Menstrual cycle affects functional cerebral asymmetries

Non-Invasive Brain Stimulation and Sex/Polypeptide Hormones in Reciprocal Interactions: A Systematic Review

A better understanding of interindividual differences and the development of targeted therapies is one of the major challenges of modern medicine. The sex of a person plays a crucial role in this regard. This systematic review aimed to summarise and analyse available evidence on the mutual interactions between non-invasive brain stimulation and sex/polypeptide hormones. The PubMed database was searched from its inception to 31 March 2023, for (i) studies that investigated the impact of sex and/or polypeptide hormones on the effects induced by non-invasive brain stimulation, or (ii) studies that investigated non-invasive brain stimulation in the modulation of sex and/or polypeptide hormones. Eighteen studies (319 healthy and 96 disabled participants) were included. Most studies focused on female sex hormone levels during the menstrual cycle. The later follicular phase is associated with a weak between hemispheric and intracortical inhibition, strong intracortical facilitation, and high stimulation-induced neural and behavioural changes. The opposite effects are observed during the luteal phase. In addition, the participant's sex, presence and/or absence of real ovulation and increase in oestradiol level by chorionic gonadotropin injection influence the stimulation-induced neurophysiological and behavioural effects. In Parkinson's disease and consciousness disorders, the repetitive application of non-invasive brain stimulation increases oestradiol and dehydroepiandrosterone levels and reduces disability. To date, male hormones have not been sufficiently included in these studies. Here, we show that the sex and/or polypeptide hormones and non-invasive brain stimulation methods are in reciprocal interactions. This may be used to create a more effective and individualised approach for healthy individuals and individuals with disabilities.

Motives and Laterality: Exploring the Links

Objectives

We explored associations between the needs for power, achievement, and affiliation and functional cerebral asymmetries (FCAs), guided by three established hypotheses about the nature of these associations.

Methods

One-hundred-and-seven participants completed picture-story measures of dispositional motives and activity inhibition (AI), a frequent moderator of motive-behavior associations, tasks measuring FCAs (line bisection, chimeric emotional face judgments, turning bias, perceptual and response asymmetries on the Poffenberger task), self-reported laterality preferences (handedness, footedness, ear and eye preference), and interhemispheric interaction (crossed-uncrossed difference). They also completed an experiment manipulating hand contractions (left, right, both, neither) while they worked on a second picture-story motive measure.

Results

Dispositional power motivation was associated with stronger rightward asymmetry and less interhemispheric transfer in high-AI and stronger leftward asymmetry and more interhemispheric transfer in low-AI individuals. For the affiliation motive, findings were fewer and in the opposite direction of those for the power motive. These findings emerged for men, but not for women. Left- or right-hand contractions led to increases in power and achievement motivation, but not affiliation motivation. Only left-hand contractions led to decreased AI.

Conclusions

We discuss these findings in the context of sex-dimorphic organizing and activating effects of steroids on motives and laterality.

Brain Lateralization: A Comparative Perspective

Comparative studies on brain asymmetry date back to the 19th century but then largely disappeared due to the assumption that lateralization is uniquely human. Since the reemergence of this field in the 1970s, we learned that left-right differences of brain and behavior exist throughout the animal kingdom and pay off in terms of sensory, cognitive, and motor efficiency. Ontogenetically, lateralization starts in many species with asymmetrical expression patterns of genes within the Nodal cascade that set up the scene for later complex interactions of genetic, environmental, and epigenetic factors. These take effect during different time points of ontogeny and create asymmetries of neural networks in diverse species. As a result, depending on task demands, left- or right-hemispheric loops of feedforward or feedback projections are then activated and can temporarily dominate a neural process. In addition, asymmetries of commissural transfer can shape lateralized processes in each hemisphere. It is still unclear if interhemispheric interactions depend on an inhibition/excitation dichotomy or instead adjust the contralateral temporal neural structure to delay the other hemisphere or synchronize with it during joint action. As outlined in our review, novel animal models and approaches could be established in the last decades, and they already produced a substantial increase of knowledge. Since there is practically no realm of human perception, cognition, emotion, or action that is not affected by our lateralized neural organization, insights from these comparative studies are crucial to understand the functions and pathologies of our asymmetric brain.

Sex hormones and number processing. Progesterone and testosterone relate to hemispheric asymmetries during number comparison

Like many visual stimuli, multi-digit numbers are of a hierarchical nature, with whole number magnitudes depending on individual digit magnitudes. Accordingly, multi-digit numbers can be processed in a holistic (whole number magnitudes) or decomposed manner (digit magnitudes). The compatibility effect during number comparison serves as an indicator of decomposed processing. It is characterized by impaired performance for items where the larger number contains the smaller unit-digit. We were recently able to demonstrate, that the compatibility effect indeed depends on an individual's tendency to process visual hierarchical stimuli on a global or local level. Accordingly, factors affecting global-local processing, should also affect number magnitude processing, i.e. the compatibility effect. Among these factors are hemispheric asymmetries, sex differences and sex hormones (estradiol, progesterone, testosterone). In the present study 39 men and 37 naturally cycling women in their luteal cycle phase completed a number comparison task with stimuli randomly presented to the left and right hemifield. As in previous studies, we observed a larger compatibility effect in the right hemifield (left hemisphere) than in the left hemifield (right hemisphere) and in men than in women. However, this is the first study to evaluate the effects of sex hormones on hemispheric asymmetries during number comparison. We found progesterone to relate to increased hemispheric asymmetries in men, but decreased hemispheric asymmetries in women. Additionally, testosterone was negatively related to hemispheric asymmetries in women's compatibility effect in reaction times. These results add to the growing evidence that sex hormones relate to hemispheric asymmetries in cognitive functions.

