were evaluated in synaptosomes. A metabolic connectivity network between brain areas was estimated based on ¹⁸FDG uptake. We found that ND increased the pAMPK^T172/AMPK ratio in both adult and aged mice but increased ¹⁸FDG uptake and mitochondrial basal respiration only in adult mice. Furthermore, ND triggered rearrangement in the metabolic connectivity of adult mice and aged mice compared to age-matched controls. Altogether, our findings suggest that ND promotes hypothalamic AMPK activation, and distinct glucose metabolism and metabolic connectivity rearrangements in the brains of adult and aged mice.

The Relationship of Steroid Hormones, Genes Related to Testosterone Metabolism and Behavior in Boys With Autism in Slovakia

OBJECTIVE

Purpose of the study was to identify the relationship among actual plasmatic levels of steroid hormones and behavioral manifestations in boys with autism and to assess the genetic contribution to these manifestations.

METHODS

172 boys with autism under 10 years of age and 135 neurotypical boys attended the study. ADI-R and ADOS-2 were used to evaluate the core symptom severities. Problem behavior was assessed using BPI-01 questionnaire. Levels of testosterone, estradiol, dehydroepiandrosterone, dehydroepiandrosterone-sulfate and sex hormone binding globulin (SHBG) were measured in plasma of autistic boys. Three SNPs (in ESR1, SHBG, SRD5A2 genes) and one STR in AR gene (number of CAG repeats in first exon) were assessed. Hormonal levels and number of CAG repeats in AR gene were used for correlation analysis with behavioral measures. Genotype and allelic frequencies were compared among autistic and neurotypical boys.

RESULTS

We found negative relationship among SHBG levels and restricted, repetitive behaviors (measured by ADOS-2) and positive relationship among actual testosterone levels and frequency of stereotyped behavior (measured by BPI-01).

CONCLUSION

Actual levels of SHBG and testosterone are related to severities of restricted and repetitive behaviors in boys with autism. Mechanisms of action of these hormones in brain require further investigation.

Help or punishment: acute stress moderates basal testosterone's association with prosocial behavior

The gonadal hormone testosterone is well-recognized to facilitate various behaviors for obtaining social status. A good reputation (i.e. competitive, generous, and trustworthy) is of crucial importance for acquiring high social status. It is unclear which type of reputation is preferred by individuals under the influence of testosterone. Given that the recent dual-hormone hypothesis emphasizes the modulating effect of stress (cortisol) on the influence of testosterone, it would be intriguing to test the role of stress-induced cortisol in testosterone-related reputation seeking. To test this hypothesis, we induced acute stress in 93 participants with cold pressor test (CPT) paradigm (vs. control condition), and then they were instructed to play a third-party intervention game, in which they made decisions as an uninvolved, outside the third party to punish a violator, help a victim, or do nothing. Salivary samples were obtained to assess participants' testosterone and cortisol levels. We split the testosterone concentration by median to low endogenous testosterone (LT) and high endogenous testosterone (HT). We found that HT individuals' prosocial preferences did not affect by acute stress. They were more likely to choose punishment than helping under both stress and control conditions. In contrast, individuals with low testosterone were more inclined to help than punish under control conditions. Interestingly, acute stress brought behavior patterns of LT individuals closer to those of HT individuals, that is, they reduced their helping behavior and increased the intensity of punishments. In this preliminary study on the preference inducement of testosterone for different types of prosocial behaviors, we discuss the physiological mechanism of the relationship between testosterone and reputation and the implications of these results for the dual-hormone hypothesis.HIGHLIGHTSLow testosterone (LT) individuals were more inclined to help than punish.High testosterone (HT) individuals were more inclined to punish than help.The HT individuals' preferences for prosocial types were not affected by acute stress.Acute stress brought the behavior patterns of LT individuals closer to those of HT individuals.

