1
|
Monteiro DC, Ramos CDS, Alves LENN, Cantilino A, Sougey EB. Functional and structural neuroimaging in premenstrual dysphoric disorder: A systematic review. J Psychiatr Res 2024; 175:205-210. [PMID: 38744159 DOI: 10.1016/j.jpsychires.2024.05.024] [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: 10/22/2023] [Revised: 01/23/2024] [Accepted: 05/08/2024] [Indexed: 05/16/2024]
Abstract
This systematic review aimed to summarize the most recent data on changes in brain structure and function in premenstrual dysphoric disorder (PMDD) as well as elucidate the possible correlations between these findings and symptom severity. Articles published in PubMed, EMBASE, ScienceDirect, PsycInfo, Web of Science, and Scopus from inception until April 2023 were systematically reviewed according to the PICO framework: population (women with PMDD), intervention (neuroimaging study), control (healthy subjects), and outcome (neuroimaging changes). In total, 1026 individuals were included from controlled (n = 22) and non-controlled (n = 2) trials. Among them, 608 had PMDD, and 418 were healthy controls. Different neuroimaging methods were addressed, such as task-based functional magnetic resonance imaging (MRI), resting-state functional MRI, proton magnetic resonance spectroscopy, diffusion tensor imaging, proton emission tomography, and structural MRI. Despite the absence of consensual results, several brain structures have been implicated in PMDD, including the prefrontal cortex, amygdala, hippocampus, insula, basal ganglia, and cerebellum. In addition, some brain changes are related to the intensity of symptoms and phases of the menstrual cycle, such as the correlation between depressive symptoms and increased serotonin transporter binding potential in the midbrain during the luteal phase.
Collapse
Affiliation(s)
- Dennison Carreiro Monteiro
- Postgraduate Program in Neuropsychiatry and Behavioral Science, Federal University of Pernambuco, Recife, Pernambuco, Brazil; Department of Neuropsychiatry, Federal University of Pernambuco, Recife, Pernambuco, Brazil.
| | - Clarence da Silva Ramos
- Postgraduate Program in Neuropsychiatry and Behavioral Science, Federal University of Pernambuco, Recife, Pernambuco, Brazil
| | | | - Amaury Cantilino
- Postgraduate Program in Neuropsychiatry and Behavioral Science, Federal University of Pernambuco, Recife, Pernambuco, Brazil
| | - Everton Botelho Sougey
- Postgraduate Program in Neuropsychiatry and Behavioral Science, Federal University of Pernambuco, Recife, Pernambuco, Brazil; Department of Neuropsychiatry, Federal University of Pernambuco, Recife, Pernambuco, Brazil
| |
Collapse
|
2
|
Sullivan AJ, Chung YS, Novotny S, Epperson CN, Kober H, Blumberg HP, Gross JJ, Ochsner KN, Pearlson G, Stevens MC. Estradiol effects on an emotional interference task in adolescents with current and remitted depression. Horm Behav 2024; 157:105450. [PMID: 37923628 PMCID: PMC10842169 DOI: 10.1016/j.yhbeh.2023.105450] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/24/2023] [Revised: 08/22/2023] [Accepted: 10/27/2023] [Indexed: 11/07/2023]
Abstract
Attentional biases to emotional stimuli are thought to reflect vulnerability for mood disorder onset and maintenance. This study examined the association between the endogenous sex hormone estradiol and emotional attentional biases in adolescent females with either current or remitted depression. Three groups of participants (mean age ± SD) completed the Emotional Interrupt Task: 1) 20 adolescent females (15.1 ± 1.83 years) currently diagnosed with Major Depressive Disorder (MDD), 2) 16 adolescent females (16.4 ± 1.31 years) who had experienced at least one episode of MDD in their lifetime but currently met criteria for MDD in remission, and 3) 30 adolescent female (15.4 ± 1.83 years) healthy controls. Attentional interference (AI) scores were calculated as differences in target response reaction time between trials with emotional facial expressions versus neutral facial expressions. Estradiol levels were assayed by Salimetrics LLC using saliva samples collected within 30 min of waking on assessment days. Robust multiple regression with product terms evaluated estradiol's main effect on AI scores, as well as hypothesized estradiol × diagnostic group interactions. Although neither mean estradiol levels nor mean AI scores in the current-MDD and remitted-MDD groups differed from controls, the relationship between estradiol and overall AI score differed between control adolescents and the remitted-MDD group. Specifically, the remitted-MDD adolescents performed worse (i.e., showed greater attentional interference) when they had higher estradiol; no significant relationship existed in the current-MDD group. Because this finding was driven by angry and not happy stimuli, it appears higher estradiol levels were associated with greater susceptibility to the attention-capturing effects of negatively-valenced emotional content in girls at risk for MDD from prior history.
Collapse
Affiliation(s)
- Abigail J Sullivan
- Olin Neuropsychiatry Research Center, Hartford HealthCare, Hartford, CT 06106, United States of America.
| | - Yu Sun Chung
- Olin Neuropsychiatry Research Center, Hartford HealthCare, Hartford, CT 06106, United States of America
| | - Stephanie Novotny
- Olin Neuropsychiatry Research Center, Hartford HealthCare, Hartford, CT 06106, United States of America
| | - C Neill Epperson
- University of Colorado School of Medicine, Aurora, CO 80045, United States of America
| | - Hedy Kober
- Yale University School of Medicine, New Haven, CT 06520, United States of America
| | - Hilary P Blumberg
- Yale University School of Medicine, New Haven, CT 06520, United States of America
| | - James J Gross
- Stanford University, Stanford, CA 94305, United States of America
| | - Kevin N Ochsner
- Columbia University, New York, NY, 10027, United States of America
| | - Godfrey Pearlson
- Olin Neuropsychiatry Research Center, Hartford HealthCare, Hartford, CT 06106, United States of America; Yale University School of Medicine, New Haven, CT 06520, United States of America
| | - Michael C Stevens
- Olin Neuropsychiatry Research Center, Hartford HealthCare, Hartford, CT 06106, United States of America; Yale University School of Medicine, New Haven, CT 06520, United States of America
| |
Collapse
|
3
|
Reuveni I, Dan R, Canetti L, Bick AS, Segman R, Azoulay M, Kalla C, Bonne O, Goelman G. Aberrant Intrinsic Brain Network Functional Connectivity During a Face-Matching Task in Women Diagnosed With Premenstrual Dysphoric Disorder. Biol Psychiatry 2023; 94:492-500. [PMID: 37031779 DOI: 10.1016/j.biopsych.2023.04.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/03/2022] [Revised: 03/11/2023] [Accepted: 04/01/2023] [Indexed: 04/11/2023]
Abstract
BACKGROUND Premenstrual dysphoric disorder (PMDD) is characterized by affective, cognitive, and physical symptoms, suggesting alterations at the brain network level. Women with PMDD demonstrate aberrant discrimination of facial emotions during the luteal phase of the menstrual cycle and altered reactivity to emotional stimuli. However, previous studies assessing emotional task-related brain reactivity using region-of-interest or whole-brain analysis have reported conflicting findings. Therefore, we utilized both region-of-interest task-reactivity and seed-voxel functional connectivity (FC) approaches to test for differences in the default mode network, salience network, and central executive network between women with PMDD and control participants during an emotional-processing task that yields an optimal setup for investigating brain network changes in PMDD. METHODS Twenty-four women with PMDD and 27 control participants were classified according to the Daily Record of Severity of Problems. Participants underwent functional magnetic resonance imaging scans while completing the emotional face-matching task during the midfollicular and late-luteal phases of their menstrual cycle. RESULTS No significant between-group differences in brain reactivity were found using region-of-interest analysis. In the FC analysis, a main effect of diagnosis was found showing decreased default mode network connectivity, increased salience network connectivity, and decreased central executive network connectivity in women with PMDD compared with control participants. A significant interaction between menstrual cycle phase and diagnosis was found in the central executive network for right posterior parietal cortex and left inferior lateral occipital cortex connectivity. A post hoc analysis revealed stronger FC during the midfollicular than the late-luteal phase of PMDD. CONCLUSIONS Aberrant FC in the 3 brain networks involved in PMDD may indicate vulnerability to experience affective and cognitive symptoms of the disorder.
Collapse
Affiliation(s)
- Inbal Reuveni
- Department of Psychiatry, Hadassah Hebrew University Medical Center, Jerusalem, Israel
| | - Rotem Dan
- Edmond and Lily Safra Center for Brain Sciences, The Hebrew University of Jerusalem, Jerusalem, Israel; Department of Neurology, Hadassah Hebrew University Medical Center, Jerusalem, Israel
| | - Laura Canetti
- Department of Psychiatry, Hadassah Hebrew University Medical Center, Jerusalem, Israel; Department of Psychology, The Hebrew University of Jerusalem, Jerusalem, Israel
| | - Atira S Bick
- Department of Neurology, Hadassah Hebrew University Medical Center, Jerusalem, Israel
| | - Ronen Segman
- Department of Psychiatry, Hadassah Hebrew University Medical Center, Jerusalem, Israel
| | - Moria Azoulay
- Department of Psychiatry, Hadassah Hebrew University Medical Center, Jerusalem, Israel; Department of Psychology, The Hebrew University of Jerusalem, Jerusalem, Israel
| | - Carmel Kalla
- Department of Psychiatry, Hadassah Hebrew University Medical Center, Jerusalem, Israel
| | - Omer Bonne
- Department of Psychiatry, Hadassah Hebrew University Medical Center, Jerusalem, Israel.
| | - Gadi Goelman
- Department of Neurology, Hadassah Hebrew University Medical Center, Jerusalem, Israel
| |
Collapse
|
4
|
Min J, Koenig J, Nashiro K, Yoo HJ, Cho C, Thayer JF, Mather M. Sex Differences in Neural Correlates of Emotion Regulation in Relation to Resting Heart Rate Variability. Brain Topogr 2023; 36:698-709. [PMID: 37353651 PMCID: PMC10415482 DOI: 10.1007/s10548-023-00974-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2023] [Accepted: 05/30/2023] [Indexed: 06/25/2023]
Abstract
Prior studies suggest that sex differences in emotion regulation (ER) ability contribute to sex disparities in affective disorders. In behavioral studies, females rely more on maladaptive strategies to cope with emotional distress than males. Neuroimaging studies suggest that males more efficiently regulate emotion than females by showing less prefrontal cortex activity (suggesting less effort) for similar amygdala activity (similar regulation outcome). However, physiological studies involving heart rate variability (HRV) indicated that, compared with males, females have higher resting HRV, indicative of parasympathetic dominance and better control of emotion. To help resolve these apparently inconsistent findings, we examined sex differences in how resting HRV relates to brain activity while using cognitive reappraisal, one of the adaptive strategies. Based on 51 males and 49 females, we found that females showed different levels of self-rated emotional intensity and amygdala activity for negative versus positive emotions, while males did not. Females also showed greater overall prefrontal cortex activity but similar levels of amygdala activity compared to males. Sex differences in how resting HRV related to brain activity during ER were evident only during viewing or regulating positive emotion. The results suggest that sex differences in the neural correlates of ER and resting HRV might lie in valence more than arousal modulation.
Collapse
Affiliation(s)
- Jungwon Min
- University of Southern California, Davis School of Gerontology, Los Angeles, USA
- University of Southern California, Department of Psychology, Los Angeles, USA
| | - Julian Koenig
- University of Cologne, Faculty of Medicine and University Hospital Cologne, Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Cologne, Germany
| | - Kaoru Nashiro
- University of Southern California, Davis School of Gerontology, Los Angeles, USA
| | - Hyun Joo Yoo
- University of Southern California, Davis School of Gerontology, Los Angeles, USA
| | - Christine Cho
- University of Southern California, Davis School of Gerontology, Los Angeles, USA
| | - Julian F Thayer
- University of California Irvine, Department of Psychological Science, Irvine, USA
| | - Mara Mather
- University of Southern California, Davis School of Gerontology, Los Angeles, USA.
- University of Southern California, Department of Psychology, Los Angeles, USA.
| |
Collapse
|
5
|
Stiernman L, Dubol M, Comasco E, Sundström-Poromaa I, Boraxbekk CJ, Johansson M, Bixo M. Emotion-induced brain activation across the menstrual cycle in individuals with premenstrual dysphoric disorder and associations to serum levels of progesterone-derived neurosteroids. Transl Psychiatry 2023; 13:124. [PMID: 37055419 PMCID: PMC10101953 DOI: 10.1038/s41398-023-02424-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/25/2022] [Revised: 03/23/2023] [Accepted: 03/29/2023] [Indexed: 04/15/2023] Open
Abstract
Premenstrual dysphoric disorder (PMDD) is a debilitating disorder characterized by severe mood symptoms in the luteal phase of the menstrual cycle. PMDD symptoms are hypothesized to be linked to an altered sensitivity to normal luteal phase levels of allopregnanolone (ALLO), a GABAA-modulating progesterone metabolite. Moreover, the endogenous 3β-epimer of ALLO, isoallopregnanolone (ISO), has been shown to alleviate PMDD symptoms through its selective and dose-dependent antagonism of the ALLO effect. There is preliminary evidence showing altered recruitment of brain regions during emotion processing in PMDD, but whether this is associated to serum levels of ALLO, ISO or their relative concentration is unknown. In the present study, subjects with PMDD and asymptomatic controls underwent functional magnetic resonance imaging (fMRI) in the mid-follicular and the late-luteal phase of the menstrual cycle. Brain responses to emotional stimuli were investigated and related to serum levels of ovarian steroids, the neurosteroids ALLO, ISO, and their ratio ISO/ALLO. Participants with PMDD exhibited greater activity in brain regions which are part of emotion-processing networks during the late-luteal phase of the menstrual cycle. Furthermore, activity in key regions of emotion processing networks - the parahippocampal gyrus and amygdala - was differentially associated to the ratio of ISO/ALLO levels in PMDD subjects and controls. Specifically, a positive relationship between ISO/ALLO levels and brain activity was found in PMDD subjects, while the opposite was observed in controls. In conclusion, individuals with PMDD show altered emotion-induced brain responses in the late-luteal phase of the menstrual cycle which may be related to an abnormal response to physiological levels of GABAA-active neurosteroids.
