Women with Premenstrual Dysphoria Lack the Seemingly Normal Premenstrual Right-Sided Relative Dominance of 5-HTP-Derived Serotonergic Activity in the Dorsolateral Prefrontal Cortices - A Possible Cause of Disabling Mood Symptoms

Functional and structural neuroimaging in premenstrual dysphoric disorder: A systematic review

This systematic review aimed to summarize the most recent data on changes in brain structure and function in premenstrual dysphoric disorder (PMDD) as well as elucidate the possible correlations between these findings and symptom severity. Articles published in PubMed, EMBASE, ScienceDirect, PsycInfo, Web of Science, and Scopus from inception until April 2023 were systematically reviewed according to the PICO framework: population (women with PMDD), intervention (neuroimaging study), control (healthy subjects), and outcome (neuroimaging changes). In total, 1026 individuals were included from controlled (n = 22) and non-controlled (n = 2) trials. Among them, 608 had PMDD, and 418 were healthy controls. Different neuroimaging methods were addressed, such as task-based functional magnetic resonance imaging (MRI), resting-state functional MRI, proton magnetic resonance spectroscopy, diffusion tensor imaging, proton emission tomography, and structural MRI. Despite the absence of consensual results, several brain structures have been implicated in PMDD, including the prefrontal cortex, amygdala, hippocampus, insula, basal ganglia, and cerebellum. In addition, some brain changes are related to the intensity of symptoms and phases of the menstrual cycle, such as the correlation between depressive symptoms and increased serotonin transporter binding potential in the midbrain during the luteal phase.

The historical progression of positron emission tomography research in neuroendocrinology

The rapid and continual development of a number of radiopharmaceuticals targeting different receptor, enzyme and small molecule systems has fostered Positron Emission Tomography (PET) imaging of endocrine system actions in vivo in the human brain for several decades. PET radioligands have been developed to measure changes that are regulated by hormone action (e.g., glucose metabolism, cerebral blood flow, dopamine receptors) and actions within endocrine organs or glands such as steroids (e.g., glucocorticoids receptors), hormones (e.g., estrogen, insulin), and enzymes (e.g., aromatase). This systematic review is targeted to the neuroendocrinology community that may be interested in learning about positron emission tomography (PET) imaging for use in their research. Covering neuroendocrine PET research over the past half century, researchers and clinicians will be able to answer the question of where future research may benefit from the strengths of PET imaging.

Radiosynthesis, Preclinical, and Clinical Positron Emission Tomography Studies of Carbon-11 Labeled Endogenous and Natural Exogenous Compounds

The presence of positron emission tomography (PET) centers at most major hospitals worldwide, along with the improvement of PET scanner sensitivity and the introduction of total body PET systems, has increased the interest in the PET tracer development using the short-lived radionuclides carbon-11. In the last few decades, methodological improvements and fully automated modules have allowed the development of carbon-11 tracers for clinical use. Radiolabeling natural compounds with carbon-11 by substituting one of the backbone carbons with the radionuclide has provided important information on the biochemistry of the authentic compounds and increased the understanding of their in vivo behavior in healthy and diseased states. The number of endogenous and natural compounds essential for human life is staggering, ranging from simple alcohols to vitamins and peptides. This review collates all the carbon-11 radiolabeled endogenous and natural exogenous compounds synthesised to date, including essential information on their radiochemistry methodologies and preclinical and clinical studies in healthy subjects.

Leptin, ghrelin, & insulin levels and food intake in premenstrual syndrome: A case-control study

OBJECTIVES

The objective of this study was to evaluate the relationship between food intake and serum levels of leptin and ghrelin in the luteal (LP) and follicular (FP) phases of the MC (menstrual cycle) in participants with and without PMS (premenstrual syndrome).

METHODS

This was a case-control study with healthy participants aged 20-45 years with regular menstrual cycles (24-35 days) with and without PMS. After the Daily Record of Severity of Problems (DRSP) was filled out for two months (PMS diagnosis), a nutritional assessment was carried out based on twelve food intake records (for two menstrual cycles) to quantify food intake.

