Hormonal Cycles, Brain Network Connectivity, and Windows of Vulnerability to Affective Disorder

The rate of affective disorder is substantially higher in women than in men, and considerable evidence points to the actions of ovarian hormones in mediating this disparity. In this Opinion, we discuss the hypothesis that cyclic changes in ovarian hormone levels produce cyclic alterations in connect...

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Bibliographic Details
Published in:Trends in neurosciences (Regular ed.) 2018-10, Vol.41 (10), p.660-676
Main Authors: Andreano, Joseph M., Touroutoglou, Alexandra, Dickerson, Brad, Barrett, Lisa Feldman
Format: Article
Language:English
Subjects:
Affect - physiology
Animals
Brain Mapping
Humans
Memory - physiology
Menstrual Cycle - physiology
Mood Disorders - psychology
Neural Pathways - physiology
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Summary:The rate of affective disorder is substantially higher in women than in men, and considerable evidence points to the actions of ovarian hormones in mediating this disparity. In this Opinion, we discuss the hypothesis that cyclic changes in ovarian hormone levels produce cyclic alterations in connectivity between the intrinsic networks of the brain. These alterations produce specific temporal windows within the menstrual cycle when internetwork connectivity is increased, associated with increased stress reactivity and better memory for unpleasant, arousing events, leading to increased negative mood and susceptibility to affective disorder. Our windows of vulnerability model offers insights for both treatment of affective disorder and research on sex differences in the brain. Prevalence of affective disorder points at a prominent sex-specific component. Specifically, women are diagnosed with affective disorder approximately twice as frequently as men are. Women experience more frequent affective symptoms during the luteal phase of the menstrual cycle, when progesterone levels are high. During the luteal phase, connectivity between the default mode and salience networks of the brain, endocrine stress responses, and memory for affective experience all increase. Similar increases in these areas are observed in comparisons between individuals with affective disorder and healthy controls. We propose that sex differences in affective disorder can be explained by a midluteal window of vulnerability in women, in which increased connectivity, stress reactivity, and affective memory make negative experiences more potent and memorable, promoting negative affect. We argue that examining sexually dimorphic aspects of brain structure and function at singular time points can be misleading, and that such differences should be conceptualized as part of a dynamic process unfolding over time. This may help explain discrepancies in studies of sex differences in brain function.
ISSN:0166-2236
1878-108X
DOI:10.1016/j.tins.2018.08.007