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Lin PC, Ko CH, Yen JY. Early and Late Luteal Executive Function, Cognitive and Somatic Symptoms, and Emotional Regulation of Women with Premenstrual Dysphoric Disorder. J Pers Med 2022; 12:jpm12050819. [PMID: 35629240 PMCID: PMC9147888 DOI: 10.3390/jpm12050819] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2022] [Revised: 04/28/2022] [Accepted: 05/16/2022] [Indexed: 01/27/2023] Open
Abstract
Objective: Cognitive and somatic symptoms were vital factors in developing personalized treatment of depressive disorder. The study aimed to evaluate the following: (1) the cognitive and somatic symptoms of premenstrual dysphoric disorder (PMDD) in the early luteal (EL) and later luteal (LL) phase; and (2) their association with depression and functional impairment of PMDD. Methods: We prospectively evaluated executive function, emotion regulation, cognitive and somatic symptoms, and depression in the EL and LL phases in women with PMDD. Sixty-three women with PMDD and 53 healthy controls completed Simon’s task and questionnaire to assess emotion regulation, inattention, fatigue, insomnia, and depression. Results: Women with PMDD had a poor performance in Simon’s task during the LL phase. They were less likely to exercise cognitive reappraisal during EL and LL phases. Their cognitive reappraisal positively correlated with executive function and negatively associated with depression. In the LL phase, they also experience higher inattention, insomnia, and fatigue, which correlate with the depression and functional impairment of PMDD. Inattention is the most associated factor of PMDD and functional impairment in controlling depression. Conclusion: Executive function was impaired in women with PMDD during the LL phase. Its performance correlated positively with emotion regulation and negatively with depression. The association between inattention and PMDD functional impairment indicates that evaluation and intervention for cognitive impairment were essential in treating women with PMDD. Further studies were required to elucidate the possible etiology underlying these associations.
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Affiliation(s)
- Pai-Cheng Lin
- Department of Psychiatry, Kaohsiung Municipal Ta-Tung Hospital, Kaohsiung 80145, Taiwan;
- Department of Psychiatry, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung 80756, Taiwan;
| | - Chih-Hung Ko
- Department of Psychiatry, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung 80756, Taiwan;
- Department of Psychiatry, Faculty of Medicine, Graduate Institute of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung 80708, Taiwan
- Department of Psychiatry, Kaohsiung Municipal Siaogang Hospital, Kaohsiung Medical University, Kaohsiung 81267, Taiwan
| | - Ju-Yu Yen
- Department of Psychiatry, Kaohsiung Municipal Ta-Tung Hospital, Kaohsiung 80145, Taiwan;
- Department of Psychiatry, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung 80756, Taiwan;
- Department of Psychiatry, Faculty of Medicine, Graduate Institute of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung 80708, Taiwan
- Correspondence: ; Tel.: +886-7-312-1101
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Keklicek H, Sermenli Aydin N, Can HB, Dönmez Aydin D, Yilmazer Kayatekin AZ, Uluçam E. Primary dysmenorrhea and postural control: Is it a problem only during menstruation? Gait Posture 2021; 85:88-95. [PMID: 33517042 DOI: 10.1016/j.gaitpost.2021.01.019] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/05/2020] [Revised: 01/16/2021] [Accepted: 01/18/2021] [Indexed: 02/02/2023]
Abstract
BACKGROUND The effects of the menstrual cycle and primary dysmenorrhea (PD) on phase-related cognitive and physical functions are controversial. This study was carried out to examine whether women with PD showed a different physical function or dual-tasking response than women without PD at times other than menstruation. METHODS Women with or without PD were recruited for the study. Individuals assessed on the first day of the menstruation and the day they reported themselves as well being (feeling good day-FGD). Zebris © FDM Type Force Platform was used to evaluate postural stability. Individuals have were asked to perform to a 3-step balance test protocol; the first session: comfortable upright standing; the second session: standing with a motor task; the third session: standing with a cognitive task (counting backward). Correctly calculated numbers were also recorded. RESULTS The number of correct answers given by individuals during the cognitive dual-task was similar on the first day of menstruation and FGD (p > 0.05). In the control group, no difference was observed between the first days of menstruation and the evaluations on FGD days with dual-task (p > 0.05). In individuals with PD, there was no difference between the measurements at different times (p > 0.05). However, in the assessment with the motor dual-task on the first day of menstruation; postural sway increased (p < 0,05). In FDG measurement; distortion in postural stability was observed with the cognitive task (p < 0,05). In the assessments performed on the first day of menstruation, there was no difference in any parameters between the groups (p > 0.05). In the measurements made on FGD day with the cognitive task; there was a difference between the groups (p < 0,05). Individuals with PD had higher postural sway. SIGNIFICANCE This study showed that the primary dysmenorrhea is not only a problem for females during menstruation, primary dysmenorrhea causes impaired ability of the individual to perform dual-tasking and continuously affects postural stability.
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Affiliation(s)
- Hilal Keklicek
- Department of Physical Therapy and Rehabilitation, Trakya University, Faculty of Health Science, 22030 Edirne, Turkey.
| | - Nimet Sermenli Aydin
- Department of Physical Therapy and Rehabilitation, Trakya University, Faculty of Health Science, 22030 Edirne, Turkey; Department of Physical Therapy and Rehabilitation, Marmara University, Faculty of Health Science, 34854 İstanbul, Turkey.
| | - Hilal Başak Can
- Department of Physical Therapy and Rehabilitation, Trakya University, Faculty of Health Science, 22030 Edirne, Turkey; Department of Physical Therapy and Rehabilitation, Marmara University, Faculty of Health Science, 34854 İstanbul, Turkey.
| | - Didem Dönmez Aydin
- Department of Anatomy, Trakya University, Faculty of Medicine, 22030 Edirne, Turkey.
| | - Ayşe Zeynep Yilmazer Kayatekin
- Department of Anatomy, Trakya University, Faculty of Medicine, 22030 Edirne, Turkey; Department of Anatomy, Zonguldak Bülent Ecevit University Faculty of Medicine, 67600 Zonguldak, Turkey.
| | - Enis Uluçam
- Department of Anatomy, Trakya University, Faculty of Medicine, 22030 Edirne, Turkey.