A Systematic Review of the Role of Oxytocin, Cortisol, and Testosterone in Facial Emotional Processing

A topic of interest is the way decoding and interpreting facial emotional expressions can lead to mutual understanding. Facial emotional expression is a basic source of information that guarantees the functioning of other higher cognitive processes (e.g., empathy, cooperativity, prosociality, or decision-making, among others). In this regard, hormones such as oxytocin, cortisol, and/or testosterone have been found to be important in modifying facial emotion processing. In fact, brain structures that participate in facial emotion processing have been shown to be rich in receptors for these hormones. Nonetheless, much of this research has been based on correlational designs. In recent years, a growing number of researchers have tried to carry out controlled laboratory manipulation of these hormones by administering synthetic forms of these hormones. The main objective of this study was to carry out a systematic review of studies that assess whether manipulation of these three hormones effectively promotes significant alterations in facial emotional processing. To carry out this review, PRISMA quality criteria for reviews were followed, using the following digital databases: PsycINFO, PubMed, Dialnet, Psicodoc, Web of Knowledge, and the Cochrane Library, and focusing on manuscripts with a robust research design (e.g., randomized, single- or double-blind, and/or placebo-controlled) to increase the value of this systematic review. An initial identification of 6340 abstracts and retrieval of 910 full texts led to the final inclusion of 101 papers that met all the inclusion criteria. Only about 18% of the manuscripts included reported a direct effect of hormone manipulation. In fact, emotional accuracy seemed to be enhanced after oxytocin increases, but it diminished when cortisol and/or testosterone increased. Nonetheless, when emotional valence and participants' gender were included, hormonal manipulation reached significance (in around 53% of the articles). In fact, these studies offered a heterogeneous pattern in the way these hormones altered speed processing, attention, and memory. This study reinforces the idea that these hormones are important, but not the main modulators of facial emotion processing. As our comprehension of hormonal effects on emotional processing improves, the potential to design good treatments to improve this ability will be greater.

Preliminary data on increased reactivity towards children in distress after testosterone administration in women: A matter of protection?

Emotional reactivity to others' distress is a vital prerequisite for a caring response. Testosterone, in contrast, is mostly associated with protection of personal dominance and decreased responsiveness to others' needs. However, experimental work also indicates that rising testosterone levels in response to infant distress can potentially facilitate protection. We assessed the impact of testosterone administration on participants' emotional reactivity to infants in distress, measuring their facial responses on the corrugator supercilii forehead muscle ('frowning') and the zygomaticus major ('smiling') as an index of emotional responses towards children. Moreover, we probed whether the effect of testosterone is moderated by participants' self-reported nurturance and protective tendencies. Our preliminary results showed that testosterone not only increased emotional reactivity to empathy eliciting images of children, but that this increase was strongest in participants with strong protective tendencies. Our administration study is the first to link testosterone to infant protection.

The modulation of social behavior and empathy via oral contraceptives and female sex hormones

Oral contraceptives (OC) and endogenous female sex hormones in naturally cycling women (NC) are related to a wide range of psychological variables (eg, cognition and affect). Little research on social behavior has been done. One study documented a tendency towards more prosocial behavior in NC than OC women, but the underlying neuroendocrine mechanisms remain unknown. The sex hormones progesterone and estradiol are potential candidates. We analyzed social decision-making and social behavior in 83 healthy women (38 OC and 45 NC) via the Social Value Orientation (SVO) and in real social interactions within a paradigm adapted from behavioral economics. We also measured empathy, and collected saliva samples to quantify the basal levels of estradiol and progesterone. Our analyses revealed higher levels of prosocial behavior and emotional empathy in NC than in OC women, a finding supported by higher levels of prosocial decisions in NC than OC women in the SVO. Regarding the underlying biological mechanisms, we detected lower progesterone levels in OC than NC women. Exploratory analyses revealed a negative correlation between progesterone and trust on the trend level. We found no correlations between estradiol and behavior. Our findings provide evidence that OC modulate social behavior and initial indications of a possible modulation by progesterone. Further research is needed to replicate our findings and extend them to other social behaviors.