Collapse
Affiliation(s)
| | - Manon Dubol
- Department of Women's and Children's Health, Science for Life Laboratory, Uppsala University, Uppsala, Sweden
| | - Erika Comasco
- Department of Women's and Children's Health, Science for Life Laboratory, Uppsala University, Uppsala, Sweden
| | | | - Carl-Johan Boraxbekk
- Department of Radiation Sciences, Diagnostic Radiology, Umeå University, Umeå, Sweden
- Institute for Clinical Medicine, Faculty of Medical and Health Sciences, University of Copenhagen, Copenhagen, Denmark
- Danish Research Centre for Magnetic Resonance (DRCMR), Centre for Functional and Diagnostic Imaging and Research, Copenhagen University Hospital - Amager and Hvidovre, Copenhagen, Denmark
- Umeå Center for Functional Brain Imaging (UFBI), Umeå University, Umeå, Sweden
- Institute of Sports Medicine Copenhagen (ISMC) and Department of Neurology, Copenhagen University Hospital Bispebjerg, Copenhagen, Denmark
| | - Maja Johansson
- Department of Clinical Sciences, Umeå University, Umeå, Sweden
| | - Marie Bixo
- Department of Clinical Sciences, Umeå University, Umeå, Sweden.
| |
Collapse
|
6
|
Sun Y, Gao M, Gao D, Chen D, Wang J. Allopregnanolone-mediated GABAA-Rα4 function in amygdala and hippocampus of PMDD liver qi-invasion syndrome model rats. Aging (Albany NY) 2023; 15:1143-1157. [PMID: 36842096 PMCID: PMC10008490 DOI: 10.18632/aging.204541] [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: 09/30/2022] [Accepted: 02/13/2023] [Indexed: 02/25/2023]
Abstract
BACKGROUND Premenstrual dysphoric disorder (PMDD) is a common mental health challenge among women of reproductive age. Allopregnanolone (3α, 5α-THP; ALLO) mediated functional alterations of GABAA receptors (GABAA-R) are involved in PMDD pathogenesis, however, the specific mechanism remains unknown. Therefore, we investigated the role of ALLO mediated GABAA-Rα4 in the pathophysiology of PMDD. PURPOSE We determined whether the pathogenesis of PMDD is associated with ALLO mediated GABAA-Rα4 expression changes in different brain regions. METHODS Rat models of PMDD liver-qi invasion syndrome (PMDD-LIS) were established via the resident intruder paradigm. Behavioral changes of rats were assessed by aggressive behavior tests, EPM and OFT. The levels of progesterone and ALLO in serum as well as brain areas were determined by ELISA. Variations in GABAA-Rα4 levels in brain regions were assessed by immunofluorescence and RT-PCR. Medicated serum was used to interfere with rat hippocampal neurons, and changes in Cl- current were recorded through electrophysiology. RESULTS Premenstrual anxiety and irritability of PMDD-LIS patients can be simulated in PMDD-LIS rat models. Exogenous ALLO significantly improved the anxiety behaviors of PMDD-LIS rats. Changes in ALLO among different brain regions varied. GABAA-Rα4 expressions were low in the amygdala and abnormally high in the hippocampus, however, ALLO alleviated these deviations. Whole-cell patch clamp recording technique showed a weaker Cl- current intensity of PMDD-LIS rats, reduced neuroinhibitory functions and increased Cl- current intensity in the ALLO group drug serum intervention and enhanced emotional inhibition function. CONCLUSION We established that ALLO regulation of the GABAA-Rα4 subunit in the amygdala and hippocampus is involved in PMDD-LIS pathogenesis.
Collapse
Affiliation(s)
- Ya Sun
- Team of Research and Innovation Focusing on Emotional Diseases and Syndromes, Innovation Research Institute of Traditional Chinese Medicine, Shandong University of Traditional Chinese Medicine, Jinan 250355, Shandong, China
| | - Mingzhou Gao
- Team of Research and Innovation Focusing on Emotional Diseases and Syndromes, Innovation Research Institute of Traditional Chinese Medicine, Shandong University of Traditional Chinese Medicine, Jinan 250355, Shandong, China
| | - Dongmei Gao
- Teaching and Research Office of Basic Theory of Traditional Chinese Medicine, College of Traditional Chinese Medicine, Shandong University of Traditional Chinese Medicine, Jinan 250355, Shandong, China
| | - Dan Chen
- Department of Graduate, Shandong University of Traditional Chinese Medicine, Jinan 250355, Shandong, China
| | - Jieqiong Wang
- Scientific Research Achievements Transformation Department, Office of Academic Research, Shandong University of Traditional Chinese Medicine, Jinan 250355, Shandong, China
| |
Collapse
|
7
|
Liu M, Zhang X, He Z, Liang Y, Zou B, Ma X, Gu S, Wang F. Opposite effects of estradiol and progesterone on woman's disgust processing. Front Psychiatry 2023; 14:1161488. [PMID: 37091703 PMCID: PMC10115175 DOI: 10.3389/fpsyt.2023.1161488] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/08/2023] [Accepted: 03/13/2023] [Indexed: 04/25/2023] Open
Abstract
Background Ovarian hormones play a critical role in emotion processing, which may be a major reason for the high rates of major depressive disorders in women. However, the exact roles of estradiol and progesterone in emotional processing remain unclear. To this end, we performed behavioral and rs-fMRI studies on the effects ovarian hormones on disgust emotion. Methods In Experiment 1, 95 Chinese female undergraduates completed the single category implicit association test (SC-IAT) and explicit measures of disgust intensity task, 32 in the menstrual phase, 30 in the follicular phase, and 33 in the luteal phase. In Experiment 2, A total of 25 healthy female undergraduates completed three sessions of the rs-fMRI. The menstrual group was scanned during cycle days 2-5, the follicular group during cycle during days 10-13, and the luteal group was scanned 3-7 days before the next menstruation. Results The behavioral results showed that women during the luteal phase had higher D scores and shorter response times (RTs) to disgust stimuli compared to the menses and follicular phases. In contrast, women during the follicular phase had fewer feelings of disgust and longer RTs to pathogen stimuli compared with that during the menses and luteal phases, but this effect was moderated by the intensity of the stimuli. rs-fMRI studies showed that women during the luteal phase have higher functional connectivity in the salience network than those in the follicular phase. Compared with the menstrual phase, women have lower functional connectivity in the amygdala during the follicular phase. Conclusion In summary, a more negative attitude to disgust stimuli and the enhanced functional connectivity of the salience network during the luteal phase may be associated with high progesterone levels, whereas lower disgust feelings and reduced functional connectivity of the amygdala during the follicular phase may be associated with high estradiol levels.
Collapse
Affiliation(s)
- Mei Liu
- Institute of Brain and Psychological Science, Sichuan Normal University, Chengdu, China
| | - Xia Zhang
- Institute of Brain and Psychological Science, Sichuan Normal University, Chengdu, China
| | - Zhengming He
- Institute of Brain and Psychological Science, Sichuan Normal University, Chengdu, China
| | - Yuan Liang
- Institute of Brain and Psychological Science, Sichuan Normal University, Chengdu, China
| | - Bihong Zou
- Institute of Brain and Psychological Science, Sichuan Normal University, Chengdu, China
| | - Xianjun Ma
- Department of Neurology, Affiliated Lianyungang Hospital of Chinese Medicine, Nanjing University of Chinese Medicine, Nanjing, China
- *Correspondence: Xianjun Ma
| | - Simeng Gu
- Institute of Brain and Psychological Science, Sichuan Normal University, Chengdu, China
- Department of Psychology, Jiangsu University Medical School, Zhenjiang, China
- Simeng Gu
| | - Fushun Wang
- Institute of Brain and Psychological Science, Sichuan Normal University, Chengdu, China
- Fushun Wang
| |
Collapse
|
8
|
Altered visual cortex excitability in premenstrual dysphoric disorder: Evidence from magnetoencephalographic gamma oscillations and perceptual suppression. PLoS One 2022; 17:e0279868. [PMID: 36584199 PMCID: PMC9803314 DOI: 10.1371/journal.pone.0279868] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2022] [Accepted: 12/15/2022] [Indexed: 12/31/2022] Open
Abstract
Premenstrual dysphoric disorder (PMDD) is a psychiatric condition characterized by extreme mood shifts during the luteal phase of the menstrual cycle (MC) due to abnormal sensitivity to neurosteroids and unbalanced neural excitation/inhibition (E/I) ratio. We hypothesized that in women with PMDD in the luteal phase, these factors would alter the frequency of magnetoencephalographic visual gamma oscillations, affect modulation of their power by excitatory drive, and decrease perceptual spatial suppression. Women with PMDD and control women were examined twice-during the follicular and luteal phases of their MC. We recorded visual gamma response (GR) while modulating the excitatory drive by increasing the drift rate of the high-contrast grating (static, 'slow', 'medium', and 'fast'). Contrary to our expectations, GR frequency was not affected in women with PMDD in either phase of the MC. GR power suppression, which is normally associated with a switch from the 'optimal' for GR slow drift rate to the medium drift rate, was reduced in women with PMDD and was the only GR parameter that distinguished them from control participants specifically in the luteal phase and predicted severity of their premenstrual symptoms. Over and above the atypical luteal GR suppression, in both phases of the MC women with PMDD had abnormally strong GR facilitation caused by a switch from the 'suboptimal' static to the 'optimal' slow drift rate. Perceptual spatial suppression did not differ between the groups but decreased from the follicular to the luteal phase only in PMDD women. The atypical modulation of GR power suggests that neuronal excitability in the visual cortex is constitutively elevated in PMDD and that this E/I imbalance is further exacerbated during the luteal phase. However, the unaltered GR frequency does not support the hypothesis of inhibitory neuron dysfunction in PMDD.
Collapse
|
9
|
Kappen M, Raeymakers S, Weyers S, Vanderhasselt MA. Stress and rumination in Premenstrual Syndrome (PMS): Identifying stable and menstrual cycle-related differences in PMS symptom severity. J Affect Disord 2022; 319:580-588. [PMID: 36162688 DOI: 10.1016/j.jad.2022.09.052] [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: 03/31/2022] [Revised: 05/24/2022] [Accepted: 09/20/2022] [Indexed: 11/25/2022]
Abstract
Since the inclusion of Premenstrual Dysphoric Disorder (PMDD) as a mood disorder in the DSM-5, Premenstrual Syndrome (PMS) symptoms have received more attention from researchers and clinicians. In this large-scale study, we investigated core psychological concepts relevant to mood disorder vulnerability between people with 1) no to mild, 2) moderate to severe, and 3) PMDD levels of PMS symptoms. Several trait measures related to mood disorders including depressive symptoms, feelings of stress and anxiety, and ruminative thinking were measured (single measurement, N = 380) along with state (momentary) reports of stress and stress-related perseverative thinking (measured twice, once in the follicular and once in the premenstrual/luteal phase, N = 237). We consistently observed that participants with higher severity of PMS symptoms also scored higher on depression, anxiety, stress, and rumination (trait measures). We also found consistent increases in momentary stress and stress-related perseverative ruminative thinking with increased PMS symptoms at each of our two test moments (in the middle of the follicular and premenstrual/luteal phase respectively). Interestingly, we did not find significant differences between our two test moments for any group, despite PMS being characterized by specific systems in the premenstrual/luteal phase. However, this could be due to noise surrounding the testing moments due to the temporal resolution of the questionnaires and the menstrual cycle estimation method. Nevertheless, these results suggest that stress and rumination are important psychological mechanisms to consider in PMS. Future PMS research studying stress and rumination on a day-to-day basis in combination with hormonal measures is warranted.
Collapse
Affiliation(s)
- Mitchel Kappen
- Department of Head and Skin, Ghent University Hospital Ghent, Department of Psychiatry and Medical Psychology, Ghent, Belgium; Ghent Experimental Psychiatry (GHEP) Lab, Ghent University, Ghent, Belgium.
| | - Sofie Raeymakers
- Department of Head and Skin, Ghent University Hospital Ghent, Department of Psychiatry and Medical Psychology, Ghent, Belgium; Ghent Experimental Psychiatry (GHEP) Lab, Ghent University, Ghent, Belgium
| | - Steven Weyers
- Department of Obstetrics and Gynecology, Women's Clinic, Ghent University Hospital, Ghent, Belgium
| | - Marie-Anne Vanderhasselt
- Department of Head and Skin, Ghent University Hospital Ghent, Department of Psychiatry and Medical Psychology, Ghent, Belgium; Ghent Experimental Psychiatry (GHEP) Lab, Ghent University, Ghent, Belgium
| |
Collapse
|
10
|
Can animal models resemble a premenstrual dysphoric condition? Front Neuroendocrinol 2022; 66:101007. [PMID: 35623450 DOI: 10.1016/j.yfrne.2022.101007] [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: 11/15/2021] [Revised: 04/22/2022] [Accepted: 05/19/2022] [Indexed: 11/23/2022]
Abstract
Around 80% of women worldwide suffer mild Premenstrual Disorders (PMD) during their reproductive life. Up to a quarter are affected by moderate to severe symptoms, and between 3% and 8% experience a severe form. It is classified as premenstrual syndrome (PMS) with predominantly physical symptoms and premenstrual dysphoric disorder (PMDD) with psychiatric symptoms. The present review analyzes the factors associated with PMD and the Hypothalamus-Pituitary-Ovarian or Hypothalamus-Pituitary-adrenal axis and discusses the main animal models used to study PMDD. Evidence shows that the ovarian hormones participate in PMDD symptoms, and several points of regulation of their synthesis, metabolism, and target sites could be altered. PMDD is complex and implies several factors that require consideration when this condition is modeled in animals. Of particular interest are those points related to areas that may represent opportunities to develop new approximations to understand the mechanisms involved in PMDD and possible treatments.