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Le J, Thomas N, Gurvich C. Cognition, The Menstrual Cycle, and Premenstrual Disorders: A Review. Brain Sci 2020; 10:brainsci10040198. [PMID: 32230889 PMCID: PMC7226433 DOI: 10.3390/brainsci10040198] [Citation(s) in RCA: 45] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2020] [Revised: 03/24/2020] [Accepted: 03/26/2020] [Indexed: 12/15/2022] Open
Abstract
Sex hormones, such as estrogens, progesterone, and testosterone, have a significant influence on brain, behavior, and cognitive functioning. The menstrual cycle has been a convenient model to examine how subtle fluctuations of these hormones can relate to emotional and cognitive functioning. The aim of the current paper is to provide a narrative review of studies investigating cognitive functioning in association with the menstrual cycle in biological females, with a focus on studies that have investigated cognitive functioning across the menstrual cycle in females with premenstrual mood disorders, such as premenstrual syndrome (PMS) and premenstrual dysphoric disorder (PMDD). In line with previous reviews, the current review concluded that there is a lack of consistent findings regarding cognitive functioning across the menstrual cycle. Most studies focused on changes in levels of blood estrogen, and neglected to explore the role of other hormones, such as progesterone, on cognitive functioning. Cognitive research involving premenstrual disorders is in its infancy, and it remains unclear whether any cognitive disturbances that are identified may be attributed to negative experience of mood and psychological symptoms or be a more direct effect of hormonal dysregulation or sensitivity. Suggestions for future research are provided.
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Neuropsychological function in relation to dysmenorrhea in adolescents. Eur J Obstet Gynecol Reprod Biol 2017; 215:224-229. [DOI: 10.1016/j.ejogrb.2017.06.030] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2017] [Revised: 06/19/2017] [Accepted: 06/19/2017] [Indexed: 11/18/2022]
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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.
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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.
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Vierk R, Bayer J, Freitag S, Muhia M, Kutsche K, Wolbers T, Kneussel M, Sommer T, Rune GM. Structure-function-behavior relationship in estrogen-induced synaptic plasticity. Horm Behav 2015; 74:139-48. [PMID: 26012713 DOI: 10.1016/j.yhbeh.2015.05.008] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/20/2015] [Revised: 04/23/2015] [Accepted: 05/17/2015] [Indexed: 01/06/2023]
Abstract
This article is part of a Special Issue "Estradiol and Cognition". In estrogen-induced synaptic plasticity, a correlation of structure, function and behavior in the hippocampus has been widely established. 17ß-estradiol has been shown to increase dendritic spine density on hippocampal neurons and is accompanied by enhanced long-term potentiation and improved performance of animals in hippocampus-dependent memory tests. After inhibition of aromatase, the final enzyme of estradiol synthesis, with letrozole we consistently found a strong and significant impairment of long-term potentiation (LTP) in female mice as early as after six hours of treatment. LTP impairment was followed by loss of hippocampal spine synapses in the hippocampal CA1 area. Interestingly, these effects were not found in male animals. In the Morris water maze test, chronic administration of letrozole did not alter spatial learning and memory in either female or male mice. In humans, analogous effects of estradiol on hippocampal morphology and physiology were observed using neuroimaging techniques. However, similar to our findings in mice, an effect of estradiol on memory performance has not been consistently observed.
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Affiliation(s)
- R Vierk
- Institute of Neuroanatomy, University Medical Center Hamburg-Eppendorf, Martinistr. 52, 20246 Hamburg, Germany
| | - J Bayer
- Institute for Systems Neuroscience, University Medical Center Hamburg-Eppendorf, Martinistr. 52, 20246 Hamburg, Germany
| | - S Freitag
- Department of Molecular Neurogenetics, Center for Molecular Neurobiology (ZMNH), University Medical Center Hamburg-Eppendorf, Falkenried 94, 20151 Hamburg, Germany
| | - M Muhia
- Department of Molecular Neurogenetics, Center for Molecular Neurobiology (ZMNH), University Medical Center Hamburg-Eppendorf, Falkenried 94, 20151 Hamburg, Germany
| | - K Kutsche
- Institute of Human Genetics, University Medical Center Hamburg-Eppendorf, Martinistr. 52, 20246 Hamburg, Germany
| | - T Wolbers
- Center for Behavioral Brain Sciences, Leipziger Str. 44, 39120 Magdeburg, Germany
| | - M Kneussel
- Department of Molecular Neurogenetics, Center for Molecular Neurobiology (ZMNH), University Medical Center Hamburg-Eppendorf, Falkenried 94, 20151 Hamburg, Germany
| | - T Sommer
- Institute for Systems Neuroscience, University Medical Center Hamburg-Eppendorf, Martinistr. 52, 20246 Hamburg, Germany.
| | - G M Rune
- Institute of Neuroanatomy, University Medical Center Hamburg-Eppendorf, Martinistr. 52, 20246 Hamburg, Germany.