Effects of testosterone administration on fMRI responses to executive function, aggressive behavior, and emotion processing tasks during severe exercise- and diet-induced energy deficit

BACKGROUND

Clinical administration of testosterone is widely used due to a variety of claimed physical and cognitive benefits. Testosterone administration is associated with enhanced brain and cognitive function, as well as mood, in energy-balanced males, although such relationships are controversial. However, the effects of testosterone administration on the brains of energy-deficient males, whose testosterone concentrations are likely to be well below normal, have not been investigated.

METHODS

This study collected functional magnetic resonance imaging (fMRI) data from 50 non-obese young men before (PRE) and shortly after (POST) 28 days of severe exercise-and-diet-induced energy deficit during which testosterone (200 mg testosterone enanthate per week in sesame oil, TEST) or placebo (sesame seed oil only, PLA) were administered. Scans were also collected after a post-energy-deficit weight regain period (REC). Participants completed five fMRI tasks that assessed aspects of: 1) executive function (Attention Network Task or ANT; Multi-Source Interference Task or MSIT; AXE Continuous Processing Task or AXCPT); 2) aggressive behavior (Provoked Aggression Task or AGG); and 3) latent emotion processing (Emotional Face Processing or EMO).

RESULTS

Changes over time in task-related fMRI activation in a priori defined task-critical brain regions during performance of 2 out of 5 tasks were significantly different between TEST and PLA, with TEST showing greater levels of activation during ANT in the right anterior cingulate gyrus at POST and during MSIT in several brain regions at REC. Changes over time in objective task performance were not statistically significant; testosterone-treated volunteers had greater self-reported anger during AGG at POST.

CONCLUSIONS

Testosterone administration can alter some aspects of brain function during severe energy deficit and increase levels of anger.

Pubertal Testosterone and Brain Response to Faces in Young Adulthood: An Interplay between Organizational and Activational Effects in Young Men

According to the organizational-activational hypothesis, the organizational effects of testosterone during (prenatal) brain development moderate the activational effects of adult testosterone on behavior. Accumulating evidence supports the notion that adolescence is another period during which sex hormones organize the nervous system. Here we investigate how pubertal sex hormones moderate the activational effects of adult sex hormones on social cognition in humans. To do so, we recruited a sample of young men (n = 507; age, ∼19 years) from a longitudinal birth cohort and investigated whether testosterone exposure during adolescence (from 9 to 17 years of age) moderates the relation between current testosterone and brain response to faces in young adulthood, as assessed with functional magnetic resonance imaging (fMRI). Our results showed that the cumulative exposure to testosterone during adolescence moderated the relation between adult testosterone and both the mean fMRI response and functional connectivity (i.e., node strength). Specifically, in participants with low exposure to testosterone during puberty, we observed a positive relationship between current testosterone and the brain response to faces; this was not the case for participants with medium and high pubertal testosterone. Furthermore, we observed a stronger relationship between the brain response and current testosterone in parts of the angry-face network associated with (vs without) motion in the eye region of an observed (angry) face. We speculate that pubertal testosterone modulates the relationship between current testosterone and brain response to social cues carried by the eyes and signaling a potential threat.SIGNIFICANCE STATEMENT Accumulating evidence supports the organizational effects of pubertal testosterone, but the body of literature examining these effects on social cognition in humans is in its infancy. With a sample of young men from a longitudinal birth cohort, we showed that the cumulative exposure to testosterone during adolescence moderated the relation between adult testosterone and both the mean BOLD signal change and functional connectivity. Specifically, we observed a positive relationship between adult testosterone and the brain response to faces in participants with low exposure to testosterone during puberty, but not in participants with medium and high pubertal testosterone. Results of further analysis suggest that sensitivity to cues carried by the eyes might underlie the relationship between testosterone and brain response to faces, especially in the context of a potential threat.

