Department of Psychiatry, Perelman School of Medicine at the University of Pennsylvania, 3535 Market Street, Philadelphia, PA, 19104, USA.
Seaver Autism Center for Research and Treatment, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
Curr Psychiatry Rep. 2018 May 18;20(6):40. doi: 10.1007/s11920-018-0906-y.
Neuroactive steroid hormones, such as estradiol and progesterone, likely play a role in the pathophysiology of female-specific psychiatric disorders such as premenstrual dysphoric disorder (PMDD) and postpartum depression and may contribute to the marked sex differences observed in the incidence and presentation of affective disorders. However, few tools are available to study the precise contributions of these neuroactive steroids (NSs). In this review, we propose that the acoustic startle response (ASR), an objective measure of an organism's response to an emotional context or stressor, is sensitive to NSs. As such, the ASR represents a unique translational tool that may help to elucidate the contribution of NSs to sex differences in psychiatric disorders.
Findings suggest that anxiety-potentiated startle (APS) and prepulse inhibition of startle (PPI) are the most robust ASR paradigms for assessing contribution of NSs to affective disorders, while affective startle response modulation (ASRM) appears less diagnostic of sex or menstrual cycle (MC) effects. However, few studies have appropriately used ASR to test a priori hypotheses about sex or MC differences. We recommend that ASR studies account for sex as a biological variable (SABV) and hormonal status to further knowledge of NS contribution to affective disorders.
神经活性甾体激素，如雌二醇和孕酮，可能在女性特有的精神疾病的病理生理学中发挥作用，如经前烦躁障碍（PMDD）和产后抑郁症，并且可能导致情感障碍的发生率和表现中观察到的明显性别差异。然而，很少有工具可用于研究这些神经活性甾体（NS）的确切作用。在这篇综述中，我们提出，听觉惊吓反应（ASR）是一种评估生物体对情绪环境或应激源反应的客观测量方法，对 NS 敏感。因此，ASR 代表了一种独特的转化工具，可帮助阐明 NS 对精神疾病中性别差异的贡献。
研究结果表明，焦虑增强的惊吓（APS）和惊吓前脉冲抑制（PPI）是评估 NS 对情感障碍贡献的最有力的 ASR 范式，而情感惊吓反应调节（ASRM）似乎对性别或月经周期（MC）的影响不太具有诊断性。然而，很少有研究使用 ASR 来恰当地检验关于性别或 MC 差异的先验假设。我们建议 ASR 研究将性别作为生物学变量（SABV）和激素状态纳入其中，以进一步了解 NS 对情感障碍的贡献。
