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Thurley J, Buades-Rotger M, Serfling G, Howaldt T, Reisch N, Krämer UM. Reduced threat avoidance but increased stress induced approach bias in women taking oral contraceptives. Psychoneuroendocrinology 2024; 167:107111. [PMID: 38943719 DOI: 10.1016/j.psyneuen.2024.107111] [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: 12/08/2023] [Revised: 05/15/2024] [Accepted: 06/21/2024] [Indexed: 07/01/2024]
Abstract
Recent research has increasingly acknowledged the impact of oral contraceptives on affective behavior and stress responses; however, the underlying mechanisms are still not well understood. Studies have previously shown that steroid hormones modulate automatic approach and avoidance behavior. Here, we thus investigated the effects of oral contraceptives on approach and avoidance behavior and whether these effects are modulated by stress. The study comprised 130 female participants, half of whom were using oral contraceptives, while the other half were not using any hormonal contraception (NC). The participants completed the Approach Avoidance Task (AAT), which measures automatic approach and avoidance behavior to socio-affective signals. The AAT was run once before and once after a stress manipulation using the Socially Evaluated Cold Pressor Test. OC users showed absent avoidance behavior to social threat signals and a stress-induced increase in approach behavior to positive social signals. The latter was found in particular in women taking androgenic acting OC, demonstrating that different OC preparations need to be taken into account in research on OC effects. However, OC and NC group did not differ in their cortisol stress response. Overall, the results suggest that OC usage impacts on approach and avoidance behavior to social signals, which might also contribute to the development of affective side effects.
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Affiliation(s)
| | - Macià Buades-Rotger
- Department of Clinical Psychology and Psychobiology, University of Barcelona, Barcelona, Spain
| | - Georg Serfling
- Medizinische Klinik I und Institut für Endokrinologie und Diabetes, Universitätsklinikum Schleswig-Holstein, Campus Lübeck, Universität zu Lübeck, Lübeck, Germany
| | | | - Nicole Reisch
- Medizinische Klinik und Poliklinik IV, LMU Klinikum München, Munich, Germany
| | - Ulrike M Krämer
- Institute of Medical Psychology, Center of Brain, Behavior and Metabolism (CBBM), University of Lübeck, Lübeck, Germany.
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2
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Zelionkaitė I, Gaižauskaitė R, Uusberg H, Uusberg A, Ambrasė A, Derntl B, Grikšienė R. The levonorgestrel-releasing intrauterine device is related to early emotional reactivity: An ERP study. Psychoneuroendocrinology 2024; 162:106954. [PMID: 38241970 DOI: 10.1016/j.psyneuen.2023.106954] [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: 08/07/2023] [Revised: 11/17/2023] [Accepted: 12/30/2023] [Indexed: 01/21/2024]
Abstract
Despite the evidence of altered emotion processing in oral contraceptive (OC) users, the impact of hormonal intrauterine devices (IUD) on emotional processing remains unexplored. Our study aimed to investigate how behavioural performance and event-related potentials (ERPs) linked with emotion reactivity and its regulation are associated with hormonal profiles of women using different types of hormonal contraception and naturally cycling women. Women using OCs (n = 25), hormonal IUDs (n = 33), and naturally cycling women in their early follicular (NCF, n = 33) or mid-luteal (NCL, n = 28) phase of the menstrual cycle were instructed to view emotional pictures (neutral, low and high negativity) and use cognitive reappraisal to up- or down-regulate negative emotions, while their electroencephalogram was recorded. Participants rated perceived negativity after each picture and their emotional arousal throughout the task. Saliva samples were collected to assess levels of 17β-estradiol, progesterone, and testosterone. As expected, emotional arousal increased throughout the task and correlated positively with perceived negativity. Perceived negativity and the amplitudes of the middle (N2/P3) and later (LPP) latency ERP components increased with increasing stimuli negativity. Emotion regulation modulated perceived negativity and the amplitudes of very late ERP components (parietal and frontal LPP). Moreover, IUD-users showed a higher negative amplitude of the frontal N2 in comparison to all three other groups, with the most consistent differences during up-regulation. Finally, testosterone correlated positively with the N2 peak in IUD-users and NCL women. Overall, our findings suggest that IUD-use and testosterone might be related to altered preconscious processing during the emotion regulation task requiring attention to the stimulus. The study underscores the need for additional research into how different hormonal contraceptives are linked to socio-emotional functioning.