Collapse
|
11
|
Anxiety-like Behavior and GABAAR/BDZ Binding Site Response to Progesterone Withdrawal in a Stress-Vulnerable Strain, the Wistar Kyoto Rats. Int J Mol Sci 2022; 23:ijms23137259. [PMID: 35806264 PMCID: PMC9266311 DOI: 10.3390/ijms23137259] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2022] [Revised: 06/16/2022] [Accepted: 06/19/2022] [Indexed: 12/10/2022] Open
Abstract
Stress susceptibility could play a role in developing premenstrual anxiety due to abnormalities in the hypothalamus–pituitary–adrenal (HPA) axis and impairments in the GABAA receptors’ benzodiazepine (BDZ) site. Hence, we studied the stress-vulnerable Wistar Kyoto rat strain (WKY) to evaluate progesterone withdrawal (PW) effects on anxiety, HPA axis response, and to explore indicators of GABAA functionality in the BDZ site. For five days, ovariectomized WKY rats were administered 2.0 mg/kg of progesterone. Twenty-four hours after the last administration, rats were tested in the anxiety-like burying behavior test (BBT) or elevated plus maze test (EPM), and corticosterone was determined. [3H]Flunitrazepam binding autoradiography served as the BDZ binding site index of the GABAA receptor in amygdala nuclei and hippocampus’s dentate gyrus (DG). Finally, different doses of diazepam in PW-WKY rats were tested in the BBT. PW induced anxiety-like behaviors in both BBT and EPM compared with No-PW rats. PW increased corticosterone, but was blunted when combined with PW and BBT. PW increased [3H]Flunitrazepam binding in the DG and central amygdala compared with No-PW rats. Diazepam at a low dose induced an anxiogenic-like response in PW rats, suggesting a paradoxical response to benzodiazepines. Overall, PW induced anxiety-like behavior, a blunted HPA axis response, and higher GABAAR/BZD binding site sensitivity in a stress-vulnerable rat strain. These findings demonstrate the role of stress-susceptibility in GABAAR functionality in a preclinical approximation of PMDD.
Collapse
|
12
|
Differential grey matter structure in women with premenstrual dysphoric disorder: evidence from brain morphometry and data-driven classification. Transl Psychiatry 2022; 12:250. [PMID: 35705554 PMCID: PMC9200862 DOI: 10.1038/s41398-022-02017-6] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/13/2022] [Revised: 05/25/2022] [Accepted: 05/31/2022] [Indexed: 11/12/2022] Open
Abstract
Premenstrual dysphoric disorder (PMDD) is a female-specific condition classified in the Diagnostic and Statical Manual-5th edition under depressive disorders. Alterations in grey matter volume, cortical thickness and folding metrics have been associated with a number of mood disorders, though little is known regarding brain morphological alterations in PMDD. Here, women with PMDD and healthy controls underwent magnetic resonance imaging (MRI) during the luteal phase of the menstrual cycle. Differences in grey matter structure between the groups were investigated by use of voxel- and surface-based morphometry. Machine learning and multivariate pattern analysis were performed to test whether MRI data could distinguish women with PMDD from healthy controls. Compared to controls, women with PMDD had smaller grey matter volume in ventral posterior cortices and the cerebellum (Cohen's d = 0.45-0.76). Region-of-interest analyses further indicated smaller volume in the right amygdala and putamen of women with PMDD (Cohen's d = 0.34-0.55). Likewise, thinner cortex was observed in women with PMDD compared to controls, particularly in the left hemisphere (Cohen's d = 0.20-0.74). Classification analyses showed that women with PMDD can be distinguished from controls based on grey matter morphology, with an accuracy up to 74%. In line with the hypothesis of an impaired top-down inhibitory circuit involving limbic structures in PMDD, the present findings point to PMDD-specific grey matter anatomy in regions of corticolimbic networks. Furthermore, the results include widespread cortical and cerebellar regions, suggesting the involvement of distinct networks in PMDD pathophysiology.
Collapse
|
13
|
Dubol M, Wikström J, Lanzenberger R, Epperson CN, Sundström-Poromaa I, Comasco E. Grey matter correlates of affective and somatic symptoms of premenstrual dysphoric disorder. Sci Rep 2022; 12:5996. [PMID: 35397641 PMCID: PMC8994757 DOI: 10.1038/s41598-022-07109-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2021] [Accepted: 02/08/2022] [Indexed: 12/21/2022] Open
Abstract
Ovarian hormones fluctuations across the menstrual cycle are experienced by about 58% of women in their fertile age. Maladaptive brain sensitivity to these changes likely leads to the severe psychological, cognitive, and physical symptoms repeatedly experienced by women with Premenstrual Dysphoric Disorder (PMDD) during the late luteal phase of the menstrual cycle. However, the neuroanatomical correlates of these symptoms are unknown. The relationship between grey matter structure and PMDD symptom severity was delineated using structural magnetic resonance imaging during the late luteal phase of fifty-one women diagnosed with PMDD, combined with Voxel- and Surface-Based Morphometry, as well as subcortical volumetric analyses. A negative correlation was found between depression-related symptoms and grey matter volume of the bilateral amygdala. Moreover, the severity of affective and somatic PMDD symptoms correlated with cortical thickness, gyrification, sulcal depth, and complexity metrics, particularly in the prefrontal, cingulate, and parahippocampal gyri. The present findings provide the first evidence of grey matter morphological characteristics associated with PMDD symptomatology in brain regions expressing ovarian hormone receptors and of relevance to cognitive-affective functions, thus potentially having important implications for understanding how structural brain characteristics relate to PMDD symptomatology.
Collapse
Affiliation(s)
- Manon Dubol
- Department of Neuroscience, Science for Life Laboratory, Uppsala University, POB 593, 75124, Uppsala, Sweden
| | - Johan Wikström
- Department of Surgical Sciences, Neuroradiology, Uppsala University, Uppsala, Sweden
| | - Rupert Lanzenberger
- Department of Psychiatry and Psychotherapy, Medical University of Vienna, Vienna, Austria
| | - C Neill Epperson
- Department of Psychiatry, Department of Family Medicine, University of Colorado School of Medicine-Anschutz Medical Campus, Aurora, USA
| | | | - Erika Comasco
- Department of Neuroscience, Science for Life Laboratory, Uppsala University, POB 593, 75124, Uppsala, Sweden.
| |
Collapse
|
14
|
Long J, Wang Y, Liu L, Zhang J. The Prominent Role of the Temporal Lobe in Premenstrual Syndrome and Premenstrual Dysphoric Disorder: Evidence From Multimodal Neuroimaging. Front Psychiatry 2022; 13:954211. [PMID: 35836663 PMCID: PMC9274249 DOI: 10.3389/fpsyt.2022.954211] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/27/2022] [Accepted: 06/08/2022] [Indexed: 01/13/2023] Open
Abstract
Premenstrual syndrome (PMS) is a group of psychological, physical, and behavioral symptoms that recur with the menstrual cycle, usually occurring a few days before menstruation and ceasing with the onset of menstruation. Premenstrual dysphoric disorder (PMDD) is a severe form of PMS that has been included in a subcategory of depression in the Diagnostic and Statistical Manual of Mental Disorders (DSM-V) according to the latest diagnostic criteria. Patients usually present with mild to moderate emotional and physical symptoms that affect their routine work, social activities, and family lives. The pathogenesis of PMDD remains unclear, and some researchers believe that it is related to fluctuations in ovarian hormone levels. However, the details of the interrelationships and regulating effects between ovarian hormones, symptoms, and the brain need to be more comprehensively determined. Recent studies have revealed some novel findings on PMS and PMDD based on brain morphology, function, and metabolism. Additionally, multiple studies have suggested that PMS and PMDD are closely related to brain structural and functional variations in certain core temporal lobe regions, such as the amygdala and hippocampus. We summarized neuroimaging studies of PMS and PMDD related to the temporal lobe by retrospectively reviewing relevant literature over the past decade. This review contributes to further clarifying the significant role of the temporal lobe in PMS and PMDD and understanding the neurochemical links between hormones, symptoms, and the brain.
Collapse
Affiliation(s)
- Jingyi Long
- Wuhan Mental Health Center, Wuhan, China.,Affiliated Wuhan Mental Health Center, Tongji Medical College of Huazhong University of Science and Technology, Wuhan, China.,Research Center for Psychological and Health Sciences, China University of Geosciences, Wuhan, China
| | - Yuejie Wang
- Wuhan Mental Health Center, Wuhan, China.,Affiliated Wuhan Mental Health Center, Tongji Medical College of Huazhong University of Science and Technology, Wuhan, China
| | - Lianzhong Liu
- Wuhan Mental Health Center, Wuhan, China.,Affiliated Wuhan Mental Health Center, Tongji Medical College of Huazhong University of Science and Technology, Wuhan, China.,Research Center for Psychological and Health Sciences, China University of Geosciences, Wuhan, China
| | - Juan Zhang
- Wuhan Mental Health Center, Wuhan, China.,Affiliated Wuhan Mental Health Center, Tongji Medical College of Huazhong University of Science and Technology, Wuhan, China.,Research Center for Psychological and Health Sciences, China University of Geosciences, Wuhan, China
| |
Collapse
|
15
|
Yan H, Ding Y, Guo W. Suicidality in patients with premenstrual dysphoric disorder-A systematic review and meta-analysis. J Affect Disord 2021; 295:339-346. [PMID: 34488087 DOI: 10.1016/j.jad.2021.08.082] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/05/2021] [Revised: 07/03/2021] [Accepted: 08/25/2021] [Indexed: 01/17/2023]
Abstract
BACKGROUND Whether premenstrual dysphoric disorder (PMDD) is correlated with the risk of suicidality and the extent of its effect on suicidality are unclear. The present study was conducted to elucidate the association between PMDD and suicidality from relevant studies. METHODS Four electronic databases, namely, Scopus, Embase, PubMed, and Web of Science, were searched from inception to November 15, 2020. Quality assessment, data synthesis, and sensitivity analysis were performed on the included studies. RESULTS Six studies with 8 532 participants were included in this meta-analysis. PMDD was associated with an increased risk of suicidal ideation (odds ratio [OR]=2.34, 95% confidence interval [CI]=1.50-3.18, I2=0.0%, p=0.99, k=4). Patients with PMDD had a greater risk of experiencing suicide attempt (OR=2.13, 95% CI=1.05-3.21, I2=0.0%, p=0.81, k=5). PMDD was associated with an increased risk of suicidal plan (OR=2.24, 95% CI=1.03-3.45, I2=0.0%, p=0.96, k=2). LIMITATIONS The diagnosis of PMDD should be considered "provisional" in all the included studies. CONCLUSIONS Among PMDD sufferers there would be a group of particularly suicidal women. Clinicians who treat patients with PMDD should be vigilant for signs of suicidal ideation and behavior to implement better treatment and preventive measures.
Collapse
Affiliation(s)
- Haohao Yan
- National Clinical Research Center for Mental Disorders, and Department of Psychiatry, The Second Xiangya Hospital of Central South University, Changsha 410011, Hunan, China
| | - Yudan Ding
- National Clinical Research Center for Mental Disorders, and Department of Psychiatry, The Second Xiangya Hospital of Central South University, Changsha 410011, Hunan, China
| | - Wenbin Guo
- National Clinical Research Center for Mental Disorders, and Department of Psychiatry, The Second Xiangya Hospital of Central South University, Changsha 410011, Hunan, China; Department of Psychiatry, The Third People's Hospital of Foshan, Foshan 528000, Guangdong, China.
| |
Collapse
|
16
|
Sikes-Keilp C, Rubinow DR. In search of sex-related mediators of affective illness. Biol Sex Differ 2021; 12:55. [PMID: 34663459 PMCID: PMC8524875 DOI: 10.1186/s13293-021-00400-4] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/10/2021] [Accepted: 10/08/2021] [Indexed: 12/25/2022] Open
Abstract
Sex differences in the rates of affective disorders have been recognized for decades. Studies of physiologic sex-related differences in animals and humans, however, have generally yielded little in terms of explaining these differences. Furthermore, the significance of these findings is difficult to interpret given the dynamic, integrative, and highly context-dependent nature of human physiology. In this article, we provide an overview of the current literature on sex differences as they relate to mood disorders, organizing existing findings into five levels at which sex differences conceivably influence physiology relevant to affective states. These levels include the following: brain structure, network connectivity, signal transduction, transcription/translation, and epigenesis. We then evaluate the importance and limitations of this body of work, as well as offer perspectives on the future of research into sex differences. In creating this overview, we attempt to bring perspective to a body of research that is complex, poorly synthesized, and far from complete, as well as provide a theoretical framework for thinking about the role that sex differences ultimately play in affective regulation. Despite the overall gaps regarding both the underlying pathogenesis of affective illness and the role of sex-related factors in the development of affective disorders, it is evident that sex should be considered as an important contributor to alterations in neural function giving rise to susceptibility to and expression of depression.