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Berman SM, London ED, Morgan M, Rapkin AJ. Elevated gray matter volume of the emotional cerebellum in women with premenstrual dysphoric disorder. J Affect Disord 2013; 146:266-71. [PMID: 22868063 PMCID: PMC3529750 DOI: 10.1016/j.jad.2012.06.038] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/12/2012] [Accepted: 06/25/2012] [Indexed: 11/17/2022]
Abstract
OBJECTIVE Premenstrual dysphoric disorder (PMDD) is characterized by severe, negative mood symptoms during the luteal phase of each menstrual cycle. We recently reported that women with PMDD show a greater increase in relative glucose metabolism in the posterior cerebellum from the follicular to the luteal phase, as compared with healthy women, and that the phase-related increase is proportional to PMDD symptom severity. We extended this work with a study of brain structure in PMDD. METHODS High-resolution magnetic resonance imaging (MRI) scans were obtained from 12 women with PMDD and 13 healthy control subjects (whole-brain volume-corrected p<.05). Voxel-based morphometry was used to assess group differences in cerebral grey-matter volume (GMV), using a statistical criterion of p<.05, correcting for multiple comparisons in the whole-brain volume. RESULTS PMDD subjects had greater GMV than controls in the posterior cerebellum but not in any other brain area. Age was negatively correlated with GMV within this region in healthy women, but not in women with PMDD. The group difference in GMV was significant for women over age 30(p=.0002) but not younger participants (p>.1). CONCLUSIONS PMDD appears to be associated with reduced age-related loss in posterior cerebellar GMV. Although the mechanism underlying this finding is unclear, cumulative effects of symptom-related cerebellar activity may be involved.
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Affiliation(s)
- Steven M. Berman
- Department of Psychiatry and Biobehavioral Sciences, University of California Los Angeles
- Brain Research Institute, University of California Los Angeles
| | - Edythe D. London
- Department of Psychiatry and Biobehavioral Sciences, University of California Los Angeles
- Brain Research Institute, University of California Los Angeles
- Department of Molecular and Medical Pharmacology, University of California Los Angeles
| | - Melinda Morgan
- Department of Obstetrics and Gynecology, University of California Los Angeles
| | - Andrea J. Rapkin
- Department of Obstetrics and Gynecology, University of California Los Angeles
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Zajdel R, Zajdel J, Zwolińska A, Śmigielski J, Beling P, Cegliński T, Nowak D. The sound of a mobile phone ringing affects the complex reaction time of its owner. Arch Med Sci 2012. [PMID: 23185201 PMCID: PMC3506222 DOI: 10.5114/aoms.2012.28891] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
INTRODUCTION Mobile phone conversation decreases the ability to concentrate and impairs the attention necessary to perform complex activities, such as driving a car. Does the ringing sound of a mobile phone affect the driver's ability to perform complex sensory-motor activities? We compared a subject's reaction time while performing a test either with a mobile phone ringing or without. MATERIAL AND METHODS The examination was performed on a PC-based reaction time self-constructed system Reactor. The study group consisted of 42 healthy students. The protocol included instruction, control without phone and a proper session with subject's mobile phone ringing. The terms of the study were standardised. RESULTS There were significant differences (p < 0.001) in reaction time in control (597 ms), mobile (633 ms) and instruction session (673 ms). The differences in female subpopulation were also significant (p < 0.01). Women revealed the longest reaction time in instruction session (707 ms), were significantly quicker in mobile (657 ms, p < 0.01) and in control session (612 ms, p < 0.001). In men, the significant difference was recorded only between instruction (622 ms) and control session (573 ms, p < 0.01). The other differences were not significant (p > 0.08). Men proofed to complete significantly quicker than women in instruction (p < 0.01) and in mobile session (p < 0.05). Differences amongst the genders in control session was not significant (p > 0.05). CONCLUSIONS The results obtained proofed the ringing of a phone exerts a significant influence on complex reaction time and quality of performed task.
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Affiliation(s)
- Radoslaw Zajdel
- Department of Medical Informatics and Statistics, Medical Univeristy of Lodz, Poland
| | - Justyna Zajdel
- Department of Medical Law, Inter-Department of Human Sciences, Medical University of Lodz, Poland
| | - Anna Zwolińska
- Chair of Experimental and Clinical Physiology, Medical University of Lodz, Poland
| | - Janusz Śmigielski
- Department of Medical Informatics and Statistics, Medical Univeristy of Lodz, Poland
| | - Piotr Beling
- Department of Medical Informatics and Statistics, Medical Univeristy of Lodz, Poland
| | - Tomasz Cegliński
- Department of Medical Informatics and Statistics, Medical Univeristy of Lodz, Poland
| | - Dariusz Nowak
- Chair of Experimental and Clinical Physiology, Medical University of Lodz, Poland
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Yen JY, Chang SJ, Long CY, Tang TC, Chen CC, Yen CF. Working memory deficit in premenstrual dysphoric disorder and its associations with difficulty in concentrating and irritability. Compr Psychiatry 2012; 53:540-5. [PMID: 21821238 DOI: 10.1016/j.comppsych.2011.05.016] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/11/2011] [Revised: 05/26/2011] [Accepted: 05/31/2011] [Indexed: 10/17/2022] Open
Abstract
OBJECTIVE This study evaluates working memory deficit among women with premenstrual dysphoric disorder (PMDD) and whether such a deficit and its premenstrual aggravation is associated with difficulty in concentrating, irritability, and impaired daily function or not. METHOD Sixty women with PMDD (PMDD group) and 60 women without PMDD (control group) completed the assessment. Severity of irritability, difficulty concentrating, total symptoms, and functional impairment of PMDD were evaluated by the Premenstrual Symptoms Screening Tool. All participants performed N2 and N3 back tasks to assess working memory in both luteal and follicular phases. RESULTS The PMDD group had significantly poorer performance on N2 and N3 back tasks than the control group did in the luteal phase but not in the follicular phase. Compared to the control group, the PMDD group also exhibited more deterioration in performance of N3 back task in the luteal phase. Performance of N2 and N3 back tasks in luteal phase was significantly associated with irritability, symptom severity, and functional impairment by PMDD. CONCLUSIONS Working memory deficit is aggravated in the luteal phase among women with PMDD. Appropriate interventions are needed to prevent negative consequences of working memory deficit.
