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Rawee P, Rosmalen JGM, Kalverdijk L, Burke SM. Development of Gender Non-Contentedness During Adolescence and Early Adulthood. Arch Sex Behav 2024:10.1007/s10508-024-02817-5. [PMID: 38413534 DOI: 10.1007/s10508-024-02817-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/28/2023] [Revised: 01/19/2024] [Accepted: 01/20/2024] [Indexed: 02/29/2024]
Abstract
Adolescence is an important period for the development of gender identity. We studied the development of gender non-contentedness, i.e., unhappiness with being the gender aligned with one's sex, from early adolescence to young adulthood, and its association with self-concept, behavioral and emotional problems, and adult sexual orientation. Participants were 2772 adolescents (53% male) from the Tracking Adolescents' Individual Lives Survey population and clinical cohort. Data from six waves were included (ages 11-26). Gender non-contentedness was assessed with the item "I wish to be of the opposite sex" from the Youth and Adult Self-Report at all six waves. Behavioral and emotional problems were measured by total scores of these scales at all six waves. Self-concept was assessed at age 11 using the Global Self-Worth and Physical Appearance subscales of the Self-Perception Profile for Children. Sexual orientation was assessed at age 22 by self-report. In early adolescence, 11% of participants reported gender non-contentedness. The prevalence decreased with age and was 4% at the last follow-up (around age 26). Three developmental trajectories of gender non-contentedness were identified: no gender non-contentedness (78%), decreasing gender non-contentedness (19%), and increasing gender non-contentedness (2%). Individuals with an increasing gender non-contentedness more often were female and both an increasing and decreasing trajectory were associated with a lower global self-worth, more behavioral and emotional problems, and a non-heterosexual sexual orientation. Gender non-contentedness, while being relatively common during early adolescence, in general decreases with age and appears to be associated with a poorer self-concept and mental health throughout development.
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Affiliation(s)
- Pien Rawee
- Department of Internal Medicine, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Judith G M Rosmalen
- Department of Internal Medicine, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
- Interdisciplinary Center for Psychopathology and Emotion Regulation, Department of Psychiatry, University Medical Center Groningen, University of Groningen, Hanzeplein 1, 9713 GZ, Groningen, The Netherlands
| | - Luuk Kalverdijk
- Interdisciplinary Center for Psychopathology and Emotion Regulation, Department of Psychiatry, University Medical Center Groningen, University of Groningen, Hanzeplein 1, 9713 GZ, Groningen, The Netherlands
| | - Sarah M Burke
- Interdisciplinary Center for Psychopathology and Emotion Regulation, Department of Psychiatry, University Medical Center Groningen, University of Groningen, Hanzeplein 1, 9713 GZ, Groningen, The Netherlands.
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Hogendoorn E, Ballering AV, van Dijk MWG, Rosmalen JGM, Burke SM. Discordance between Adolescents and Parents in Functional Somatic Symptom Reports: Sex Differences and Future Symptom Prevalence. J Youth Adolesc 2023; 52:2182-2195. [PMID: 37354312 PMCID: PMC10371884 DOI: 10.1007/s10964-023-01810-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2023] [Accepted: 06/07/2023] [Indexed: 06/26/2023]
Abstract
Functional somatic symptoms, i.e., physical complaints that cannot be sufficiently explained by an objectifiable biomedical abnormality, become increasingly more prevalent in girls than in boys during adolescence. Both parents and adolescents report more functional somatic symptoms in girls, but their reports correspond only limitedly. It remains unknown whether parent-adolescent discordance contributes to the higher symptom prevalence in girls. This study investigated parent-adolescent discordance in reported functional somatic symptoms throughout adolescence, examined the longitudinal association of parent-adolescent discordance with symptom prevalence in early adulthood and focused on sex differences in these processes. Participants included 2229 adolescents (50.7% female) from four assessments (age 11 to 22 years) of the TRAILS population cohort. Parents and adolescents reported significantly more symptoms in girls than in boys during adolescence. Variance analyses showed that throughout adolescence, parents reported fewer symptoms than girls self-reported and more than boys self-reported. Regression analyses using standardized difference scores showed that lower parent-report than self-report was positively associated with symptom prevalence in early adulthood. Polynomial regression analyses revealed no significant interaction between parent-reported and adolescent self-reported symptoms. Associations did not differ between boys and girls. The findings show that lower parent-reported than self-reported symptoms predict future symptom prevalence in both sexes, but this discordance was more observed in girls. The higher functional somatic symptom prevalence in girls might be partly explained by parental underestimation of symptoms.
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Affiliation(s)
- Elske Hogendoorn
- University of Groningen, University Medical Center Groningen, Department of Psychiatry, Groningen, The Netherlands.
| | - Aranka V Ballering
- University of Groningen, University Medical Center Groningen, Department of Psychiatry, Groningen, The Netherlands
| | - Marijn W G van Dijk
- University of Groningen, Department of Developmental Psychology, Heymans Institute for Psychological Research, Groningen, The Netherlands
| | - Judith G M Rosmalen
- University of Groningen, University Medical Center Groningen, Department of Psychiatry, Groningen, The Netherlands
- University of Groningen, University Medical Center Groningen, Department of Internal Medicine, Groningen, The Netherlands
| | - Sarah M Burke
- University of Groningen, University Medical Center Groningen, Department of Psychiatry, Groningen, The Netherlands
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Lin LH, Ghasemi M, Burke SM, Mavis CK, Nichols JR, Torka P, Mager DE, Hernandez-Ilizaliturri FJ, Goey AKL. Population Pharmacokinetics and Pharmacodynamics of Carfilzomib in Combination with Rituximab, Ifosfamide, Carboplatin, and Etoposide in Adult Patients with Relapsed/Refractory Diffuse Large B Cell Lymphoma. Target Oncol 2023; 18:685-695. [PMID: 37632592 PMCID: PMC10803178 DOI: 10.1007/s11523-023-00992-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/12/2023] [Indexed: 08/28/2023]
Abstract
BACKGROUND In patients with relapsed/refractory (R/R) diffuse large B-cell lymphoma (DLBCL), salvage chemotherapy regimens (e.g., rituximab, ifosfamide, carboplatin, and etoposide, R-ICE) yield poor outcomes. Carfilzomib, an irreversible proteasome inhibitor, can overcome acquired rituximab-chemotherapy resistance and, when combined with R-ICE, improves outcomes in patients with R/R DLBCL. OBJECTIVE This analysis aimed to develop a population pharmacokinetic/pharmacodynamic (PK/PD) model for carfilzomib in R/R DLBCL patients. PATIENTS AND METHODS In a single-center, open-label, prospective phase 1 study, patients received carfilzomib (10, 15, or 20 mg/m2) on days 1, 2, 8, and 9, and standard doses of R-ICE on days 3-6 every 21 days (maximum of three cycles). Carfilzomib plasma concentrations up to 24 h postinfusion were measured by liquid chromatography coupled with tandem mass spectrometry. Proteasome activity (PD biomarker) in peripheral blood mononuclear cells was assessed on days 1-2 with sparse sampling. PK/PD models were developed using NONMEM v7.4.1 interfaced with Finch Studio v1.1.0 and PsN v4.7.0. Model selection was guided by objective function value, goodness-of-fit, and visual predictive checks. Stepwise covariate modeling was used for covariate selection. RESULTS Twenty-eight patients were enrolled in the PK/PD analysis, from whom 217 PK samples and 127 PD samples were included. Carfilzomib PK was best described by a two-compartment model with linear disposition (typical total clearance of 133 L/h). Proteasome activity was best characterized using a turnover model with irreversible inactivation. All parameters were estimated with good precision. No statistically significant covariates were identified. CONCLUSIONS A validated population-based PK/PD model of carfilzomib was developed successfully. Further research is needed to identify sources of variability in response to treatment with carfilzomib in combination with R-ICE. CLINICAL TRIAL REGISTRATION ClinicalTrials.gov identifier number NCT01959698.
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Affiliation(s)
- Lan-Hsi Lin
- Department of Pharmaceutical Sciences, School of Pharmacy and Pharmaceutical Sciences, University at Buffalo, Buffalo, NY, USA
- Bioanalytics, Metabolomics, and Pharmacokinetics Shared Resource, Roswell Park Comprehensive Cancer Center, Buffalo, NY, USA
| | - Mohammad Ghasemi
- Bioanalytics, Metabolomics, and Pharmacokinetics Shared Resource, Roswell Park Comprehensive Cancer Center, Buffalo, NY, USA
- Department of Pharmacology and Therapeutics, Roswell Park Comprehensive Cancer Center, Buffalo, NY, USA
| | - Sarah M Burke
- Bioanalytics, Metabolomics, and Pharmacokinetics Shared Resource, Roswell Park Comprehensive Cancer Center, Buffalo, NY, USA
| | - Cory K Mavis
- Department of Medicine-Lymphoma, Roswell Park Comprehensive Cancer Center, Buffalo, NY, USA
| | - Jenna R Nichols
- Clinical Research Services, Roswell Park Comprehensive Cancer Center, Buffalo, NY, USA
| | - Pallawi Torka
- Department of Medicine-Lymphoma, Roswell Park Comprehensive Cancer Center, Buffalo, NY, USA
| | - Donald E Mager
- Department of Pharmaceutical Sciences, School of Pharmacy and Pharmaceutical Sciences, University at Buffalo, Buffalo, NY, USA
| | | | - Andrew K L Goey
- Bioanalytics, Metabolomics, and Pharmacokinetics Shared Resource, Roswell Park Comprehensive Cancer Center, Buffalo, NY, USA.
- Department of Pharmacology and Therapeutics, Roswell Park Comprehensive Cancer Center, Buffalo, NY, USA.
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Hogendoorn E, Hartman CA, Burke SM, van Dijk MWG, Rosmalen JGM. Longitudinal relations between autistic-like features and functional somatic symptoms in adolescence. Autism 2023; 27:1690-1701. [PMID: 36588286 PMCID: PMC10375000 DOI: 10.1177/13623613221143874] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
Abstract Autistic-like features and functional somatic symptoms (FSS) frequently co-occur. It remains unknown how autistic-like features and FSS affect each other and develop throughout adolescence. This study examined reciprocal relations between autistic-like features and FSS in adolescence. Participants were 2772 adolescents (52.5% male) from the Tracking Adolescents’ Individual Lives Survey population and clinical cohort. Data from four waves were included, covering the ages between 11 and 19 years. Autistic-like features were measured using the Children’s Social Behavior Questionnaire. FSS were assessed using the Youth Self Report and Adult Self Report, respectively. Using the random intercept cross-lagged panel model, a stable positive, moderately strong between-persons association was found between autistic-like features and FSS. No within-persons reciprocal effects from wave to wave were observed. Secondary analyses revealed a consistent relation with FSS for three different domains of autistic-like features (social and communication behaviors, repetitive behaviors, and self-regulatory behaviors), and highly similar interrelations in a subsample of adolescents with a clinical autism spectrum disorder diagnosis. In conclusion, the co-occurrence between autistic-like features and FSS is stable throughout adolescence. Clinicians working with adolescents with autistic-like features should be alert to the presence FSS, and vice versa.