Collapse
Affiliation(s)
| | - David R Rubinow
- Department of Psychiatry, University of North Carolina, Chapel Hill, NC, USA.
| |
Collapse
|
17
|
Amiel Castro RT, Ehlert U, Fischer S. Variation in genes and hormones of the hypothalamic-pituitary-ovarian axis in female mood disorders - A systematic review and meta-analysis. Front Neuroendocrinol 2021; 62:100929. [PMID: 34171352 DOI: 10.1016/j.yfrne.2021.100929] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/28/2021] [Revised: 06/02/2021] [Accepted: 06/20/2021] [Indexed: 11/28/2022]
Abstract
Women's increased risk for depression during reproductive transitions suggests an involvement of the hypothalamic-pituitary-ovarian (HPO) axis. This is the first systematic review and meta-analysis of HPO functioning in female mood disorders. Inclusionary criteria were: i) women suffering from premenstrual dysphoric disorder (PMDD) or a depressive disorder, ii) assessment of HPO-axis related biomarkers, iii) a case-control design. Sixty-three studies (N = 5,129) were included. There was evidence for PMDD to be paralleled by lower luteal oestradiol levels. Women with depression unrelated to reproductive transition showed lower testosterone levels than healthy controls and there was some evidence for lower dehydroepiandrosterone sulfate levels. There were no differences in HPO-related parameters between women with pregnancy, postpartum, and perimenopausal depression and controls. Women with PMDD and depression unrelated to reproductive transitions exhibit specific changes in the HPO-axis, which potentially contribute to their symptoms. Further research into reproductive mood disorders characterised by extreme endocrine changes is warranted.
Collapse
Affiliation(s)
- Rita T Amiel Castro
- University of Zurich, Institute of Psychology, Clinical Psychology and Psychotherapy, Binzmühlestrasse 14/26, 8050-Zurich, Switzerland.
| | - Ulrike Ehlert
- University of Zurich, Institute of Psychology, Clinical Psychology and Psychotherapy, Binzmühlestrasse 14/26, 8050-Zurich, Switzerland
| | - Susanne Fischer
- University of Zurich, Institute of Psychology, Clinical Psychology and Psychotherapy, Binzmühlestrasse 14/26, 8050-Zurich, Switzerland
| |
Collapse
|
18
|
Freitas FDF, de Medeiros ACQ, Lopes FDA. Effects of Social Distancing During the COVID-19 Pandemic on Anxiety and Eating Behavior-A Longitudinal Study. Front Psychol 2021; 12:645754. [PMID: 34140913 PMCID: PMC8203923 DOI: 10.3389/fpsyg.2021.645754] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2021] [Accepted: 04/19/2021] [Indexed: 01/11/2023] Open
Abstract
As social animals, humans need to live in groups. This contact with conspecifics is essential for their evolution and survival. Among the recommendations to reduce transmission of the new coronavirus (SARS-CoV-2) responsible for COVID-19 are social distancing and home confinement. These measures may negatively affect the social life and, consequently, the emotional state and eating behavior of individuals. We assessed the impact of the COVID-19 pandemic on the anxiety, premenstrual symptoms, and eating behavior of young women. Data collection was conducted in person (prepandemic—from March to December 2019) and online (during the pandemic—August 2020). A total of 71 participants, average age of 21.26 years (SD = 0.41), took part in the study. Trait anxiety during the pandemic was significantly lower than in the prepandemic period. Investigation of the “anxiety/stress” symptom of the Premenstrual Symptoms Screening Tool (PSST) revealed that this symptom was more severe before the pandemic. There was a decline in the desire for sweet and fatty foods during the pandemic. However, craving for traditional foods rose significantly in the same period. Uncontrolled and emotional eating were significantly lower during the pandemic. The results suggest that the pandemic may have had a positive impact on anxiety and eating behavior of the participants, which may be due to differences between urban and rural populations and the latter living with their families. These findings are important for raising a discussion regarding the effects of the current environment on the regulation of cognitive and dietary adaptations.
Collapse
Affiliation(s)
- Fernanda da Fonseca Freitas
- Post-Graduate Program in Psychobiology, Department of Physiology and Behavior, Federal University of Rio Grande do Norte, Natal, Brazil.,Health Sciences College of Trairi, Federal University of Rio Grande do Norte, Santa Cruz, Brazil
| | | | - Fívia de Araújo Lopes
- Post-Graduate Program in Psychobiology, Department of Physiology and Behavior, Federal University of Rio Grande do Norte, Natal, Brazil.,Department of Physiology and Behavior, Federal University of Rio Grande do Norte, Natal, Brazil
| |
Collapse
|
19
|
Chen Y, Herrold AA, Gallagher V, Martinovich Z, Bari S, Vike NL, Vesci B, Mjaanes J, McCloskey LR, Reilly JL, Breiter HC. Preliminary Report: Localized Cerebral Blood Flow Mediates the Relationship between Progesterone and Perceived Stress Symptoms among Female Collegiate Club Athletes after Mild Traumatic Brain Injury. J Neurotrauma 2021; 38:1809-1820. [PMID: 33470158 PMCID: PMC8336258 DOI: 10.1089/neu.2020.7217] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
Female athletes are under-studied in the field of concussion research, despite evidence of higher injury prevalence and longer recovery time. Hormonal fluctuations caused by the natural menstrual cycle (MC) or hormonal contraceptive (HC) use impact both post-injury symptoms and neuroimaging findings, but the relationships among hormone, symptoms, and brain-based measures have not been jointly considered in concussion studies. In this preliminary study, we compared cerebral blood flow (CBF) measured with arterial spin labeling between concussed female club athletes 3-10 days after mild traumatic brain injury (mTBI) and demographic, HC/MC matched controls (CON). We tested whether CBF statistically mediates the relationship between progesterone serum levels and post-injury symptoms, which may support a hypothesis for progesterone's role in neuroprotection. We found a significant three-way relationship among progesterone, CBF, and perceived stress score (PSS) in the left middle temporal gyrus for the mTBI group. Higher progesterone was associated with lower (more normative) PSS, as well as higher (more normative) CBF. CBF mediates 100% of the relationship between progesterone and PSS (Sobel p value = 0.017). These findings support a hypothesis for progesterone having a neuroprotective role after concussion and highlight the importance of controlling for the effects of sex hormones in future concussion studies.
Collapse
Affiliation(s)
- Yufen Chen
- Center for Translational Imaging, Department of Radiology, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
| | | | - Virginia Gallagher
- Warren Wright Adolescent Center, Department of Psychiatry and Behavioral Sciences, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
| | - Zoran Martinovich
- Warren Wright Adolescent Center, Department of Psychiatry and Behavioral Sciences, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
| | - Sumra Bari
- Warren Wright Adolescent Center, Department of Psychiatry and Behavioral Sciences, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
| | - Nicole L. Vike
- Warren Wright Adolescent Center, Department of Psychiatry and Behavioral Sciences, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
| | - Brian Vesci
- Northwestern Health Services Sports Medicine, Northwestern University, Evanston, Illinois, USA
| | - Jeffrey Mjaanes
- Northwestern Health Services Sports Medicine, Northwestern University, Evanston, Illinois, USA
| | - Leanne R. McCloskey
- Department of Obstetrics and Gynecology, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
| | - James L. Reilly
- Warren Wright Adolescent Center, Department of Psychiatry and Behavioral Sciences, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
| | - Hans C. Breiter
- Warren Wright Adolescent Center, Department of Psychiatry and Behavioral Sciences, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
- Laboratory of Neuroimaging and Genetics, Department of Psychiatry, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts, USA
| |
Collapse
|
20
|
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.
Collapse
|
21
|
Dubol M, Epperson CN, Sacher J, Pletzer B, Derntl B, Lanzenberger R, Sundström-Poromaa I, Comasco E. Neuroimaging the menstrual cycle: A multimodal systematic review. Front Neuroendocrinol 2021; 60:100878. [PMID: 33098847 DOI: 10.1016/j.yfrne.2020.100878] [Citation(s) in RCA: 58] [Impact Index Per Article: 19.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/31/2020] [Revised: 09/29/2020] [Accepted: 10/15/2020] [Indexed: 12/15/2022]
Abstract
Increasing evidence indicates that ovarian hormones affect brain structure, chemistry and function of women in their reproductive age, potentially shaping their behavior and mental health. Throughout the reproductive years, estrogens and progesterone levels fluctuate across the menstrual cycle and can modulate neural circuits involved in affective and cognitive processes. Here, we review seventy-seven neuroimaging studies and provide a comprehensive and data-driven evaluation of the accumulating evidence on brain plasticity associated with endogenous ovarian hormone fluctuations in naturally cycling women (n = 1304). The results particularly suggest modulatory effects of ovarian hormones fluctuations on the reactivity and structure of cortico-limbic brain regions. These findings highlight the importance of performing multimodal neuroimaging studies on neural correlates of systematic ovarian hormone fluctuations in naturally cycling women based on careful menstrual cycle staging.
Collapse
Affiliation(s)
- Manon Dubol
- Department of Neuroscience, Science for Life Laboratory, Uppsala University, Sweden
| | - C Neill Epperson
- Department of Psychiatry, Department of Family Medicine, University of Colorado School of Medicine-Anschutz Medical Campus, USA
| | - Julia Sacher
- Emotion Neuroimaging Lab, Max Planck Institute for Human Cognitive and Brain Sciences, Germany
| | - Belinda Pletzer
- Department of Psychology, Centre for Cognitive Neuroscience, University of Salzburg, Austria
| | - Birgit Derntl
- Department of Psychiatry and Psychotherapy, University of Tuebingen, Germany
| | - Rupert Lanzenberger
- Department of Psychiatry and Psychotherapy, Medical University of Vienna, Austria
| | | | - Erika Comasco
- Department of Neuroscience, Science for Life Laboratory, Uppsala University, Sweden; Department of Psychiatry and Psychotherapy, Medical University of Vienna, Austria.
| |
Collapse
|
22
|
Zhang J, Liao J, Wang T, Yuan R, Zhao Y, Han Z, Tang L, Zhao L. Effects of joy and sorrow on pulse-graph parameters in healthy female college students based on emotion-evoked experiments. Explore (NY) 2020; 17:303-311. [PMID: 33153899 DOI: 10.1016/j.explore.2020.09.011] [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: 10/06/2019] [Revised: 09/15/2020] [Accepted: 09/27/2020] [Indexed: 11/30/2022]
Abstract
OBJECTIVE To explore the effects of joy and sorrow on pulse-graph parameters in healthy subjects and analyze their potential effect to provide preliminary evidence that pulse diagnosis can identify human emotional changes. DESIGN AND INTERVENTION Forty healthy female college students from Beijing University of Chinese Medicine were recruited. The emotion-evoking experiment was conducted to observe the effects of joy and sorrow on pulse-graph parameters, taking neutral emotion as a control. The experiment included the following criteria. (1) Emotions evoked and evaluated: the same subjects watched three emotional videos which were, respectively, neutral, joyful and sorrowful to evoke the corresponding emotions. They completed the "subjective emotion evaluation form" (SEEF) before watching each video (T0), immediately after watching the video (T1) and 15 min after watching the video (T2) to conduct subjective emotion evaluation. Simultaneously, their heart rate, galvanic skin response and heart rate variability were collected with a 16-lead physiological recorder to conduct an objective evaluation of emotional arousal. (2) Collection of pulse-graph parameters: pulse-graph parameters of the subjects at T0, T1 and T2 were collected with a pulse condition analyzer. RESULTS When watching the joy video, the rapid ejection phase extended significantly, both the left ventricular diastole and the cardiac cycle shortened significantly. When watching the sorrow video, the left ventricular diastole extended significantly, the cardiac cycle showed an upward trend, and heart rate showed a downward trend. CONCLUSION Joy and sorrow have a certain effect on pulse-graph parameters of the subjects. The mechanisms may be that joy contributes to rapid ejection phase extension and a shortening of the left ventricular diastole and the cardiac cycle, while sorrow extends the left ventricular diastole. According to the theory of Traditional Chinese Medicine (TCM), the visceral functions can be mediated through human qi flow. Moderate joy and sorrow can promote, respectively, the smooth qi flow of the heart and the lung. However, excessive or long-term joy and sorrow can lead to disharmonious qi flow of the two viscera. Therefore, maintaining moderate emotions is beneficial to the physiological functions of the viscera. Great emotional fluctuations may damage the visceral functions. Future studies with effects of other emotions on pulse-graph parameters are warranted to determine the reliability of the association of emotions and pulse diagnosis.