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Affiliation(s)
- Ju-Yu Yen
- Department of Psychiatry, Kaohsiung Medical University Hospital, Kaohsiung 807, Taiwan
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Souza EGV, Ramos MG, Hara C, Stumpf BP, Rocha FL. Neuropsychological performance and menstrual cycle: a literature review. TRENDS IN PSYCHIATRY AND PSYCHOTHERAPY 2012; 34:5-12. [DOI: 10.1590/s2237-60892012000100003] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/04/2011] [Accepted: 08/04/2011] [Indexed: 11/22/2022]
Abstract
Approximately 80% of all women of reproductive age experience psychological and physical changes associated with the premenstrual phase. Cognitive alterations are among the most common complaints. In this context, studies have assessed cognitive performance across the menstrual cycle in healthy women and also in women with premenstrual syndrome (PMS). The main objective of the present study was to review the literature on cognitive function in different phases of the menstrual cycle in women of reproductive age, both healthy and with PMS, in particular premenstrual dysphoric disorder (PMDD). We searched MEDLINE and LILACS databases. A total of 27 studies were selected. The studies used heterogeneous methodologies. Most studies suggested that healthy women show small fluctuations in cognitive performance across the menstrual cycle, with low performance scores in the luteal phase for visuospatial and motor skills, attention and concentration, verbal memory, visual memory, working memory, and reaction time. Among women with PMS or PMDD, low performance scores for visuospatial and motor skills, attention and concentration, verbal memory, working memory, reaction time and impulsivity were also detected in the luteal phase. Symptoms observed in PMS/PMDD patients showed low intensity, but greater when compared with healthy women. Evidence indicates fluctuations in cognitive performance in the different phases of the menstrual cycle in healthy and PMS women, with worse performance for women with PMS/PMDD in the luteal phase. However, methodological limitations prevent us from drawing solid conclusions. Further studies are needed to investigate the impact of these cognitive fluctuations on patients' daily activities.
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DeLorenzo C, Lichenstein S, Schaefer K, Dunn J, Marshall R, Organisak L, Kharidia J, Robertson B, Mann JJ, Parsey RV. SEP-225289 serotonin and dopamine transporter occupancy: a PET study. J Nucl Med 2011; 52:1150-5. [PMID: 21680689 DOI: 10.2967/jnumed.110.084525] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
UNLABELLED SEP-225289 is a novel compound that, based on in vitro potencies for transporter function, potentially inhibits reuptake at dopamine, norepinephrine, and serotonin transporters. An open-label PET study was conducted during the development of SEP-225289 to investigate its dopamine and serotonin transporter occupancy. METHODS Different single doses of SEP-225289 were administered to healthy volunteers in 3 cohorts: 8 mg (n = 7), 12 mg (n = 5), and 16 mg (n = 7). PET was performed before and approximately 24 h after oral administration of SEP-225289, to assess occupancy at trough levels. Dopamine and serotonin transporter occupancies were estimated from PET using (11)C-N-(3-iodoprop-2E-enyl)-2β-carbomethoxy-3β-(4-methylphenyl)nortropane ((11)C-PE2I) and (11)C-N,N-dimethyl-2-(2-amino-4-cyanophenylthio)benzylamine ((11)C-DASB), respectively. Plasma concentration of SEP-225289 was assessed before ligand injection, and subjects were monitored for adverse events. RESULTS Average dopamine and serotonin transporter occupancies increased with increasing doses of SEP-225289. Mean dopamine and serotonin transporter occupancies were 33% ± 11% and 2% ± 13%, respectively, for 8 mg; 44% ± 4% and 9% ± 10%, respectively, for 12 mg; and 49% ± 7% and 14% ± 15%, respectively, for 16 mg. On the basis of the relationship between occupancy and plasma concentration, dopamine transporter IC(50) (the plasma concentration of drug at 50% occupancy) was determined (4.5 ng/mL) and maximum dopamine transporter occupancy was extrapolated (85%); however, low serotonin transporter occupancy prevented similar serotonin transporter calculations. No serious adverse events were reported. CONCLUSION At the doses evaluated, occupancy of the dopamine transporter was significantly higher than that of the serotonin transporter, despite similar in vitro potencies, confirming that, in addition to in vitro assays, PET occupancy studies can be instrumental to the drug development process by informing early decisions about indication, dose, and therapeutic potential.
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Baker FC, Colrain IM. Daytime sleepiness, psychomotor performance, waking EEG spectra and evoked potentials in women with severe premenstrual syndrome. J Sleep Res 2009; 19:214-27. [PMID: 19840240 DOI: 10.1111/j.1365-2869.2009.00782.x] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
We assessed daytime sleepiness using objective and subjective measures in women with severe premenstrual syndrome (PMS) compared with women without significant premenstrual symptoms. Nine women with severe PMS and eight controls (aged 18-40 years) completed a laboratory-based daytime protocol including the maintenance of wakefulness test (MWT), psychomotor vigilance task (PVT), quantitative waking electroencephalogram (EEG), auditory and visual event-related potentials (ERPs), and sleepiness and mood scales during the mid-follicular and late-luteal (premenstrual) phases of the menstrual cycle. In association with increased perceived sleepiness, fatigue and other premenstrual symptoms in the late-luteal phase, women with PMS performed more poorly on the PVT, with increased lapses and slower reaction times (P < 0.05), compared with the follicular phase and controls. However, there were no significant group or menstrual phase differences in latency to sleep on the MWT. Waking spectral EEG power and ERP measures also did not differentiate PMS women when symptomatic. Both groups of women displayed increased spectral power in the delta/theta frequencies (2-6 Hz) and fast alpha frequency (11-12 Hz) in the late-luteal phase relative to the follicular phase. Trait-like differences were apparent in that women with PMS had increased beta1 (12-16 Hz) power and smaller P300 amplitude than controls in both menstrual cycle phases. Our findings indicate that women with severe PMS are subjectively sleepy and fatigued, and show psychomotor slowing when symptomatic compared with when they are symptom-free and compared with controls. However, the ability to maintain wakefulness under soporific conditions, spectral properties of waking EEG and cognitive processing do not vary in synchrony with premenstrual symptoms.
