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Tonon AC, Ramos-Lima LF, Kuhathasan N, Frey BN. Early Life Trauma, Emotion Dysregulation and Hormonal Sensitivity Across Female Reproductive Life Events. Curr Psychiatry Rep 2024; 26:530-542. [PMID: 39187611 DOI: 10.1007/s11920-024-01527-y] [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] [Accepted: 08/14/2024] [Indexed: 08/28/2024]
Abstract
PURPOSE OF REVIEW To explore the relationship between early life trauma, hormonal sensitivity, and psychiatric disorders across female-reproductive life events, with a focus on the neurobiological mechanisms. RECENT FINDINGS Childhood trauma significantly increases the risk of subsequent mood disorders during periods of intense hormonal fluctuation such as premenstrual, pregnancy, postpartum, and perimenopause. Neurobiological changes resulting from early trauma influence emotion regulation, which emerges as a key predisposing, exacerbating, and perpetuating factor to hormonal sensitivity and subsequent psychiatric symptoms. We identified altered stress response and allopregnanolone imbalance, bias in cognitive processing of emotions, neuroimage correlates and sleep disturbances as potential underlying neurobiological mechanisms. This review integrates cumulative findings supporting a theoretical framework linking early life trauma to hormonal sensitivity and mood disorders. We propose that some women might be more susceptible to such hormonal fluctuations because of emotion dysregulation following significant early life trauma.
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Affiliation(s)
- André C Tonon
- Mood Disorders Program and Women's Health Concerns Clinic, St. Joseph's Healthcare Hamilton, 100 West 5th Street, Hamilton, ON, L8N 3K7, Canada
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, 100 West 5th Street, Hamilton, ON, L8N 3K7, Canada
| | - Luis Francisco Ramos-Lima
- Mood Disorders Program and Women's Health Concerns Clinic, St. Joseph's Healthcare Hamilton, 100 West 5th Street, Hamilton, ON, L8N 3K7, Canada
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, 100 West 5th Street, Hamilton, ON, L8N 3K7, Canada
| | - Nirushi Kuhathasan
- Mood Disorders Program and Women's Health Concerns Clinic, St. Joseph's Healthcare Hamilton, 100 West 5th Street, Hamilton, ON, L8N 3K7, Canada
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, 100 West 5th Street, Hamilton, ON, L8N 3K7, Canada
| | - Benicio N Frey
- Mood Disorders Program and Women's Health Concerns Clinic, St. Joseph's Healthcare Hamilton, 100 West 5th Street, Hamilton, ON, L8N 3K7, Canada.
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, 100 West 5th Street, Hamilton, ON, L8N 3K7, Canada.
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Dubol M, Stiernman L, Sundström-Poromaa I, Bixo M, Comasco E. Cortical morphology variations during the menstrual cycle in individuals with and without premenstrual dysphoric disorder. J Affect Disord 2024; 355:470-477. [PMID: 38552916 DOI: 10.1016/j.jad.2024.03.130] [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: 10/24/2023] [Revised: 02/16/2024] [Accepted: 03/23/2024] [Indexed: 04/09/2024]
Abstract
BACKGROUND Premenstrual dysphoric disorder (PMDD) is hypothesized to stem from maladaptive neural sensitivity to ovarian steroid hormone fluctuations. Recently, we found thinner cortices in individuals with PMDD, compared to healthy controls, during the symptomatic phase. Here, we aimed at investigating whether such differences illustrate state-like characteristics specific to the symptomatic phase, or trait-like features defining PMDD. METHODS Patients and controls were scanned using structural magnetic resonance imaging during the mid-follicular and late-luteal phase of the menstrual cycle. Group-by-phase interaction effects on cortical architecture metrics (cortical thickness, gyrification index, cortical complexity, and sulcal depth) were assessed using surface-based morphometry. RESULTS Independently of menstrual cycle phase, a main effect of diagnostic group on surface metrics was found, primarily illustrating thinner cortices (0.3 < Cohen's d > 1.1) and lower gyrification indices (0.4 < Cohen's d > 1.0) in patients compared to controls. Furthermore, menstrual cycle-specific effects were detected across all participants, depicting a decrease in cortical thickness (0.4 < Cohen's d > 1.7) and region-dependent changes in cortical folding metrics (0.4 < Cohen's d > 2.2) from the mid-follicular to the late luteal phase. LIMITATIONS Small effects (d = 0.3) require a larger sample size to be accurately characterized. CONCLUSIONS These findings provide initial evidence of trait-like cortical characteristics of the brain of individuals with premenstrual dysphoric disorder, together with indications of menstrual cycle-related variations in cortical architecture in patients and controls. Further investigations exploring whether these differences constitute stable vulnerability markers or develop over the years may help understand PMDD etiology.