Collapse
Affiliation(s)
- Jiayuan Zhang
- School of Traditional Chinese Medicine, Beijing University of Chinese Medicine, No. 11, Bei San Huan Dong Lu, Chaoyang District, Beijing 100029, China
| | - Jieying Liao
- School of Traditional Chinese Medicine, Beijing University of Chinese Medicine, No. 11, Bei San Huan Dong Lu, Chaoyang District, Beijing 100029, China
| | - Tianfang Wang
- School of Traditional Chinese Medicine, Beijing University of Chinese Medicine, No. 11, Bei San Huan Dong Lu, Chaoyang District, Beijing 100029, China.
| | - Rong Yuan
- School of Traditional Chinese Medicine, Beijing University of Chinese Medicine, No. 11, Bei San Huan Dong Lu, Chaoyang District, Beijing 100029, China
| | - Yan Zhao
- School of Traditional Chinese Medicine, Beijing University of Chinese Medicine, No. 11, Bei San Huan Dong Lu, Chaoyang District, Beijing 100029, China
| | - Zhuo Han
- Department of Psychology (Beijing Key Laboratory of Applied Experimental Psychology), Beijing Normal University, Beijing, China, No. 19, XinJieKouWai St., HaiDian District, Beijing 100875, China
| | - Ling Tang
- Department of Gynecology, Dongzhimen Hospital, Beijing University of Chinese Medicine, No. 5, Hai Yun Cang, Dongcheng District, Beijing 100700, China
| | - Lihong Zhao
- School of Traditional Chinese Medicine, Beijing University of Chinese Medicine, No. 11, Bei San Huan Dong Lu, Chaoyang District, Beijing 100029, China
| |
Collapse
|
23
|
Hornung J, Lewis CA, Derntl B. Sex hormones and human brain function. HANDBOOK OF CLINICAL NEUROLOGY 2020; 175:195-207. [PMID: 33008525 DOI: 10.1016/b978-0-444-64123-6.00014-x] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Sex hormones have organizational and activational effects on the human brain and can interact with the neurotransmitter systems. These biologic mechanisms may have a far-reaching impact, with both behavioral consequences and structural as well as functional brain modulation. The impact of cycling hormone levels throughout the menstrual cycle on cognitive and emotion processing has especially received some attention recently. Therefore, the aim of this chapter is to give an overview of findings regarding the effects of estradiol and progesterone, but also testosterone, on functional brain domains comprising cognition, emotion, and reward processing.
Collapse
Affiliation(s)
- Jonas Hornung
- Department of Psychiatry and Psychotherapy, University of Tübingen, Tübingen, Germany
| | - Carolin A Lewis
- Department of Psychiatry and Psychotherapy, University of Tübingen, Tübingen, Germany
| | - Birgit Derntl
- Department of Psychiatry and Psychotherapy, University of Tübingen, Tübingen, Germany.
| |
Collapse
|
24
|
Sundström-Poromaa I, Comasco E, Sumner R, Luders E. Progesterone - Friend or foe? Front Neuroendocrinol 2020; 59:100856. [PMID: 32730861 DOI: 10.1016/j.yfrne.2020.100856] [Citation(s) in RCA: 64] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/31/2020] [Revised: 07/05/2020] [Accepted: 07/24/2020] [Indexed: 12/12/2022]
Abstract
Estradiol is the "prototypic" sex hormone of women. Yet, women have another sex hormone, which is often disregarded: Progesterone. The goal of this article is to provide a comprehensive review on progesterone, and its metabolite allopregnanolone, emphasizing three key areas: biological properties, main functions, and effects on mood in women. Recent years of intensive research on progesterone and allopregnanolone have paved the way for new treatment of postpartum depression. However, treatment for premenstrual syndrome and premenstrual dysphoric disorder as well as contraception that women can use without risking mental health problems are still needed. As far as progesterone is concerned, we might be dealing with a two-edged sword: while its metabolite allopregnanolone has been proven useful for treatment of PPD, it may trigger negative symptoms in women with PMS and PMDD. Overall, our current knowledge on the beneficial and harmful effects of progesterone is limited and further research is imperative.
Collapse
Affiliation(s)
| | - Erika Comasco
- Department of Neuroscience, Science for Life Laboratory, Uppsala University, Uppsala, Sweden
| | | | - Eileen Luders
- School of Psychology, University of Auckland, New Zealand; Laboratory of Neuro Imaging, School of Medicine, University of Southern California, Los Angeles, USA
| |
Collapse
|
25
|
Females’ menstrual cycle and incentive salience: Insights on neural reaction towards erotic pictures and effects of gonadal hormones. COMPREHENSIVE PSYCHONEUROENDOCRINOLOGY 2020; 3:100006. [PMID: 35756542 PMCID: PMC9216261 DOI: 10.1016/j.cpnec.2020.100006] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2020] [Revised: 06/10/2020] [Accepted: 06/16/2020] [Indexed: 11/25/2022] Open
Abstract
Background Studies in regard to womens’ neural reactivity to erotic and other positive emotional cues in association with sexual hormones are relatively rare and findings rather inconclusive. Concerning the neural reactions towards erotic stimuli, the late positive potential (LPP) is seen as the most relevant ERP-component: More positive amplitudes are supposed to reflect larger motivational salience and higher arousal in reaction to the presented stimuli. Therefore, it was expected that the LPP in reaction to erotic pictures would be more pronounced during fertile periods of the menstrual cycle around ovulation, as well as to be associated with estradiol-levels. A similar pattern was hypothesized to be present with testosterone-levels, whereas no association with progesterone was expected. Method N = 35 free-cycling women completed an Erotic picture Stroop task (neutral, positive, and erotic stimuli, with three neutral- and three erotic subcategories) during follicular phase, ovulation and luteal phase, while EEG was recorded. Subjects provided saliva samples in order to determine estradiol-, progesterone-, and testosterone levels at each measuring time, and affective states were assessed using the Positive and Negative Affect Scale (PANAS). Results LPPs in reaction to erotic-compared to positive- and neutral pictures were larger in every cycle phase. LPPs in reaction to erotic couples were strongest in comparison to every other (sub-) category. During ovulation, higher estradiol-concentrations were associated with lower LPP-amplitudes towards erotic-couples- than to neutral pictures. No effects of progesterone, no direct effect of testosterone, as well as no effects of cycle phase, were evident. Conclusion Results partly contradict our hypotheses, as estradiol was expected to be positively associated with LPP during fertile stages. Possible differences between stimulus-entities (words v. pictures) and ideas for further research are being discussed. Associations of LPP-amplitudes in reaction to erotic (vs. neutral) pictures with estradiol. Higher Estradiol concentrations are associated with blunted LPP-amplitudes towards erotic pictures during ovulation. Progesterone is not associated with the reactivity towards erotic pictures in the LPP. Cycle phase is not associated with the reactivity towards erotic pictures in the LPP.
Collapse
|
26
|
Sharma R, Smith SA, Boukina N, Dordari A, Mistry A, Taylor BC, Felix N, Cameron A, Fang Z, Smith A, Ismail N. Use of the birth control pill affects stress reactivity and brain structure and function. Horm Behav 2020; 124:104783. [PMID: 32533958 DOI: 10.1016/j.yhbeh.2020.104783] [Citation(s) in RCA: 28] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/22/2020] [Revised: 05/20/2020] [Accepted: 05/22/2020] [Indexed: 11/25/2022]
Abstract
Millions of women worldwide use oral contraceptives (i.e., birth control pill; OCs), often starting during puberty/adolescence; however, it is unknown how OC use during this critical period of development affects the brain, especially with regard to emotional working memory. Here, we examined stress reactivity, and brain structure and function in OC users using the Trier Social Stress Test and structural and functional magnetic resonance imaging (MRI). Our results show that OC use during puberty/adolescence gives rise to a blunted stress response and alters brain activation during working memory processing. OC use, in general, is also linked to increased prefrontal brain activation during working memory processing for negatively arousing stimuli. OC use is also related to significant structural changes in brain regions implicated in memory and emotional processing. Together, these findings highlight that OC use induces changes to brain structure and function and alters stress reactivity. These findings may provide a mechanistic insight for the increased vulnerability to mood-related mental illness in women after OC use.
Collapse
Affiliation(s)
- Rupali Sharma
- Neuroimmunology, Stress and Endocrinology (NISE) Lab, School of Psychology, Faculty of Social Science, University of Ottawa, Canada
| | - Samantha A Smith
- Neuroimmunology, Stress and Endocrinology (NISE) Lab, School of Psychology, Faculty of Social Science, University of Ottawa, Canada
| | - Nadia Boukina
- Brain Imaging Group (BIG) Lab, School of Psychology, Faculty of Social Science, University of Ottawa, Canada
| | - Aisa Dordari
- School of Integrated Science, Faculty of Science, Carleton University, Canada
| | - Alana Mistry
- Neuroimmunology, Stress and Endocrinology (NISE) Lab, School of Psychology, Faculty of Social Science, University of Ottawa, Canada
| | | | - Nereah Felix
- Neuroimmunology, Stress and Endocrinology (NISE) Lab, School of Psychology, Faculty of Social Science, University of Ottawa, Canada
| | - Andrew Cameron
- Brain Imaging Group (BIG) Lab, School of Psychology, Faculty of Social Science, University of Ottawa, Canada
| | - Zhuo Fang
- Brain Imaging Group (BIG) Lab, School of Psychology, Faculty of Social Science, University of Ottawa, Canada
| | - Andra Smith
- Brain Imaging Group (BIG) Lab, School of Psychology, Faculty of Social Science, University of Ottawa, Canada; University of Ottawa Brain and Mind Research Institute, Canada
| | - Nafissa Ismail
- Neuroimmunology, Stress and Endocrinology (NISE) Lab, School of Psychology, Faculty of Social Science, University of Ottawa, Canada; University of Ottawa Brain and Mind Research Institute, Canada.
| |
Collapse
|
27
|
Dan R, Reuveni I, Canetti L, Weinstock M, Segman R, Goelman G, Bonne O. Trait-related changes in brain network topology in premenstrual dysphoric disorder. Horm Behav 2020; 124:104782. [PMID: 32470339 DOI: 10.1016/j.yhbeh.2020.104782] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/02/2020] [Revised: 04/26/2020] [Accepted: 05/22/2020] [Indexed: 11/19/2022]
Abstract
The female predominance in the prevalence of depression is partially accounted by reactivity to hormonal fluctuations. Premenstrual dysphoric disorder (PMDD) is a reproductive subtype of depression characterized by cyclic emotional and somatic symptoms that recur before menstruation. Despite the growing understanding that most psychiatric disorders arise from dysfunctions in distributed brain circuits, the brain's functional connectome and its network properties of segregation and integration were not investigated in PMDD. To this end, we examined the brain's functional network organization in PMDD using graph theoretical analysis. 24 drug naïve women with PMDD and 27 controls without premenstrual symptoms underwent 2 resting-state fMRI scans, during the mid-follicular and late-luteal menstrual cycle phases. Functional connectivity MRI, graph theory metrics, and levels of sex hormones were computed during each menstrual phase. Altered network topology was found in PMDD across symptomatic and remitted stages in major graph metrics (characteristic path length, clustering coefficient, transitivity, local and global efficiency, centrality), indicating decreased functional network segregation and increased functional network integration. In addition, PMDD patients exhibited hypoconnectivity of the anterior temporal lobe and hyperconnectivity of the basal ganglia and thalamus, across menstrual phases. Furthermore, the relationship between difficulties in emotion regulation and PMDD was mediated by specific patterns of functional connectivity, including connections of the striatum, thalamus, and prefrontal cortex. The shifts in the functional connectome and its topology in PMDD may suggest trait vulnerability markers of the disorder.
Collapse
Affiliation(s)
- Rotem Dan
- Edmond and Lily Safra Center for Brain Sciences (ELSC), The Hebrew University of Jerusalem, Jerusalem, Israel; Department of Neurology, Hadassah Hebrew University Medical Center, Jerusalem, Israel
| | - Inbal Reuveni
- Department of Psychiatry, Hadassah Hebrew University Medical Center, Jerusalem, Israel
| | - Laura Canetti
- Department of Psychiatry, Hadassah Hebrew University Medical Center, Jerusalem, Israel; Department of Psychology, The Hebrew University of Jerusalem, Jerusalem, Israel
| | - Marta Weinstock
- Institute of Drug Research, The Hebrew University of Jerusalem, Jerusalem, Israel
| | - Ronen Segman
- Department of Psychiatry, Hadassah Hebrew University Medical Center, Jerusalem, Israel
| | - Gadi Goelman
- Department of Neurology, Hadassah Hebrew University Medical Center, Jerusalem, Israel.
| | - Omer Bonne
- Department of Psychiatry, Hadassah Hebrew University Medical Center, Jerusalem, Israel
| |
Collapse
|
28
|
Riddle J, Ahn S, McPherson T, Girdler S, Frohlich F. Progesterone modulates theta oscillations in the frontal-parietal network. Psychophysiology 2020; 57:e13632. [PMID: 33400260 DOI: 10.1111/psyp.13632] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2020] [Revised: 04/27/2020] [Accepted: 05/24/2020] [Indexed: 11/27/2022]
Abstract
The neuroactive metabolites of the steroid hormones progesterone (P4) and testosterone (T) are GABAergic modulators that influence cognition, yet, the specific effect of P4 and T on brain network activity remains poorly understood. Here, we investigated if a fundamental oscillatory network activity pattern, often related to cognitive control, frontal midline theta (FMT) oscillations, are modulated by steroids hormones, P4 and T. We measured the concentration of P4 and T using salivary enzyme immunoassay and FMT oscillations using high-density electroencephalography (EEG) during eyes-open resting-state in 55 healthy women and men. Electrical brain activity was analyzed using Fourier analysis, aperiodic signal fitting, and beamformer source localization. Steroid hormone concentrations and biological sex were used as predictors for scalp and source-estimated amplitude of theta oscillations. Elevated concentrations of P4 predicted increased amplitude of FMT oscillations across both sexes, and no relationship was found with T. The positive correlation with P4 was specific to the frontal midline electrodes and survived correction for the background aperiodic signal of the brain. Using source localization, FMT oscillations were localized to the frontal-parietal network (FPN). Additionally, theta amplitude within the FPN, but not the default mode network, positively correlated with P4 concentration. Our results suggest that P4 concentration modulates brain activity via upregulation of theta oscillations in the FPN.