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Affiliation(s)
- Fiona C Baker
- Human Sleep Research Program, SRI International, 333 Ravenswood Avenue, Menlo Park, CA 94043, USA.
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Reed SC, Levin FR, Evans SM. Changes in mood, cognitive performance and appetite in the late luteal and follicular phases of the menstrual cycle in women with and without PMDD (premenstrual dysphoric disorder). Horm Behav 2008; 54:185-93. [PMID: 18413151 PMCID: PMC2491904 DOI: 10.1016/j.yhbeh.2008.02.018] [Citation(s) in RCA: 104] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/19/2007] [Revised: 02/15/2008] [Accepted: 02/21/2008] [Indexed: 11/30/2022]
Abstract
Although it's been reported that women with premenstrual dysphoric disorder (PMDD) have increased negative mood, appetite (food cravings and food intake), alcohol intake and cognitive deficits premenstrually, few studies have examined these changes concurrently within the same group of women or compared to women without PMDD. Thus, to date, there is not a clear understanding of the full range of PMDD symptoms. The present study concurrently assessed mood and performance tasks in 29 normally cycling women (14 women who met DSM-IV criteria for PMDD and 15 women without PMDD). Women had a total of ten sessions: two practice sessions, 4 sessions during the follicular phase and 4 sessions during the late luteal phase of the menstrual cycle. Each session, participants completed mood and food-related questionnaires, a motor coordination task, performed various cognitive tasks and ate lunch. There was a significant increase in dysphoric mood during the luteal phase in women with PMDD compared to their follicular phase and compared to Control women. Further, during the luteal phase, women with PMDD showed impaired performance on the Immediate and Delayed Word Recall Task, the Immediate and Delayed Digit Recall Task and the Digit Symbol Substitution Test compared to Control women. Women with PMDD, but not Control women, also showed increased desire for food items high in fat during the luteal phase compared to the follicular phase and correspondingly, women with PMDD consumed more calories during the luteal phase (mostly derived from fat) compared to the follicular phase. In summary, women with PMDD experience dysphoric mood, a greater desire and actual intake of certain foods and show impaired cognitive performance during the luteal phase. An altered serotonergic system in women with PMDD may be the underlying mechanism for the observed symptoms; correspondingly, treatment with specific serotonin reuptake inhibitors (SSRIs) remains the preferred treatment at this time.
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Affiliation(s)
- Stephanie Collins Reed
- New York State Psychiatric Institute and Department of Psychiatry, College of Physicians and Surgeons of Columbia University, 1051 Riverside Drive, Unit 120, New York, NY 10032, USA.
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Zajdel R, Nowak D. Simple and complex reaction time measurement A preliminary evaluation of new approach and diagnostic tool. Comput Biol Med 2007; 37:1724-30. [PMID: 17573065 DOI: 10.1016/j.compbiomed.2007.04.008] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2005] [Revised: 01/22/2007] [Accepted: 04/23/2007] [Indexed: 10/23/2022]
Abstract
Investigations of reaction time have been employed in various medical specialties as well as psychology. Although numerous tools have been employed, a universal diagnostic tool has yet to be developed in meeting the requirements of all specialties. Therefore, based on the assumptions of the test theory, we developed a new diagnostic tool, a designed program, designated as Reactor. Subsequent to its implementation in Visual Basic for application and MS Access, Reactor was initially estimated in a group of students. Preliminary evaluation of the Reactor has revealed that it is an innovative and useful diagnostic tool in compliance with the physiological model of reaction time in humans.
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Affiliation(s)
- Radosław Zajdel
- Department of Medical Informatics and Statistics, Medical University of Lodz, Poland.
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15
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Fridén C, Hirschberg AL, Saartok T, Renström P. Knee joint kinaesthesia and neuromuscular coordination during three phases of the menstrual cycle in moderately active women. Knee Surg Sports Traumatol Arthrosc 2006; 14:383-9. [PMID: 15942744 DOI: 10.1007/s00167-005-0663-4] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/10/2004] [Accepted: 03/01/2005] [Indexed: 11/27/2022]
Abstract
An increased incidence of sports related injuries in the premenstrual phase as well as in the menstrual phase of the menstrual cycle has been described. This may be explained by alterations in proprioception and neuromuscular coordination due to hormonal variations. Prospective, within women analysis of knee joint kinesthesia and neuromuscular coordination were performed by repeated measures analysis of variance in three hormonally verified phases of three consecutive menstrual cycles. Thirty-two healthy, moderately active female subjects volunteered to participate in the study. Twenty-five of the subjects performed at least one hormonally verified menstrual cycle. A specially designed device was used to investigate knee joint kinaesthesia and neuromuscular coordination was measured with the square hop test. These tests were carried out in the menstrual phase, ovulation phase and premenstrual phase determined by hormone analyses in three consecutive menstrual cycles. An impaired knee joint kinaesthesia was detected in the premenstrual phase and the performance of square hop test was significantly improved in the ovulation phase compared to the other two phases. The results of this study indicate that the variation of sex hormones in the menstrual cycle has an effect on performance of knee joint kinaesthesia and neuromuscular coordination.
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Affiliation(s)
- Cecilia Fridén
- Section of Sports Medicine M3 Research center, Division of Surgical Sciences, Karolinska Institutet, 171 76 Stockholm, Sweden.