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Affiliation(s)
- Ingrida Zelionkaitė
- Department of Neurobiology and Biophysics, Vilnius University, Saulėtekio ave. 7, 10257, Vilnius, Lithuania.
| | - Rimantė Gaižauskaitė
- Department of Neurobiology and Biophysics, Vilnius University, Saulėtekio ave. 7, 10257, Vilnius, Lithuania
| | - Helen Uusberg
- Institute of Psychology, University of Tartu, Ülikooli 18, 50090, Tartu, Estonia
| | - Andero Uusberg
- Institute of Psychology, University of Tartu, Ülikooli 18, 50090, Tartu, Estonia
| | - Aistė Ambrasė
- Department of Psychiatry and Psychotherapy, Women's Mental Health & Brain Function, Tübingen Center for Mental Health, University of Tübingen, Calwerstraße 14, 72016, Tübingen, Germany
| | - Birgit Derntl
- Department of Psychiatry and Psychotherapy, Women's Mental Health & Brain Function, Tübingen Center for Mental Health, University of Tübingen, Calwerstraße 14, 72016, Tübingen, Germany; DZPG (German Center for Mental Health), Partner site Tübingen, Germany
| | - Ramunė Grikšienė
- Department of Neurobiology and Biophysics, Vilnius University, Saulėtekio ave. 7, 10257, Vilnius, Lithuania
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Spalek K, Coynel D, de Quervain D, Milnik A. Sex-dependent differences in connectivity patterns are related to episodic memory recall. Hum Brain Mapp 2023; 44:5612-5623. [PMID: 37647201 PMCID: PMC10619411 DOI: 10.1002/hbm.26465] [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: 04/03/2023] [Revised: 07/12/2023] [Accepted: 08/08/2023] [Indexed: 09/01/2023] Open
Abstract
Previous studies have shown that females typically outperform males on episodic memory tasks. In this study, we investigated if (1) there are differences between males and females in their connectome characteristics, (2) if these connectivity patterns are associated with memory performance, and (3) if these brain connectome characteristics contribute to the differences in episodic memory performance between sexes. In a sample of 655 healthy young subjects (n = 391 females; n = 264 males), we derived brain network characteristics from diffusion-weighted imaging (DWI) data using models of crossing fibers within each voxel of the brain and probabilistic tractography (graph strength, shortest path length, global efficiency, and weighted transitivity). Group differences were analysed with linear models and mediation analyses were used to explore how connectivity patterns might relate to sex-dependent differences in memory performance. Our results show significant sex-dependent differences in weighted transitivity (d = 0.42), with males showing higher values. Further, we observed a negative association between weighted transitivity and memory performance (r = -0.12). Finally, these distinct connectome characteristics partially mediated the observed differences in memory performance (effect size of the indirect effect r = 0.02). Our findings indicate a higher interconnectedness in females compared to males. Additionally, we demonstrate that the sex-dependent differences in episodic memory performance can be partially explained by the differences in this connectome measure. These results further underscore the importance of sex-dependent differences in brain connectivity and their impact on cognitive function.
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Affiliation(s)
- Klara Spalek
- Division of Cognitive NeuroscienceDepartment of BiomedicineUniversity of BaselBaselSwitzerland
- Division of Molecular NeuroscienceDepartment of BiomedicineUniversity of BaselBaselSwitzerland
- Hoekzema Lab, Adult PsychiatryUniversity Medical Centre AmsterdamAmsterdamNetherlands
| | - David Coynel
- Division of Cognitive NeuroscienceDepartment of BiomedicineUniversity of BaselBaselSwitzerland
- Research Cluster Molecular and Cognitive NeurosciencesUniversity of BaselBaselSwitzerland
| | - Dominique de Quervain
- Division of Cognitive NeuroscienceDepartment of BiomedicineUniversity of BaselBaselSwitzerland
- Research Cluster Molecular and Cognitive NeurosciencesUniversity of BaselBaselSwitzerland
- Psychiatric University Clinics, University of BaselBaselSwitzerland
| | - Annette Milnik
- Division of Cognitive NeuroscienceDepartment of BiomedicineUniversity of BaselBaselSwitzerland
- Division of Molecular NeuroscienceDepartment of BiomedicineUniversity of BaselBaselSwitzerland
- Psychiatric University Clinics, University of BaselBaselSwitzerland
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4
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Pedersen MV, Hansen LMB, Garforth B, Zak PJ, Winterdahl M. Adrenocorticotropic hormone secretion in response to anticipatory stress and venepuncture: The role of menstrual phase and oral contraceptive use. Behav Brain Res 2023; 452:114550. [PMID: 37343838 DOI: 10.1016/j.bbr.2023.114550] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2023] [Revised: 06/07/2023] [Accepted: 06/17/2023] [Indexed: 06/23/2023]
Abstract
INTRODUCTION Oral contraceptives (OCs) are primarily known for their effects on the reproductive system, but they can also impact the hypothalamic-pituitary-adrenal (HPA) axis. The present study aimed to compare plasma adrenocorticotropic hormone (ACTH) responses to the anticipatory stress of participating in a scientific experiment and venepuncture in OC users versus naturally cycling (NC) women, with a focus on variations throughout the menstrual cycle. METHODS We recruited 131 young women (average age 20.5) and obtained blood samples to measure plasma ACTH concentrations immediately after venepuncture and again after 15 min of group activities designed to facilitate interpersonal attachment and stress-buffering. RESULTS ACTH levels decreased in 70% of all participants throughout the group activities. A two-way repeated measures ANOVA highlighted a significant interaction between time and OC use, indicating differential changes in ACTH levels during social interaction between OC users and NC women. Further, the post-hoc analysis revealed that a period of stress-buffering group activities significantly decreased ACTH levels in NC women during menstrual and secretory phases, but not during the proliferative phase. In contrast, OC users did not display a decrease during group activities, regardless of the phase. CONCLUSION This study underscores the influence of OC use on stress regulation, demonstrating that OCs not only modulate reproductive functions but also impact ACTH stress reactivity. Additionally, it emphasizes the importance of considering hormonal contraceptive use and menstrual cycle phases when assessing female stress responses.
