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Depressive and anxiety symptoms, and neural correlates of reward and punishment anticipation in female athletes with amenorrhea
OBJECTIVE: Studies in estrogen deficiency states such as primary ovarian insufficiency and Turner syndrome suggest that estrogen status may be an important modulator of mood and emotions. In this study we compared depressive and anxiety symptoms between adolescent and young adult female oligo-amenor...
Autores principales: | , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
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Frontiers Media S.A.
2023
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Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10233051/ https://www.ncbi.nlm.nih.gov/pubmed/37274342 http://dx.doi.org/10.3389/fendo.2023.976050 |
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author | Baskaran, Charumathi Kumar, Poornima Plessow, Franziska Nimmala, Supritha Ackerman, Kathryn E. Eddy, Kamryn T. Pizzagalli, Diego A. Misra, Madhusmita |
author_facet | Baskaran, Charumathi Kumar, Poornima Plessow, Franziska Nimmala, Supritha Ackerman, Kathryn E. Eddy, Kamryn T. Pizzagalli, Diego A. Misra, Madhusmita |
author_sort | Baskaran, Charumathi |
collection | PubMed |
description | OBJECTIVE: Studies in estrogen deficiency states such as primary ovarian insufficiency and Turner syndrome suggest that estrogen status may be an important modulator of mood and emotions. In this study we compared depressive and anxiety symptoms between adolescent and young adult female oligo-amenorrheic athletes (AA) and eumenorrheic females (EM), and explored structural, and functional changes in related brain areas during reward processing, a behavioral construct that is altered in depression and anxiety. METHODS: We included (i) 24 AA participating in ≥4 hours/week of aerobic exercise or running ≥20 miles/week for ≥6 months in the preceding year, with lack of menstrual cycles for ≥3 months within at least 6 preceding months of oligo-amenorrhea, OR in premenarchal girls, absence of menses at >15 years), and (ii) 27 EM aged 14-25 years. Participants completed the Beck Depression Inventory-II (BDI-II), State and Trait Anxiety Inventory (STAI), and Mood and Anxiety Symptoms Questionnaire (MASQ). Structural MRI and brain activation during a functional MRI (fMRI) task that probes reward and punishment processing was examined in a subset of 10 AA and 23 EM. RESULTS: Median (IQR) age and BMI of AA and EM groups were 20.6 (19.0-22.6) vs. 20.6 (19.2-23.7) years, p=0.6 and v 20.3 (18.8-21.5) vs. 21.9 (19.6-23.5) kg/m2, p=0.005, respectively. While groups did not differ for BDI-II scores, AA had higher anhedonic depression MASQ scores (p=0.04), and STAI (p=0.03) scores vs. EM. In the fMRI subset, AA had higher caudate volumes vs. EM [F(1, 29)=9.930, p=0.004]. Lower activation observed in the right caudate during reward anticipation in AA compared with EM (p=0.036) suggests blunted reward processing in the striatum in estrogen deficient states. CONCLUSION: Athletes with amenorrhea had higher depressive and anxiety symptomatology compared to eumenorrheic young women. Exploratory analyses demonstrated increased caudate volumes and decreased caudate activation during reward processing in athletes with amenorrhea suggesting that estrogen may play a role in reward processing. |
format | Online Article Text |
id | pubmed-10233051 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2023 |
publisher | Frontiers Media S.A. |
record_format | MEDLINE/PubMed |
spelling | pubmed-102330512023-06-02 Depressive and anxiety symptoms, and neural correlates of reward and punishment anticipation in female athletes with amenorrhea Baskaran, Charumathi Kumar, Poornima Plessow, Franziska Nimmala, Supritha Ackerman, Kathryn E. Eddy, Kamryn T. Pizzagalli, Diego A. Misra, Madhusmita Front Endocrinol (Lausanne) Endocrinology OBJECTIVE: Studies in estrogen deficiency states such as primary ovarian insufficiency and Turner syndrome suggest that estrogen status may be an important modulator of mood and emotions. In this study we compared depressive and anxiety symptoms between adolescent and young adult female oligo-amenorrheic athletes (AA) and eumenorrheic females (EM), and explored structural, and functional changes in related brain areas during reward processing, a behavioral construct that is altered in depression and anxiety. METHODS: We included (i) 24 AA participating in ≥4 hours/week of aerobic exercise or running ≥20 miles/week for ≥6 months in the preceding year, with lack of menstrual cycles for ≥3 months within at least 6 preceding months of oligo-amenorrhea, OR in premenarchal girls, absence of menses at >15 years), and (ii) 27 EM aged 14-25 years. Participants completed the Beck Depression Inventory-II (BDI-II), State and Trait Anxiety Inventory (STAI), and Mood and Anxiety Symptoms Questionnaire (MASQ). Structural MRI and brain activation during a functional MRI (fMRI) task that probes reward and punishment processing was examined in a subset of 10 AA and 23 EM. RESULTS: Median (IQR) age and BMI of AA and EM groups were 20.6 (19.0-22.6) vs. 20.6 (19.2-23.7) years, p=0.6 and v 20.3 (18.8-21.5) vs. 21.9 (19.6-23.5) kg/m2, p=0.005, respectively. While groups did not differ for BDI-II scores, AA had higher anhedonic depression MASQ scores (p=0.04), and STAI (p=0.03) scores vs. EM. In the fMRI subset, AA had higher caudate volumes vs. EM [F(1, 29)=9.930, p=0.004]. Lower activation observed in the right caudate during reward anticipation in AA compared with EM (p=0.036) suggests blunted reward processing in the striatum in estrogen deficient states. CONCLUSION: Athletes with amenorrhea had higher depressive and anxiety symptomatology compared to eumenorrheic young women. Exploratory analyses demonstrated increased caudate volumes and decreased caudate activation during reward processing in athletes with amenorrhea suggesting that estrogen may play a role in reward processing. Frontiers Media S.A. 2023-05-18 /pmc/articles/PMC10233051/ /pubmed/37274342 http://dx.doi.org/10.3389/fendo.2023.976050 Text en Copyright © 2023 Baskaran, Kumar, Plessow, Nimmala, Ackerman, Eddy, Pizzagalli and Misra https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms. |
spellingShingle | Endocrinology Baskaran, Charumathi Kumar, Poornima Plessow, Franziska Nimmala, Supritha Ackerman, Kathryn E. Eddy, Kamryn T. Pizzagalli, Diego A. Misra, Madhusmita Depressive and anxiety symptoms, and neural correlates of reward and punishment anticipation in female athletes with amenorrhea |
title | Depressive and anxiety symptoms, and neural correlates of reward and punishment anticipation in female athletes with amenorrhea |
title_full | Depressive and anxiety symptoms, and neural correlates of reward and punishment anticipation in female athletes with amenorrhea |
title_fullStr | Depressive and anxiety symptoms, and neural correlates of reward and punishment anticipation in female athletes with amenorrhea |
title_full_unstemmed | Depressive and anxiety symptoms, and neural correlates of reward and punishment anticipation in female athletes with amenorrhea |
title_short | Depressive and anxiety symptoms, and neural correlates of reward and punishment anticipation in female athletes with amenorrhea |
title_sort | depressive and anxiety symptoms, and neural correlates of reward and punishment anticipation in female athletes with amenorrhea |
topic | Endocrinology |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10233051/ https://www.ncbi.nlm.nih.gov/pubmed/37274342 http://dx.doi.org/10.3389/fendo.2023.976050 |
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