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16
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Schmitt JAJ, Jorissen BL, Dye L, Markus CR, Deutz NEP, Riedel WJ. Memory function in women with premenstrual complaints and the effect of serotonergic stimulation by acute administration of an alpha-lactalbumin protein. J Psychopharmacol 2005; 19:375-84. [PMID: 15982992 DOI: 10.1177/0269881105053288] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Serotonergic hypofunction may underlie at least part of the symptoms that are experienced by women with premenstrual complaints, including memory deficits. In the current study we investigated changes in memory functions in the premenstrual phase compared to the early postmenstrual phase in 16 women with premenstrual complaints. In addition, the effect of an acute serotonergic stimulation by administration of an alpha-lactalbumin protein on premenstrual memory performance was assessed using a double-blind placebo-controlled crossover design. It was found that both short-term and long-term memory for words (30-word learning task) and abstract figures (abstract visual learning task) were mildly impaired in the premenstrual phase. Administration of alpha-lactalbumin during the premenstrual phase could only partially attenuate the memory performance decrements that are seen in the premenstrual phase. Specifically, alphalactalbumin improved long-term memory for abstract figures, but not for words. There were no effects of menstrual phase or alpha-lactalbumin on planning functions (computerized Tower of London). The data suggest that serotonergic hypofunction may play a role in premenstrual memory decline, but serotonergic mechanisms cannot fully account for observed cognitive changes in the premenstrual phase.
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Affiliation(s)
- Jeroen A J Schmitt
- Experimental Psychopharmacology Unit, Brain & Behaviour Institute, Universiteit Maastricht, Maastricht, The Netherlands, Nestlé Research Center, Lausanne, Switzerland.
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17
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De Ronchi D, Ujkaj M, Boaron F, Muro A, Piselli M, Quartesan R. Symptoms of depression in late luteal phase dysphoric disorder: a variant of mood disorder? J Affect Disord 2005; 86:169-74. [PMID: 15935236 DOI: 10.1016/j.jad.2005.01.013] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/29/2004] [Revised: 01/05/2005] [Accepted: 01/10/2005] [Indexed: 11/19/2022]
Abstract
BACKGROUND In premenstrual syndrome, depressed mood in the luteal phase of the menstrual cycle is acknowledged, whereas the presence of symptoms of depression during the follicular phase remains in debate. METHODS On the basis of prospective daily recording of the presence and severity of symptoms for at least two menstrual cycles, 43 women were diagnosed with Late Luteal Phase Dysphoric Disorder (LLPD) according to the criteria of the third edition revision of the Diagnostic and Statistical Manual of Mental Disorders. They were compared to a group of 85 women who showed no evidence of LLPD for two menstrual cycles. Structured psychiatric interviews were administered during the follicular phase. Only those subjects without Axis I disorders were subsequently included in the study. RESULTS Those women with minor/moderate symptoms of depression had an odds of suffering from LLPD of 1.9 (95% CI=1.5-2.4, p<0.001) in relation to increasing severity of symptoms of depression at the total MADRS scale (1-point increase). The ORs of LLPD in relation to each dimension (1-point increase) of the emotional/affective, cognitive, and neurovegetative symptoms were 1.6 (95% CI=1.2-2.3, p=0.003), 2.8 (95% CI=0.9-8.5, p=0.077) and 3.3 (95% CI=1.9-5.9, p<0.001), respectively. LIMITATIONS No hormonal changes that may be associated with symptoms of LLPD were determined in this study. CONCLUSIONS LLPD is likely to represent a variant of a depressive disorder, where premenstrual psychobiological changes seem to exacerbate mild depressive symptoms and signs to which LLPD women are otherwise predisposed. This hypothesis opens new perspectives for prevention and of even treatment for LLPD. Further longitudinal studies with larger populations and evaluation of hormonal changes are needed to confirm these data.
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Affiliation(s)
- Diana De Ronchi
- Institute of Psychiatry, University of Bologna, Viale Carlo Pepoli 5, 40123 Bologna, Italy.
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18
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Beaudoin J, Marrocco R. Attentional validity effect across the human menstrual cycle varies with basal temperature changes. Behav Brain Res 2005; 158:23-9. [PMID: 15680191 DOI: 10.1016/j.bbr.2004.08.005] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2004] [Revised: 08/02/2004] [Accepted: 08/05/2004] [Indexed: 10/26/2022]
Abstract
This study examined the correlation between covert attention and basal temperature change during menstrual cycle phase in 22 adult females. Previous work showing beneficial effects of estrogen on working memory led us to hypothesize that attentional function would be facilitated at the apparent time of ovulation. Menstrual phase was determined through questionnaires and objective measurements of basal body temperature (BBT) spikes over a 1 month period. The cued target detection (CTD) task was used to assess visuospatial attentional performance at three times during the menstrual cycle. The mean reaction times (RTs) to visual targets were measured as a function of menstrual cycle phase, cue type and target location. As predicted, the onset of ovulation showed decreased reaction times and a significant increase in the cue validity effect on the days immediately preceding and following ovulation. The magnitude of the attention validity effect was negatively correlated with the basal temperature rise. Women lacking basal temperature shifts failed to show these changes. Results support the conclusion that the natural fluctuations of body temperature, and possibly reproductive hormones, during the menstrual cycle may enhance the attentional component of cognitive performance.