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Affiliation(s)
| | | | - Ben Garforth
- Translational Neuropsychiatry Unit, Aarhus University, Aarhus, Denmark
| | - Paul J Zak
- Center for Neuroeconomics Studies, Claremont Graduate University, Claremont, CA, USA
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Gravelsins L, Zhao S, Einstein G. Hormonal contraception and cognition: Considering the influence of endogenous ovarian hormones and genes for clinical translation. Front Neuroendocrinol 2023; 70:101067. [PMID: 37084896 DOI: 10.1016/j.yfrne.2023.101067] [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: 07/05/2022] [Revised: 03/18/2023] [Accepted: 03/30/2023] [Indexed: 04/23/2023]
Abstract
Despite the well-known influence of ovarian hormones on the brain and widespread use of hormonal contraception (HC) since the 1960s, our knowledge of HC's cognitive effects remains limited. To date, the cognitive findings have been inconsistent. In order to establish what might make HC studies more consistent, we surveyed the literature on HCs and cognition to determine whether studies considered HC formulation, phase, pharmacokinetics, duration, and gene interactions, and assessed whether oversight of these factors might contribute to variable findings. We found that synthetic HC hormones exert dose-dependent effects, the day of oral contraceptive (Pill) ingestion is critical for understanding cognitive changes, and gene-cognition relationships differ in women taking the Pill likely due to suppressed endogenous hormones. When these factors were overlooked, results were not consistent. We close with recommendations for research more likely to yield consistent findings and be therefore, translatable.
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Affiliation(s)
- Laura Gravelsins
- University of Toronto, Address: 100 Saint George Street, Canada, Toronto, Ontario M5S 3G3.
| | - Sophia Zhao
- University of Toronto, Address: 100 Saint George Street, Canada, Toronto, Ontario M5S 3G3
| | - Gillian Einstein
- University of Toronto, Address: 100 Saint George Street, Canada, Toronto, Ontario M5S 3G3; Rotman Research Institute, Address: 3560 Bathurst St, Canada, North York, Ontario M6A 2E1; Linköping University, Address: SE-581 83 Linköping, Sweden
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6
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Pletzer B, Winkler-Crepaz K, Hillerer K. Progesterone and contraceptive progestin actions on the brain: A systematic review of animal studies and comparison to human neuroimaging studies. Front Neuroendocrinol 2023; 69:101060. [PMID: 36758768 DOI: 10.1016/j.yfrne.2023.101060] [Citation(s) in RCA: 10] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/30/2022] [Revised: 01/25/2023] [Accepted: 02/03/2023] [Indexed: 02/09/2023]
Abstract
In this review we systematically summarize the effects of progesterone and synthetic progestins on neurogenesis, synaptogenesis, myelination and six neurotransmitter systems. Several parallels between progesterone and older generation progestin actions emerged, suggesting actions via progesterone receptors. However, existing results suggest a general lack of knowledge regarding the effects of currently used progestins in hormonal contraception regarding these cellular and molecular brain parameters. Human neuroimaging studies were reviewed with a focus on randomized placebo-controlled trials and cross-sectional studies controlling for progestin type. The prefrontal cortex, amygdala, salience network and hippocampus were identified as regions of interest for future preclinical studies. This review proposes a series of experiments to elucidate the cellular and molecular actions of contraceptive progestins in these areas and link these actions to behavioral markers of emotional and cognitive functioning. Emotional effects of contraceptive progestins appear to be related to 1) alterations in the serotonergic system, 2) direct/indirect modulations of inhibitory GABA-ergic signalling via effects on the allopregnanolone content of the brain, which differ between androgenic and anti-androgenic progestins. Cognitive effects of combined oral contraceptives appear to depend on the ethinylestradiol dose.