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Burke SM, Kamal M, Goey AKL. Development and Validation of a Quantitative LC-MS/MS Method for CDK4/6 Inhibitors Palbociclib, Ribociclib, Abemaciclib, and Abemaciclib-M2 in Human Plasma. Ther Drug Monit 2023; 45:327-336. [PMID: 36728357 PMCID: PMC10175095 DOI: 10.1097/ftd.0000000000001063] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2022] [Accepted: 10/23/2022] [Indexed: 02/03/2023]
Abstract
BACKGROUND The cyclin-dependent kinase 4 and 6 (CDK4/6) inhibitors, palbociclib, ribociclib, and abemaciclib, are standard-of-care agents for patients with hormone receptor-positive human epidermal growth factor receptor 2-negative metastatic breast cancer. In support of therapeutic drug monitoring and clinical pharmacokinetic studies, a liquid chromatography coupled with tandem mass spectrometry assay for the simultaneous quantitation of CDK4/6 inhibitors and the major active metabolite M2 of abemaciclib in human plasma has been developed. METHODS Analytes were extracted from 50 μL of human plasma by precipitating proteins with methanol and then collecting the supernatant. Reversed-phase high-performance liquid chromatography was performed for analyte separation using a biphasic gradient at a flow rate of 0.25-0.5 mL/min. The total run time was 9.5 minutes. The analytes were detected using MS/MS with electrospray ionization operating in positive ion mode. RESULTS Validation according to the US Food and Drug Administration's guidance showed that the new assay produced accurate (94.7%-107%) and precise (within-run: 1.2%-8.2%; between-run: 0.6%-7.5%) measurements of all analytes over a concentration range of 5-2000 ng/mL. Overall, analyte recoveries were consistent (mean values: 110%-129%). The analytes were also stable in human plasma and the final extract under various storage conditions. Finally, the clinical applicability of the assay was confirmed by quantitation of all analytes in plasma samples obtained from patients treated with CDK4/6 inhibitors. Reproducibility of the measured analyte concentrations in study samples was confirmed successfully by incurred sample reanalysis. CONCLUSIONS A sensitive liquid chromatography coupled with tandem mass spectrometry method to measure CDK4/6 inhibitors was developed and validated according to the Food and Drug Administration criteria. Quantitation of all analytes in clinical plasma samples confirmed that the assay is suitable for therapeutic drug monitoring and clinical pharmacokinetic studies of CDK4/6 inhibitors.
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Affiliation(s)
- Sarah M Burke
- Bioanalytics, Metabolomics, and Pharmacokinetics Shared Resource, Roswell Park Comprehensive Cancer Center, Buffalo, New York
| | - Mustafa Kamal
- Bioanalytics, Metabolomics, and Pharmacokinetics Shared Resource, Roswell Park Comprehensive Cancer Center, Buffalo, New York
| | - Andrew K L Goey
- Bioanalytics, Metabolomics, and Pharmacokinetics Shared Resource, Roswell Park Comprehensive Cancer Center, Buffalo, New York
- Department of Pharmacology and Therapeutics, Roswell Park Comprehensive Cancer Center, Buffalo, New York
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van Heesewijk J, Steenwijk MD, Kreukels BPC, Veltman DJ, Bakker J, Burke SM. Alterations in the inferior fronto-occipital fasciculus - a specific neural correlate of gender incongruence? Psychol Med 2023; 53:3461-3470. [PMID: 35301969 PMCID: PMC10277722 DOI: 10.1017/s0033291721005547] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/18/2021] [Revised: 11/06/2021] [Accepted: 12/28/2021] [Indexed: 11/05/2022]
Abstract
BACKGROUND Increasing numbers of adolescents seek help for gender-identity questions. Consequently, requests for medical treatments, such as puberty suppression, are growing. However, studies investigating the neurobiological substrate of gender incongruence (when birth-assigned sex and gender identity do not align) are scarce, and knowledge about the effects of puberty suppression on the developing brain of transgender youth is limited. METHODS Here we cross-sectionally investigated sex and gender differences in regional fractional anisotropy (FA) as measured by diffusion MR imaging, and the impact of puberty on alterations in the white-matter organization of 35 treatment-naive prepubertal children and 41 adolescents with gender incongruence, receiving puberty suppression. The transgender groups were compared with 79 age-matched, treatment-naive cisgender (when sex and gender align) peers. RESULTS We found that transgender adolescents had lower FA in the bilateral inferior fronto-occipital fasciculus (IFOF), forceps major and corpus callosum than cisgender peers. In addition, average FA values of the right IFOF correlated negatively with adolescents' cumulative dosage of puberty suppressants received. Of note, prepubertal children also showed significant FA group differences in, again, the right IFOF and left cortico-spinal tract, but with the reverse pattern (transgender > cisgender) than was seen in adolescents. CONCLUSIONS Importantly, our results of lower FA (indexing less longitudinal organization, fiber coherence, and myelination) in the IFOF of gender-incongruent adolescents replicate prior findings in transgender adults, suggesting a salient neural correlate of gender incongruence. Findings highlight the complexity with which (pubertal) sex hormones impact white-matter development and add important insight into the neurobiological substrate associated with gender incongruence.
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Affiliation(s)
- Jason van Heesewijk
- Center of Expertise on Gender Dysphoria, Amsterdam University Medical Centers, location VUmc, De Boelelaan 1131, Amsterdam, Noord-Holland, Netherlands
| | - Martijn D. Steenwijk
- Center of Expertise on Gender Dysphoria, Amsterdam University Medical Centers, location VUmc, De Boelelaan 1131, Amsterdam, Noord-Holland, Netherlands
| | - Baudewijntje P. C. Kreukels
- Center of Expertise on Gender Dysphoria, Amsterdam University Medical Centers, location VUmc, De Boelelaan 1131, Amsterdam, Noord-Holland, Netherlands
| | - Dick J. Veltman
- Center of Expertise on Gender Dysphoria, Amsterdam University Medical Centers, location VUmc, De Boelelaan 1131, Amsterdam, Noord-Holland, Netherlands
| | - Julie Bakker
- Center of Expertise on Gender Dysphoria, Amsterdam University Medical Centers, location VUmc, De Boelelaan 1131, Amsterdam, Noord-Holland, Netherlands
| | - Sarah M. Burke
- Center of Expertise on Gender Dysphoria, Amsterdam University Medical Centers, location VUmc, De Boelelaan 1131, Amsterdam, Noord-Holland, Netherlands
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Ballering AV, Burke SM, Maeckelberghe ELM, Rosmalen JGM. How to Ensure Inclusivity in Large-Scale General Population Cohort Studies? Lessons Learned with Regard to Including and Assessing Sex, Gender, and Sexual Orientation. Arch Sex Behav 2023:10.1007/s10508-023-02600-y. [PMID: 37186037 DOI: 10.1007/s10508-023-02600-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/27/2021] [Revised: 04/04/2023] [Accepted: 04/05/2023] [Indexed: 05/17/2023]
Abstract
Despite recent advances in the measurement of sex, gender, and sexual orientation in large-scale cohort studies, the three concepts are still gaining relatively little attention, may be mistakenly equated, or non-informatively operationalized. The resulting imprecise or lacking information hereon in studies is problematic, as sex, gender, and sexual orientation are important health-related factors. Omission of these concepts from general population cohort studies might dismiss participants' identity and experiences and pushes research on sexual or gender minority populations toward purposive sampling, potentially introducing selection bias. It also reinforces the unintentional notion of irrelevance of these concepts to health research, ultimately disadvantaging sexual and gender minority populations. Similarly, a lack of uniform measures on sex, gender, and sexual orientation hampers multi-cohort studies in which data from multiple studies are combined, facilitating increased statistical power. This paper discusses the encountered pitfalls and lessons learned on including and assessing sex, gender, and sexual orientation in large-scale general population cohort studies, exemplified by the Dutch Lifelines Cohort Study. Additionally, we propose hands-on strategies on how to operationalize these concepts in an inclusive manner that is useful for large-scale general population cohort studies.
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Affiliation(s)
- Aranka V Ballering
- Department of Psychiatry, University Medical Center Groningen, University of Groningen, P.O. Box 30.001, 9700 RB, Groningen, The Netherlands.
| | - Sarah M Burke
- Department of Psychiatry, University Medical Center Groningen, University of Groningen, P.O. Box 30.001, 9700 RB, Groningen, The Netherlands
| | - Els L M Maeckelberghe
- University Medical Center Groningen, Wenckebach Institute for Training and Education, University of Groningen, Groningen, The Netherlands
| | - Judith G M Rosmalen
- Department of Psychiatry, University Medical Center Groningen, University of Groningen, P.O. Box 30.001, 9700 RB, Groningen, The Netherlands
- Department of Internal Medicine, University Medical Center of Groningen, University of Groningen, Groningen, The Netherlands
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van de Groep S, Zanolie K, Burke SM, Brandner P, Fuligni AJ, Crone EA. Growing in generosity? The Effects of Giving Magnitude, Target, and Audience on the Neural Signature of Giving in Adolescence. Dev Cogn Neurosci 2022; 54:101084. [PMID: 35180635 PMCID: PMC8857499 DOI: 10.1016/j.dcn.2022.101084] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2021] [Revised: 01/18/2022] [Accepted: 02/07/2022] [Indexed: 01/25/2023] Open
Abstract
Giving is essential for forming and maintaining social relationships, which is an important developmental task for adolescents. This pre-registered fMRI study investigated behavioral and neural correlates of adolescents’ (N = 128, ages 9 – 19 years) small versus large size giving in different social contexts related to target (i.e., giving to a friend or unfamiliar peer) and peer presence (i.e., anonymous versus audience giving). Participants gave more in the small size than large size condition, more to friends than to unfamiliar peers, and more in the audience compared to anonymous condition. Giving very small or large amounts was associated with increased activity in the medial prefrontal cortex (mPFC) and anterior insula (AI), and older adolescents showed increased lateral and anterior PFC activation for small size giving. We observed activity in the intraparietal cortex (IPL), dorsolateral prefrontal cortex, and AI for giving to friends, but no age-related differences in this activity. Behaviorally, in contrast, we observed that older adolescents differentiated more in giving between friends and unfamiliar peers. Finally, we observed interactions between peer presence and target in the AI, and between giving magnitude and target in the precuneus. Together, findings reveal higher context-dependency of giving and more lateral PFC activity for small versus large giving in older adolescents.
