The impact of menarche on hippocampal mechanisms of severity of psychotic-like experiences in the ABCD study.
The impact of menarche on hippocampal mechanisms of severity of psychotic-like experiences in the ABCD study.
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ABCD 研究中初潮对精神病样经历严重程度的海马机制的影响。
DOI：
10.1016/j.psyneuen.2024.106961
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发表时间：
2024
影响因子：
3.7
通讯作者：
Mittal,VijayA
中科院分区：
文献类型：
--
作者：
Damme,KatherineSF;Hernandez,JoannaJ;Mittal,VijayA
越来越多的证据表明，雌激素在精神病的发病机制中起着重要的调节作用。雌激素在新兴的精神病理学和神经发育的动态发展背景下出现。因此，雌二醇（雌激素的主要形式）可能会直接或间接地影响精神病的不稳定性，通过其对雌激素敏感的区域，如海马神经发育的影响。了解这种影响可能会提供新的见解精神病不稳定的机制。这项研究包括来自青少年大脑认知发育（ABCD）研究（年龄8-13岁）的4422名女性参与者的基线和第2年时间点，这些参与者的雌二醇可用性不同（初潮前，初潮后，初潮前和初潮后时间点）。在多水平模型中，使用月经初潮状态（前/后），雌二醇的可用性与精神病样经历（PLE）的严重程度直接相关，并与海马连接性产生交互作用。PLE的严重程度是最高的个人与初潮强调的重要性，发展的时机。虽然PLE的严重程度随着时间的推移而降低，但在2年内仍保持临床相关性。较低的海马连接与PLE严重程度升高有关。这种影响被雌二醇调节;在雌二醇可用之前（初潮前），较低的海马连接显著有助于PLE的严重程度，但当雌二醇可用时（初潮后）海马连接障碍并不能解释PLE的严重程度。这种调节作用表明，雌激素对海马可塑性的影响也降低了海马对PLE严重程度的机械作用。此外，月经初潮后PLE严重程度没有显着直接降低，这可能表明其他相互作用的精神病不稳定因素在这个关键发育时期的作用有所增加。
Accumulating evidence suggests that estrogens play an important modulatory role in the pathogenesis of psychosis. Estrogens come online within a dynamic developmental context of emerging psychopathology and neurodevelopment. As a result, estradiol (the primary form of estrogen) may influence psychosis lability directly or indirectly through its neurodevelopmental influence on estrogens-sensitive areas like the hippocampus. Understanding this influence may provide novel insight into mechanisms of psychosis lability. This study included baseline and year 2 timepoints from 4422 female participants from the Adolescent Brain Cognitive Development (ABCD) study (age 8–13), who varied in estradiol availability (pre-menarche, post-menarche, pre- and post-menarche timepoints). Estradiol availability was related to psychotic-like experiences (PLE) severity both directly and as an interactive effect with hippocampal connectivity using menarche status (pre/post) in a multilevel model. PLE severity was highest in individuals with early menarche emphasizing the importance of the developmental timing. Although PLE severity decreased over time in the sample, it stayed clinically-relevant over 2 years. Lower hippocampal connectivity was related to elevated PLE severity. This effect was moderated by estradiol; before the availability of estradiol (pre-menarche), lower hippocampal connectivity significantly contributed to the PLE severity, but when estradiol was available (post-menarche) hippocampal dysconnectivity did not account for PLE severity. This moderation suggests that the estrodiol’s influence on hippocampal plasticity also reduced the mechanistic role of the hippocampus on PLE severity. Further, the lack of a significant direct reduction of PLE severity post-menarche, may suggest an increased role for other interacting psychosis lability factors during this critical developmental period.