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Affiliation(s)
- Jessica Beaudoin
- Institute of Neuroscience, 1254 University of Oregon, Eugene, OR 97403-1254, USA
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19
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20
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Fridén C, Ramsey DK, Backstrom T, Benoit DL, Saartok T, Lindén Hirschberg A. Altered postural control during the luteal phase in women with premenstrual symptoms. Neuroendocrinology 2005; 81:150-7. [PMID: 15985762 DOI: 10.1159/000086592] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/13/2005] [Accepted: 03/24/2005] [Indexed: 11/19/2022]
Abstract
The purpose of this study was to investigate postural control in women with and without premenstrual symptoms (PMS) in three hormonally verified phases of the menstrual cycle. Thirty-two women were recruited to participate in the study and 25 of these women were included in the results. Menstrual cycle phases were determined by sex hormone analyses in serum and LH detection in urine. A prospective rating of PMS was used to divide the subjects into two groups: one with PMS (cyclic) and one without (non-cyclic). For measurement of postural control, subjects stood on a force platform (AMTI) in two-legged stance (eyes open and closed) and one-legged stance (eyes open and closed). There were no significant differences in the two-legged stance between the phases of the menstrual cycle or between groups. In one-legged stance with eyes open, there was a significant increase in postural displacement in the mid-luteal phase in the cyclic group, but no differences were detected between phases in the non-cyclic group. These findings may be related to the previously reported increased injury rate and psychomotor slowing in the luteal phase in women with PMS.
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Affiliation(s)
- Cecilia Fridén
- Section of Sports Medicine, Division of Surgical Sciences, Karolinska Institutet, Stockholm, Sweden.
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21
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Freeman EW. Effects of antidepressants on quality of life in women with premenstrual dysphoric disorder. PHARMACOECONOMICS 2005; 23:433-44. [PMID: 15896095 DOI: 10.2165/00019053-200523050-00003] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/02/2023]
Abstract
This review examines the effects of antidepressant medications on premenstrual dysphoric disorder (PMDD) and the diminished quality of life (QOL) that accompanies the disorder. PMDD is a chronic condition in women that emerges in the second half of the menstrual cycle and remits during the menstrual period. The affective and behavioural symptoms of PMDD adversely affect functioning and QOL to a disabling degree, particularly in the domains of family and personal relationships, work productivity and social activities. The serotonergic antidepressants, specifically the selective serotonin reuptake inhibitors (SSRIs), are effective for PMDD. Continuous and luteal-phase dosing regimens with SSRIs are similarly effective and well tolerated. Treatment of PMDD with a serotonergic antidepressant significantly improves functioning and QOL in all studies that have systematically examined QOL issues in this disorder. Although the data show that PMDD is effectively treated with serotonergic antidepressants and that functional impairment that accompanies the disorder is also improved with treatment, the social and economic burden of PMDD continues to be widely unrecognised. Greater awareness of the effectiveness of treatments and reliable measures of the direct and indirect healthcare costs of the disorder when it remains untreated are needed.
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Affiliation(s)
- Ellen W Freeman
- Department of Obstetrics/Gynecology, University of Pennsylvania, Philadelphia, Pennsylvania 19104-5509, USA.
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22
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Hsu FC, Garside MJ, Massey AE, McAllister-Williams RH. Effects of a single dose of cortisol on the neural correlates of episodic memory and error processing in healthy volunteers. Psychopharmacology (Berl) 2003; 167:431-42. [PMID: 12684731 DOI: 10.1007/s00213-003-1413-2] [Citation(s) in RCA: 60] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/05/2002] [Accepted: 01/15/2003] [Indexed: 10/20/2022]
Abstract
RATIONALE Neuropsychological impairments seen in depression may be secondary to hypercortisolaemia. Repeated cortisol administration impairs episodic memory with an alteration in event-related potentials (ERPs) recorded during information retrieval. It is unclear whether such ERP effects are specific to episodic memory, or whether repeated cortisol administration is required. OBJECTIVE To investigate the effect of a single dose of hydrocortisone on the neural correlates of episodic memory and error detection. METHODS Twenty healthy subjects were treated with hydrocortisone (100 mg) or placebo orally, in a double-blind, two-way crossover study. ERPs were recorded during an episodic memory and a Stroop task, 1-3 h following the medication. RESULTS Cortisol increased error rates during the Stroop task but had no effect on episodic memory. The magnitude of ERPs associated with incorrect response in the Stroop task between -250 ms and +500 ms post-response was increased by cortisol, with no effect on correct-response ERPs. There was no effect of cortisol on episodic memory-retrieval-dependent ERPs. CONCLUSIONS Cortisol can impair not only episodic memory but also processes involved in error detection. In contrast to repeated cortisol administration, a single dose of cortisol does not alter the behavioural performance or the electrophysiological correlates of episodic memory. However, it increases error rates in a choice response task with associated quantitative changes in incorrect-response ERPs. This probably reflects an alteration in anterior cingulate cortex activity. Such changes may contribute to the neuropsychological impairment seen in depression. This study also demonstrates the utility of ERPs for investigating the effect of neuroendocrine manipulations on the neural correlates of neuropsychological function.
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Affiliation(s)
- F C Hsu
- Psychobiology Research Group, School of Neurology, Neurobiology and Psychiatry, University of Newcastle upon Tyne, Newcastle upon Tyne, UK
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Soares CN, Cohen LS, Otto MW, Harlow BL. Characteristics of women with premenstrual dysphoric disorder (PMDD) who did or did not report history of depression: a preliminary report from the Harvard Study of Moods and Cycles. JOURNAL OF WOMEN'S HEALTH & GENDER-BASED MEDICINE 2001; 10:873-8. [PMID: 11747682 DOI: 10.1089/152460901753285778] [Citation(s) in RCA: 31] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
We examined the characteristics of 33 women with a diagnosis of premenstrual dysphoric disorder (PMDD) who did (n = 19) or did not (n = 14) report a history of major depression. Five hundred thirteen older premenopausal women (ages 36-44) from a community-based sample completed a prospective evaluation of PMDD with daily records. The diagnosis of PMDD was confirmed in 33 women (6.3%), and 14 subjects met criteria for PMDD with no history of depression. Demographic characteristics, cigarette smoking, and menstrual and reproductive history of subjects with PMDD who did or did not report a history of depression were compared. Women with PMDD and no history of depression were more educated and more frequently had a marital disruption (p < 0.05). No significant differences were observed with respect to reproduction-related characteristics or past cigarette smoking. These preliminary data suggest the existence of characteristics particularly related to women who meet criteria for PMDD and have no history of depression. Given the significant psychosocial impairment commonly associated with PMDD symptoms and the existing data that support its classification and adequate treatment as a distinct clinical entity, further studies are needed to better identify predictors of this syndrome unrelated to a lifetime history of depression.
