Neural Substrates of Emotion Regulation in Premenstrual Dysphoric Disorder

描述(由申请人提供)：经前焦虑症(PMDD)是经前综合征的一种严重变种，影响2%-5%的育龄妇女，生活质量的下降与严重抑郁障碍相当(Epson等人，2012年；Halbreich等人，2003年；Wittchen等人，2002年)。然而，对这种疾病的研究还不够充分，对其神经生物学基础缺乏了解，阻碍了PMDD的治疗。情绪性症状，如易怒/愤怒，抑郁，情绪波动，焦虑，出现在黄体期，表明情绪调节问题可能是导致这种障碍的原因之一，但我们知道没有关于PMDD女性情绪调节的研究。我们假设，调节情绪调节的神经回路功能障碍是PMDD情感症状的重要因素。该项目的主要目标是使用功能磁共振成像(FMRI)来测试这一想法， 在患有经前抑郁症的女性和没有这种疾病的对照参与者中。两组女性(每组18名)将在执行有效任务的同时接受功能磁共振成像，这些任务包括呈现情绪唤起的图像，以及有意和偶然地调节负面情绪反应。检测将在月经周期的黄体晚期、PMDD症状出现时和卵泡期进行。该项目的成功将有助于阐明PMDD症状的病因，并为评估改善这种疾病的行为和药物干预提供生物标志物。

DESCRIPTION (provided by applicant): Premenstrual dysphoric disorder (PMDD), a severe variant of premenstrual syndrome, affects 2-5% of women in their reproductive years, with decreases in quality of life comparable to those observed in major depressive disorder (Epperson et al., 2012; Halbreich et al., 2003; Wittchen et al., 2002). The disorder is nonetheless understudied, and treatment of PMDD is hindered by a lack of knowledge regarding its neurobiological basis. Affective symptoms, such as irritability/anger, depression, mood swings, anxiety, which appear in the luteal phase, suggest that problems with emotion regulation may contribute to the disorder, but we are aware of no study of emotion regulation in women with PMDD. We hypothesize that dysfunction in the neural circuitry that mediates emotion regulation is an important contributor to the affective symptoms of PMDD. The primary objective of this project is to test this idea, using functional magnetic resonance imaging (fMRI), in women with PMDD and comparison participants without the disorder. Two groups of women (n=18 per group) will undergo fMRI while performing validated tasks that involve presentation of emotionally evocative images, and the intentional and incidental regulation of negative emotional response. Testing will be done during the late luteal phase of the menstrual cycle, when PMDD symptoms occur, and the follicular phase. Success in this project will help clarify the etiology of the symptoms of PMDD, and provide biomarkers for assessing behavioral and pharmacological interventions to ameliorate this disorder.