Friend vs. Foe: Cognitive and Affective Empathy in Women With Different Hormonal States

Empathy is crucial for social functioning as well as social coherence. It can be influenced by modulatory factors such as familiarity and liking (i.e., emotional closeness). Furthermore, there are first hints that hormonal status may modulate affective but not cognitive empathy in women. The aim of this study was to investigate potential separate as well as combined modulatory effects of emotional closeness and hormonal status on female cognitive and affective empathy. Three hormonal status groups of women (n = 62) were studied: (1) naturally-cycling (NC) women in the early follicular phase (fNC), (2) NC women during periovulatory phase (oNC), and (3) oral contraceptive (OC) users. All women underwent a newly developed empathy task (i.e., Tübinger Empathy Test, TET) presenting textual descriptions of positive and negative emotional scenes relating to three different perspectives (i.e., self vs. friend vs. enemy/disliked person). Regardless of hormonal status, empathic responses were higher for the friend compared to the enemy perspective for both empathy components. However, cognitive empathy was less affected by varying emotional closeness toward the target person than affective empathy. Hormonal status modulated only affective empathy. OC users showed significantly less affective empathy toward the enemy compared to the fNC women. Overall, affective empathy seems more sensitive to modulatory effects of emotional closeness and hormonal status than cognitive empathy. Possible implications of this current investigation for future research on empathy and OC use, contraceptive education as well as for other clinical applications are discussed.

Hormonal and modality specific effects on males' emotion recognition ability

Successful emotion recognition is a key component of human socio-emotional communication skills. However, little is known about the factors impacting males' accuracy in emotion recognition tasks. This pre-registered study examined potential candidates, focusing on the modality of stimulus presentation, emotion category and individual baseline hormone levels. In an additional exploratory analysis, we examined the association of testosterone x cortisol interaction with recognition accuracy and reaction times. We obtained accuracy and reaction time scores from 282 males who categorized voice, face and voice-face stimuli for nonverbal emotional content. Results showed that recognition accuracy was significantly higher in the audio-visual than in the auditory or visual modality. While Spearman's rank correlations showed no significant association of testosterone (T) with recognition accuracy or with response times for specific emotions, the logistic and linear regression models uncovered some evidence for a positive association between T and recognition accuracy as well as between cortisol (C) and reaction time. In addition, the overall effect size of T by C interaction with recognition accuracy and reaction time was significant, but small. Our results establish that audio-visual congruent stimuli enhance recognition accuracy and provide novel empirical support by showing that the interaction of testosterone and cortisol relates to males' accuracy and response times in emotion recognition tasks.

Testosterone administration in human social neuroendocrinology: Past, present, and future

Over the past 20 years, social neuroendocrinology researchers have developed pharmacological challenge paradigms to assess the extent to which testosterone plays a causal role in human psychological and behavioural processes. The current paper provides a brief summary of this research and offers recommendations for future research examining the neuroendocrine mechanisms underlying human behaviour.

