Table 4.
Summary of laboratory evidence for PMDD.
| Authors | Study sample | Age (years) Mean (SD)/range |
Findings |
|---|---|---|---|
| Genetics | |||
| Comasco (49) | PMDD—31 Healthy controls—31 |
Not available | 5-HTTLPR and BDNF Val66Met polymorphisms not associated with PMDD. Met-allele carrier -lower emotion-induced fronto-cingulate cortex activation during luteal phase in PMDD |
| Dhingra (47) | PMDD—53 women Healthy controls—51 |
PMDD—27–46 Healthy controls—22–48 |
Presence of at least one C allele of serotonergic 5HT1A receptor associated with a 2.5-fold increased risk of PMDD |
| Huo (48) | PMDD—91 Healthy controls—56 |
39.5 ± 5.9 | SNPs in oestrogen receptor α-gene (ESR1) positively associated with PMDD |
| Endocrinal | |||
| Progesterone/allopregnanolone/oestrogen | |||
| Klatzkin (51) | Prior depression with PMDD (PMDD-Dep) = 13 Non-PMDD Depression (Non-PMDD-Dep) = 12 Non-Dep PMDD = 23 Non-PMDD, Non-Dep = 29 |
PMDD-Dep—33.8 (1.8) Non-PMDD-Dep—36.5 (1.9) non-Dep PMDD—31.7 (2.1) Non-PMDD, Non-Dep—33.6 (1.6) |
Non-Dep PMDD had higher pre-progesterone and allopregnanolone levels following progesterone administration than other groups |
| Hsiao (45) | PMDD = 43 | 30.79 (7.13) | No statistically significant correlations between depression or anxiety ratings and oestrogen or progesterone concentrations |
| Neurotransmitters | |||
| Serotonin | |||
| Rasgon (44) | PMS = 5 Healthy Control = 5 |
PMS—24 ± 0 Healthy control—27 ± 4 |
L-tryptophan challenge PMS >HC blunted whole blood serotonin response in the luteal phase |
| Rapkin (52) | PMS = 14 Healthy controls = 13 |
Age: NA | Serotonin-PMS < Healthy Control |
| Dopamine and norepinephrine | |||
| Menkes (53) | PMS = 16 | 37.9 ± 5.8 | Significant premenstrual tyrosine decrement |
| Neuroimaging | |||
| Structural imaging | |||
| Syan et al. (54) | PMDD—20 Healthy controls—25 |
PMDD—31.80 ± 7.33 Healthy controls—27.44 ± 7.74 |
No significant group effect |
| Berman et al. (55) | PMDD—12 Healthy controls—13 |
PMDD—30.9 ± 6.63 Healthy controls—29.2 ± 6.50 |
PMDD > HC: ↑ grey matter volume cerebellum |
| Protopopescu et al. (56) | PMDD—10 Healthy controls—11 |
29 (22–35) | No significant group effect |
| Functional imaging | |||
| Emotional stimuli-reactivity | |||
| Petersen et al. (50) | PMDD—18 Healthy controls—18 |
PMDD—29.2 ± 7.24 Healthy controls—25.4 ± 6.99 |
DLPFC reactivity for PMDD lower in the late luteal phase compared with healthy subjects and follicular phase |
| Gingnell et al. (57) | PMDD—14 Healthy controls—13 |
PMDD—35 ± 8.9 Healthy controls—33.1 ± 7.8 |
↑amygdala activity and functional connectivity between the amygdala, insula, and anterior cingulate cortex (ACC) during the late luteal phase in PMDD |
| Comasco et al. (49) | PMDD—16 Healthy controls—15 |
PMDD—33.3 ± 8.9 Healthy controls—30.5 ± 8.1 |
PMDD >HC- ↑activations in the inferior and middle frontal gyri, right superior parietal gyrus, and left angular gyrus to negative facial expressions |
| Gingnell et al. (58) | PMDD—14 Healthy controls—14 |
PMDD—35 ± 8.9 Healthy controls—32.7 ± 7.7 |
Luteal phase PMDD >HC hyperactivations in lateral OFC, mPFC, and DLPFC regions during the anticipation of negative pictures |
| Gingnell et al. (59) | PMDD—14 Healthy controls—15 |
PMDD—34.9 ± 8.9 Healthy controls—33.7 ± 8.4 |
PMDD >CS mid-follicular phase, positive correlation between P4 levels and amygdala BOLD response to angry and fearful faces, PMDD >CS: ↑ amygdala BOLD signal during the mid-follicular phase |
| Protopopescu et al. (56) | PMDD—8 Healthy controls—12 |
PMDD—27.4 (22–33) Healthy controls—28.0 (22–35) |
PMDD >HC ↑ amygdala BOLD signal during the late luteal phase, ↓ NAcc activation for the positive condition in women with PMDD compared with healthy Controls during the late luteal phase. |
| Neurocognitive tasks | |||
| Baller et al. (60) | PMDD—14 Healthy controls—14 |
PMDD—38.1 ± 8.2 Healthy controls—36.0 ± 8 |
PMDD > HC: ↑ activations of superior and middle frontal gyri, inferior parietal lobule and cerebellum during N-back working memory task |
| Bannbers et al. (61) | PMDD—14 Healthy controls—13 |
PMDD—34.9 ± 8.9 Healthy controls—34.9 ± 8.6 |
↓ activation pre- and post-central gyri, parietal cortex, right caudate nucleus, and the left insula during the mid-follicular phase PMDD >HC: ↑ left insula reactivity during response inhibition during the late luteal phase |
| Magnetic resonance spectroscopy | |||
| Liu et al. (62) | PMDD—20 Healthy controls—20 |
PMDD—23.0 ± 1.6 Healthy controls—23.6 ± 1.4 |
PMDD <HC: ↓GABA = anterior cingulate cortex/medical prefrontal Cortex, basal ganglia ↓GABA/creatine ratio anterior cingulate cortex/medical prefrontal cortex, basal ganglia ↑ glutamate–glutamine/GABA ratio anterior cingulate cortex/medical prefrontal cortex, basal ganglia |
| Batra et al. (63) | PMDD—12 Healthy controls—13 |
PMDD—35.0 ± 4.61 Healthy controls—30.0 ± 8.14 |
Mid-FP >late LP: ↑ glutamate/creatine ratio mPFC in both groups No group effect |
| Epperson et al. (64) | PMDD—9 Healthy controls—14 |
PMDD—34.6 ± 4.5 Healthy controls—30.1 ± 6.23 |
PMDD <CS during Follicular Phase FP >mid/late LP: ↑ GABA in CS FP <mid/late LP: ↓ GABA in PMDD |
| Rasgon et al. (65) | PMDD—5 Healthy controls—7 |
PMDD—29.0 ± 4.5 Healthy controls—28.0 ± 9.9 |
mid-FP > late LP: ↓ NAA/Cr ratio mPFC GM in both groups mid-FP >late LP: ↑ Ch/Cr ratio parietal WM in both groups |
| Jovanovic et al. (66) | PMDD—5 Healthy controls—5 |
PMDD—32.4 ± 6.2 Healthy controls—30.2 ± 7.6 |
CS: late LP > FP: ↑ 5-HT1A binding in dorsal RN PMDD: no change |