Collapse
Affiliation(s)
- Justin Riddle
- Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.,Carolina Center for Neurostimulation, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.,Center for Women's Mood Disorders, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Sangtae Ahn
- Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.,Carolina Center for Neurostimulation, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.,School of Electronic Engineering, Kyungpook National University, Daegu, South Korea
| | - Trevor McPherson
- Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.,Carolina Center for Neurostimulation, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Susan Girdler
- Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.,Center for Women's Mood Disorders, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Flavio Frohlich
- Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.,Carolina Center for Neurostimulation, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.,Department of Neurology, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.,Department of Cell Biology and Physiology, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.,Department of Biomedical Engineering, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.,Neuroscience Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| |
Collapse
|
29
|
Lieberz J, Scheele D, Spengler FB, Matheisen T, Schneider L, Stoffel-Wagner B, Kinfe TM, Hurlemann R. Kinetics of oxytocin effects on amygdala and striatal reactivity vary between women and men. Neuropsychopharmacology 2020; 45:1134-1140. [PMID: 31785587 PMCID: PMC7235226 DOI: 10.1038/s41386-019-0582-6] [Citation(s) in RCA: 45] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/21/2019] [Revised: 11/20/2019] [Accepted: 11/25/2019] [Indexed: 02/06/2023]
Abstract
Accumulating evidence suggests that intranasal oxytocin (OXT; 24 IU) reduces amygdala responses to fear-related stimuli in men, while exerting inverse effects in women. However, OXT enhances activity of the brain reward system in both sexes. Importantly, a crucial and still open question is whether there are sex-specific dose-response relationships for the amygdala and striatal regions. To address this question, a total of 90 healthy women participated in a double-blind, placebo-controlled crossover functional magnetic resonance imaging (fMRI) study and the results were compared with our previous findings from men. Participants were randomly assigned to three doses of OXT (6 IU, 12 IU, and 24 IU) and completed an emotional face recognition task including fearful and happy faces of varying emotional intensities. Across doses, OXT enhanced amygdala reactivity to low fearful faces compared to placebo and increased responses to happy faces in the dorsal striatum in women. While treatment effects on amygdala reactivity were evident at each given dose, the OXT effect on striatal responses to social stimuli was more pronounced with higher doses, but this dose-dependent effect did not survive correction for multiple comparisons. Importantly, OXT effects on amygdala and striatal activation significantly differed between sexes and striatal baseline sexual-dimorphic response patterns were diminished after administration of OXT. Our findings suggest that OXT increases the salience of social signals by strengthening the sensitivity for these signals in the amygdala and in the striatum in women, while OXT may primarily induce anxiolysis by reducing amygdala responses in men.
Collapse
Affiliation(s)
- Jana Lieberz
- 0000 0001 2240 3300grid.10388.32Division of Medical Psychology, University of Bonn, 53105 Bonn, Germany
| | - Dirk Scheele
- Division of Medical Psychology, University of Bonn, 53105, Bonn, Germany.
| | - Franny B. Spengler
- grid.5963.9Institute for Psychology, University of Freiburg, 79104 Freiburg, Germany
| | - Tatjana Matheisen
- 0000 0001 2240 3300grid.10388.32Division of Medical Psychology, University of Bonn, 53105 Bonn, Germany
| | - Lìa Schneider
- 0000 0001 2240 3300grid.10388.32Division of Medical Psychology, University of Bonn, 53105 Bonn, Germany
| | - Birgit Stoffel-Wagner
- 0000 0001 2240 3300grid.10388.32Institute of Clinical Chemistry and Clinical Pharmacology, University of Bonn, 53105 Bonn, Germany
| | - Thomas M. Kinfe
- 0000 0001 2107 3311grid.5330.5Department of Neurosurgery, Division of Functional Neurosurgery and Stereotaxy, Friedrich-Alexander University (FAU) Erlangen-Nürnberg, 91054 Erlangen, Germany
| | - René Hurlemann
- 0000 0001 2240 3300grid.10388.32Division of Medical Psychology, University of Bonn, 53105 Bonn, Germany ,0000 0001 2240 3300grid.10388.32Department of Psychiatry, University of Bonn, 53105 Bonn, Germany ,0000 0001 1009 3608grid.5560.6Department of Psychiatry, University of Oldenburg Medical Campus, 26160 Bad Zwischenahn, Germany
| |
Collapse
|
30
|
Dubol M, Epperson CN, Lanzenberger R, Sundström-Poromaa I, Comasco E. Neuroimaging premenstrual dysphoric disorder: A systematic and critical review. Front Neuroendocrinol 2020; 57:100838. [PMID: 32268180 DOI: 10.1016/j.yfrne.2020.100838] [Citation(s) in RCA: 36] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/31/2020] [Revised: 03/26/2020] [Accepted: 03/31/2020] [Indexed: 01/29/2023]
Abstract
Endocrine organizational and activational influences on cognitive and affective circuits are likely critical to the development of premenstrual dysphoric disorder (PMDD), a sex-specific hormone-dependent mood disorder. An overview of the anatomical and functional neural characterization of this disorder is presented here by means of neuroimaging correlates, identified from eighteen publications (n = 361 subjects). While white matter integrity remains uninvestigated, greater cerebellar grey matter volume and metabolism were observed in patients with PMDD, along with altered serotonergic and GABAergic neurotransmission. Differential corticolimbic activation in response to emotional stimuli distinguishes the PMDD brain, namely enhanced amygdalar and diminished fronto-cortical function. Thus far, the emotional distress and dysregulation linked to PMDD seem to be defined by structural, chemical and functional brain signatures; however, their characterization remains sparsely studied and somewhat inconsistent. Clear and well-replicated neurobiological features of PMDD are needed to promote timely diagnoses and inform development of prevention and treatment strategies.
Collapse
Affiliation(s)
- Manon Dubol
- Department of Neuroscience, Science for Life Laboratory, Uppsala University, Sweden
| | - C Neill Epperson
- Department of Psychiatry, Department of Family Medicine, University of Colorado, School of Medicine-Anschutz Medical Campus, United States
| | - Rupert Lanzenberger
- Department of Psychiatry and Psychotherapy, Medical University of Vienna, Austria
| | | | - Erika Comasco
- Department of Neuroscience, Science for Life Laboratory, Uppsala University, Sweden; Department of Psychiatry and Psychotherapy, Medical University of Vienna, Austria.
| |
Collapse
|
31
|
Shirazi TN, Rosenfield KA, Cárdenas RA, Breedlove SM, Puts DA. No evidence that hormonal contraceptive use or circulating sex steroids predict complex emotion recognition. Horm Behav 2020; 119:104647. [PMID: 31778719 PMCID: PMC8496674 DOI: 10.1016/j.yhbeh.2019.104647] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/19/2019] [Revised: 11/17/2019] [Accepted: 11/20/2019] [Indexed: 12/27/2022]
Abstract
Relatively little is known about the effects of endogenous and exogenous steroid hormones on ecologically relevant behavioral and cognitive phenotypes in women, such as emotion recognition, despite the widespread use of steroid hormone-altering hormonal contraceptives (HCs). Though some previous studies have examined the effect of HC use, estradiol, progesterone, and testosterone on emotion recognition in women, they have been limited by cross-sectional designs, small sample sizes (total n < 100), and compromised statistical power to detect significant effects. Using data from two test sessions in a large sample of naturally cycling women (NC; n = 192) and women on HCs (n = 203), we found no group differences in emotion recognition; further, the lack of group differences in emotion recognition was not modulated by item difficulty or emotional valence. Among NC women who provided saliva samples across two sessions that were assayed for estradiol and progesterone concentrations, we found no compelling evidence across models that between-subject differences and within-subject fluctuations in these ovarian hormones predicted emotion recognition accuracy, with the exception that between-subjects estradiol negatively predicted emotion recognition for emotions of neutral valence (p = .042). Among HC women who provided saliva samples across two sessions that were assayed for testosterone, we found no compelling evidence that between-subjects differences and within-subject fluctuations in testosterone predicted emotion recognition accuracy. Overall, our analyses provide little support for the idea that circulating endogenous or exogenous ovarian hormones influence emotion recognition in women.
Collapse
Affiliation(s)
- Talia N Shirazi
- Department of Anthropology, Pennsylvania State University, University Park, PA, 16802, United States of America
| | - Kevin A Rosenfield
- Department of Anthropology, Pennsylvania State University, University Park, PA, 16802, United States of America
| | - Rodrigo A Cárdenas
- Department of Psychology, Pennsylvania State University, University Park, PA, 16802, United States of America
| | - S Marc Breedlove
- Department of Neuroscience, Michigan State University, East Lansing, MI 48824, United States of America
| | - David A Puts
- Department of Anthropology, Pennsylvania State University, University Park, PA, 16802, United States of America.
| |
Collapse
|
32
|
Lulu HOU, Lirong CHEN, Renlai ZHOU. Altered reward processing in women with premenstrual syndrome: Evidence from ERPs and time-frequency analysis. ACTA PSYCHOLOGICA SINICA 2020. [DOI: 10.3724/sp.j.1041.2020.00742] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Affiliation(s)
- HOU Lulu
- Department of Psychology, Nanjing University, Nanjing 210023, China
| | - CHEN Lirong
- Department of Psychology, Nanjing University, Nanjing 210023, China
| | - ZHOU Renlai
- Department of Psychology, Nanjing University, Nanjing 210023, China
| |
Collapse
|
33
|
Petersen N, Ghahremani DG, Rapkin AJ, Berman SM, Wijker N, Liang L, London ED. Resting-state functional connectivity in women with PMDD. Transl Psychiatry 2019; 9:339. [PMID: 31827073 PMCID: PMC6906514 DOI: 10.1038/s41398-019-0670-8] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/10/2019] [Revised: 11/11/2019] [Accepted: 11/26/2019] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Premenstrual dysphoric disorder (PMDD) is an understudied, debilitating disorder of women. Given evidence for prefrontal cortical and limbic dysfunction in PMDD, we compared intrinsic connectivity of the executive control network (ECN), default mode network (DMN), and amygdala in women with PMDD vs. controls. METHODS Thirty-six women (18 PMDD, 18 control) participated in fMRI during the follicular and luteal phases of the menstrual cycle. At each time, resting-state functional connectivity was evaluated both before and after participants performed an emotion regulation task. The ECN was identified using independent components analysis, and connectivity of left and right amygdala seeds was also evaluated. RESULTS Nonparametric permutation testing identified a cluster in the left middle temporal gyrus (MTG) with significantly stronger connectivity to the left ECN in women with PMDD vs. controls in all four fMRI sessions. Women with PMDD exhibited no difference in functional connectivity between menstrual cycle phases. Amygdala connectivity did not differ between the groups but differed significantly with menstrual phase, with left amygdala connectivity to cingulate cortex being significantly stronger during the follicular vs. luteal phase. Right amygdala connectivity to the middle frontal gyrus was also stronger during the follicular vs. luteal phase, with no group differences. These findings suggest that women with PMDD have different intrinsic network dynamics in the left executive control network compared to healthy controls.
Collapse
Affiliation(s)
- Nicole Petersen
- 0000 0000 9632 6718grid.19006.3eDepartment of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, Los Angeles, CA 90024 USA
| | - Dara G. Ghahremani
- 0000 0000 9632 6718grid.19006.3eDepartment of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, Los Angeles, CA 90024 USA
| | - Andrea J. Rapkin
- 0000 0000 9632 6718grid.19006.3eDepartment of Obstetrics and Gynecology, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA 90024 USA
| | - Steven M. Berman
- 0000 0000 9632 6718grid.19006.3eDepartment of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, Los Angeles, CA 90024 USA
| | - Noor Wijker
- 0000 0000 9632 6718grid.19006.3eDepartment of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, Los Angeles, CA 90024 USA
| | - Letty Liang
- 0000 0000 9632 6718grid.19006.3eDepartment of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, Los Angeles, CA 90024 USA
| | - Edythe D. London
- 0000 0000 9632 6718grid.19006.3eDepartment of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, Los Angeles, CA 90024 USA ,0000 0000 9632 6718grid.19006.3eDepartment of Molecular and Medical Pharmacology, University of California, Los Angeles, Los Angeles, CA 90024 USA ,0000 0000 9632 6718grid.19006.3eBrain Research Institute, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA 90024 USA
| |
Collapse
|
34
|
Cutting to the Pathophysiology Chase: Translating Cutting-Edge Neuroscience to Rehabilitation Practice in Sports-Related Concussion Management. J Orthop Sports Phys Ther 2019; 49:811-818. [PMID: 31154951 DOI: 10.2519/jospt.2019.8884] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Mild traumatic brain injury, or concussion, is a common sports injury. Concussion involves physical injury to brain tissue and vascular and axonal damage that manifests as transient and often nonspecific clinical symptoms. Concussion diagnosis is challenging, and the relationship between brain injury and clinical symptoms is unclear. The purpose of this commentary was to translate cutting-edge neuroscience to rehabilitation practice. We (1) highlight potential biomarkers that may improve our understanding of concussion and its recovery, (2) explain why researchers must address the paucity of concussion research in female athletes, and (3) present female-specific factors that should be accounted for in future studies. Integrating objective, quantitative measures of concussion pathophysiology with concussion history, genetics, and genomics will help caregivers identify concussed athletes, tailor recovery protocols, and protect athletes from potential long-term effects of cumulative head impact. J Orthop Sports Phys Ther 2019;49(11):811-818. Epub 1 Jun 2019. doi:10.2519/jospt.2019.8884.