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Affiliation(s)
- Belinda Pletzer
- Department of Psychology & Centre for Cognitive Neuroscience, Paris-Lodron-University Salzburg, Salzburg Austria.
| | | | - Katharina Hillerer
- Department of Gynaecology & Obstetrics, Private Medical University, Salzburg, Austria
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7
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Oral contraceptives and cognition: A systematic review. Front Neuroendocrinol 2022; 69:101052. [PMID: 36581228 DOI: 10.1016/j.yfrne.2022.101052] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/10/2022] [Revised: 12/19/2022] [Accepted: 12/21/2022] [Indexed: 12/27/2022]
Abstract
Oral contraceptives (OCs) are widely used. While the physical impacts of OCs have been well researched, there is increasing interest on potential impacts of OCs on brain, behaviour and cognition. We systematically reviewed the literature to determine the influence of OCs on cognition, including neurocognition, social cognition and emotional processing. Inclusionary criteria were: (a) premenopausal females taking OCs; (b) a control group of naturally cycling women or OCs users in their inactive (i.e. 'sugar pill') phase; and (c) at least one measure of performance on a neurocognitive or social cognitive task. The systematic review found that OC use was associated with some differences in performance on all cognitive domains examined (with the exception of basic auditory attention and psychomotor performance). Several factors were identified that are likely to modulate the way OCs influence cognition, including task related factors, OC type and control group characteristics. Directions for future research are highlighted.
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8
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Coenjaerts M, Trimborn I, Adrovic B, Stoffel-Wagner B, Cahill L, Philipsen A, Hurlemann R, Scheele D. Exogenous estradiol and oxytocin modulate sex differences in hippocampal reactivity during the encoding of episodic memories. Neuroimage 2022; 264:119689. [PMID: 36349596 DOI: 10.1016/j.neuroimage.2022.119689] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2022] [Revised: 10/04/2022] [Accepted: 10/14/2022] [Indexed: 11/06/2022] Open
Abstract
Considerable evidence supports sex differences in episodic memory. The hormones estradiol and oxytocin both affect episodic memory and may contribute to these sex differences, but possible underlying hormonal interactions have not been tested in a sample involving both sexes. To this end, we conducted a randomized, placebo-controlled, parallel-group functional magnetic resonance imaging (fMRI) study including healthy free-cycling women (n = 111) and men (n = 115). The fMRI session was conducted under four experimental conditions: 1. transdermal estradiol (2 mg) and intranasal oxytocin (24 IU), 2. transdermal placebo and intranasal oxytocin, 3. transdermal estradiol and intranasal placebo, 4. transdermal placebo and intranasal placebo. Participants were scanned during the encoding of positive, neutral, and negative scenes. Recognition memory was tested three days following the scanning sessions without additional treatments. Under placebo, women showed a significantly better recognition memory and increased hippocampal responses to subsequently remembered items independent of the emotional valence compared to men. The separate treatments with either hormone significantly diminished this mnemonic sex difference and reversed the hippocampal activation pattern. However, the combined treatments produced no significant effect. Collectively, the results suggest that both hormones play a crucial role in modulating sex differences in episodic memory. Furthermore, possible antagonistic interactions between estradiol and oxytocin could explain previously observed opposing hormonal effects in women and men.
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Affiliation(s)
- Marie Coenjaerts
- Division of Medical Psychology, Department of Psychiatry and Psychotherapy, University Hospital Bonn, Bonn 53105, Germany.
| | - Isabelle Trimborn
- Division of Medical Psychology, Department of Psychiatry and Psychotherapy, University Hospital Bonn, Bonn 53105, Germany
| | - Berina Adrovic
- Division of Medical Psychology, Department of Psychiatry and Psychotherapy, University Hospital Bonn, Bonn 53105, Germany
| | - Birgit Stoffel-Wagner
- Institute for Clinical Chemistry and Clinical Pharmacology, University of Bonn, Bonn 53105, Germany
| | - Larry Cahill
- Department of Neurobiology and Behavior, University of California, Irvine, CA 92697-3800, United States
| | - Alexandra Philipsen
- Department of Psychiatry and Psychotherapy, University Hospital Bonn, Bonn 53105, Germany
| | - René Hurlemann
- Department of Psychiatry, School of Medicine & Health Sciences, University of Oldenburg, Oldenburg 26129, Germany; Research Center Neurosensory Science, University of Oldenburg, Oldenburg 26129, Germany
| | - Dirk Scheele
- Department of Social Neuroscience, Faculty of Psychology, Ruhr-University Bochum, Bochum 44780, Germany.