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Mueller SC, Guillamon A, Zubiaurre-Elorza L, Junque C, Gomez-Gil E, Uribe C, Khorashad BS, Khazai B, Talaei A, Habel U, Votinov M, Derntl B, Lanzenberger R, Seiger R, Kranz GS, Kreukels BPC, Kettenis PTC, Burke SM, Lambalk NB, Veltman DJ, Kennis M, Sánchez FJ, Vilain E, Fisher AD, Mascalchi M, Gavazzi G, Orsolini S, Ristori J, Dannlowski U, Grotegerd D, Konrad C, Schneider MA, T'Sjoen G, Luders E. The Neuroanatomy of Transgender Identity: Mega-Analytic Findings From the ENIGMA Transgender Persons Working Group. J Sex Med 2021; 18:1122-1129. [PMID: 37057468 DOI: 10.1016/j.jsxm.2021.03.079] [Citation(s) in RCA: 26] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2020] [Revised: 02/22/2021] [Accepted: 03/24/2021] [Indexed: 12/23/2022]
Abstract
BACKGROUND In contrast to cisgender persons, transgender persons identify with a different gender than the one assigned at birth. Although research on the underlying neurobiology of transgender persons has been accumulating over the years, neuroimaging studies in this relatively rare population are often based on very small samples resulting in discrepant findings. AIM To examine the neurobiology of transgender persons in a large sample. METHODS Using a mega-analytic approach, structural MRI data of 803 non-hormonally treated transgender men (TM, n = 214, female assigned at birth with male gender identity), transgender women (TW, n = 172, male assigned at birth with female gender identity), cisgender men (CM, n = 221, male assigned at birth with male gender identity) and cisgender women (CW, n = 196, female assigned at birth with female gender identity) were analyzed. OUTCOMES Structural brain measures, including grey matter volume, cortical surface area, and cortical thickness. RESULTS Transgender persons differed significantly from cisgender persons with respect to (sub)cortical brain volumes and surface area, but not cortical thickness. Contrasting the 4 groups (TM, TW, CM, and CW), we observed a variety of patterns that not only depended on the direction of gender identity (towards male or towards female) but also on the brain measure as well as the brain region examined. CLINICAL TRANSLATION The outcomes of this large-scale study may provide a normative framework that may become useful in clinical studies. STRENGTHS AND LIMITATIONS While this is the largest study of MRI data in transgender persons to date, the analyses conducted were governed (and restricted) by the type of data collected across all participating sites. CONCLUSION Rather than being merely shifted towards either end of the male-female spectrum, transgender persons seem to present with their own unique brain phenotype. Mueller SC, Guillamon A, Zubiaurre-Elorza L, et al. The Neuroanatomy of Transgender Identity: Mega-Analytic Findings From the ENIGMA Transgender Persons Working Group. J Sex Med 2021;18:1122-1129.
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Affiliation(s)
- Sven C Mueller
- Department of Experimental Clinical and Health Psychology, Ghent University, Ghent, Belgium
- Department of Personality, Psychological Assessment and Treatment, University of Deusto, Bilbao, Spain
| | - Antonio Guillamon
- Deparment of Psychobiology, National Distance Education University, Madrid, Spain
| | - Leire Zubiaurre-Elorza
- Department of Methods and Experimental Psychology, Faculty of Psychology and Education, University of Deusto, Bilbao, Spain
| | - Carme Junque
- Faculty of Medicine, University of Barcelona, Barcelona, Spain
| | | | - Carme Uribe
- Faculty of Medicine, University of Barcelona, Barcelona, Spain
| | - Behzad S Khorashad
- Psychiatry and Behavioral Sciences Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
- Department of Women's and Children's Health, Karolinska University Hospital, Karolinska Institute, Solna, Stockholm, Sweden
| | - Behnaz Khazai
- Keck School of Medicine, Mark and Mary Stevens Neuroimaging and Informatics Institute, Los Angeles, CA, USA
| | - Ali Talaei
- Psychiatry and Behavioral Sciences Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Ute Habel
- Psychiatry, Psychotherapy, and Psychosomatics, University Clinic RWTH, Aachen, Germany
- Research Centre Jülich, Institute of Neuroscience and Medicine (INM-10), Jülich, Germany
| | - Mikhail Votinov
- Psychiatry, Psychotherapy, and Psychosomatics, University Clinic RWTH, Aachen, Germany
- Research Centre Jülich, Institute of Neuroscience and Medicine (INM-10), Jülich, Germany
| | - Birgit Derntl
- Deptarment of Psychiatry and Psychotherapy, University of Tuebingen, Germany
| | - Rupert Lanzenberger
- Department of Psychiatry and Psychotherapy, Medical University of Vienna, Vienna, Austria
| | - Rene Seiger
- Department of Psychiatry and Psychotherapy, Medical University of Vienna, Vienna, Austria
| | - Georg S Kranz
- Department of Psychiatry and Psychotherapy, Medical University of Vienna, Vienna, Austria
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hongkong
| | | | | | - Sarah M Burke
- Psychology, Developmental and Educational Psychology, University of Leiden, Leiden, The Netherlands
| | - Nils B Lambalk
- Obstetrics and Gynaecology, Amsterdam University Medical Center, Amsterdam, The Netherlands
| | - Dick J Veltman
- Psychiatry, Amsterdam University Medical Center, Amsterdam, The Netherlands
| | - Mathilde Kennis
- Department of Cognitive Neuroscience, Maastricht University, Maastricht, The Netherlands
| | | | - Eric Vilain
- Center for Genetic Medicine Research, Children's National Hospital, Washington, DC, USA
- Department of Genomics and Precision Medicine, George Washington University, Washington, DC, USA
| | - Alessandra Daphne Fisher
- Andrology, Women's Endocrinology, Gender Incongruence Unit, Careggi University Hospital, Florence, Italy
| | - Mario Mascalchi
- Department of Experimental and Clinical Biomedical Sciences, University of Florence, Florence, Italy
| | - Gioele Gavazzi
- Department of Neuroscience, Psychology, Drug Research, Child Health, University of Florence, Florence, Italy
| | - Stefano Orsolini
- Department of Electrical, Electronic, and Information Engineering "Guglielmo Marconi", University of Bologna, Cesena, Italy
| | - Jiska Ristori
- Center for Genetic Medicine Research, Children's National Hospital, Washington, DC, USA
| | - Udo Dannlowski
- Institute for Translational Psychiatry, University of Muenster, Muenster, Germany
| | - Dominik Grotegerd
- Institute for Translational Psychiatry, University of Muenster, Muenster, Germany
| | - Carsten Konrad
- Department of Psychiatry and Psychotherapy, Agaplesion Diakonieklinikum, Rotenburg, Germany
| | | | - Guy T'Sjoen
- Department of Endocrinology & Center for Sexology and Gender, Ghent University Hospital, Ghent, Belgium
| | - Eileen Luders
- School of Psychology, University of Auckland, Auckland, New Zealand
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Burke SM. Commentary: Gender diversity and adolescent mental health - a reflection on Potter et al. (2020). J Child Psychol Psychiatry 2021; 62:180-183. [PMID: 32865228 DOI: 10.1111/jcpp.13309] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/28/2020] [Revised: 07/10/2020] [Accepted: 07/15/2020] [Indexed: 12/31/2022]
Abstract
Using a multidimensional measure of gender identity for youths, Potter and colleagues elegantly investigated the prevalence of gender diversity and associated mental health problems in a large sample of young adolescents. The authors address an important need of studies within the behavioral and medical sciences to consider more carefully variations in a person's subjective experience of gender. Their study shows that individual differences in gender identity significantly relate to adolescent mental health problems. Moreover, findings of the current study, and future follow-up assessments of the ABCD cohort, will, hopefully, add important quantitative, empirical data to the controversial discussions on gender identity development and gender diversity in childhood and adolescence (Journal of Child Psychology and Psychiatry, 59, 2018, 1244; Pediatric gender identity, 2020, Cham, Switzerland: Springer International; International Journal of Transgenderism, 19, 2018, 225).
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11
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Fernández R, Burke SM. Editorial: Research in Transgender Healthcare: What Have We Learned and Where Are We Going? Front Endocrinol (Lausanne) 2021; 12:832866. [PMID: 35069457 PMCID: PMC8776714 DOI: 10.3389/fendo.2021.832866] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/10/2021] [Accepted: 12/20/2021] [Indexed: 11/13/2022] Open
Affiliation(s)
- Rosa Fernández
- Laboratory of Psychobiology, Department of Psychology, Institute Advanced Scientific Research Center (CICA), University of A Coruña, A Coruña, Spain
- *Correspondence: Rosa Fernández,
| | - Sarah M. Burke
- University Medical Center Groningen, Department of Psychiatry, Interdisciplinary Center for Psychopathology and Emotion Regulation, University of Groningen, Groningen, Netherlands
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12
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Chen D, Strang JF, Kolbuck VD, Rosenthal SM, Wallen K, Waber DP, Steinberg L, Sisk CL, Ross J, Paus T, Mueller SC, McCarthy MM, Micevych PE, Martin CL, Kreukels BPC, Kenworthy L, Herting MM, Herlitz A, Haraldsen IRJH, Dahl R, Crone EA, Chelune GJ, Burke SM, Berenbaum SA, Beltz AM, Bakker J, Eliot L, Vilain E, Wallace GL, Nelson EE, Garofalo R. Consensus Parameter: Research Methodologies to Evaluate Neurodevelopmental Effects of Pubertal Suppression in Transgender Youth. Transgend Health 2020; 5:246-257. [PMID: 33376803 PMCID: PMC7759272 DOI: 10.1089/trgh.2020.0006] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
Purpose: Pubertal suppression is standard of care for early pubertal transgender youth to prevent the development of undesired and distressing secondary sex characteristics incongruent with gender identity. Preliminary evidence suggests pubertal suppression improves mental health functioning. Given the widespread changes in brain and cognition that occur during puberty, a critical question is whether this treatment impacts neurodevelopment. Methods: A Delphi consensus procedure engaged 24 international experts in neurodevelopment, gender development, puberty/adolescence, neuroendocrinology, and statistics/psychometrics to identify priority research methodologies to address the empirical question: is pubertal suppression treatment associated with real-world neurocognitive sequelae? Recommended study approaches reaching 80% consensus were included in the consensus parameter. Results: The Delphi procedure identified 160 initial expert recommendations, 44 of which ultimately achieved consensus. Consensus study design elements include the following: a minimum of three measurement time points, pubertal staging at baseline, statistical modeling of sex in analyses, use of analytic approaches that account for heterogeneity, and use of multiple comparison groups to minimize the limitations of any one group. Consensus study comparison groups include untreated transgender youth matched on pubertal stage, cisgender (i.e., gender congruent) youth matched on pubertal stage, and an independent sample from a large-scale youth development database. The consensus domains for assessment includes: mental health, executive function/cognitive control, and social awareness/functioning. Conclusion: An international interdisciplinary team of experts achieved consensus around primary methods and domains for assessing neurodevelopmental effects (i.e., benefits and/or difficulties) of pubertal suppression treatment in transgender youth.
