Neural correlates of emotion reactivity and emotion regulation in premenstrual dysphoric disorder : evidence for menstrual cycle phase-dependent and -independent effects in key regions of the salience network

• Background: Emotion regulation deficits have been highlighted as a transdiagnostic feature of multiple psychiatric disorders. Deficient prefrontal “top-down” regulation of key nodes of the salience network (SN) associated with emotion generation, has previously been hypothesized to be relevant also in premenstrual dysphoric disorder (PMDD).Methods: In the present study, we used functional magnetic resonance imaging (fMRI) to investigate menstrual-cycle related variations in brain activity and connectivity in response to two separate emotional tasks (emotion reactivity and regulation) in 29 women with PMDD and 27 controls. We also examined whether differential brain activation between groups is related to premenstrual symptom severity and serum levels of progesterone-derived neuroactive steroids.Results: We did not find convincing evidence for reduced activity in regions associated with the conscious control of emotion in PMDD. However, women with PMDD showed increased reactivity in key nodes of the SN and the default mode network (DMN) during the luteal phase compared to control women. Furthermore, SN hyperactivity was apparent also during the follicular phase and related to PMDD symptom severity. We found no evidence of altered network connectivity across the menstrual cycle in PMDD women.Conclusion: SN dysfunction during the luteal phase may mediate multiple network aberrations. Furthermore, higher baseline (follicular) SN activity may render PMDD women more susceptible to severe mood symptoms in response to hormonal fluctuations. What drives increased SN activity in the follicular phase is unknown, but innate and neuroplastic mechanisms are proposed.

Subject headings

MEDICIN OCH HÄLSOVETENSKAP  -- Klinisk medicin (hsv//swe)

MEDICAL AND HEALTH SCIENCES  -- Clinical Medicine (hsv//eng)

MEDICIN OCH HÄLSOVETENSKAP  -- Klinisk medicin -- Annan klinisk medicin (hsv//swe)

MEDICAL AND HEALTH SCIENCES  -- Clinical Medicine -- Other Clinical Medicine (hsv//eng)

Keyword

obstetrik och gynekologi

Obstetrics and Gynaecology

Publication and Content Type

vet (subject category)

ovr (subject category)