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9
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Methods and considerations for the use of hormonal contraceptives in rat models of neurobehavior. Front Neuroendocrinol 2022; 66:101011. [PMID: 35716802 DOI: 10.1016/j.yfrne.2022.101011] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/31/2022] [Revised: 06/08/2022] [Accepted: 06/11/2022] [Indexed: 01/19/2023]
Abstract
Hormonal contraceptives (HCs), prescribed to millions of women around the world, alter the ovarian hormonal cycle resulting in neurobehavioral changes in HC users. Human epidemiological and experimental data has characterized some of these effects with oftentimes conflicting or irreproducible results, reflecting a dearth of research considering different compositions, routes of administration, or time-courses of HC use. Non-human animal research can model these effects and help elucidate the underlying mechanisms by which different HCs modulate neurobehavioral outcomes. Still, animal models using HCs are not well-established. This may be because the pharmacological profile of HCs - including the metabolism, receptor binding affinity, and neuromodulatory effects - is dynamic and not always clearly translatable between animals and humans. The current review addresses these issues and provides basic methods and considerations for the use of HCs in animal models of neurobehavior to help advance the field of behavioral neuroendocrinology and inform decisions regarding to women's health.
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10
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Li J, Deng SW. Social attention, memory, and memory-guided orienting change across the menstrual cycle. Physiol Behav 2022; 251:113808. [PMID: 35421422 DOI: 10.1016/j.physbeh.2022.113808] [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: 01/28/2022] [Revised: 03/31/2022] [Accepted: 04/10/2022] [Indexed: 10/18/2022]
Abstract
Numerous studies have shown that perception of emotion and emotional memory vary across the menstrual cycle. However, most of these studies used stimuli that contained not only emotional but also social elements. Importantly, the social cognitive abilities of individuals are as crucial as emotional abilities for danger avoidance and recruitment of allies. Therefore, the issue that natural hormonal fluctuations may affect emotion processing should be revisited. To investigate whether the effects of the menstrual cycle are emotion-specific or can also be attributed to social information processing, the present study examined social attention across the menstrual cycle in three tasks-visual search, memory, and memory-guided orienting-with a combination of behavioral and eye-tracking measures. We used images of people standing upright with neutral emotion as social distractors and everyday objects with physical properties matched as non-social distractors. Thirty-six healthy women without hormone use and with stable menstrual cycles of 26 - 30 days participated in the three tasks in the late follicular phase (FP) and mid-luteal phase (LP), respectively. During visual search, participants were asked to search for targets accompanied by social or non-social distractors in complex scenes. Social attentional bias, as evidenced by longer search times and shorter gaze behaviors for targets with social distractors, was found in the FP but not in the LP. In the following memory task, memory accuracy for targets was higher in the FP than in the LP, and the memory for targets with social distractors was more precise in both phases. Finally, in the orienting task, targets in social scenes were detected more slowly than in non-social scenes in LP. Taken together, these findings point to the interplay between social attention, memory, and memory-oriented attention and reveal the distinct processing pathways for social information in the FP and LP. The underlying mechanisms from an evolutionary perspective and from behavioral and neural basis were discussed.
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Affiliation(s)
- Jianhua Li
- Department of Psychology, University of Macau, Macao, China; Center for Cognitive and Brain Sciences, University of Macau, Macao, China
| | - Sophia W Deng
- Department of Psychology, University of Macau, Macao, China; Center for Cognitive and Brain Sciences, University of Macau, Macao, China.
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A. Al-Gham M, A. Baothma O, Afzal M, I. Alzarea S, Anwar F, Shahid Nad M, Kazmi I. Levonorgestrel and Desogestrel Modulate Gut Microbiota and Blood Biochemistry of Female Wistar Rats. INT J PHARMACOL 2022. [DOI: 10.3923/ijp.2022.826.841] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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12
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Schmidt NM, Hennig J, Munk AJL. Event-Related Potentials in Women on the Pill: Neural Correlates of Positive and Erotic Stimulus Processing in Oral Contraceptive Users. Front Neurosci 2022; 15:798823. [PMID: 35058744 PMCID: PMC8764149 DOI: 10.3389/fnins.2021.798823] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2021] [Accepted: 12/09/2021] [Indexed: 11/13/2022] Open
Abstract
Background/Aims: Exposure toward positive emotional cues with - and without - reproductive significance plays a crucial role in daily life and regarding well-being as well as mental health. While possible adverse effects of oral contraceptive (OC) use on female mental and sexual health are widely discussed, neural processing of positive emotional stimuli has not been systematically investigated in association with OC use. Considering reported effects on mood, well-being and sexual function, and proposed associations with depression, it was hypothesized that OC users showed reduced neural reactivity toward positive and erotic emotional stimuli during early as well as later stages of emotional processing and also rated these stimuli as less pleasant and less arousing compared to naturally cycling (NC) women. Method: Sixty-two female subjects (29 NC and 33 OC) were assessed at three time points across the natural menstrual cycle and corresponding time points of the OC regimen. Early (early posterior negativity, EPN) and late (late positive potential, LPP) event-related potentials in reaction to positive, erotic and neutral stimuli were collected during an Emotional Picture Stroop Paradigm (EPSP). At each appointment, subjects provided saliva samples for analysis of gonadal steroid concentration. Valence and arousal ratings were collected at the last appointment. Results: Oral contraceptive users had significantly lower endogenous estradiol and progesterone concentrations compared to NC women. No significant group differences in either subjective stimulus evaluations or neural reactivity toward positive and erotic emotional stimuli were observed. For the OC group, LPP amplitudes in reaction to erotic vs. neutral pictures differed significantly between measurement times across the OC regimen. Discussion: In this study, no evidence regarding alterations of neural reactivity toward positive and erotic stimuli in OC users compared to NC was found. Possible confounding factors and lines for future research are elaborated and discussed.