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Affiliation(s)
- Manon Dubol
- Department of Women's and Children's Health, Science for Life Laboratory, Uppsala University, Sweden
| | | | | | - Marie Bixo
- Department of Clinical Sciences, Umeå University, Sweden
| | - Erika Comasco
- Department of Women's and Children's Health, Science for Life Laboratory, Uppsala University, Sweden.
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Kaltsouni E, Schmidt F, Zsido RG, Eriksson A, Sacher J, Sundström-Poromaa I, Sumner RL, Comasco E. Electroencephalography findings in menstrually-related mood disorders: A critical review. Front Neuroendocrinol 2024; 72:101120. [PMID: 38176542 DOI: 10.1016/j.yfrne.2023.101120] [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: 05/09/2023] [Revised: 12/21/2023] [Accepted: 12/31/2023] [Indexed: 01/06/2024]
Abstract
The female reproductive years are characterized by fluctuations in ovarian hormones across the menstrual cycle, which have the potential to modulate neurophysiological and behavioral dynamics. Menstrually-related mood disorders (MRMDs) comprise cognitive-affective or somatic symptoms that are thought to be triggered by the rapid fluctuations in ovarian hormones in the luteal phase of the menstrual cycle. MRMDs include premenstrual syndrome (PMS), premenstrual dysphoric disorder (PMDD), and premenstrual exacerbation (PME) of other psychiatric disorders. Electroencephalography (EEG) non-invasively records in vivo synchronous activity from populations of neurons with high temporal resolution. The present overview sought to systematically review the current state of task-related and resting-state EEG investigations on MRMDs. Preliminary evidence indicates lower alpha asymmetry at rest being associated with MRMDs, while one study points to the effect being luteal-phase specific. Moreover, higher luteal spontaneous frontal brain activity (slow/fast wave ratio as measured by the delta/beta power ratio) has been observed in persons with MRMDs, while sleep architecture results point to potential circadian rhythm disturbances. In this review, we discuss the quality of study designs as well as future perspectives and challenges of supplementing the diagnostic and scientific toolbox for MRMDs with EEG.
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Affiliation(s)
- Elisavet Kaltsouni
- Department of Womeńs and Childreńs Health, Science for Life Laboratory, Uppsala University, Sweden
| | - Felix Schmidt
- Department of Womeńs and Childreńs Health, Science for Life Laboratory, Uppsala University, Sweden; Centre for Women's Mental Health during the Reproductive Lifespan, Uppsala University, 751 85 Uppsala, Sweden
| | - Rachel G Zsido
- Cognitive Neuroendocrinology, Max Planck Institute for Human Cognitive and Brain Sciences, Germany; Department of Psychiatry, Clinical Neuroscience Laboratory for Sex Differences in the Brain, Massachusetts General Hospital, Harvard Medical School, USA
| | - Allison Eriksson
- Centre for Women's Mental Health during the Reproductive Lifespan, Uppsala University, 751 85 Uppsala, Sweden; Department of Womeńs and Childreńs Health, Uppsala University, Sweden
| | - Julia Sacher
- Cognitive Neuroendocrinology, Max Planck Institute for Human Cognitive and Brain Sciences, Germany; Clinic of Cognitive Neurology, University of Leipzig, Germany
| | | | | | - Erika Comasco
- Department of Womeńs and Childreńs Health, Science for Life Laboratory, Uppsala University, Sweden.