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Affiliation(s)
- Diane Chen
- Potocsnak Family Division of Adolescent and Young Adult Medicine, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, Illinois, USA.,Pritzker Department of Psychiatry and Behavioral Health, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, Illinois, USA.,Department of Psychiatry & Behavioral Sciences, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA.,Department of Pediatrics, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
| | - John F Strang
- Division of Neuropsychology, Children's National Medical Center, Washington, District of Columbia, USA.,Center for Neuroscience, Children's Research Institute, Children's National Medical Center, Washington, District of Columbia, USA.,Department of Pediatrics, George Washington University School of Medicine, Washington, District of Columbia, USA.,Department of Neurology, George Washington University School of Medicine, Washington, District of Columbia, USA.,Department of Psychiatry, George Washington University School of Medicine, Washington, District of Columbia, USA
| | - Victoria D Kolbuck
- Potocsnak Family Division of Adolescent and Young Adult Medicine, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, Illinois, USA
| | - Stephen M Rosenthal
- Division of Endocrinology, Benioff Children's Hospital, University of California San Francisco, San Francisco, California, USA
| | - Kim Wallen
- Department of Psychology, Yerkes National Primate Research Center, Emory University, Atlanta, Georgia, USA
| | - Deborah P Waber
- Department of Psychiatry, Boston Children's Hospital, Boston, Massachusetts, USA.,Department of Psychiatry, Harvard Medical School, Boston, Massachusetts, USA
| | - Laurence Steinberg
- Department of Psychology, Temple University, Philadelphia, Pennsylvania, USA
| | - Cheryl L Sisk
- Department of Psychology, Michigan State University, East Lansing, Michigan, USA
| | - Judith Ross
- Nemours duPont Hospital for Children, Wilmington, Delaware, USA.,Department of Pediatrics, Thomas Jefferson University, Philadelphia, Pennsylvania, USA
| | - Tomas Paus
- Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital, Toronto, Ontario, Canada.,Department of Psychology, University of Toronto, Toronto, Ontario, Canada.,Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
| | - Sven C Mueller
- Department of Experimental Clinical and Health Psychology, Ghent University, Ghent, Belgium.,Department of Personality, Psychological Assessment and Treatment, University of Deusto, Bilbao, Spain
| | - Margaret M McCarthy
- Program in Neuroscience, Department of Pharmacology, University of Maryland School of Medicine, Baltimore, Maryland, USA
| | - Paul E Micevych
- David Geffen School of Medicine at UCLA, Los Angeles, California, USA
| | - Carol L Martin
- School of Social and Family Dynamics, Arizona State University, Tempe, Arizona, USA
| | - Baudewijntje P C Kreukels
- Amsterdam UMC, Location VUmc, Department of Medical Psychology and Center of Expertise on Gender Dysphoria, Amsterdam, The Netherlands
| | - Lauren Kenworthy
- Division of Neuropsychology, Children's National Medical Center, Washington, District of Columbia, USA.,Center for Neuroscience, Children's Research Institute, Children's National Medical Center, Washington, District of Columbia, USA.,Department of Pediatrics, George Washington University School of Medicine, Washington, District of Columbia, USA.,Department of Neurology, George Washington University School of Medicine, Washington, District of Columbia, USA.,Department of Psychiatry, George Washington University School of Medicine, Washington, District of Columbia, USA
| | - Megan M Herting
- Department of Preventive Medicine, University of Southern California, Los Angeles, California, USA.,Department of Pediatrics, University of Southern California, Los Angeles, California, USA
| | - Agneta Herlitz
- Section of Psychology, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | | | - Ronald Dahl
- School of Public Health, University of California, Berkeley, Berkeley, California, USA
| | - Eveline A Crone
- Department of Developmental and Educational Psychology, Brain and Development Research Center, Leiden University, Leiden, The Netherlands
| | - Gordon J Chelune
- Department of Neurology, University of Utah School of Medicine, Salt Lake City, Utah, USA
| | - Sarah M Burke
- Department of Developmental and Educational Psychology, Brain and Development Research Center, Leiden University, Leiden, The Netherlands
| | - Sheri A Berenbaum
- Department of Psychology, The Pennsylvania State University, University Park, Pennsylvania, USA.,Department of Pediatrics, The Pennsylvania State University, University Park, Pennsylvania, USA
| | - Adriene M Beltz
- Department of Psychology, University of Michigan, Ann Arbor, Michigan, USA
| | - Julie Bakker
- GIGA Neurosciences, Liège University, Liège, Belgium
| | - Lise Eliot
- Department of Neuroscience, Rosalind Franklin University of Medicine & Science, Chicago, Illinois, USA
| | - Eric Vilain
- Center for Genetic Medicine Research, Children's National Medical Center, Washington, District of Columbia, USA.,Department of Genomics and Precision Medicine, George Washington University, Washington, District of Columbia, USA.,Epigenetics, Data, & Politics at Centre National de la Recherche Scientifique, Paris, France
| | - Gregory L Wallace
- Department of Speech, Language, and Hearing Science, George Washington University, Washington, District of Columbia, USA
| | - Eric E Nelson
- Center for Biobehavioral Health, The Research Institute, Nationwide Children's Hospital, Columbus, Ohio, USA.,Department of Pediatrics, The Ohio State University College of Medicine, Columbus, Ohio, USA
| | - Robert Garofalo
- Potocsnak Family Division of Adolescent and Young Adult Medicine, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, Illinois, USA.,Department of Pediatrics, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
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13
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Burke SM, Zimmerman CE, Laske SM, Koch JC, Derry AM, Guernon S, Branfireun BA, Swanson HK. Fish growth rates and lake sulphate explain variation in mercury levels in ninespine stickleback (Pungitius pungitius) on the Arctic Coastal Plain of Alaska. Sci Total Environ 2020; 743:140564. [PMID: 32758814 DOI: 10.1016/j.scitotenv.2020.140564] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/15/2020] [Revised: 06/24/2020] [Accepted: 06/25/2020] [Indexed: 06/11/2023]
Abstract
Mercury concentrations in freshwater food webs are governed by complex biogeochemical and ecological interactions that spatially vary and are often mediated by climate. The Arctic Coastal Plain of Alaska (ACP) is a heterogeneous, lake-rich landscape where variability in mercury accumulation is poorly understood. Earlier research indicated that the level of catchment influence on lakes varied spatially on the ACP, and affected mercury accumulation in lake sediments. This work sought to determine drivers of spatial variation in mercury accumulation in lake food webs on the ACP. Three lakes that were a priori identified as "high catchment influence" (Reindeer Camp region) and three lakes that were a priori identified as "low catchment influence" (Atqasuk region) were sampled, and variability in water chemistry, food web ecology, and mercury accumulation was investigated. Among-lake differences in ninespine stickleback (Pungitius pungitius) length-adjusted methylmercury concentrations were significantly explained by sulphate concentration in lake water, a tracer of catchment runoff input. This effect was mediated by fish growth, which had no pattern between regions. Together, lake water sulphate concentration and fish age-at-size (proxy for growth) accounted for nearly all of the among-lake variability in length-adjusted methylmercury concentrations in stickleback (R2adj = 0.94, p < 0.01). The percentage of total mercury as methylmercury (a proxy for net Hg methylation) was higher in sediments of more autochthonous, "low catchment influence" lakes (p < 0.05), and in the periphyton of more allochthonous, "high catchment influence" lakes (p < 0.05). The results indicate that dominant sources of primary production (littoral macrophyte/biofilm vs. pelagic phytoplankton) and food web structure (detrital vs. grazing) are regulated by catchment characteristics on the ACP, and that this ultimately influences the amount of methylmercury in the aquatic food web. These results have important implications for predicting future mercury concentrations in fish in lakes where fish growth rates and catchment inputs may change in response to a changing climate.
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Affiliation(s)
- S M Burke
- Department of Biology and Water Institute, University of Waterloo, 200 University Ave. West, Waterloo, Ontario N2L 3G1, Canada; Environment and Climate Change Canada (ECCC), Aquatic Contaminants Research Division, 867 Lakeshore Rd., Burlington, ON L7S 1A1, Canada.
| | - C E Zimmerman
- U. S. Geological Survey, Alaska Science Center, 4210 University Dr., Anchorage, AK 99508, USA
| | - S M Laske
- U. S. Geological Survey, Alaska Science Center, 4210 University Dr., Anchorage, AK 99508, USA
| | - J C Koch
- U. S. Geological Survey, Alaska Science Center, 4210 University Dr., Anchorage, AK 99508, USA
| | - A M Derry
- Département des sciences biologiques, Université du Québec à Montréal (UQAM), P.O. Box 8888, Succ. Centre-Ville, Montréal, Québec H3C 3P8, Canada
| | - S Guernon
- Département des sciences biologiques, Université du Québec à Montréal (UQAM), P.O. Box 8888, Succ. Centre-Ville, Montréal, Québec H3C 3P8, Canada
| | - B A Branfireun
- Western University, Department of Biological Sciences, London, Ontario N6A 3K7, Canada
| | - H K Swanson
- Department of Biology and Water Institute, University of Waterloo, 200 University Ave. West, Waterloo, Ontario N2L 3G1, Canada
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14
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Burke SM, van Heesewijk JO, Menks WM, Klink DT, Kreukels BPC, Cohen-Kettenis PT, Bakker J. Postnatal Effects of Sex Hormones on Click-Evoked Otoacoustic Emissions: A Study of Adolescents with Gender Dysphoria. Arch Sex Behav 2020; 49:455-465. [PMID: 32056039 PMCID: PMC7031217 DOI: 10.1007/s10508-020-01652-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/25/2017] [Revised: 01/25/2020] [Accepted: 01/27/2020] [Indexed: 06/10/2023]
Abstract
Click-evoked otoacoustic emissions (CEOAEs) are echo-like sounds, generated by the inner ear in response to click-stimuli. A sex difference in emission strength is observed in neonates and adults, with weaker CEOAE amplitudes in males. These differences are assumed to originate from testosterone influences during prenatal male sexual differentiation and to remain stable throughout life. However, recent studies suggested activational, postnatal effects of sex hormones on CEOAEs. Adolescents diagnosed with gender dysphoria (GD) may receive gonadotropin-releasing hormone analogs (GnRHa) in order to suppress endogenous sex hormones and, therefore, pubertal maturation, followed by cross-sex hormone (CSH) treatment. Using a cross-sectional design, we examined whether hormonal interventions in adolescents diagnosed with GD (62 trans boys, assigned female at birth, self-identifying as male; 43 trans girls, assigned male at birth, self-identifying as female), affected their CEOAEs compared to age- and sex-matched controls (44 boys, 37 girls). Sex-typical differences in CEOAE amplitude were observed among cisgender controls and treatment-naïve trans boys but not in other groups with GD. Treatment-naïve trans girls tended to have more female-typical CEOAEs, suggesting hypomasculinized early sexual differentiation, in support of a prominent hypothesis on the etiology of GD. In line with the predicted suppressive effects of androgens, trans boys receiving CSH treatment, i.e., testosterone plus GnRHa, showed significantly weaker right-ear CEOAEs compared with control girls. A similar trend was seen in trans boys treated with GnRHa only. Unexpectedly, trans girls showed CEOAE masculinization with addition of estradiol. Our findings show that CEOAEs may not be used as an unequivocal measure of prenatal androgen exposure as they can be modulated postnatally by sex hormones, in the form of hormonal treatment.
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Affiliation(s)
- Sarah M Burke
- Department of Medical Psychology, Center of Expertise on Gender Dysphoria, Amsterdam University Medical Centers, 1081 HX, Amsterdam, The Netherlands
- Department of Developmental and Educational Psychology, Brain and Development Research Center, Leiden University, Leiden, The Netherlands
| | - Jason O van Heesewijk
- Department of Medical Psychology, Center of Expertise on Gender Dysphoria, Amsterdam University Medical Centers, 1081 HX, Amsterdam, The Netherlands.
| | - Willeke M Menks
- Donders Institute for Brain, Cognition and Behaviour, Radboud University, Nijmegen, The Netherlands
| | - Daniel T Klink
- Department of Pediatric Endocrinology, Center of Expertise on Gender Dysphoria, Amsterdam University Medical Centers, Location VUmc, Amsterdam, The Netherlands
- Pediatrics and Genetics Research Unit, Division of Pediatric Endocrinology, Department of Pediatrics, Ghent University Hospital, Ghent University, Ghent, Belgium
| | - Baudewijntje P C Kreukels
- Department of Medical Psychology, Center of Expertise on Gender Dysphoria, Amsterdam University Medical Centers, 1081 HX, Amsterdam, The Netherlands
| | - Peggy T Cohen-Kettenis
- Department of Medical Psychology, Center of Expertise on Gender Dysphoria, Amsterdam University Medical Centers, 1081 HX, Amsterdam, The Netherlands
| | - Julie Bakker
- GIGA Neuroscience, University of Liege, Liège, Belgium
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15
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Beking T, Burke SM, Geuze RH, Staphorsius AS, Bakker J, Groothuis AGG, Kreukels BPC. Testosterone effects on functional amygdala lateralization: A study in adolescent transgender boys and cisgender boys and girls. Psychoneuroendocrinology 2020; 111:104461. [PMID: 31630051 DOI: 10.1016/j.psyneuen.2019.104461] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/24/2018] [Revised: 09/16/2019] [Accepted: 09/18/2019] [Indexed: 01/05/2023]
Abstract
The influence of testosterone on the development of human brain lateralization has been subject of debate for a long time, partly because studies investigating this are necessarily mostly correlational. In the present study we used a quasi-experimental approach by assessing functional brain lateralization in trans boys (female sex assigned at birth, diagnosed with Gender Dysphoria, n = 21) before and after testosterone treatment, and compared these results to the functional lateralization of age-matched control groups of cisgender boys (n = 20) and girls (n = 21) around 16 years of age. The lateralization index of the amygdala was determined with functional magnetic resonance imaging (fMRI) during an emotional face matching task with angry and fearful faces, as the literature indicates that boys show more activation in the right amygdala than girls during the perception of emotional faces. As expected, the lateralization index in trans boys shifted towards the right amygdala after testosterone treatment, and the cumulative dose of testosterone treatment correlated significantly with amygdala lateralization after treatment. However, we did not find any significant group differences in lateralization and endogenous testosterone concentrations predicted rightward amygdala lateralization only in the cis boys, but not in cis girls or trans boys. These inconsistencies may be due to sex differences in sensitivity to testosterone or its metabolites, which would be a worthwhile course for future studies.