RESULTS

Of the 69 participants analyzed, 35 experienced PMS and 34 did not experience PMS. For participants with PMS, calorie and carbohydrate intake was higher during LP than in FP (p = 0.004 and p = 0.003, respectively), whereas these changes were not observed in participants without PMS (p > 0.05). There were interactions between the groups and the MC phases (LP and FP) for the intake of calories (p = 0.028) and carbohydrates (p = 0.001). There was a marginal negative relationship between the levels of ghrelin and calorie intake in FP (rS = -0.314, p = 0.066) in the PMS group and a negative relationship between the levels of ghrelin and leptin in LP (rS = -0.490, p = 0.004) in the group without PMS.

CONCLUSIONS

These results indicated a higher calorie and carbohydrate intake during LP in participants with PMS, in addition to the hypothesis that the roles of ghrelin and leptin in energy regulation may be different in participants with PMS compared to those without PMS.

Variation in genes and hormones of the hypothalamic-pituitary-ovarian axis in female mood disorders - A systematic review and meta-analysis

Women's increased risk for depression during reproductive transitions suggests an involvement of the hypothalamic-pituitary-ovarian (HPO) axis. This is the first systematic review and meta-analysis of HPO functioning in female mood disorders. Inclusionary criteria were: i) women suffering from premenstrual dysphoric disorder (PMDD) or a depressive disorder, ii) assessment of HPO-axis related biomarkers, iii) a case-control design. Sixty-three studies (N = 5,129) were included. There was evidence for PMDD to be paralleled by lower luteal oestradiol levels. Women with depression unrelated to reproductive transition showed lower testosterone levels than healthy controls and there was some evidence for lower dehydroepiandrosterone sulfate levels. There were no differences in HPO-related parameters between women with pregnancy, postpartum, and perimenopausal depression and controls. Women with PMDD and depression unrelated to reproductive transitions exhibit specific changes in the HPO-axis, which potentially contribute to their symptoms. Further research into reproductive mood disorders characterised by extreme endocrine changes is warranted.

Views of Dutch general practitioners about premenstrual symptoms: A qualitative interview study

Background

General practitioners (GPs) encounter women suffering from premenstrual symptoms. Often women with premenstrual problems experience little understanding from GPs. Views of GPs will influence their approach to these women and their care. Insight into these views is lacking but could help in designing educational programmes for GPs.

Objectives

To explore the views of Dutch GPs towards aetiology, diagnostic process, and preferred treatment of premenstrual symptoms.

Methods

In 2017, we conducted a qualitative, semi-structured, interview survey among 27 GPs, varying in age, gender, and practice setting.

Results

Important themes emerged from the interviews: ‘no need for a symptom diary,’ ‘PMS defined as illness’ exclusively in case of disruption of normal functioning, and ‘symptomatic treatment’ as preferred approach. Most GPs considered PMS to be a physiological phenomenon, with taking history as an adequate diagnostic tool. Almost all GPs regarded a normal cyclical hormonal cycle as causal; many also mentioned the combination with personal sensitivity. Some pointed to a dividing line between physiological condition and illness if women could not function normally in daily life. Lastly, the approach GPs preferred was focussing on relieving symptoms of individual patients. In addition to explaining the hormonal cycle and lifestyle advice, all GPs advocated oral contraceptives, and if necessary psychological support. GPs expressed negative feelings about prescribing antidepressants.

Conclusion

GPs considered physiological changes and personal sensitivity as aetiological factors. We recommend more training to improve GPs knowledge and more insight into the burden of women with PMS. A symptom diary is an essential diagnostic tool for GPs.

Magnitude of premenstrual dysphoric disorder and its correlation with academic performance among female medical and health science students at University of Gondar, Ethiopia, 2019: a cross-sectional study

OBJECTIVE

To assess the magnitude of premenstrual dysphoric disorder (PMDD) and associated factors among female students of the College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia, 2019.

DESIGN

Institution-based cross-sectional study design.

SETTING

College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia.

PARTICIPANTS

386 participants were recruited for self-administered interview using the stratified followed by simple random sampling technique.

