Gingnell Malin, Ahlstedt Victoria, Bannbers Elin, Wikström Johan, Sundström-Poromaa Inger, Fredrikson Mats
Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden.
Department of Psychology, Uppsala University, Uppsala, Sweden.
Biol Mood Anxiety Disord. 2014 Feb 26;4(1):3. doi: 10.1186/2045-5380-4-3.
Premenstrual dysphoric disorder (PMDD), characterized by luteal phase-induced negative affect and loss of impulse control, often results in compromised social interactions. Although amygdala activation is generally linked to negative affect, increased amygdala reactivity to aversive stimuli in the luteal phase has not been consistently reported in PMDD. We tested the hypothesis that amygdala hyper-reactivity in PMDD is symptom specific, rather than generalized, and linked to socially relevant stimuli. Blood oxygenation level dependent signal changes during exposure to negative images with social and non-social content were evaluated in the mid-follicular and late luteal phase of the menstrual cycle. Fourteen women with PMDD and 13 healthy controls participated.
When compared with healthy controls, women with PMDD in the luteal phase had enhanced reactivity to social stimuli compared to non-social stimuli in the amygdala and insula, but attenuated reactivity in the anterior cingulate cortex. Functional couplings between emotion processing and controlling areas were significantly different, being positive in women with PMDD and negative in healthy controls. Changes in progesterone levels in women with PMDD correlated positively with altered amygdala reactivity.
Socially relevant aversive stimulation elicited enhanced activity in affective processing brain regions that were functionally coupled to compromised activity in cognitive control areas. Because increased reactivity correlated positively with alterations in ovarian steroid levels, data preliminary support the hypothesis that enhanced progesterone sensitivity in PMDD affects corticolimbic processing of social emotions.
经前烦躁障碍(PMDD)以黄体期诱发的负面情绪和冲动控制丧失为特征,常导致社交互动受损。虽然杏仁核激活通常与负面情绪有关,但PMDD患者黄体期杏仁核对厌恶刺激的反应性增加尚未得到一致报道。我们检验了这样一个假设,即PMDD中的杏仁核高反应性是症状特异性的,而非全身性的,且与社会相关刺激有关。在月经周期的卵泡中期和黄体晚期,评估了暴露于具有社会和非社会内容的负面图像期间的血氧水平依赖信号变化。14名患有PMDD的女性和13名健康对照者参与了研究。
与健康对照者相比,黄体期的PMDD女性杏仁核和脑岛对社会刺激的反应性比非社会刺激增强,但前扣带回皮质的反应性减弱。情绪处理和控制区域之间的功能耦合存在显著差异,在PMDD女性中为正,在健康对照者中为负。PMDD女性的孕酮水平变化与杏仁核反应性改变呈正相关。
社会相关的厌恶刺激在情感处理脑区引发了增强的活动,这些脑区在功能上与认知控制区域受损的活动相关联。由于反应性增加与卵巢甾体水平的改变呈正相关,数据初步支持了这样的假设,即PMDD中孕酮敏感性增强会影响社会情绪的皮质边缘处理。