Testosterone synthesis in the female songbird brain

Decades of work have established the brain as a source of steroid hormones, termed 'neurosteroids'. The neurosteroid neuroestradiol is produced in discrete brain areas and influences cognition, sensory processing, reproduction, neurotransmission, and disease. A prevailing research focus on neuroestradiol has essentially ignored whether its immediate synthesis precursor - the androgen testosterone - is also dynamically regulated within the brain. Testosterone itself can rapidly influence neurophysiology and behavior, and there is indirect evidence that the female brain may synthesize significant quantities of testosterone to regulate cognition, reproduction, and behavior. In songbirds, acoustic communication is regulated by neuroestrogens. Neuroestrogens are rapidly synthetized in the caudomedial nidopallium (NCM) of the auditory cortex of zebra finches in response to song and can influence auditory processing and song discrimination. Here, we examined the in vivo dynamics of NCM levels of the neuroestrogen synthesis precursor, testosterone. Unlike estradiol, testosterone did not appear to fluctuate in the female NCM during song exposure. However, a substantial song-induced elevation of testosterone was revealed in the left hemisphere NCM of females when local aromatization (i.e., conversion to estrogens) was locally blocked. This elevation was eliminated when local androgen synthesis was concomitantly blocked. Further, no parallel elevation was observed in the circulation in response to song playback, consistent with a local, neural origin of testosterone synthesis. To our knowledge, this study provides the first direct demonstration that testosterone fluctuates rapidly in the brain in response to socially-relevant environmental stimuli. Our findings suggest therefore that locally-derived 'neuroandrogens' can dynamically influence brain function and behavior. SIGNIFICANCE STATEMENT: This study demonstrates that androgen synthesis occurs rapidly in vivo in the brain in response to social cues, in a lateralized manner. Specifically, testosterone synthesis occurs within the left secondary auditory cortex when female zebra finches hear male song. Therefore, testosterone could act as a neuromodulator to rapidly shape sensory processing. Androgens have been linked to functions such as the control of female libido, and many steroidal drugs used for contraception, anti-cancer treatments, and sexual dysfunction likely influence the brain synthesis and action of testosterone. The current findings therefore establish a clear role for androgen synthesis in the female brain with implications for understanding neural circuit function and behavior in animals, including humans.

Neural responses in the pain matrix when observing pain of others are unaffected by testosterone administration in women

There is evidence of testosterone having deteriorating effects on cognitive and affective empathic behaviour in men and women under varying conditions. However, whether testosterone influences empathy for pain has not yet been investigated. Therefore, we tested neural responses to witnessing others in pain in a within-subject placebo-controlled testosterone administration study in healthy young women. Using functional magnetic resonance imaging, we provide affirming evidence that an empathy-inducing paradigm causes changes in the activity throughout the pain circuitry, including the bilateral insula and anterior cingulate cortex. Administration of testosterone, however, did not influence these activation patterns in the pain matrix. Testosterone has thus downregulating effects on aspects of empathic behaviour, but based on these data does not seem to influence neural responses during empathy for others' pain. This finding gives more insight into the role of testosterone in human empathy.

Effects of exogenous testosterone application on network connectivity within emotion regulation systems

Studies with steroid hormones underlined the vital role of testosterone on social-emotional processing. However, there is still a lack of studies investigating whether testosterone modulates network connectivity during resting-state. Here, we tested how the exogenous application of testosterone would affect functional connectivity between regions implicated in emotion regulation. In total, 96 male participants underwent resting-state fMRI scanning. Before the measurement, half of the subjects received 5 g Testim^TM gel (containing 50 mg testosterone) and the other half a corresponding amount of placebo gel. Seeds for the connectivity analysis were meta-analytically defined. First, all regions associated with emotion regulation were chosen via Neurosynth (data driven). Among those, specific seeds were selected and categorized based on the neural model of emotion regulation by Etkin and colleagues (Etkin et al., 2015) (theory-guided). Resting-state connectivity analysis revealed decreased connectivity between the right DLPFC and the right amygdala as well as between the VMPFC and the left IPL for the testosterone group compared to the placebo group. A complementary dynamic causal modeling (DCM) analysis on findings from the resting-state connectivity analysis underlined a bidirectional coupling which was decreased close to zero by testosterone administration. Our results demonstrate that testosterone administration disrupts resting-state connectivity within fronto-subcortical and fronto-parietal circuits. The findings suggest that even without a specific task (e.g. challenge, reward processing) testosterone modulates brain networks important for social-emotional processing.