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Affiliation(s)
- T Beking
- University of Groningen, Department Clinical & Developmental Neuropsychology. Grote Kruisstraat 2/1, 9712 TS, Groningen, the Netherlands.
| | - S M Burke
- Leiden University, Brain & Development Research Centre, Department of Developmental and Educational Psychology. Wassenaarseweg 52, 2333 AK, Leiden, the Netherlands.
| | - R H Geuze
- University of Groningen, Department Clinical & Developmental Neuropsychology. Grote Kruisstraat 2/1, 9712 TS, Groningen, the Netherlands.
| | - A S Staphorsius
- Amsterdam University Medical Centers, Location VU, Department of Internal Medicine, Center of Expertise on Gender Dysphoria. PO Box 7057, 1007 MB, Amsterdam, the Netherlands.
| | - J Bakker
- Liège University, GIGA Neurosciences, Avenue Hippocrate 15, B36, 4000, Liège, Belgium.
| | - A G G Groothuis
- University of Groningen, Groningen Institute for Evolutionary Life Sciences, Nijenborgh 7, 9747 AG, Groningen, the Netherlands.
| | - B P C Kreukels
- Amsterdam University Medical Centers, Location VU, Department of Medical Psychology, Center of Expertise on Gender Dysphoria, PO Box 7057, 1007 MB, Amsterdam, the Netherlands.
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16
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Abstract
Sex differences in behavior, and whether these behavioral differences are related to sex differences in brain development, has been a longstanding topic of debate. Presumably, sex differences can provide critically important leads for explaining the etiology of various illnesses that show (i) large sex differences in prevalence and (ii) have an origin before or during adolescence. The general aim of this chapter is to provide an overview of scientific studies on sex differences in normative brain and behavioral development across puberty and adolescence, including the (sex) hormone-driven transition phase of puberty. Moreover, we describe the literature on brain and behavioral development in gender dysphoria, a severe and persistent incongruence between the self-identified gender and the assigned sex at birth. From the literature it becomes clear there is evidence for a specific link between pubertal maturation and developmental changes in arousal, motivation, and emotion. However, this link is rather similar between boys and girls. Moreover, although there is substantial evidence for sex differences in mean brain structure, these have not always been linked to sex differences in behavior, cognition, or psychopathology. Furthermore, there is little evidence for sex differences in brain development and thus, studies so far have been unable to explain sex differences in cognition. Suggestions for future research and methodologic considerations are provided.
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Affiliation(s)
- Jiska S Peper
- Department of Psychology, Leiden University, Leiden, The Netherlands.
| | - Sarah M Burke
- Department of Psychology, Leiden University, Leiden, The Netherlands
| | - Lara M Wierenga
- Department of Psychology, Leiden University, Leiden, The Netherlands
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17
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Majid DSA, Burke SM, Manzouri A, Moody TD, Dhejne C, Feusner JD, Savic I. Neural Systems for Own-body Processing Align with Gender Identity Rather Than Birth-assigned Sex. Cereb Cortex 2019; 30:2897-2909. [PMID: 31813993 DOI: 10.1093/cercor/bhz282] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2019] [Revised: 10/04/2019] [Indexed: 01/18/2023] Open
Abstract
Gender identity is a core aspect of self-identity and is usually congruent with birth-assigned sex and own body sex-perception. The neuronal circuits underlying gender identity are unknown, but greater awareness of transgenderism has sparked interest in studying these circuits. We did this by comparing brain activation and connectivity in transgender individuals (for whom gender identity and birth-assigned sex are incongruent) with that in cisgender controls (for whom they are congruent) when performing a body self-identification task during functional magnetic resonance imaging. Thirty transgender and 30 cisgender participants viewed images of their own bodies and bodies morphed in sex toward or opposite to birth-assigned sex, rating each image to the degree they identified with it. While controls identified with images of themselves, transgender individuals identified with images morphed "opposite" to their birth-assigned sex. After covarying out the effect of self-similarity ratings, both groups activated similar self- and body-processing systems when viewing bodies that aligned with their gender identity rather than birth-assigned sex. Additionally, transgender participants had greater limbic involvement when viewing ambiguous, androgynous images of themselves morphed toward their gender identity. These results shed light on underlying self-processing networks specific to gender identity and uncover additional involvement of emotional processing in transgender individuals.
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Affiliation(s)
- D S Adnan Majid
- Department of Psychiatry and Biobehavioral Sciences, University of California Los Angeles, Los Angeles, CA 90095, USA
| | - Sarah M Burke
- Department of Developmental and Educational Psychology, Leiden University, 2311 EZ Leiden, The Netherlands.,Department of Women's and Children's Health, Karolinska Institutet, 171 77 Solna, Stockholm, Sweden
| | | | - Teena D Moody
- Department of Psychiatry and Biobehavioral Sciences, University of California Los Angeles, Los Angeles, CA 90095, USA
| | - Cecilia Dhejne
- Department of Medicine, Karolinska University Hospital, Huddinge, Karolinska Institutet, 171 76 Solna, Stockholm, Sweden
| | - Jamie D Feusner
- Department of Psychiatry and Biobehavioral Sciences, University of California Los Angeles, Los Angeles, CA 90095, USA
| | - Ivanka Savic
- Department of Women's and Children's Health, Karolinska Institutet, 171 77 Solna, Stockholm, Sweden.,Department of Neurology, University of California Los Angeles, Los Angeles, CA 90095, USA
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18
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Burke SM, Majid DSA, Manzouri AH, Moody T, Feusner JD, Savic I. Sex differences in own and other body perception. Hum Brain Mapp 2018; 40:474-488. [PMID: 30430680 PMCID: PMC6587810 DOI: 10.1002/hbm.24388] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2018] [Revised: 08/07/2018] [Accepted: 08/28/2018] [Indexed: 12/30/2022] Open
Abstract
Own body perception, and differentiating and comparing one's body to another person's body, are common cognitive functions that have relevance for self‐identity and social interactions. In several psychiatric conditions, including anorexia nervosa, body dysmorphic disorder, gender dysphoria, and autism spectrum disorder, self and own body perception, as well as aspects of social communication are disturbed. Despite most of these conditions having skewed prevalence sex ratios, little is known about whether the neural basis of own body perception differs between the sexes. We addressed this question by investigating brain activation using functional magnetic resonance imaging during a Body Perception task in 15 male and 15 female healthy participants. Participants viewed their own body, bodies of same‐sex, or opposite‐sex other people, and rated the degree that they appeared like themselves. We found that men and women did not differ in the pattern of brain activation during own body perception compared to a scrambled control image. However, when viewing images of other bodies of same‐sex or opposite‐sex, men showed significantly stronger activations in attention‐related and reward‐related brain regions, whereas women engaged stronger activations in striatal, medial‐prefrontal, and insular cortices, when viewing the own body compared to other images of the opposite sex. It is possible that other body images, particularly of the opposite sex, may be of greater salience for men, whereas images of own bodies may be more salient for women. These observations provide tentative neurobiological correlates to why women may be more vulnerable than men to conditions involving own body perception.
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Affiliation(s)
- Sarah M Burke
- Brain & Development Research Centre, Department of Developmental and Educational Psychology, Leiden University, Leiden, The Netherlands.,Department of Women's and Children's Health, Karolinska Institute and University Hospital, Stockholm, Sweden
| | - D S Adnan Majid
- Department of Psychiatry and Biobehavioral Sciences, University of California Los Angeles, Los Angeles, California
| | - Amir H Manzouri
- Department of Women's and Children's Health, Karolinska Institute and University Hospital, Stockholm, Sweden.,Department of Psychology, Stockholm University, Stockholm, Sweden
| | - Teena Moody
- Department of Psychiatry and Biobehavioral Sciences, University of California Los Angeles, Los Angeles, California
| | - Jamie D Feusner
- Department of Psychiatry and Biobehavioral Sciences, University of California Los Angeles, Los Angeles, California
| | - Ivanka Savic
- Department of Women's and Children's Health, Karolinska Institute and University Hospital, Stockholm, Sweden.,Department of Neurology, University of California Los Angeles, Los Angeles, California
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19
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Spaans JP, Burke SM, Altikulaç S, Braams BR, Op de Macks ZA, Crone EA. Win for your kin: Neural responses to personal and vicarious rewards when mothers win for their adolescent children. PLoS One 2018; 13:e0198663. [PMID: 29879189 PMCID: PMC5991740 DOI: 10.1371/journal.pone.0198663] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2018] [Accepted: 05/23/2018] [Indexed: 12/20/2022] Open
Abstract
Mother-child relationships change considerably in adolescence, but it is not yet understood how mothers experience vicarious rewards for their adolescent children. In the current study, we investigated neural responses of twenty mothers winning and losing money for their best friend and for their adolescent child in a gambling task. During the task, functional neuroimaging data were acquired. We examined the activation patterns when playing for or winning for self, adolescent children and friends in four a-priori selected ROIs (nucleus accumbens, dorsomedial prefrontal cortex, precuneus and temporo-parietal junction). Behaviorally, mothers indicated that they experienced most enjoyment when they gained money for their children and that their children deserved to win more, relative to friends and self. At the neural level, nucleus accumbens activity was stronger when winning versus losing. This pattern was not only found when playing for self, but also for friends and children, possibly reflecting the rewarding value of vicarious prosocial gains. In addition, dorsomedial prefrontal cortex, precuneus, and temporo-parietal junction were more active when receiving outcomes for children and friends compared to self, possibly reflecting increased recruitment of mentalizing processes. Interestingly, activity in this network was stronger for mothers who indicated that their children and friends deserved to win more. These findings provide initial evidence that vicarious rewards for one’s children are processed similarly as rewards for self, and that activation in social brain regions are related to social closeness.