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Affiliation(s)
- Norina M. Schmidt
- Department of Differential and Biological Psychology, University of Giessen, Giessen, Germany
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13
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Lewis CA, Kimmig ACS, Kroemer NB, Pooseh S, Smolka MN, Sacher J, Derntl B. No Differences in Value-Based Decision-Making Due to Use of Oral Contraceptives. Front Endocrinol (Lausanne) 2022; 13:817825. [PMID: 35528016 PMCID: PMC9075610 DOI: 10.3389/fendo.2022.817825] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/18/2021] [Accepted: 03/11/2022] [Indexed: 12/17/2022] Open
Abstract
Fluctuating ovarian hormones have been shown to affect decision-making processes in women. While emerging evidence suggests effects of endogenous ovarian hormones such as estradiol and progesterone on value-based decision-making in women, the impact of exogenous synthetic hormones, as in most oral contraceptives, is not clear. In a between-subjects design, we assessed measures of value-based decision-making in three groups of women aged 18 to 29 years, during (1) active oral contraceptive intake (N = 22), (2) the early follicular phase of the natural menstrual cycle (N = 20), and (3) the periovulatory phase of the natural menstrual cycle (N = 20). Estradiol, progesterone, testosterone, and sex-hormone binding globulin levels were assessed in all groups via blood samples. We used a test battery which measured different facets of value-based decision-making: delay discounting, risk-aversion, risk-seeking, and loss aversion. While hormonal levels did show the expected patterns for the three groups, there were no differences in value-based decision-making parameters. Consequently, Bayes factors showed conclusive evidence in support of the null hypothesis. We conclude that women on oral contraceptives show no differences in value-based decision-making compared to the early follicular and periovulatory natural menstrual cycle phases.
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Affiliation(s)
- Carolin A. Lewis
- Department of Psychiatry and Psychotherapy, Tübingen Center for Mental Health (TüCMH), University of Tuebingen, Tuebingen, Germany
- Emotion Neuroimaging Lab, Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany
- International Max Planck Research School on Neuroscience of Communication: Function, Structure, and Plasticity, Leipzig, Germany
- *Correspondence: Carolin A. Lewis,
| | - Ann-Christin S. Kimmig
- Department of Psychiatry and Psychotherapy, Tübingen Center for Mental Health (TüCMH), University of Tuebingen, Tuebingen, Germany
- International Max Planck Research School for Cognitive and Systems Neuroscience, University of Tuebingen, Tuebingen, Germany
| | - Nils B. Kroemer
- Department of Psychiatry and Psychotherapy, Tübingen Center for Mental Health (TüCMH), University of Tuebingen, Tuebingen, Germany
| | - Shakoor Pooseh
- Department of Psychiatry, Technische Universität Dresden, Dresden, Germany
- Freiburg Center for Data Analysis and Modeling, Albert-Ludwigs-Universität Freiburg, Freiburg, Germany
| | - Michael N. Smolka
- Department of Psychiatry, Technische Universität Dresden, Dresden, Germany
| | - Julia Sacher
- Emotion Neuroimaging Lab, Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany
- Clinic for Cognitive Neurology, University of Leipzig, Leipzig, Germany
| | - Birgit Derntl
- Department of Psychiatry and Psychotherapy, Tübingen Center for Mental Health (TüCMH), University of Tuebingen, Tuebingen, Germany
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Gamsakhurdashvili D, Antov MI, Stockhorst U. Facial Emotion Recognition and Emotional Memory From the Ovarian-Hormone Perspective: A Systematic Review. Front Psychol 2021; 12:641250. [PMID: 34093322 PMCID: PMC8174660 DOI: 10.3389/fpsyg.2021.641250] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2020] [Accepted: 04/19/2021] [Indexed: 12/27/2022] Open
Abstract
Background We review original papers on ovarian-hormone status in two areas of emotional processing: facial emotion recognition and emotional memory. Ovarian-hormone status is operationalized by the levels of the steroid sex hormones 17β-estradiol (E2) and progesterone (P4), fluctuating over the natural menstrual cycle and suppressed under oral contraceptive (OCs) use. We extend previous reviews addressing single areas of emotional processing. Moreover, we systematically examine the role of stimulus features such as emotion type or stimulus valence and aim at elucidating factors that reconcile the inconsistent results. Methods We followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines and included papers published until September 2020 indexed in PubMed and Web of Science databases. Search terms were MeSH terms (emotional OR emotion) AND (X) AND (estrogen OR progesterone OR menstrual cycle OR oral contraceptives) with (X) representing our separately searched areas, resulting in (processing OR recognition OR empathy), and (memory OR recall). To be included, articles had to (1) be written and published in English, (2) examine healthy, non-pregnant adult women in their reproductive age, and (3) measure or at least estimate levels of E2 and P4. In PubMed, the search was (4) limited to humans and (5) to the search term present in the title or abstract. Results Features of the provided stimulus material (emotion type and/or valence) constitute a relevant influence that interacts with E2- and P4-related ovarian-hormone status. For instance, recognition of basic emotions appears to be more related to P4- than E2-levels. Quite consistent, OC intake (vs. natural menstrual cycling) was accompanied by impaired recognition accuracy of basic and also complex emotions, although not in a recent large-sample study assessing complex emotions. Memory recall of negative content was mainly enhanced by P4, especially after having been stressed. Discussion and Conclusion We document the methodological diversity in the field, presumably contributing to the heterogeneity of results. More studies explicitly contrasting the early follicular phase, mid-cycle phase, mid-luteal, and OC intake while standardizing tasks are needed. Research would take advantage of using within-subject designs and accounting for the recognition of complex emotions.