Potential explanations of behavioural and other differences and similarities between males and females with autism spectrum disorder

Several potential explanations may be dependent on the dynamics of prenatal and postnatal testosterone in males and females, and to be consistent with Baron-Cohen's concept of extreme male brain. This paper explores the evidence that male and female autistic subjects differ on the average in that they have had different exposures to the causes of autism, females bearing higher genetic burdens for ASD (autistic spectrum disorder), and males having a greater exposure to high intrauterine levels of testosterone (T). The high levels of intrauterine (and possibly postnatal) testosterone to which ASD cases have been exposed, cause a less masculinized physical habitus (including facial features) in exposed males, and a more masculinized physical habitus in exposed females. ASD genes (as opposed to intrauterine testosterone) are mainly responsible for a low mean IQ in ASD (especially female cases). Exposure to high intrauterine T increases the probability that foetuses will be male, thus potentially explaining the high sex ratio (proportion male) of cases of ASD. The Gender Incoherence Model seems to be based on facts unrelated directly to autism. The shifts towards the other sex are argued to be consequent on sex-different reactions to prenatal exposure to high T, not on the pathology itself. The suspected underdiagnosis of female cases is partially dependent on the different proportions of environmental and genetic causes to which male and female cases are hypothesized to have been exposed, and the consequent 'more normal' behaviour of female cases.

Does testosterone impair men's cognitive empathy? Evidence from two large-scale randomized controlled trials

The capacity to infer others' mental states (known as 'mind reading' and 'cognitive empathy') is essential for social interactions across species, and its impairment characterizes psychopathological conditions such as autism spectrum disorder and schizophrenia. Previous studies reported that testosterone administration impaired cognitive empathy in healthy humans, and that a putative biomarker of prenatal testosterone exposure (finger digit ratios) moderated the effect. However, empirical support for the relationship has relied on small sample studies with mixed evidence. We investigate the reliability and generalizability of the relationship in two large-scale double-blind placebo-controlled experiments in young men (n = 243 and n = 400), using two different testosterone administration protocols. We find no evidence that cognitive empathy is impaired by testosterone administration or associated with digit ratios. With an unprecedented combined sample size, these results counter current theories and previous high-profile reports, and demonstrate that previous investigations of this topic have been statistically underpowered.

What Do You Have in Mind? Measures to Assess Mental State Reasoning in Neuropsychiatric Populations

Social interaction is closely associated with both functional capacity and well-being. Previous research has not only revealed evidence of social dysfunction in individuals with a wide range of psychiatric and neurological disorders but also generated an abundance of potential measures for assessing social cognition. This review explores the most popular measures used within neuropsychiatric populations to investigate the ability to recognize or reason about the mental states of others. Measures are also critically analyzed in terms of strengths and limitations to aid task selection in future clinical studies. The most frequently applied assessment tools use verbal, visual or audiovisual forms of presentation and assess recognition of mental states from facial features, self-rated empathy, the understanding of other's cognitive mental states such as beliefs and intentions, or the ability to combine knowledge of other's thoughts and emotions in order to understand subtle communications or socially inappropriate behavior. Key weaknesses of previous research include limited investigation of relationships with clinical symptoms, and underutilization of measures of everyday social functioning that offer a useful counterpart to traditional "lab" tasks. Future studies should aim to carefully select measures not only based on the range of skills to be assessed but also taking into account potential difficulties with interpretation and the need to gain insight into the application of social cognitive skills as well as ability per se. Some of the best measures include those with well-matched control trials (e.g., Yoni Task) or those that restrict the influence of verbal deficits (e.g., intentions comic strip task), elicit spontaneous mentalizing (e.g., Animations Task), and possess greater ecological validity (e.g., Movie for the Assessment of Social Cognition). Social cognitive research within psychiatric populations will be further enhanced through the development of more closely matched control tasks, and the exploration of relationships between task performance, medication, strategy use, and broader emotional and motor functions.

