Premenstrual dysphoric disorder and prefrontal reactivity during anticipation of emotional stimuli
Premenstrual dysphoric disorder and prefrontal reactivity during anticipation of emotional stimuli
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DOI：
10.1016/j.euroneuro.2013.08.002
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发表时间：
2013-11-01
影响因子：
5.6
通讯作者：
Sundstrom-Poromaa, Inger
中科院分区：
文献类型：
--
作者：
Gingnell, Malin;Bannbers, Elin;Sundstrom-Poromaa, Inger
约 5% 的育龄女性患有经前期紊乱 (PMDD)。大脑情绪处理区域对卵巢类固醇水平变化的敏感性增加被认为是经前抑郁症病理生理学的一部分，但之前关于情绪处理的神经影像学研究尚未得出结论。然而，之前对患有经前抑郁症（PMDD）的女性进行的行为研究表明，在情绪预期期间黄体期惊吓反应性增强。在这里，我们使用功能磁共振成像 (fMRI) 来研究患有和不患有经前抑郁症的女性在整个月经周期中预期和暴露于情绪刺激期间的中枢神经回路活动。与健康对照组相比，患有经前抑郁症的女性在黄体期预期负面情绪刺激时，前额叶皮层的反应性显着增强，但暴露于负面情绪刺激时则没有。在经前抑郁症患者中，在预期或观看负面情绪刺激期间的大胆反应并不依赖于雌二醇或黄体酮的绝对水平。然而，黄体酮水平与背外侧前额叶皮层对积极情绪刺激的情绪诱发反应呈正相关。这些发现表明，经前抑郁症患者在黄体期期间，预期期间的皮质情绪回路反应发生了改变，这可能是经前抑郁症女性报告的情绪症状或缺乏情绪控制背后的病理生理学的一部分。 (C) 2013 Elsevier B.V. 和 ECNP。版权所有。
Premenstrual disorder (PMDD) affects around 5% of women in childbearing ages. An increased sensitivity in emotion processing areas of the brain to variations in ovarian steroid levels has been suggested as part of the pathophysiology in PMDD, but prior neuroimaging studies of emotion processing are yet inconclusive. Previous behavioral studies of women with PMDD have, however, reported enhanced luteal phase startle responsivity during emotional anticipation. Here we used functional magnetic resonance imaging (fMRI) to investigate central neural circuitry activity during anticipation of, and exposure to, emotional stimuli across the menstrual cycle in women with and without PMDD. As compared to healthy controls, women with PMDD displayed significantly enhanced reactivity in the prefrontal cortex during anticipation of, but not exposure to, negative emotional stimuli during the luteal phase. In PMDD patients, BOLD reactivity during anticipation or viewing of negative emotional stimuli was not dependent on absolute levels of estradiol or progesterone. However, progesterone levels were positively correlated with emotion-induced reactivity in the dorsolateral prefrontal cortex to positive emotional stimuli. These findings suggest that cortical emotional circuitry reactivity during anticipation is altered in PMDD during the luteal phase, which might be part of the pathophysiology behind the emotional symptoms or lack of emotional control reported by women with PMDD. (C) 2013 Elsevier B.V. and ECNP. All rights reserved.