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Affiliation(s)
- Jochem P. Spaans
- Department of Developmental and Educational Psychology, Institute of Psychology, Leiden University, Leiden, the Netherlands
- Leiden Institute for Brain and Cognition, Leiden University, Leiden, the Netherlands
- * E-mail:
| | - Sarah M. Burke
- Department of Developmental and Educational Psychology, Institute of Psychology, Leiden University, Leiden, the Netherlands
- Leiden Institute for Brain and Cognition, Leiden University, Leiden, the Netherlands
| | - Sibel Altikulaç
- Department of Clinical Developmental Psychology, Faculty of Behavioural and Movement Sciences, Institute of Psychology, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Barbara R. Braams
- Department of Psychology and Center for Brain Science, Harvard University, Cambridge, Massachusetts, United States of America
| | - Zdeňa A. Op de Macks
- Department of Developmental and Educational Psychology, Institute of Psychology, Leiden University, Leiden, the Netherlands
- Leiden Institute for Brain and Cognition, Leiden University, Leiden, the Netherlands
| | - Eveline A. Crone
- Department of Developmental and Educational Psychology, Institute of Psychology, Leiden University, Leiden, the Netherlands
- Leiden Institute for Brain and Cognition, Leiden University, Leiden, the Netherlands
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Burke SM, Manzouri AH, Dhejne C, Bergström K, Arver S, Feusner JD, Savic-Berglund I. Testosterone Effects on the Brain in Transgender Men. Cereb Cortex 2018; 28:1582-1596. [PMID: 28334217 PMCID: PMC6248653 DOI: 10.1093/cercor/bhx054] [Citation(s) in RCA: 37] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2016] [Revised: 01/19/2017] [Accepted: 02/16/2017] [Indexed: 12/22/2022] Open
Abstract
Transgender individuals experience incongruence between their gender identity and birth-assigned sex. The resulting gender dysphoria (GD), which some gender-incongruent individuals experience, is theorized to be a consequence of atypical cerebral sexual differentiation, but support for this assertion is inconsistent. We recently found that GD is associated with disconnected networks involved in self-referential thinking and own body perception. Here, we investigate how these networks in trans men (assigned female at birth with male gender identity) are affected by testosterone. In 22 trans men, we obtained T1-weighted, diffusion-weighted, and resting-state functional magnetic resonance imaging scans before and after testosterone treatment, measuring cortical thickness (Cth), subcortical volumes, fractional anisotropy (FA), and functional connectivity. Nineteen cisgender controls (male and female) were also scanned twice. The medial prefrontal cortex (mPFC) was thicker in trans men than controls pretreatment, and remained unchanged posttreatment. Testosterone treatment resulted in increased Cth in the insular cortex, changes in cortico-cortical thickness covariation between mPFC and occipital cortex, increased FA in the fronto-occipital tract connecting these regions, and increased functional connectivity between mPFC and temporo-parietal junction, compared with controls. Concluding, in trans men testosterone treatment resulted in functional and structural changes in self-referential and own body perception areas.
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Affiliation(s)
- Sarah M Burke
- Department of Women's and Children's Health, Karolinska Institutet and
University Hospital, SE-171 76 Stockholm, Sweden
| | | | - Cecilia Dhejne
- ANOVA, Center of Expertise in Andrology, Sexual Medicine, and Transgender
Medicine, Karolinska University Hospital, SE-171 76 Stockholm, Sweden
- Center for Psychiatric Research, Department of Clinical Neuroscience,
Karolinska Institutet, SE-171 77 Stockholm, Sweden
| | - Karin Bergström
- Department of Women's and Children's Health, Karolinska Institutet and
University Hospital, SE-171 76 Stockholm, Sweden
| | - Stefan Arver
- ANOVA, Center of Expertise in Andrology, Sexual Medicine, and Transgender
Medicine, Karolinska University Hospital, SE-171 76 Stockholm, Sweden
- Department of Medicine/Huddinge, Karolinska Institutet, SE-141 86
Stockholm, Sweden
| | - Jamie D Feusner
- Department of Psychiatry and Biobehavioral Sciences, University of
California Los Angeles, Los Angeles, CA 90095, USA
| | - Ivanka Savic-Berglund
- Department of Women's and Children's Health, Karolinska Institutet and
University Hospital, SE-171 76 Stockholm, Sweden
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Burke SM, Manzouri AH, Savic I. Structural connections in the brain in relation to gender identity and sexual orientation. Sci Rep 2017; 7:17954. [PMID: 29263327 PMCID: PMC5738422 DOI: 10.1038/s41598-017-17352-8] [Citation(s) in RCA: 50] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2017] [Accepted: 11/23/2017] [Indexed: 12/22/2022] Open
Abstract
Both transgenderism and homosexuality are facets of human biology, believed to derive from different sexual differentiation of the brain. The two phenomena are, however, fundamentally unalike, despite an increased prevalence of homosexuality among transgender populations. Transgenderism is associated with strong feelings of incongruence between one's physical sex and experienced gender, not reported in homosexual persons. The present study searches to find neural correlates for the respective conditions, using fractional anisotropy (FA) as a measure of white matter connections that has consistently shown sex differences. We compared FA in 40 transgender men (female birth-assigned sex) and 27 transgender women (male birth-assigned sex), with both homosexual (29 male, 30 female) and heterosexual (40 male, 40 female) cisgender controls. Previously reported sex differences in FA were reproduced in cis-heterosexual groups, but were not found among the cis-homosexual groups. After controlling for sexual orientation, the transgender groups showed sex-typical FA-values. The only exception was the right inferior fronto-occipital tract, connecting parietal and frontal brain areas that mediate own body perception. Our findings suggest that the neuroanatomical signature of transgenderism is related to brain areas processing the perception of self and body ownership, whereas homosexuality seems to be associated with less cerebral sexual differentiation.
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Affiliation(s)
- Sarah M Burke
- Brain & Development Research Centre, Department of Developmental and Educational Psychology, Leiden University, Leiden, The Netherlands.
- Department of Women's and Children's Health, Karolinska Institute and University Hospital, Stockholm, Sweden.
| | - Amir H Manzouri
- Stressmotagningen, S:t Göransgatan 84, 112 38, Stockholm, Sweden
| | - Ivanka Savic
- Department of Women's and Children's Health, Karolinska Institute and University Hospital, Stockholm, Sweden
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Nota NM, Kreukels BPC, den Heijer M, Veltman DJ, Cohen-Kettenis PT, Burke SM, Bakker J. Brain functional connectivity patterns in children and adolescents with gender dysphoria: Sex-atypical or not? Psychoneuroendocrinology 2017; 86:187-195. [PMID: 28972892 DOI: 10.1016/j.psyneuen.2017.09.014] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/26/2017] [Accepted: 09/14/2017] [Indexed: 01/01/2023]
Abstract
Various previous studies have reported that brains of people diagnosed with gender dysphoria (GD) show sex-atypical features. In addition, recent functional magnetic resonance imaging studies found that several brain resting-state networks (RSNs) in adults with GD show functional connectivity (FC) patterns that are not sex-atypical, but specific for GD. In the current study we examined whether FC patterns are also altered in prepubertal children and adolescents with GD in comparison with non-gender dysphoric peers. We investigated FC patterns within RSNs that were previously examined in adults: visual networks (VNs), sensorimotor networks (SMNs), default mode network (DMN) and salience network. Thirty-one children (18 birth assigned males; 13 birth assigned females) and 40 adolescents with GD (19 birth assigned males or transgirls; 21 birth assigned females or transboys), and 39 cisgender children (21 boys; 18 girls) and 41 cisgender adolescents (20 boys; 21 girls) participated. We used independent component analysis to obtain the network maps of interest and compared these across groups. Within one of the three VNs (VN-I), adolescent transgirls showed stronger FC in the right cerebellum compared with all other adolescent groups. Sex differences in FC between the cisgender adolescent groups were observed in the right supplementary motor area within one of the two SMNs (SMN-II; girls>boys) and the right posterior cingulate gyrus within the posterior DMN (boys>girls). Within these networks adolescent transgirls showed FC patterns similar to their experienced gender (female). Also adolescent transboys showed a FC pattern similar to their experienced gender (male), but within the SMN-II only. The prepubertal children did not show any group differences in FC, suggesting that these emerge with aging and during puberty. Our findings provide evidence for the existence of both GD-specific and sex-atypical FC patterns in adolescents with GD.
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Affiliation(s)
- Nienke M Nota
- Department of Internal Medicine, Division of Endocrinology, VU University Medical Center, De Boelelaan 1117, 1081 HV Amsterdam, The Netherlands
| | - Baudewijntje P C Kreukels
- Department of Medical Psychology, Neuroscience Campus Amsterdam, VU University Medical Center, De Boelelaan 1117, 1081 HV Amsterdam, The Netherlands.
| | - Martin den Heijer
- Department of Internal Medicine, Division of Endocrinology, VU University Medical Center, De Boelelaan 1117, 1081 HV Amsterdam, The Netherlands
| | - Dick J Veltman
- Department of Psychiatry, Neuroscience Campus Amsterdam, VU University Medical, Center, De Boelelaan 1117, 1081 HV Amsterdam, The Netherlands
| | - Peggy T Cohen-Kettenis
- Department of Medical Psychology, Neuroscience Campus Amsterdam, VU University Medical Center, De Boelelaan 1117, 1081 HV Amsterdam, The Netherlands
| | - Sarah M Burke
- Department of Developmental and Educational Psychology, Leiden University, Pieter de la Court Gebouw, Wassenaarseweg 52, 2333 AK Leiden, The Netherlands
| | - Julie Bakker
- Department of Medical Psychology, Neuroscience Campus Amsterdam, VU University Medical Center, De Boelelaan 1117, 1081 HV Amsterdam, The Netherlands; Neuroendocrinology, GIGA Neurosciences, University of Liège, Avenue Hippocrate, 15, 4000 Liège, Belgium
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Nota NM, Burke SM, den Heijer M, Soleman RS, Lambalk CB, Cohen-Kettenis PT, Veltman DJ, Kreukels BP. Brain sexual differentiation and effects of cross-sex hormone therapy in transpeople: A resting-state functional magnetic resonance study. Neurophysiol Clin 2017; 47:361-370. [DOI: 10.1016/j.neucli.2017.09.001] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2017] [Revised: 09/05/2017] [Accepted: 09/05/2017] [Indexed: 02/02/2023] Open
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Jacobs JC, Yaquian E, Burke SM, Rouse M, Zaric G. The economic impact of workplace wellness programmes in Canada. Occup Med (Lond) 2017; 67:429-434. [DOI: 10.1093/occmed/kqx075] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Burke SM, Kreukels BP, Cohen-Kettenis PT, Veltman DJ, Klink DT, Bakker J. Male-typical visuospatial functioning in gynephilic girls with gender dysphoria - organizational and activational effects of testosterone. J Psychiatry Neurosci 2016; 41:395-404. [PMID: 27070350 PMCID: PMC5082510 DOI: 10.1503/jpn.150147] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/23/2023] Open
Abstract
BACKGROUND Sex differences in performance and regional brain activity during mental rotation have been reported repeatedly and reflect organizational and activational effects of sex hormones. We investigated whether adolescent girls with gender dysphoria (GD), before and after 10 months of testosterone treatment, showed male-typical brain activity during a mental rotation task (MRT). METHODS Girls with GD underwent fMRI while performing the MRT twice: when receiving medication to suppress their endogenous sex hormones before onset of testosterone treatment, and 10 months later during testosterone treatment. Two age-matched control groups participated twice as well. RESULTS We included 21 girls with GD, 20 male controls and 21 female controls in our study. In the absence of any group differences in performance, control girls showed significantly increased activation in frontal brain areas compared with control boys (pFWE = 0.012). Girls with GD before testosterone treatment differed significantly in frontal brain activation from the control girls (pFWE = 0.034), suggesting a masculinization of brain structures associated with visuospatial cognitive functions. After 10 months of testosterone treatment, girls with GD, similar to the control boys, showed increases in brain activation in areas implicated in mental rotation. LIMITATIONS Since all girls with GD identified as gynephilic, their resemblance in spatial cognition with the control boys, who were also gynephilic, may have been related to their shared sexual orientation rather than their shared gender identity. We did not account for menstrual cycle phase or contraceptive use in our analyses. CONCLUSION Our findings suggest atypical sexual differentiation of the brain in natal girls with GD and provide new evidence for organizational and activational effects of testosterone on visuospatial cognitive functioning.