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Okuma K, Kono K, Otaka M, Ebara A, Odachi A, Tokuno H, Masuyama H. Characteristics of the Gut Microbiota in Japanese Patients with Premenstrual Syndrome. Int J Womens Health 2022; 14:1435-1445. [PMID: 36199913 PMCID: PMC9529230 DOI: 10.2147/ijwh.s377066] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2022] [Accepted: 09/08/2022] [Indexed: 11/23/2022] Open
Abstract
Purpose The present study aimed to characterize the gut microbiota of individuals with premenstrual syndrome. Patients and Methods The gut microbiota of 24 Japanese women with PMS (PMS group) and 144 healthy Japanese women (control group) were compared. Analysis of the α- and β-diversities and the gut microbial composition at the genus level were performed using 16S rRNA gene sequence data obtained from stool samples. Results A significant difference in age was observed between the PMS and control groups; however, no significant difference was observed in BMI. The α-diversity measured using the Simpson index was significantly higher in the PMS group than the control group. Visualization of the β-diversity using non-metric multidimensional scaling and permutational multivariate analysis of variance (PERMANOVA) showed that the distance of the gut microbiota between the PMS and control groups is significantly different. Furthermore, a significant difference in the composition of the gut microbiota was observed between the PMS and control groups. At the genus level, the abundances of Collinsella, Bifidobacterium, and Blautia were significantly higher in the PMS group than in the control group. In particular, the abundance of Collinsella in the PMS group was approximately 4.5 times higher than that in the control group. To rule out the confounding effect of age in the abundances of Bifidobacterium, Blautia, and Collinsella, the gut microbiota of the PMS and control groups were compared by age group. Results showed that Collinsella had the highest effect size in participants of 30–40 years of age (mean age: 36.39 ± 4.68 years). Conclusion These results suggest that the PMS group possesses a characteristic gut microbiota. In particular, Collinsella was strongly associated with PMS. Since Collinsella has been reported to be associated with diet, dietary interventions such as prebiotics targeting Collinsella may be effective in preventing, improving, and alleviating PMS.
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Affiliation(s)
- Kana Okuma
- Research and Development Division, Symbiosis Solutions Inc, Chiyoda-ku, Tokyo, 101-0064, Japan
| | - Kanako Kono
- Research and Development Division, Symbiosis Solutions Inc, Chiyoda-ku, Tokyo, 101-0064, Japan
| | - Machiko Otaka
- Research and Development Division, Symbiosis Solutions Inc, Chiyoda-ku, Tokyo, 101-0064, Japan
| | - Aya Ebara
- Research and Development Division, Symbiosis Solutions Inc, Chiyoda-ku, Tokyo, 101-0064, Japan
| | - Ayano Odachi
- Research and Development Division, Symbiosis Solutions Inc, Chiyoda-ku, Tokyo, 101-0064, Japan
| | - Hidetaka Tokuno
- Research and Development Division, Symbiosis Solutions Inc, Chiyoda-ku, Tokyo, 101-0064, Japan
| | - Hiroaki Masuyama
- Research and Development Division, Symbiosis Solutions Inc, Chiyoda-ku, Tokyo, 101-0064, Japan
- Correspondence: Hiroaki Masuyama, Research and Development Division, Symbiosis Solutions Inc, 3F, VORT Suidobashi III Bldg, 2-8-11 Kandasarugakucho, Chiyoda-ku, Tokyo, 101-0064, Japan, Tel +81-3-6275-0878, Fax +81-3-6275-0879, Email
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