Testosterone reduces the threat premium in competitive resource division

Like other animals, humans are sensitive to facial cues of threat. Recent evidence suggests that we use this information to dynamically calibrate competitive decision-making over resources, ceding more to high-threat individuals (who appear more willing/able to retaliate) and keeping more from low-threat individuals. Little is known, however, about the biological factors that support such threat assessment and decision-making systems. In a pre-registered, double-blind, placebo-controlled, cross-over testosterone administration study ( n = 118 men), we show for the first time that testosterone reduces the effects of threat on decision-making: participants ceded more resources to high-threat (versus low-threat) individuals (replicating the 'threat premium'), but this effect was blunted by testosterone, which selectively reduced the amount of resources ceded to those highest in threat. Thus, our findings suggest that testosterone influences competitive decision-making by recalibrating the integration of threat into the decision-making process.

Trait and state patterns of basolateral amygdala connectivity at rest are related to endogenous testosterone and aggression in healthy young women

The steroid hormone testosterone (T) has been suggested to influence reactive aggression upon its action on the basolateral amygdala (BLA), a key brain region for threat detection. However, it is unclear whether T modulates resting-state functional connectivity (rsFC) of the BLA, and whether this predicts subsequent aggressive behavior. Aggressive interactions themselves, which often induce changes in T concentrations, could further alter BLA rsFC, but this too remains untested. Here we investigated the effect of endogenous T on rsFC of the BLA at baseline as well as after an aggressive encounter, and whether this was related to behavioral aggression in healthy young women (n = 39). Pre-scan T was negatively correlated with basal rsFC between BLA and left superior temporal gyrus (STG; p < .001, p < .05 Family-Wise Error [FWE] cluster-level corrected), which in turn was associated with increased aggression (r = .37, p = .020). BLA-STG coupling at rest might thus underlie hostile readiness in low-T women. In addition, connectivity between the BLA and the right superior parietal lobule (SPL), a brain region involved in higher-order perceptual processes, was reduced in aggressive participants (p < .001, p < .05 FWE cluster-level corrected). On the other hand, post-task increases in rsFC between BLA and medial orbitofrontal cortex (mOFC) were linked to reduced aggression (r = -.36, p = .023), consistent with the established notion that the mOFC regulates amygdala activity in order to curb aggressive impulses. Finally, competition-induced changes in T were associated with increased coupling between the BLA and the right lateral OFC (p < .001, p < .05 FWE cluster-level corrected), but this effect was unrelated to aggression. We thus identified connectivity patterns that prospectively predict aggression in women, and showed how aggressive interactions in turn impact these neural systems.

Understanding the Role of Puberty in Structural and Functional Development of the Adolescent Brain

Over the past two decades, there has been a tremendous increase in our understanding of structural and functional brain development in adolescence. However, understanding the role of puberty in this process has received much less attention. This review examines this relationship by summarizing recent research studies where the role of puberty was investigated in relation to brain structure, connectivity, and task-related functional magnetic resonance imaging (fMRI). The studies together suggest that puberty may contribute to adolescent neural reorganization and maturational advancement, and sex differences also emerge in puberty. The current body of work shows some mixed results regarding impact and exact direction of pubertal influence. We discuss several limitations of current studies and propose future directions on how to move the field forward.

Prenatal testosterone and theory of mind development: Findings from disorders of sex development

Women on average perform better than men on the "Reading the Mind in the Eyes" test (RMET) which is a measure of Theory of Mind (ToM). The aim of this study was to assess whether these sex differences are influenced by differences in prenatal testosterone levels through a study on individuals with Disorders of Sex Development and matched controls. ToM performance was examined using the RMET in female-assigned-at-birth individuals with increased prenatal testosterone exposure (Congenital Adrenal Hyperplasia (CAH) and 5-alpha Reductase type-2 Deficiency (5α-RD-2)), female-assigned-at-birth individuals with testosterone insensitivity (Complete Androgen Insensitivity Syndrome (CAIS)), and their age-matched unaffected male and female relatives. A total number of 158 individuals participated in the study; 19 with 5α-RD-2, 17 with CAH, 18 women with CAIS, 52 matched unaffected men and 52 matched unaffected women. All subgroups were around 20 years of age. Women with CAH scored significantly lower on RMET than control women and CAIS individuals. CAIS individuals scored significantly higher than control men and participants with 5α-RD. Statistically, CAIS individuals' performance on RMET was similar to control women's, women with CAH did not differ significantly from control men and 5α-RD-2 individuals scored significantly lower than control men. These results, which are in line with previous theories, illustrate that performance on the RMET, as an index of ToM, may be influenced by variations in prenatal androgens levels.