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Affiliation(s)
- C N Soares
- Perinatal and Reproductive Psychiatry Clinical Research Program, Massachusetts General Hospital, Harvard Medical School, 15 Parkman Street, Boston, MA 02114, USA.
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25
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Frye GM, Silverman SD. Is it premenstrual syndrome? Keys to focused diagnosis, therapies for multiple symptoms. Postgrad Med 2000; 107:151-4, 157-9. [PMID: 10844948 DOI: 10.3810/pgm.2000.5.1.1071] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Premenstrual syndrome (PMS) is sometimes facetiously blamed when a woman behaves erratically, when in fact, the cyclic symptoms of true PMS do cause significant difficulties in everyday life and relationships. In this article, Drs Frye and Silverman outline the criteria for diagnosing PMS and premenstrual dysphoric disorder and describe medications, nutritional supplements, and behavior modifications that have proved effective for relief of PMS symptoms.
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Affiliation(s)
- G M Frye
- Lancaster General Hospital Family Practice Residency Program, Pennsylvania, USA.
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26
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Hill SY, Shen S, Locke J, Lowers L, Steinhauer S, Konicky C. Developmental changes in postural sway in children at high and low risk for developing alcohol-related disorders. Biol Psychiatry 2000; 47:501-11. [PMID: 10715356 DOI: 10.1016/s0006-3223(99)00175-4] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
BACKGROUND To utilize the power of latent growth analysis to evaluate changes in postural sway during development in children who are either at high or low risk for developing alcoholism. METHODS A total of 629 assessments of postural sway have been performed in children and adolescents (n = 126) who were evaluated annually over a 7-year period. RESULTS Latent curve models indicated that these children/adolescents show a linear decrease in sway with age. Moreover, significantly different rates of change in the amount of sway between high- and low-risk offspring were seen. With the exception of one of the four stances tested, high-risk boys consistently showed a slower rate of improvement with respect to the amount of sway exhibited compared to low-risk boys. In girls, similar rates of improvement with age were seen in high- and low-risk individuals, though in one stance the high-risk girls showed a deterioration (greater sway with increasing age). CONCLUSIONS Previous reports of increased postural sway in high-risk offspring most likely reflect a developmental delay (high-risk children have greater sway than is appropriate for their age based on normative values by age).
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Affiliation(s)
- S Y Hill
- Department of Psychiatry, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania 15213, USA
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27
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Brennen T, Martinussen M, Hansen BO, Hjemdal O. Arctic cognition: a study of cognitive performance in summer and winter at 69 degrees N. APPLIED COGNITIVE PSYCHOLOGY 1999; 13:561-80. [PMID: 11543349 DOI: 10.1002/(sici)1099-0720(199912)13:6<561::aid-acp661>3.0.co;2-j] [Citation(s) in RCA: 21] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
Evidence has accumulated over the past 15 years that affect in humans is cyclical. In winter there is a tendency to depression, with remission in summer, and this effect is stronger at higher latitudes. In order to determine whether human cognition is similarly rhythmical, this study investigated the cognitive processes of 100 participants living at 69 degrees N. Participants were tested in summer and winter on a range of cognitive tasks, including verbal memory, attention and simple reaction time tasks. The seasonally counterbalanced design and the very northerly latitude of this study provide optimal conditions for detecting impaired cognitive performance in winter, and the conclusion is negative: of five tasks with seasonal effects, four had disadvantages in summer. Like the menstrual cycle, the circannual cycle appears to influence mood but not cognition.
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Endicott J, Amsterdam J, Eriksson E, Frank E, Freeman E, Hirschfeld R, Ling F, Parry B, Pearlstein T, Rosenbaum J, Rubinow D, Schmidt P, Severino S, Steiner M, Stewart DE, Thys-Jacobs S. Is premenstrual dysphoric disorder a distinct clinical entity? JOURNAL OF WOMEN'S HEALTH & GENDER-BASED MEDICINE 1999; 8:663-79. [PMID: 10839653 DOI: 10.1089/jwh.1.1999.8.663] [Citation(s) in RCA: 109] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Does the evidence now available support the concept of premenstrual dysphoric disorder (PMDD) as a distinct clinical disorder such that the relative safety and efficacy of potential treatment can be evaluated? In a roundtable discussion of this question, a wealth of information was reviewed by a panel of experts. The key characteristics of PMDD, with clear onset and offset of symptoms closely linked to the menstrual cycle and the prominence of symptoms of anger, irritability, and internal tension, were contrasted with those of known mood and anxiety disorders. PMDD displays a distinct clinical picture that, in the absence of treatment, is remarkably stable from cycle to cycle and over time. Effective treatment of PMDD can be accomplished with serotinergic agents. At least 60% of patients respond to selective serotonin reuptake inhibitors (SSRIs). In comparison with other disorders, PMDD symptoms respond to low doses of SSRIs and to intermittent dosing. Normal functioning of the hypothalamic-pituitary-adrenal (HPA) axis, biologic characteristics generally related to the serotonin system, and a genetic component unrelated to major depression are further features of PMDD that separate it from other affective (mood) disorders. Based on this evidence, the consensus of the group was that PMDD is a distinct clinical entity. Potential treatments for this disorder can now be evaluated on this basis to meet the clear need for effective therapy.
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Affiliation(s)
- J Endicott
- College of Physicians and Surgeons, Columbia University, New York, New York 10032, USA
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