Collapse
|
35
|
Aperribai L, Alonso-Arbiol I. The role of mental health variables and coping strategies in premenstrual syndrome. Health Care Women Int 2019; 41:368-379. [PMID: 31622184 DOI: 10.1080/07399332.2019.1663193] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
In this study we aimed to examine the relationship between PMS and some mental health variables (anxiety, depression, neuroticism) and coping strategies. We analyzed their predictive value by assessing 55 women's symptoms. We found that all the studied health variables and coping strategies were significantly correlated with reported PMS's Negative Symptomatology scores in the premenstrual phase. Interdisciplinary training programs on instrumental coping strategies might be carried out. In future studies researchers might examine how severe Depression would impact on PMS, and which specific intervention strategies would diminish PMS's distressing effects on women's quality of life worldwide.
Collapse
Affiliation(s)
- Leire Aperribai
- Department of Educational Psychology and Pedagogy, Begoñako Andra Mari Teacher Training University College, BAM, Bilbao, Spain
| | - Itziar Alonso-Arbiol
- Department of Psychology, University of the Basque Country UPV/EHU, Donostia-San Sebastian, Spain
| |
Collapse
|
36
|
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.
Collapse
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
| |
Collapse
|
37
|
Bierzynska M, Sobczak PA, Kozak A, Bielecki M, Strelau J, Kossut MM. No Risk, No Differences. Neural Correlates of Temperamental Traits Revealed Using Naturalistic fMRI Method. Front Psychol 2019; 10:1757. [PMID: 31447728 PMCID: PMC6691771 DOI: 10.3389/fpsyg.2019.01757] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2019] [Accepted: 07/15/2019] [Indexed: 12/31/2022] Open
Abstract
The main goal of this study was to identify the moderating role of temperamental traits, as defined by Strelau's Regulative Theory of Temperament (RTT), in explaining brain activity evoked by video stimuli of varying stimulatory value. fMRI scans were performed in a group of 61 young females in the luteal phase of the menstrual cycle. The validity of stimulus selection had been verified prior to the main study by collecting declarative measures of affective reactions, including valence, arousal, and basic emotions ratings. The choice of dynamic and complex video-stimuli allowed us to induce high levels of arousal effectively. Three categories of movies used in the experiment included neutral, low arousing, and highly arousing scenes. Movies classified into the last category depicted extreme-sport activities allowing us to confront the subjects with recordings potentially life-threatening situations. Results of the study revealed that activation of orbitofrontal cortex in highly arousing conditions is linked to the levels of activity, while traits of perseverance and emotional reactivity were negatively correlated with the BOLD signal in this structure. Low arousing movies evoked higher activation of the amygdala and left hippocampus in emotionally reactive subjects. Obtained results might be coherently interpreted in the light of RTT theory, therefore providing its first validation using functional brain imaging.
Collapse
Affiliation(s)
- Maria Bierzynska
- Laboratory of Neuroplasticity, Nencki Institute of Experimental Biology, Warsaw, Poland
| | - Pamela Anna Sobczak
- Faculty of Psychology, SWPS University of Social Sciences and Humanities, Warsaw, Poland
| | - Anna Kozak
- Laboratory of Neuroplasticity, Nencki Institute of Experimental Biology, Warsaw, Poland
| | - Maksymilian Bielecki
- Faculty of Psychology, SWPS University of Social Sciences and Humanities, Warsaw, Poland
| | - Jan Strelau
- Faculty of Psychology, SWPS University of Social Sciences and Humanities, Warsaw, Poland
| | - Malgorzata Maria Kossut
- Laboratory of Neuroplasticity, Nencki Institute of Experimental Biology, Warsaw, Poland.,Faculty of Psychology, SWPS University of Social Sciences and Humanities, Warsaw, Poland
| |
Collapse
|
38
|
Blume SR, Padival M, Urban JH, Rosenkranz JA. Disruptive effects of repeated stress on basolateral amygdala neurons and fear behavior across the estrous cycle in rats. Sci Rep 2019; 9:12292. [PMID: 31444385 PMCID: PMC6707149 DOI: 10.1038/s41598-019-48683-3] [Citation(s) in RCA: 34] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2019] [Accepted: 08/08/2019] [Indexed: 02/02/2023] Open
Abstract
Stress is a precipitating factor in depression and anxiety disorders. Patients with these disorders often show amygdala abnormalities. The basolateral amygdala (BLA) is integral in mood and emotion, and is sensitive to stress. While much is known about effects of stress on BLA neuron activity and morphology in males, less is known in females. We tested whether repeated stress exerts distinct effects on BLA in vivo neuronal activity and morphology of Golgi-stained BLA neurons [lateral (LAT) and basal (BA) nuclei] in adult female rats. Repeated restraint stress increased BLA neuronal firing and caused hypertrophy of BLA neurons in males, while it decreased LAT and BA neuronal firing and caused hypotrophy of neurons in the LAT of females. BLA neuronal activity and function, such as fear conditioning, shifts across the estrous cycle. Repeated stress disrupted this pattern of BLA activity and fear expression over the estrous cycle. The disruptive effects of stress on the pattern of BLA function across estrous may produce behavior that is non-optimal for a specific phase of the estrous cycle. The contrasting effects of stress may contribute to sex differences in the effects of stress on mood and psychiatric disorders.
Collapse
Affiliation(s)
- Shannon R Blume
- Discipline of Cellular and Molecular Pharmacology, The Chicago Medical School, Rosalind Franklin University, North Chicago, IL, 60064, USA
- AbbVie, Inc., 1 North Waukegan Road, North Chicago, IL, 60064, USA
| | - Mallika Padival
- Discipline of Cellular and Molecular Pharmacology, The Chicago Medical School, Rosalind Franklin University, North Chicago, IL, 60064, USA
- Center for Neurobiology of Stress Resilience and Psychiatric Disorders, The Chicago Medical School, Rosalind Franklin University, North Chicago, IL, 60064, USA
| | - Janice H Urban
- Discipline of Physiology and Biophysics, The Chicago Medical School, Rosalind Franklin University, North Chicago, IL, 60064, USA
- Center for Neurobiology of Stress Resilience and Psychiatric Disorders, The Chicago Medical School, Rosalind Franklin University, North Chicago, IL, 60064, USA
| | - J Amiel Rosenkranz
- Discipline of Cellular and Molecular Pharmacology, The Chicago Medical School, Rosalind Franklin University, North Chicago, IL, 60064, USA.
- Center for Neurobiology of Stress Resilience and Psychiatric Disorders, The Chicago Medical School, Rosalind Franklin University, North Chicago, IL, 60064, USA.
| |
Collapse
|
39
|
Correlations between five-pattern personality scores from traditional Chinese medicine and autonomic nervous response indicators in healthy female college students. JOURNAL OF TRADITIONAL CHINESE MEDICAL SCIENCES 2019. [DOI: 10.1016/j.jtcms.2019.03.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
|
40
|
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.
Collapse
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
| |
Collapse
|
41
|
Abstract
PURPOSE OF REVIEW Risk for suicidal behavior may fluctuate across the menstrual cycle. Here, we use the RDoC framework to review potential mechanisms by which the cycle may increase acute suicide risk. RECENT FINDINGS The menstrual cycle impacts the majority of RDoC constructs linked to suicide risk, particularly among hormone-sensitive women, such as those with premenstrual dysphoric disorder or premenstrual exacerbation of a psychiatric disorder. Despite this, there are no published studies examining suicidal ideation, planning, or behavior longitudinally across the cycle. More work is needed to understand how hormone sensitivity may relate to both trait and state suicide risk. Intensive multilevel investigations of cyclical hormone effects on suicide risk through specific RDoC mechanisms are suggested. This is a fertile research area and may provide key insights regarding the mechanisms of acute suicide risk.
Collapse
Affiliation(s)
- Sarah A. Owens
- Department of Psychology, University of North Carolina at Chapel Hill
| | - Tory Eisenlohr-Moul
- Department of Psychiatry, Women's Mental Health Research Program, University of Illinois at Chicago, 912 S Wood St., South Tower, Room 335, Chicago, IL, 60612, USA. .,Department of Psychology, University of Illinois at Chicago, Chicago, IL, 60612, USA.
| |
Collapse
|
42
|
Wei SM, Schiller CE, Schmidt PJ, Rubinow DR. The role of ovarian steroids in affective disorders. Curr Opin Behav Sci 2018. [DOI: 10.1016/j.cobeha.2018.04.013] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
|
43
|
Andreano JM, Touroutoglou A, Dickerson B, Barrett LF. Hormonal Cycles, Brain Network Connectivity, and Windows of Vulnerability to Affective Disorder. Trends Neurosci 2018; 41:660-676. [PMID: 30274602 DOI: 10.1016/j.tins.2018.08.007] [Citation(s) in RCA: 44] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2018] [Revised: 07/20/2018] [Accepted: 08/08/2018] [Indexed: 12/15/2022]
Abstract
The rate of affective disorder is substantially higher in women than in men, and considerable evidence points to the actions of ovarian hormones in mediating this disparity. In this Opinion, we discuss the hypothesis that cyclic changes in ovarian hormone levels produce cyclic alterations in connectivity between the intrinsic networks of the brain. These alterations produce specific temporal windows within the menstrual cycle when internetwork connectivity is increased, associated with increased stress reactivity and better memory for unpleasant, arousing events, leading to increased negative mood and susceptibility to affective disorder. Our windows of vulnerability model offers insights for both treatment of affective disorder and research on sex differences in the brain.
Collapse
Affiliation(s)
- Joseph M Andreano
- Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Charlestown, MA 02129, USA; Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Harvard Medical School, Charlestown, MA, 02129, USA.
| | - Alexandra Touroutoglou
- Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Charlestown MA 02129, USA; Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Harvard Medical School, Charlestown, MA, 02129, USA
| | - Brad Dickerson
- Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Charlestown MA 02129, USA; Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Harvard Medical School, Charlestown, MA, 02129, USA
| | - Lisa Feldman Barrett
- Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Charlestown, MA 02129, USA; Department of Psychology, Northeastern University, Boston, MA 02115, USA; Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Harvard Medical School, Charlestown, MA, 02129, USA
| |
Collapse
|
44
|
Petersen N, Ghahremani DG, Rapkin AJ, Berman SM, Liang L, London ED. Brain activation during emotion regulation in women with premenstrual dysphoric disorder. Psychol Med 2018; 48:1795-1802. [PMID: 29145910 PMCID: PMC9196139 DOI: 10.1017/s0033291717003270] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
BACKGROUND Difficulties in regulating emotions are linked to the core symptoms of premenstrual dysphoric disorder (PMDD). We therefore investigated the neural substrates of emotion-regulation problems in women with PMDD. METHODS On the basis of self-evaluations over 2 months on the Daily Record of Severity of Problems, eligible participants were assigned to two groups: PMDD and control (18 per group). Functional magnetic resonance imaging (fMRI) and a well-validated task were used to assess brain function during emotion regulation. Participants were tested twice, once during the follicular (asymptomatic) and once in the late luteal (symptomatic) phase of the menstrual cycle. RESULTS Women with PMDD gave higher ratings of negative affect in the luteal phase than in the follicular phase, and compared with healthy control participants during the luteal phase. A region-of-interest fMRI analysis indicated that during the late luteal phase, women with PMDD had hypoactivation in right dorsolateral prefrontal cortex (dlPFC) during all conditions of the emotion-regulation task, not only in the contrast that isolated emotion regulation. An exploratory whole-brain, voxel-wise analysis showed that women with PMDD had less activation in the precentral gyrus during the luteal phase than the follicular phase, and less activation in the postcentral gyrus compared with control participants. CONCLUSIONS During the luteal phase of the menstrual cycle, women with PMDD experience difficulty regulating emotions. Hypoactivation in the right dlPFC may contribute to this problem, but may be related more generally to other affective symptoms of PMDD. Hypofunction in the right pre- and postcentral gyri warrants additional study.
Collapse
Affiliation(s)
- Nicole Petersen
- Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, Los Angeles, CA, 90024, USA
| | - Dara G. Ghahremani
- Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, Los Angeles, CA, 90024, USA
| | - Andrea J. Rapkin
- Department of Obstetrics and Gynecology, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, 90024, USA
| | - Steven M. Berman
- Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, Los Angeles, CA, 90024, USA
| | - Letty Liang
- Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, Los Angeles, CA, 90024, USA
| | - Edythe D. London
- Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, Los Angeles, CA, 90024, USA
- Department of Molecular and Medical Pharmacology, University of California Los Angeles, Los Angeles, CA, 90024, USA
- Brain Research Institute, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, 90024, USA
| |
Collapse
|
45
|
Cortical and subcortical changes in patients with premenstrual syndrome. J Affect Disord 2018; 235:191-197. [PMID: 29656266 DOI: 10.1016/j.jad.2018.04.046] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/30/2018] [Revised: 03/20/2018] [Accepted: 04/04/2018] [Indexed: 01/13/2023]
Abstract
BACKGROUND Premenstrual syndrome (PMS) is characterized by a series of emotional, physical and behavioral symptoms. Although PMS is related to dysfunctions of the central nervous system, the neuropathological mechanism of PMS still has not been clearly established. The aim of this study is to evaluate potential differences in both cortical thickness and subcortical volumes in PMS patients compared to healthy controls (HCs). METHODS Twenty PMS patients and twenty HCs underwent a structural magnetic resonance imaging scan and clinical assessment. Cortical thickness and subcortical volumes were computed using the FreeSurfer image analysis suite. Relationships between cortical thickness/subcortical volumes and the daily rating of severity of problems (DRSP) score were then measured in patients. RESULTS Compared to HCs, PMS patients exhibited reduced cortical thickness in the medial prefrontal cortex (MPFC), orbitofrontal cortex (OFC) and insula, and increased subcortical volumes of the amygdala, thalamus and pallidum. Furthermore, negative correlations were detected between the DRSP and cortical thickness in the anterior cingulate cortex and precuneus. LIMITATIONS The study is limited by a small sample size and narrow age range of participants. CONCLUSIONS Our findings indicate that the abnormal morphological changes are mainly implicated in emotional regulation and visceral perception in PMS patients. We hope that our study may contribute to a better understanding of PMS.