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Affiliation(s)
- Dali Gamsakhurdashvili
- Experimental Psychology II and Biological Psychology, Institute of Psychology, University of Osnabrück, Osnabrück, Germany
| | - Martin I Antov
- Experimental Psychology II and Biological Psychology, Institute of Psychology, University of Osnabrück, Osnabrück, Germany
| | - Ursula Stockhorst
- Experimental Psychology II and Biological Psychology, Institute of Psychology, University of Osnabrück, Osnabrück, Germany
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Cognitive and emotional empathy after stimulation of brain mineralocorticoid and NMDA receptors in patients with major depression and healthy controls. Neuropsychopharmacology 2020; 45:2155-2161. [PMID: 32722659 PMCID: PMC7785026 DOI: 10.1038/s41386-020-0777-x] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/08/2020] [Revised: 06/19/2020] [Accepted: 07/10/2020] [Indexed: 02/06/2023]
Abstract
Mineralocorticoid receptors (MR) are predominantly expressed in the hippocampus and prefrontal cortex. Both brain areas are associated with social cognition, which includes cognitive empathy (ability to understand others' emotions) and emotional empathy (ability to empathize with another person). MR stimulation improves memory and executive functioning in patients with major depressive disorder (MDD) and healthy controls, and leads to glutamate-mediated N-methyl-D-aspartate receptor (NMDA-R) signaling. We examined whether the beneficial effects of MR stimulation can be extended to social cognition (empathy), and whether DCS would have additional beneficial effects. In this double-blind placebo-controlled single-dose study, we randomized 116 unmedicated MDD patients (mean age 34 years, 78% women) and 116 age-, sex-, and education years-matched healthy controls to four conditions: MR stimulation (fludrocortisone (0.4 mg) + placebo), NMDA-R stimulation (placebo + D-cycloserine (250 mg)), MR and NMDA-R stimulation (both drugs), or placebo. Cognitive and emotional empathy were assessed by the Multifaceted Empathy Test. The study was registered on clinicaltrials.gov (NCT03062150). MR stimulation increased cognitive empathy across groups, whereas NMDA-R stimulation decreased cognitive empathy in MDD patients only. Independent of receptor stimulation, cognitive empathy did not differ between groups. Emotional empathy was not affected by MR or NMDA-R stimulation. However, MDD patients showed decreased emotional empathy compared with controls but, according to exploratory analyses, only for positive emotions. We conclude that MR stimulation has beneficial effects on cognitive empathy in MDD patients and healthy controls, whereas NMDA-R stimulation decreased cognitive empathy in MDD patients. It appears that MR rather than NMDA-R are potential treatment targets to modulate cognitive empathy in MDD.
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Nasseri P, Herrera AY, Gillette K, Faude S, White JD, Velasco R, Mather M. Hormonal contraceptive phases matter: Resting-state functional connectivity of emotion-processing regions under stress. Neurobiol Stress 2020; 13:100276. [PMID: 33344729 PMCID: PMC7739174 DOI: 10.1016/j.ynstr.2020.100276] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2020] [Revised: 10/26/2020] [Accepted: 11/17/2020] [Indexed: 11/30/2022] Open
Abstract
Hormonal contraceptives (HCs) affect various processes related to emotion processing, including emotional memory, fear extinction, and the cortisol response to stress. Despite the modulating role of HCs on the stress response in women and variance in synthetic hormone levels across the HC cycle, little is known about the phase-related effects of HCs on the brain's response to stress. We investigated the effect of HC cycle phase on functional connectivity of memory- and emotion-related regions at rest after exposure to a stressor. Twenty HC users completed two sessions of resting-state functional magnetic resonance imaging after exposure to the cold pressor test, one during the hormone-present HC phase (when synthetic hormones are taken) and one during the hormone-absent HC phase (when synthetic hormones are not taken). Women showed higher functional connectivity between left amygdala and ventromedial prefrontal cortex during the hormone-present phase. During the hormone-absent phase, women showed higher coupling between left parahippocampus and right superior lateral occipital cortex. Our results suggest that the synthetic hormones contained in HCs may protect against the negative effects of stress on functional connectivity of emotional processing regions.