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Affiliation(s)
- Sarah M. Burke
- Correspondence to: S.M. Burke, Karolinska Institute, Department of Women’s and Children’s Health, Karolinska Hospital, Stockholm, Sweden;
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Staphorsius AS, Kreukels BPC, Cohen-Kettenis PT, Veltman DJ, Burke SM, Schagen SEE, Wouters FM, Delemarre-van de Waal HA, Bakker J. Puberty suppression and executive functioning: An fMRI-study in adolescents with gender dysphoria. Psychoneuroendocrinology 2015; 56:190-9. [PMID: 25837854 DOI: 10.1016/j.psyneuen.2015.03.007] [Citation(s) in RCA: 56] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/21/2014] [Revised: 03/03/2015] [Accepted: 03/04/2015] [Indexed: 10/23/2022]
Abstract
Adolescents with gender dysphoria (GD) may be treated with gonadotropin releasing hormone analogs (GnRHa) to suppress puberty and, thus, the development of (unwanted) secondary sex characteristics. Since adolescence marks an important period for the development of executive functioning (EF), we determined whether the performance on the Tower of London task (ToL), a commonly used EF task, was altered in adolescents with GD when treated with GnRHa. Furthermore, since GD has been proposed to result from an atypical sexual differentiation of the brain, we determined whether untreated adolescents with GD showed sex-atypical brain activations during ToL performance. We found no significant effect of GnRHa on ToL performance scores (reaction times and accuracy) when comparing GnRHa treated male-to-females (suppressed MFs, n=8) with untreated MFs (n=10) or when comparing GnRHa treated female-to-males (suppressed FMs, n=12) with untreated FMs (n=10). However, the suppressed MFs had significantly lower accuracy scores than the control groups and the untreated FMs. Region-of-interest (ROI) analyses showed significantly greater activation in control boys (n=21) than control girls (n=24) during high task load ToL items in the bilateral precuneus and a trend (p<0.1) for greater activation in the right DLPFC. In contrast, untreated adolescents with GD did not show significant sex differences in task load-related activation and had intermediate activation levels compared to the two control groups. GnRHa treated adolescents with GD showed sex differences in neural activation similar to their natal sex control groups. Furthermore, activation in the other ROIs (left DLPFC and bilateral RLPFC) was also significantly greater in GnRHa treated MFs compared to GnRHa treated FMs. These findings suggest that (1) GnRHa treatment had no effect on ToL performance in adolescents with GD, and (2) pubertal hormones may induce sex-atypical brain activations during EF in adolescents with GD.
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Affiliation(s)
- Annemieke S Staphorsius
- Neuroendocrinology Group, Netherlands Institute for Neuroscience, Meibergdreef 47, 1105 BA Amsterdam, The Netherlands
| | - Baudewijntje P C Kreukels
- Center of Expertise on Gender Dysphoria, Department of Medical Psychology, Neuroscience Campus Amsterdam, VU University Medical Center, De Boelelaan 1117, 1081 HZ Amsterdam, The Netherlands
| | - Peggy T Cohen-Kettenis
- Center of Expertise on Gender Dysphoria, Department of Medical Psychology, Neuroscience Campus Amsterdam, VU University Medical Center, De Boelelaan 1117, 1081 HZ Amsterdam, The Netherlands
| | - Dick J Veltman
- Department of Psychiatry, Neuroscience Campus Amsterdam, VU University Medical Center, De Boelelaan 1117, 1081 HZ Amsterdam, The Netherlands
| | - Sarah M Burke
- Neuroendocrinology Group, Netherlands Institute for Neuroscience, Meibergdreef 47, 1105 BA Amsterdam, The Netherlands; Center of Expertise on Gender Dysphoria, Department of Medical Psychology, Neuroscience Campus Amsterdam, VU University Medical Center, De Boelelaan 1117, 1081 HZ Amsterdam, The Netherlands
| | - Sebastian E E Schagen
- Department of Pediatric Endocrinology, Neuroscience Campus Amsterdam, VU University Medical Center, De Boelelaan 1117, 1081 HZ Amsterdam, The Netherlands; Department of Pediatrics, Leiden University Medical Center, Albinusdreef 2, 2333 ZA Leiden, The Netherlands
| | - Femke M Wouters
- Department of Pediatric Endocrinology, Neuroscience Campus Amsterdam, VU University Medical Center, De Boelelaan 1117, 1081 HZ Amsterdam, The Netherlands
| | | | - Julie Bakker
- Neuroendocrinology Group, Netherlands Institute for Neuroscience, Meibergdreef 47, 1105 BA Amsterdam, The Netherlands; GIGA Neurosciences, University of Liège, Avenue de l'Hôpital 1B36, 4000 Liège, Belgium.
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Burke SM, Menks WM, Cohen-Kettenis PT, Klink DT, Bakker J. Click-evoked otoacoustic emissions in children and adolescents with gender identity disorder. Arch Sex Behav 2014; 43:1515-1523. [PMID: 24567168 DOI: 10.1007/s10508-014-0278-2] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/19/2013] [Revised: 07/28/2013] [Accepted: 11/10/2013] [Indexed: 06/03/2023]
Abstract
Click-evoked otoacoustic emissions (CEOAEs) are echo-like sounds that are produced by the inner ear in response to click-stimuli. CEOAEs generally have a higher amplitude in women compared to men and neonates already show a similar sex difference in CEOAEs. Weaker responses in males are proposed to originate from elevated levels of testosterone during perinatal sexual differentiation. Therefore, CEOAEs may be used as a retrospective indicator of someone's perinatal androgen environment. Individuals diagnosed with Gender Identity Disorder (GID), according to DSM-IV-TR, are characterized by a strong identification with the other gender and discomfort about their natal sex. Although the etiology of GID is far from established, it is hypothesized that atypical levels of sex steroids during a critical period of sexual differentiation of the brain might play a role. In the present study, we compared CEOAEs in treatment-naïve children and adolescents with early-onset GID (24 natal boys, 23 natal girls) and control subjects (65 boys, 62 girls). We replicated the sex difference in CEOAE response amplitude in the control group. This sex difference, however, was not present in the GID groups. Boys with GID showed stronger, more female-typical CEOAEs whereas girls with GID did not differ in emission strength compared to control girls. Based on the assumption that CEOAE amplitude can be seen as an index of relative androgen exposure, our results provide some evidence for the idea that boys with GID may have been exposed to lower amounts of androgen during early development in comparison to control boys.
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Affiliation(s)
- Sarah M Burke
- Center of Expertise on Gender Dysphoria, Department of Medical Psychology, VU University Medical Center, De Boelelaan 1131, 1081 HX, Amsterdam, The Netherlands,
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Burke SM, Cohen-Kettenis PT, Veltman DJ, Klink DT, Bakker J. Hypothalamic response to the chemo-signal androstadienone in gender dysphoric children and adolescents. Front Endocrinol (Lausanne) 2014; 5:60. [PMID: 24904525 PMCID: PMC4037295 DOI: 10.3389/fendo.2014.00060] [Citation(s) in RCA: 43] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/21/2013] [Accepted: 04/10/2014] [Indexed: 11/17/2022] Open
Abstract
The odorous steroid androstadienone, a putative male chemo-signal, was previously reported to evoke sex differences in hypothalamic activation in adult heterosexual men and women. In order to investigate whether puberty modulated this sex difference in response to androstadienone, we measured the hypothalamic responsiveness to this chemo-signal in 39 pre-pubertal and 41 adolescent boys and girls by means of functional magnetic resonance imaging. We then investigated whether 36 pre-pubertal children and 38 adolescents diagnosed with gender dysphoria (GD; DSM-5) exhibited sex-atypical (in accordance with their experienced gender), rather than sex-typical (in accordance with their natal sex) hypothalamic activations during olfactory stimulation with androstadienone. We found that the sex difference in responsiveness to androstadienone was already present in pre-pubertal control children and thus likely developed during early perinatal development instead of during sexual maturation. Adolescent girls and boys with GD both responded remarkably like their experienced gender, thus sex-atypical. In contrast, pre-pubertal girls with GD showed neither a typically male nor female hypothalamic activation pattern and pre-pubertal boys with GD had hypothalamic activations in response to androstadienone that were similar to control boys, thus sex-typical. We present here a unique data set of boys and girls diagnosed with GD at two different developmental stages, showing that these children possess certain sex-atypical functional brain characteristics and may have undergone atypical sexual differentiation of the brain.
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Affiliation(s)
- Sarah M. Burke
- Center of Expertise on Gender Dysphoria, Neuroscience Campus Amsterdam, Department of Medical Psychology, VU University Medical Center, Amsterdam, Netherlands
- Neuroendocrinology Group, Netherlands Institute for Neuroscience, Amsterdam, Netherlands
| | - Peggy T. Cohen-Kettenis
- Center of Expertise on Gender Dysphoria, Neuroscience Campus Amsterdam, Department of Medical Psychology, VU University Medical Center, Amsterdam, Netherlands
| | - Dick J. Veltman
- Department of Psychiatry, Neuroscience Campus Amsterdam, VU University Medical Center, Amsterdam, Netherlands
| | - Daniel T. Klink
- Center of Expertise on Gender Dysphoria, Department of Pediatric Endocrinology, VU University Medical Center, Amsterdam, Netherlands
| | - Julie Bakker
- Center of Expertise on Gender Dysphoria, Neuroscience Campus Amsterdam, Department of Medical Psychology, VU University Medical Center, Amsterdam, Netherlands
- Neuroendocrinology Group, Netherlands Institute for Neuroscience, Amsterdam, Netherlands
- GIGA Neuroscience, University of Liege, Liege, Belgium
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Dean GE, Reishtein JL, McVey J, Ambrose M, Burke SM, Haskins M, Jones J. Implementing a Dedicated Education Unit: A Practice Partnership With Oncology Nurses. Clin J Oncol Nurs 2013; 17:208-10. [DOI: 10.1188/13.cjon.208-210] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Burke SM, Utley A. Climbing towards recovery: investigating physically injured combat veterans' psychosocial response to scaling Mt. Kilimanjaro. Disabil Rehabil 2012; 35:732-9. [PMID: 22897354 DOI: 10.3109/09638288.2012.707743] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
PURPOSE To explore physically injured combat veterans' psychosocial response to scaling Mt. Kilimanjaro. METHOD Participants (n = 4) were male and ranged in age from 22 to 44 years. They had all been wounded as a result of active duty in Afghanistan between 15 and 42 months (M = 27.25) before the study. Data were collected throughout a 9-day climb on Mt. Kilimanjaro using multiple sources of ethnographic data collection techniques including semi-structured interviews and detailed observations. Data were analyzed using cross case analysis. RESULTS The findings are divided into themes that were drawn out of the data to illustrate the participants' psychosocial response to their experience of climbing on Mt. Kilimanjaro. Key themes of self-determination, active coping and social support were identified from the data. CONCLUSION Support for those in recovery from trauma should foster psychosocial resources needed for healthy functioning. Future research should explore the role of meaningful and challenging activities as a way of improving the experience of recovery following serious injury.
