探索经前期烦躁障碍的生物学机制：从基因到 GABA。
Towards understanding the biology of premenstrual dysphoric disorder: From genes to GABA.
机构信息
Department of Psychiatry & Behavioral Sciences, The Johns Hopkins University School of Medicine, 550 N. Broadway Street, Baltimore, MD 21205, USA.
Department of Psychiatry and Neurobehavioral Sciences, University of Virginia, PO Box 800548, Charlottesville, VA 22908, USA.
出版信息
Neurosci Biobehav Rev. 2023 Jun;149:105168. doi: 10.1016/j.neubiorev.2023.105168. Epub 2023 Apr 12.
Premenstrual dysphoric disorder (PMDD) is a severe mood disorder, with affective symptoms that rise and fall in concert with the hormonal fluctuations of the menstrual cycle. PMDD's pathophysiology is poorly understood. This review describes recent research on potential biological contributors to PMDD, with a focus on neuroactive steroids, genetics, neuroimaging and cellular studies. Studies suggest that a key contributor is abnormal central nervous system (CNS) response to fluctuations in neuroactive steroid hormones. Imaging studies are limited but support alterations in serotonergic and GABA transmission. Genetic studies suggest heritability, yet specific genetic contributors have not been characterized. Finally, recent cutting-edge cellular studies indicate an underlying vulnerability to the effect of sex hormones at a cellular level. Overall the findings across studies do not yet fit together into a complete description of the underlying biology of PMDD. It is possible that PMDD consists of biological subtypes, and future research may benefit from a subtyping approach.
经前期烦躁障碍（PMDD）是一种严重的情绪障碍，其情感症状与月经周期中的激素波动同步上升和下降。PMDD 的病理生理学尚未完全了解。本综述描述了 PMDD 潜在生物学贡献者的最新研究，重点是神经活性甾体、遗传学、神经影像学和细胞研究。研究表明，中枢神经系统（CNS）对神经活性甾体激素波动的异常反应是一个关键因素。影像学研究有限，但支持 5-羟色胺能和 GABA 能传递的改变。遗传研究表明存在遗传性，但尚未确定具体的遗传贡献者。最后，最近的前沿细胞研究表明，在细胞水平上对性激素的作用存在潜在的脆弱性。总的来说，这些研究结果还没有形成一个完整的 PMDD 潜在生物学描述。PMDD 可能由生物学亚型组成，未来的研究可能受益于亚分型方法。
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