MEASUREMENT

Data were collected by self-administered interview. Diagnostic and Statistical Manual of Mental Disorders, fifth edition (DSM-5) was used to measure PMDD. The Perceived Stress Scale (PSS) and the Oslo-3 social support are used to assess the factors. The data were checked, cleaned and entered into EpiData V.3.1 and exported to Statistical Package for Social Science (SPSS) V.21.0 for analysis. Bivariate and multivariable binary logistic regressions were used. OR with 95% CI was employed to see the strength of associations between dependent and independent variables. Variables with a p value <0.05 in multivariable logistic regression were declared as significantly associated.

RESULT

386 participants were involved in the study, with a response rate of 84.6%. The overall magnitude of PMDD in this study was 34.7% (30.3 to 39.1). Severe menstrual pain (adjusted OR (AOR)=2.82, 95% CI: 1.83 to 4.23), perception of an impact on academic performance due to menstrual pain (AOR=2.31, 95% CI: 1.23 to 4.32), and high perceived stress (AOR=3.52, 95% CI: 2.58 to 5.60) were significantly associated with PMDD disorder among female medical and health sciences students.

CONCLUSION

PMDD is high among female medical and health sciences students. Thus, it needs early screening and intervention especially for those who have severe menstrual pain, perceived to have an impact on academic performance and high perceived stress.

A new oxidative stress indicator: Effect of 5-hydroxytryptophan on thiol-disulfide homeostasis in exercise

OBJECTIVES

The aim of the present study was to evaluate the relationship between exercise and both 5-hydroxytryptophan and oxidative stress using thiol-disulfide homeostasis via what is likely a novel biomarker.

METHODS

Male albino Wistar rats (n = 32) were randomly divided into four groups as follows: control, exercise group, 5-hydroxytryptophan group (5H), and 5-HTP + exercise group (5Hex). Exercise and 5-HTP administration (25mg/kg per d) were performed 5d/wk for 10 wk. After completion of the experimental protocol, to determine oxidative stress parameters, serum total thiol and native thiol concentrations were measured. Dynamic disulfide status, reduced thiol, oxidized thiol (OT), and thiol oxidation reduction percentage ratios were compared between the groups. The methods used in the present study to measure dynamic thiol-disulfide homeostasis as calorimetric and duplex quantities were developed in 2014. These new methods are simple, reliable, and sensitive, with both high linearity and repeatability.

RESULTS

Compared with the control group, serum dynamic disulfide levels were significantly lower in the 5H group and highest in the control group. The lowest OT and the highest reduced thiol rates were determined to be in the 5H group. The highest OT value was found in the 5Hex group. Thiol oxidation reduction values were found to be highest in the 5H group and lowest in the 5Hex group.

CONCLUSIONS

Both 5-HTP and moderate exercise seem to be significantly effective in inhibiting oxidative damage. In addition, the new oxidative stress measurement method used in this study is a promising practical and useful method to evaluate and improve the performance of athletes.

Sex steroid hormones and brain function: PET imaging as a tool for research

Sex steroid hormones are major regulators of sexual characteristic among species. These hormones, however, are also produced in the brain. Steroidal hormone-mediated signalling via the corresponding hormone receptors can influence brain function at the cellular level and thus affect behaviour and higher brain functions. Altered steroid hormone signalling has been associated with psychiatric disorders, such as anxiety and depression. Neurosteroids are also considered to have a neuroprotective effect in neurodegenerative diseases. So far, the role of steroid hormone receptors in physiological and pathological conditions has mainly been investigated post mortem on animal or human brain tissues. To study the dynamic interplay between sex steroids, their receptors, brain function and behaviour in psychiatric and neurological disorders in a longitudinal manner, however, non-invasive techniques are needed. Positron emission tomography (PET) is a non-invasive imaging tool that is used to quantitatively investigate a variety of physiological and biochemical parameters in vivo. PET uses radiotracers aimed at a specific target (eg, receptor, enzyme, transporter) to visualise the processes of interest. In this review, we discuss the current status of the use of PET imaging for studying sex steroid hormones in the brain. So far, PET has mainly been investigated as a tool to measure (changes in) sex hormone receptor expression in the brain, to measure a key enzyme in the steroid synthesis pathway (aromatase) and to evaluate the effects of hormonal treatment by imaging specific downstream processes in the brain. Although validated radiotracers for a number of targets are still warranted, PET can already be a useful technique for steroid hormone research and facilitate the translation of interesting findings in animal studies to clinical trials in patients.