Collapse
|
46
|
Osório FL, de Paula Cassis JM, Machado de Sousa JP, Poli-Neto O, Martín-Santos R. Sex Hormones and Processing of Facial Expressions of Emotion: A Systematic Literature Review. Front Psychol 2018; 9:529. [PMID: 29695991 PMCID: PMC5904259 DOI: 10.3389/fpsyg.2018.00529] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2017] [Accepted: 03/27/2018] [Indexed: 12/15/2022] Open
Abstract
Background: We systematically reviewed the literature to determine the influence of sex hormones on facial emotion processing (FEP) in healthy women at different phases of life. Methods: Searches were performed in PubMed, Web of Science, PsycINFO, LILACS, and SciELO. Twenty-seven articles were included in the review and allocated into five different categories according to their objectives and sample characteristics (menstrual cycle, oral contraceptives, pregnancy/postpartum, testosterone, and progesterone). Results: Despite the limited number of studies in some categories and the existence of inconsistencies in the results of interest, the findings of the review suggest that FEP may be enhanced during the follicular phase. Studies with women taking oral contraceptives showed reduced recognition accuracy and decreased responsiveness of different brain structures during FEP tasks. Studies with pregnant women and women in the postpartum showed that hormonal changes are associated with alterations in FEP and in brain functioning that could indicate the existence of a hypervigilant state in new and future mothers. Exogenous administration of testosterone enhanced the recognition of threatening facial expressions and the activation of brain structures involved in the processing of emotional stimuli. Conclusions: We conclude that sex hormones affect FEP in women, which may have an impact in adaptive processes of the species and in the onset of mood symptoms associated with the premenstrual syndrome.
Collapse
Affiliation(s)
- Flávia L. Osório
- Department of Neuroscience and Behavior, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, Brazil
- National Institute of Science and Technology, Translational Medicine (INCT-TM), National Council for Scientific and Technological Development (CNPq), São Paulo, Brazil
| | - Juliana M. de Paula Cassis
- Department of Neuroscience and Behavior, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, Brazil
| | - João P. Machado de Sousa
- Department of Neuroscience and Behavior, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, Brazil
- National Institute of Science and Technology, Translational Medicine (INCT-TM), National Council for Scientific and Technological Development (CNPq), São Paulo, Brazil
| | - Omero Poli-Neto
- Department of Gynecology and Obstetrics, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, Brazil
| | - Rocio Martín-Santos
- Department of Psychiatry, Institute of Neurosciences, Universidad Autónoma de Barcelona, Barcelona, Spain
| |
Collapse
|
47
|
Yen JY, Wang PW, Su CH, Liu TL, Long CY, Ko CH. Estrogen levels, emotion regulation, and emotional symptoms of women with premenstrual dysphoric disorder: The moderating effect of estrogen receptor 1α polymorphism. Prog Neuropsychopharmacol Biol Psychiatry 2018; 82:216-223. [PMID: 29146473 DOI: 10.1016/j.pnpbp.2017.11.013] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/14/2017] [Revised: 11/03/2017] [Accepted: 11/09/2017] [Indexed: 12/21/2022]
Abstract
BACKGROUND This study evaluated the association between estrogen levels, emotion regulation, depression, anxiety, and stress of women with premenstrual dysphoric disorder (PMDD). We also evaluated the moderating effect of estrogen receptor (ESR) α-Xbal polymorphism on the aforementioned association. METHODS A total of 100 women were diagnosed with PMDD based on psychiatric interviews and a prospective investigation of 3 menstrual cycles. A total of 96 normal individuals were recruited as controls. Their estrogen levels, depression, anxiety, stress, and ESR α-Xbal polymorphism in both premenstrual and follicular phases were assessed, and these data were included in the final analysis. RESULTS The PMDD group had high depression, anxiety, and stress and low emotional adjusting and tolerating in the premenstrual phase. Emotional adjustment was negatively associated with depression, anxiety and stress. No association was observed between PMDD and estrogen level. However, premenstrual estrogen level was negatively correlated with anxiety and stress in women with PMDD. The association was only significant in G carriers of ESR α-Xbal, as was the difference in premenstrual emotion regulation between the PMDD and control groups. CONCLUSIONS The results demonstrate the association between estrogen and anxiety in PMDD, supporting the claim that women with PMDD differ in their responses to normal estrogen levels. Furthermore, this association and dysfunctional emotional regulation in PMDD existed only among the G carriers of ESR α-Xbal polymorphism. Future studies should investigate the effect of estrogen on brain functions involving emotional regulation in women with PMDD, stratified by ESR α-Xbal polymorphism.
Collapse
Affiliation(s)
- Ju-Yu Yen
- Department of Psychiatry, Kaohsiung Municipal Ta-Tung Hospital, Kaohsiung, Taiwan; Department of Psychiatry, Faculty of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan; Department of Psychiatry, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
| | - Peng-Wei Wang
- Department of Psychiatry, Faculty of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan; Department of Psychiatry, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan; Graduate Institute of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Chen-Hsiang Su
- Department of Psychiatry, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
| | - Tai-Ling Liu
- Department of Psychiatry, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
| | - Cheng-Yu Long
- Department of Obstetrics and Gynecology, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
| | - Chih-Hung Ko
- Department of Psychiatry, Faculty of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan; Department of Psychiatry, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan; Graduate Institute of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan; Department of Psychiatry, Kaohsiung Municipal Hsiao-Kang Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan.
| |
Collapse
|
48
|
Bixo M, Johansson M, Timby E, Michalski L, Bäckström T. Effects of GABA active steroids in the female brain with a focus on the premenstrual dysphoric disorder. J Neuroendocrinol 2018; 30. [PMID: 29072794 DOI: 10.1111/jne.12553] [Citation(s) in RCA: 55] [Impact Index Per Article: 9.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/29/2017] [Revised: 10/15/2017] [Accepted: 10/21/2017] [Indexed: 12/28/2022]
Abstract
Premenstrual dysphoric disorder (PMDD) afflicts 3%-5% of women of childbearing age, and is characterised by recurrent negative mood symptoms (eg, irritability, depression, anxiety and emotional lability) during the luteal phase of the menstrual cycle. The aetiology of PMDD is unknown, although a temporal association with circulating ovarian steroids, in particular progesterone and its metabolite allopregnanolone, has been established during the luteal phase. Allopregnanolone is a positive modulator of the GABAA receptor: it is sedative in high concentrations but may precipitate paradoxical adverse effects on mood at levels corresponding to luteal phase concentrations in susceptible women. Saccadic eye velocity (SEV) is a measure of GABAA receptor sensitivity; in experimental studies of healthy women, i.v. allopregnanolone decreases SEV. Women with PMDD display an altered sensitivity to an i.v. injection of allopregnanolone compared to healthy controls in this model. In functional magnetic resonance imaging (fMRI) studies, women with PMDD react differently to emotional stimuli in contrast to controls. A consistent finding in PMDD patients is increased amygdala reactivity during the luteal phase. Post-mortem studies in humans have revealed that allopregnanolone concentrations vary across different brain regions, although mean levels in the brain also reflect variations in peripheral serum concentrations. The amygdala processes emotions such as anxiety and aggression. This is interesting because allopregnanolone is detected at high concentrations within the region into which marked increases in blood flow are measured with fMRI following progesterone/allopregnanolone administration. Allopregnanolone effects are antagonised by its isomer isoallopregnanolone (UC1010), which significantly reduces negative mood symptoms in women with PMDD when administered s.c. in the premenstrual phase. This was shown in a randomised, placebo-controlled clinical trial in which the primary outcome was change in symptom scoring on the Daily Rating of Severity of Problems (DRSP): the treatment reduced negative mood scores (P < .005), as well as total DRSP scores (P < .01), compared to placebo in women with PMDD. In conclusion, the underlying studies of this review provide evidence that allopregnanolone is the provoking factor behind the negative mood symptoms in PMDD and that isoallopregnanolone could ameliorate the symptoms as a result of its ability to antagonise the allopregnanolone effect on the GABAA receptor.
Collapse
Affiliation(s)
- M Bixo
- Department of Clinical Science, Obstetrics and Gynecology, Umeå University, Umeå, Sweden
| | - M Johansson
- Department of Clinical Science, Obstetrics and Gynecology, Umeå University, Umeå, Sweden
| | - E Timby
- Department of Clinical Science, Obstetrics and Gynecology, Umeå University, Umeå, Sweden
| | - L Michalski
- Department of Clinical Science, Obstetrics and Gynecology, Umeå University, Umeå, Sweden
| | - T Bäckström
- Department of Clinical Science, Obstetrics and Gynecology, Umeå University, Umeå, Sweden
| |
Collapse
|
49
|
Sundström-Poromaa I. The Menstrual Cycle Influences Emotion but Has Limited Effect on Cognitive Function. VITAMINS AND HORMONES 2018; 107:349-376. [DOI: 10.1016/bs.vh.2018.01.016] [Citation(s) in RCA: 30] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
|
50
|
Slyepchenko A, Lokuge S, Nicholls B, Steiner M, Hall GBC, Soares CN, Frey BN. Subtle persistent working memory and selective attention deficits in women with premenstrual syndrome. Psychiatry Res 2017; 249:354-362. [PMID: 28152471 DOI: 10.1016/j.psychres.2017.01.031] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/09/2016] [Revised: 01/06/2017] [Accepted: 01/13/2017] [Indexed: 01/16/2023]
Abstract
As a recurrent, cyclical phenomenon, premenstrual syndrome (PMS) affects a significant proportion of women of the reproductive age, and leads to regular monthly days of functional impairment. Symptoms of PMS include somatic and psychological symptoms, such as headaches, sleep disturbances, social withdrawal and mood changes, during the late luteal phase of the menstrual cycle, which alleviate during the follicular phase. This study investigated neurocognitive functioning in women with moderate to severe PMS symptoms (n=13) compared to women with mild/no PMS (n=27) through administration of a battery of neuropsychological tests during the asymptomatic follicular phase of the menstrual cycle. Relative to women with mild/no PMS symptoms, women with moderate to severe PMS showed significantly poorer accuracy and more errors of omission on the N-0-back, as well as more errors of omission on the N-2-back task, indicating the presence of impairment in selective attention and working memory. This study provides evidence of persistent, subtle working memory and selective attention difficulties in those with moderate to severe PMS during the follicular phase of the menstrual cycle.
Collapse
Affiliation(s)
- Anastasiya Slyepchenko
- Women's Health Concerns Clinic, St. Joseph's Healthcare Hamilton, 100 West 5th Street, Suite C124, Hamilton, ON, Canada L8N 3K7; MiNDS Neuroscience Graduate Program, McMaster University, 1280 Main St. W., Hamilton, ON, Canada.
| | - Sonali Lokuge
- Women's Health Concerns Clinic, St. Joseph's Healthcare Hamilton, 100 West 5th Street, Suite C124, Hamilton, ON, Canada L8N 3K7; Department of Obstetrics and Gynecology, University of Toronto, 123 Edward St. Suite 1200, Toronto, ON, Canada.
| | - Brianne Nicholls
- Women's Health Concerns Clinic, St. Joseph's Healthcare Hamilton, 100 West 5th Street, Suite C124, Hamilton, ON, Canada L8N 3K7.
| | - Meir Steiner
- Women's Health Concerns Clinic, St. Joseph's Healthcare Hamilton, 100 West 5th Street, Suite C124, Hamilton, ON, Canada L8N 3K7; MiNDS Neuroscience Graduate Program, McMaster University, 1280 Main St. W., Hamilton, ON, Canada; Department of Psychiatry and Behavioural Neurosciences, McMaster University, 1280 Main St. W., Hamilton, ON, Canada.
| | - Geoffrey B C Hall
- MiNDS Neuroscience Graduate Program, McMaster University, 1280 Main St. W., Hamilton, ON, Canada; Department of Psychiatry and Behavioural Neurosciences, McMaster University, 1280 Main St. W., Hamilton, ON, Canada.
| | - Claudio N Soares
- Department of Psychiatry, School of Medicine, Queen's University, Kingston, ON, Canada.
| | - Benicio N Frey
- Women's Health Concerns Clinic, St. Joseph's Healthcare Hamilton, 100 West 5th Street, Suite C124, Hamilton, ON, Canada L8N 3K7; MiNDS Neuroscience Graduate Program, McMaster University, 1280 Main St. W., Hamilton, ON, Canada; Department of Psychiatry and Behavioural Neurosciences, McMaster University, 1280 Main St. W., Hamilton, ON, Canada; Mood Disorders Program, St. Joseph's Healthcare Hamilton, 100 West 5th St, Hamilton, ON, Canada.
| |
Collapse
|