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Affiliation(s)
- Padideh Nasseri
- University of Southern California, Neuroscience Graduate Program, Los Angeles, CA, USA
| | - Alexandra Ycaza Herrera
- University of Southern California, Leonard Davis School of Gerontology, Los Angeles, CA, USA
| | - Katherine Gillette
- University of Southern California, Leonard Davis School of Gerontology, Los Angeles, CA, USA
| | - Sophia Faude
- University of Southern California, Leonard Davis School of Gerontology, Los Angeles, CA, USA
| | - Jessica D. White
- University of Southern California, Leonard Davis School of Gerontology, Los Angeles, CA, USA
| | - Ricardo Velasco
- University of Southern California, Leonard Davis School of Gerontology, Los Angeles, CA, USA
| | - Mara Mather
- University of Southern California, Neuroscience Graduate Program, Los Angeles, CA, USA
- University of Southern California, Leonard Davis School of Gerontology, Los Angeles, CA, USA
- University of Southern California, Department of Psychology, Los Angeles, CA, USA
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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.
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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.
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Lewis CA, Kimmig ACS, Zsido RG, Jank A, Derntl B, Sacher J. Effects of Hormonal Contraceptives on Mood: A Focus on Emotion Recognition and Reactivity, Reward Processing, and Stress Response. Curr Psychiatry Rep 2019; 21:115. [PMID: 31701260 PMCID: PMC6838021 DOI: 10.1007/s11920-019-1095-z] [Citation(s) in RCA: 68] [Impact Index Per Article: 13.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
PURPOSE OF REVIEW We review recent research investigating the relationship of hormonal contraceptives and mood with a focus on relevant underlying mechanisms, such as emotion recognition and reactivity, reward processing, and stress response. RECENT FINDINGS Adverse effects of hormonal contraceptives (HCs) on mood seem most consistent in women with a history of depressive symptoms and/or previous negative experience with HC-intake. Current evidence supports a negativity bias in emotion recognition and reactivity in HC-users, although inconsistent to some extent. Some data, however, do indicate a trend towards a blunted reward response and a potential dysregulation of the stress response in some HC-users. HC-effects on psychological and neurophysiological mechanisms underlying mood are likely context-dependent. We provide suggestions on how to address some of the contributing factors to this variability in future studies, such as HC-dose, timing, administration-mode, and individual risk. A better understanding of how and when HCs affect mood is critical to provide adequate contraceptive choices to women worldwide.
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Affiliation(s)
- Carolin A Lewis
- Emotion Neuroimaging Lab, Max Planck Institute for Human Cognitive and Brain Sciences, Stephanstr. 1A, 04103, Leipzig, Germany.
- International Max Planck Research School on Neuroscience of Communication: Function, Structure, and Plasticity, Leipzig, Germany.
- Department of Psychiatry and Psychotherapy, University of Tuebingen, Calwerstr, 14, 72076, Tuebingen, Germany.
| | - Ann-Christin S Kimmig
- Department of Psychiatry and Psychotherapy, University of Tuebingen, Calwerstr, 14, 72076, Tuebingen, Germany
- International Max Planck Research School for Cognitive and Systems Neuroscience, University of Tuebingen, Tuebingen, Germany
| | - Rachel G Zsido
- Emotion Neuroimaging Lab, Max Planck Institute for Human Cognitive and Brain Sciences, Stephanstr. 1A, 04103, Leipzig, Germany
- International Max Planck Research School on Neuroscience of Communication: Function, Structure, and Plasticity, Leipzig, Germany
- Department of Neurology, Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany
| | - Alexander Jank
- Department of Obstetrics, University Hospital Leipzig, Leipzig, Germany
| | - Birgit Derntl
- Department of Psychiatry and Psychotherapy, University of Tuebingen, Calwerstr, 14, 72076, Tuebingen, Germany
- Werner Reichardt Center for Integrative Neuroscience, University of Tuebingen, Tuebingen, Germany
- LEAD Research School and Graduate Network, University of Tuebingen, Tuebingen, Germany
| | - Julia Sacher
- Emotion Neuroimaging Lab, Max Planck Institute for Human Cognitive and Brain Sciences, Stephanstr. 1A, 04103, Leipzig, Germany
- Department of Neurology, Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany
- Clinic for Cognitive Neurology, University of Leipzig, Leipzig, Germany
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