Article

Neuroimaging evidence of cerebellar involvement in premenstrual dysphoric disorder

Department of Obstetrics and Gynecology, David Geffen School of Medicine at University of California at Los Angeles, Los Angeles, California 90095-1740, USA.
Biological psychiatry (Impact Factor: 9.47). 02/2011; 69(4):374-80. DOI: 10.1016/j.biopsych.2010.09.029
Source: PubMed

ABSTRACT Premenstrual dysphoric disorder (PMDD) is a debilitating cyclic disorder that is characterized by affective symptoms, including irritability, depression, and anxiety, which arise in the luteal phase of the menstrual cycle and resolve soon after the onset of menses. Despite a prevalence of up to 8% in women of reproductive age, few studies have investigated the brain mechanisms that underlie this disorder.
We used positron emission tomography with [(18)F] fluorodeoxyglucose and self-report questionnaires to assess cerebral glucose metabolism and mood in 12 women with PMDD and 12 healthy comparison subjects in the follicular and late luteal phases of the menstrual cycle. The primary biological end point was incorporated regional cerebral radioactivity (scaled to the global mean) as an index of glucose metabolism. Relationships between regional brain activity and mood ratings were assessed. Blood samples were taken before each session for assay of plasma estradiol and progesterone concentrations.
There were no group differences in hormone levels in either the follicular or late luteal phase, but the groups differed in the effect of menstrual phase on cerebellar activity. Women with PMDD but not comparison subjects showed an increase in cerebellar activity (particularly in the right cerebellar vermis) from the follicular phase to the late luteal phase (p = .003). In the PMDD group, this increase in cerebellar activity was correlated with worsening of mood (p = .018).
These findings suggest that the midline cerebellar nuclei, which have been implicated in other mood disorders, also contribute to negative mood in PMDD.

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    • "Toward a functional neuroanatomy of PMDD fMRI 8 PMDD, 12 controls BOLD activation during an emotional word Go/NoGo task in whole-brain (corrected) and frontal cortex, amygdala and nucleus accumbens ROIs Symptomatic women with PMDD had higher amygdala activation by negative words and lower nucleus accumbens activation by positive words than controls No Rapkin et al. 2011. Neuroimaging evidence of cerebellar involvement in PMDD FDG PET 12 PMDD, 12 controls "
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    • "Although the temporal relationship between peak luteal progesterone and occurrence of mood changes is obvious (Bäckström et al., 2003), results of clinical case–control studies are inconsistent. Many studies reported no significant differences in levels of estradiol and progesterone between women who are affected by premenstrual syndrome and those who are not (review in Bäckström et al., 2003; Andreen et al., 2009; Rapkin et al., 2011). In other studies , PMS patients had either decreased (Dennerstein et al., 1984; Munday et al., 1981) or increased (Eriksson et al., 1992; Redei and Freeman, 1995) levels of progesterone. "
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