Functional significance of men's testosterone reactivity to social stimuli

Rapid testosterone fluctuations in response to social stimuli are observed across a wide range of species, and the highly conserved nature of these fluctuations suggests an adaptive function. This paper reviews the current literature on testosterone reactivity, primarily in human males, and illustrates how life-history theory provides an adequate theoretical framework to interpret findings. The review is structured around supporting evidence suggesting that situations implicated in mating effort either directly (e.g., interactions with a mate) or indirectly (e.g., intrasexual competition) are generally associated with a brief elevation of testosterone, while situations implicated in parenting effort (e.g., nurturant interactions with offspring) are generally associated with a decline in testosterone. Further, we discuss how these fluctuations in testosterone have been linked to future behaviors, and how situational, motivational, and physiological variables moderate the interplay between social stimuli, testosterone reactivity, and behavior. Supporting the notion that testosterone can play a causal role in modulating behavior in response to social stimuli, we also summarize recent single administration studies examining the effects of testosterone on physiology, neurobiology, and behavior. A conceptual model provides links between supported findings, and hypothesized pathways requiring future testing.

The neurobiology of fatherhood

Only about 5% of mammalian species exhibit paternal caregiving in nature, and paternal behavior has evolved multiple times independently among mammals. The most parsimonious way to evolve paternal behavior may be to utilize pre-existing neural systems that are in place for maternal behavior. Despite evidence for similarity in the neurobiology of maternal and paternal behavior in rodents, paternal behavior also has its own dedicated neural circuitry in some species. Human fathers engage conserved subcortical systems that motivate caregiving in rodent parents and human mothers, as well as cortical systems involved with empathy that they share with human mothers. Finally, paternal behavior is modulated by similar hormones and neuropeptides in rodents, non-human primates, and humans.

Brain connectivity aberrations in anabolic-androgenic steroid users

Sustained anabolic-androgenic steroid (AAS) use has adverse behavioral consequences, including aggression, violence and impulsivity. Candidate mechanisms include disruptions of brain networks with high concentrations of androgen receptors and critically involved in emotional and cognitive regulation. Here, we tested the effects of AAS on resting-state functional brain connectivity in the largest sample of AAS-users to date. We collected resting-state functional magnetic resonance imaging (fMRI) data from 151 males engaged in heavy resistance strength training. 50 users tested positive for AAS based on the testosterone to epitestosterone (T/E) ratio and doping substances in urine. 16 previous users and 59 controls tested negative. We estimated brain network nodes and their time-series using ICA and dual regression and defined connectivity matrices as the between-node partial correlations. In line with the emotional and behavioral consequences of AAS, current users exhibited reduced functional connectivity between key nodes involved in emotional and cognitive regulation, in particular reduced connectivity between the amygdala and default-mode network (DMN) and between the dorsal attention network (DAN) and a frontal node encompassing the superior and inferior frontal gyri (SFG/IFG) and the anterior cingulate cortex (ACC), with further reductions as a function of dependency, lifetime exposure, and cycle state (on/off).

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Sustained AAS use has adverse behavioral consequences, including aggression, violence and impulsivity.

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We obtained r-fMRI data from 50 male users testing positive for AAS and 16 previous users and 59 controls testing negative.

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We used ICA and dual regression, and defined connectivity matrices as the between-node temporal partial correlations.

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Current users showed significantly reduced connectivity between amygdala and DMN and between DAN and a SFG/IFG/ACC node.