Toffoletto Simone, Lanzenberger Rupert, Gingnell Malin, Sundström-Poromaa Inger, Comasco Erika
Department of Neuroscience, Uppsala University, Uppsala, Sweden.
Department of Psychiatry and Psychotherapy, Medical University of Vienna, Austria.
Psychoneuroendocrinology. 2014 Dec;50:28-52. doi: 10.1016/j.psyneuen.2014.07.025. Epub 2014 Aug 13.
Ovarian hormones are pivotal for the physiological maintenance of the brain function as well as its response to environmental stimuli. There is mounting evidence attesting the relevance of endogenous ovarian hormones as well as exogenous estradiol and progesterone for emotional and cognitive processing. The present review systematically summarized current knowledge on sex steroid hormonal modulation of neural substrates of emotion and cognition revealed by functional magnetic resonance imaging (fMRI). Twenty-four studies of healthy naturally cycling and combined oral contraceptives (COC) user women, or women undergoing experimental manipulations, during their reproductive age, were included. Furthermore, six studies of premenstrual dysphoric disorder (PMDD), a hormonally based mood disorder, and three of gender dysphoria (GD), which provides an intriguing opportunity to examine the effect of high-dose cross-sex hormone therapy (CSHT) on brain functioning, were included. Globally, low (early follicular and the entire follicular phase for estrogen and progesterone, respectively) and high (COC, CSHT, late follicular and luteal phase for estrogen; COC, mid- and late-luteal phase for progesterone) hormonal milieu diversely affected the response of several brain regions including the amygdala, anterior cingulate cortex, and inferior frontal gyrus, but their functional recruitment across groups and domains was scattered. The constellation of findings provides initial evidence of the influence of sex steroid hormones on cortical and subcortical regions implicated in emotional and cognitive processing. Further well-powered and multimodal neuroimaging studies will be needed to identify the neural mechanism of functional brain alterations induced by sex steroid hormones.
卵巢激素对于大脑功能的生理维持及其对环境刺激的反应至关重要。越来越多的证据证明内源性卵巢激素以及外源性雌二醇和孕酮与情绪和认知加工的相关性。本综述系统总结了通过功能磁共振成像（fMRI）揭示的性类固醇激素对情绪和认知神经基质调节的现有知识。纳入了24项针对处于生殖年龄的自然月经周期健康女性、复方口服避孕药（COC）使用者或接受实验操作的女性的研究。此外，还纳入了6项关于经前烦躁障碍（PMDD，一种基于激素的情绪障碍）的研究以及3项关于性别烦躁症（GD）的研究，后者为研究高剂量跨性别激素疗法（CSHT）对大脑功能的影响提供了一个有趣的机会。总体而言，低激素环境（雌激素和孕酮分别处于卵泡早期和整个卵泡期）和高激素环境（雌激素方面为COC、CSHT、卵泡晚期和黄体期；孕酮方面为COC、黄体中期和晚期）对包括杏仁核、前扣带回皮质和额下回在内的多个脑区的反应有不同影响，但它们在不同组和不同领域的功能激活情况是分散的。这些研究结果共同提供了性类固醇激素对参与情绪和认知加工的皮质和皮质下区域有影响的初步证据。还需要进一步开展有足够效力和多模态的神经影像学研究，以确定性类固醇激素诱导大脑功能改变的神经机制。