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Affiliation(s)
- S M Burke
- Centre for Sport and Exercise Sciences, Institute of Membrane and Systems Biology, University of Leeds, Leeds, UK.
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Burke SM, Veltman DJ, Gerber J, Hummel T, Bakker J. Heterosexual men and women both show a hypothalamic response to the chemo-signal androstadienone. PLoS One 2012; 7:e40993. [PMID: 22815889 PMCID: PMC3397979 DOI: 10.1371/journal.pone.0040993] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2012] [Accepted: 06/18/2012] [Indexed: 11/18/2022] Open
Abstract
The odorous steroid compound 4,16-androstadien-3-one (androstadienone), found in axillary sweat, was previously reported to evoke hypothalamic activation in heterosexual women, but not in heterosexual men. However, subjects were exposed to the pure crystalline form of androstadienone, which raised the question whether the observed hypothalamic response is physiologically relevant. Therefore, in the present study, we asked whether sexually dimorphic hypothalamic responses could be measured when subjects were exposed to lower, more physiologically relevant concentrations of androstadienone. A total of 21 women and 16 men, all heterosexual, participated in our functional magnetic resonance imaging study (fMRI). Three different concentrations of androstadienone diluted in propylene glycol (10 mM “high,” 0.1 mM “medium” and 0.001 mM “low”) were delivered to the subjects’ nostrils using a computer-controlled stimulator. When exposed to the “high” androstadienone concentration, women showed stronger hypothalamic activation than men. By contrast, men showed more hypothalamic activation when exposed to the “medium” androstadienone concentrations in comparison to women. Thus, we replicated that smelling the chemo-signal androstadienone elicits a hypothalamic activation. However, this effect does not seem to be gender-specific, because androstadienone activated the hypothalamus in both men and women, suggesting that androstadienone exerts specific effects in heterosexual individuals of both sexes.
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Affiliation(s)
- Sarah M. Burke
- Department of Medical Psychology, VU University Medical Center, Amsterdam, The Netherlands
| | - Dick J. Veltman
- Department of Psychiatry, VU University Medical Center, Amsterdam, The Netherlands
| | - Johannes Gerber
- Department of Neuroradiology, University of Dresden Medical School, Dresden, Germany
| | - Thomas Hummel
- Department of Otorhinolaryngology, University of Dresden Medical School, Dresden, Germany
| | - Julie Bakker
- Department of Medical Psychology, VU University Medical Center, Amsterdam, The Netherlands
- GIGA Neuroscience, University of Liege, Liege, Belgium
- Netherlands Institute for Neuroscience, Amsterdam, The Netherlands
- * E-mail:
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Burke SM, van de Giessen E, de Win M, Schilt T, van Herk M, van den Brink W, Booij J. Serotonin and dopamine transporters in relation to neuropsychological functioning, personality traits and mood in young adult healthy subjects. Psychol Med 2011; 41:419-429. [PMID: 20367893 DOI: 10.1017/s0033291710000486] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
BACKGROUND Serotonin and dopamine neurotransmitter systems are implicated in the regulation of mood, cognition and personality traits and their dysfunction is thought to be implicated in diverse psychopathologies. However, in healthy subjects the relationship between the serotonin and dopamine systems and neuropsychological functioning and personality traits is not clearly established. In the present study we investigated whether neuropsychological functioning, personality traits and mood states of a group of healthy subjects are associated with in vivo measures of serotonin transporters (SERTs) and dopamine transporters (DATs). METHOD A total of 188 young healthy subjects underwent neuropsychological and subjective measurements of memory function, depression and impulsivity. Participants' SERT and DAT availability in predefined regions of interest were assessed using single photon emission computed tomography (SPECT) with the radiotracer [123I]β-CIT. Individual magnetic resonance imaging (MRI) scans served as anatomic reference. RESULTS We did not find any significant association between SERT or DAT availability and neuropsychological test performance or self-reported impulsivity and mood. There were no significant sex differences in SERT or DAT availability, but men performed significantly better on some tests of visuospatial functioning than women. CONCLUSIONS Robust negative findings for striatal DAT availability seriously question earlier findings of positive associations between DAT availability and cognitive functions in healthy subjects. Our results also suggest that subcortical SERT availability is not associated with the neuropsychological functions and personality traits assessed. In summary, the present study suggests that neuropsychological and personality measurements in young healthy people are not associated with subcortical SERT or striatal DAT availabilities in the brain.
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Affiliation(s)
- S M Burke
- Department of Medical Psychology, VU University Medical Center, Amsterdam, The Netherlands
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Burke SM, Shmulevitz M, Mohan K, Lee PWK, Issekutz TB, Marshall JS. Human mast cells respond to viral infection by recruiting NK cells and T cells. Allergy Asthma Clin Immunol 2010. [PMCID: PMC2874284 DOI: 10.1186/1710-1492-6-s1-p15] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
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Burke SM, Marshall JS. Keystone symposium on 'Mast cells, Basophils and IgE: host defense and disease'. Expert Rev Clin Immunol 2007; 3:259-60. [PMID: 20477668 DOI: 10.1586/1744666x.3.3.259] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Affiliation(s)
- Sarah M Burke
- Dalhousie University, Department of Microbiology and Immunology, Halifax, Nova Scotia, Canada.
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Abstract
OBJECTIVE To determine whether induced mood alters health reports. DESIGN Randomized experiments testing a) mood influence on two global self-rated health (SRH) assessments (Study 1; N = 168) and b) testing whether illness relevant thinking moderates the influence of induced negative mood on SRH and physical symptom reports (Study 2; N = 143). MAIN OUTCOME MEASURES Two global SRH items. Results. Effect sizes for induced mood were near zero across both studies (r's = 0.00-0.07). Aggregate analyses of induced mood studies showed a small adverse effect of induced negative mood on SRH, but these analyses masked roughly equal instances of better SRH among groups with worse mood. CONCLUSION Published experimental research shows no consistent pattern of poorer SRH following negative mood induction in college-aged samples. Sample size and gender may account for variation in health ratings among induced mood groups.
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Affiliation(s)
- Steven D Barger
- Department of Psychology, Northern Arizona University, Flagstaff, AZ 86011, USA.
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Evans SJ, Choudary PV, Vawter MP, Li J, Meador-Woodruff JH, Lopez JF, Burke SM, Thompson RC, Myers RM, Jones EG, Bunney WE, Watson SJ, Akil H. DNA microarray analysis of functionally discrete human brain regions reveals divergent transcriptional profiles. Neurobiol Dis 2003; 14:240-50. [PMID: 14572446 PMCID: PMC3098567 DOI: 10.1016/s0969-9961(03)00126-8] [Citation(s) in RCA: 42] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Transcriptional profiles within discrete human brain regions are likely to reflect structural and functional specialization. Using DNA microarray technology, this study investigates differences in transcriptional profiles of highly divergent brain regions (the cerebellar cortex and the cerebral cortex) as well as differences between two closely related brain structures (the anterior cingulate cortex and the dorsolateral prefrontal cortex). Replication of this study across three independent laboratories, to address false-positive and false-negative results using microarray technology, is also discussed. We find greater than a thousand transcripts to be differentially expressed between cerebellum and cerebral cortex and very few transcripts to be differentially expressed between the two neocortical regions. We further characterized transcripts that were found to be specifically expressed within brain regions being compared and found that ontological classes representing signal transduction machinery, neurogenesis, synaptic transmission, and transcription factors were most highly represented.
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Affiliation(s)
- S J Evans
- Pritzker Consortium for Severe Psychiatric Disorders, San Francisco, CA, USA.
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Burke SM. Creating competency for home healthcare. Case management manual: a work-in-progress. Home Healthc Nurse Manag 1999; 3:2-7. [PMID: 10876502] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 04/14/2023]
Affiliation(s)
- S M Burke
- St. Mary's Good Samaritan, Inc. Home Health/Hospice, Mt. Vernon, Illinois 62864-2880, USA.
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Affiliation(s)
- S M Burke
- Villanova University College of Nursing, Pennsylvania, USA
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Burke SM. Oral imitrex for migraine relief. MCN Am J Matern Child Nurs 1996; 21:316. [PMID: 8952287 DOI: 10.1097/00005721-199611000-00020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Affiliation(s)
- S M Burke
- Villanova University College of Nursing, Pennsylvania, USA
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Burke SM. Respigam for protection against RSV. MCN Am J Matern Child Nurs 1996; 21:258. [PMID: 8840776 DOI: 10.1097/00005721-199609000-00013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Affiliation(s)
- S M Burke
- Villanova University College of Nursing, Pennsylvania, USA
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Burke SM. Hydroxyurea in sickle cell disease. MCN Am J Matern Child Nurs 1996; 21:210. [PMID: 8754440 DOI: 10.1097/00005721-199607000-00029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Affiliation(s)
- S M Burke
- Villanova University College of Nursing, Pennsylvania, USA
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Burke SM. Azithromycin: only once a day. MCN Am J Matern Child Nurs 1996; 21:162. [PMID: 8857402 DOI: 10.1097/00005721-199605000-00019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Affiliation(s)
- S M Burke
- Villanova University, College of Nursing, Pennsylvania, USA
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Affiliation(s)
- S M Burke
- Villanova University College of Nursing, Pennsylvania, USA
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Affiliation(s)
- S M Burke
- Villanova University College of Nursing, Pennsylvania, USA
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Burke SM. Home health challenges: paperwork vs. peoplework. Nurs Manag (Harrow) 1990; 21:64. [PMID: 2234681 DOI: 10.1097/00006247-199011000-00017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
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del Bueno DJ, Griffin LR, Burke SM, Foley MA. The clinical teacher. A critical link in competence development. J Nurs Staff Dev 1990; 6:135-8. [PMID: 2362216] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
Regardless of market conditions, staff development personnel are responsible for helping to meet the organization's need for competent staff. Collaboration between the organization's education and clinical staff is essential to effect a successful transfer from having knowledge to performing effectively. One organization's response to the challenge of competence development, and how a successful transfer of learning can be achieved by collaboration between clinical educators and clinical staff is reported.
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Burke SM, Pflaum SW, Knafle JD. The influence of black English on diagnosis of reading in learning disabled and normal readers. J Learn Disabil 1982; 15:19-22. [PMID: 7069280 DOI: 10.1177/002221948201500105] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/21/2023]
Abstract
This study investigated the removal of black English dialect features from the error scores of three oral reading tests—the Gray Oral Reading Test, the Gilmore Oral Reading Test, and the Spache Diagnostic Reading Scales. The 40 children in the sample population (20 control children matched by age and sex with 20 children identified by the school as learning disabled) were given all three tests. Each test was scored first using test manual criteria and then rescored using those criteria but eliminating from the error count any dialect miscue. On all three tests, LD children scored lower than control children. Also, the effect of removing dialect miscues as errors caused an overall increase in reading scores on all three tests. On the Gray and Spache tests, but not on the Gilmore test, control children benefited more from the removal of dialect responses as errors than LD children. Additionally, the results indicated that dialect had a greater impact on the scores of the Gilmore than it did on the Gray and Spache tests.
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