Dual-Task Paradigm Reveals Variation in Left Hemisphere Involvement in Verbal Processing Across the Menstrual Cycle in Normally Cycling Women

Cognitive performance and cerebral hemispheric function are known to vary with fluctuating levels of estradiol and progesterone across the menstrual cycle in naturally cycling females. However, the literature is mixed with regard to how each hemisphere may be affected by elevated ovarian hormones. To better understand this, the current study employed a dual-task paradigm to examine potential shifts in hemispheric involvement for a verbal problem-solving task across the menstrual cycle in 30 right-handed, normally cycling young adult females (18-21 years old). To our knowledge, no study to date has utilized dual-task procedures to directly investigate the potential shifts in hemispheric function across the menstrual cycle. Specifically, participants were tested during both menses and their estimated midluteal phase where they engaged in repetitive unilateral finger-tapping while concurrently solving anagrams silently or aloud. Analysis of finger-tapping interference during the dual-task conditions revealed that solving anagrams silently was lateralized to the left hemisphere while solving anagrams aloud yielded a pattern of more bilateral hemispheric involvement, both of which were consistent across both menses and midluteal phases. Analysis of cognitive performance, however, revealed that silent anagrams performance while tapping with the right, but not left, hand significantly increased during the midluteal phase. Consistent with a number of other studies using different methodological approaches, the current dual-task findings suggest that when ovarian hormone levels are putatively elevated, there is enhanced recruitment of left hemisphere resources while performing a lateralized verbal task.

Perfusion Changes with Photic Stimulation During two Phases of the Menstrual Cycle: A Pilot Study Comparing Controls and True Menstrual Migraine Patients

This pilot study investigated the effect of menstrual cycle phase (late luteal and mid-follicular) on cerebral perfusion changes during photic stimulation in both controls ( n = 5) and true menstrual migraine patients ( n = 5). No significant differences in resting baseline perfusion were observed between the two groups during either phase of the menstrual cycle. During the late luteal phase, changes in perfusion within the occipital lobe due to photic stimulation were similar for both groups. However, during the mid-follicular phase, occipital perfusion during visual stimulation decreased for controls but significantly increased for true menstrual migraine patients ( P < 0.05). A two way repeated measures ANOVA also demonstrated a significant difference between menstrual migraine patients and controls for photic activation ( P < 0.05).

Reproductive Steroid Regulation of Mood and Behavior

In this article, we examine evidence supporting the role of reproductive steroids in the regulation of mood and behavior in women and the nature of that role. In the first half of the article, we review evidence for the following: (i) the reproductive system is designed to regulate behavior; (ii) from the subcellular to cellular to circuit to behavior, reproductive steroids are powerful neuroregulators; (iii) affective disorders are disorders of behavioral state; and (iv) reproductive steroids affect virtually every system implicated in the pathophysiology of depression. In the second half of the article, we discuss the diagnosis of the three reproductive endocrine-related mood disorders (premenstrual dysphoric disorder, postpartum depression, and perimenopausal depression) and present evidence supporting the relevance of reproductive steroids to these conditions. Existing evidence suggests that changes in reproductive steroid levels during specific reproductive states (i.e., the premenstrual phase of the menstrual cycle, pregnancy, parturition, and the menopause transition) trigger affective dysregulation in susceptible women, thus suggesting the etiopathogenic relevance of these hormonal changes in reproductive mood disorders. Understanding the source of individual susceptibility is critical to both preventing the onset of illness and developing novel, individualized treatments for reproductive-related affective dysregulation. © 2016 American Physiological Society. Compr Physiol 6:1135-1160, 2016e.

Sex hormones affect language lateralisation but not cognitive control in normally cycling women

This article is part of a Special Issue "Estradiol and Cognition". Natural fluctuations of sex hormones during the menstrual cycle have been shown to modulate language lateralisation. Using the dichotic listening (DL) paradigm, a well-established measurement of language lateralisation, several studies revealed that the left hemispheric language dominance was stronger when levels of estradiol were high. A recent study (Hjelmervik et al., 2012) showed, however, that high levels of follicular estradiol increased lateralisation only in a condition that required participants to cognitively control (top-down) the stimulus-driven (bottom-up) response. This finding suggested that sex hormones modulate lateralisation only if cognitive control demands are high. The present study investigated language lateralisation in 73 normally cycling women under three attention conditions that differed in cognitive control demands. Saliva estradiol and progesterone levels were determined by luminescence immunoassays. Women were allocated to a high or low estradiol group. The results showed a reduced language lateralisation when estradiol and progesterone levels were high. The effect was independent of the attention condition indicating that estradiol marginally affected cognitive control. The findings might suggest that high levels of estradiol especially reduce the stimulus-driven (bottom-up) aspect of lateralisation rather than top-down cognitive control.

The importance of the derivative in sex-hormone cycles: a reason why behavioural measures in sex-hormone studies are so mercurial

To study the dynamic changes in cognition across the human menstrual cycle, twenty, healthy, naturally-cycling women undertook a lateralized spatial figural comparison task on twelve occasions at approximately 3-4 day intervals. Each session was conducted in laboratory conditions with response times, accuracy rates, eye movements, salivary estrogen and progesterone concentrations and Profile of Mood states questionnaire data collected on each occasion. The first two sessions of twelve for the response variables were discarded to avoid early effects of learning thereby providing 10 sessions spread across each participant's complete menstrual cycle. Salivary progesterone data for each participant was utilized to normalize each participant's data to a standard 28 day cycle. Data was analysed categorically by comparing peak progesterone (luteal phase) to low progesterone (follicular phase) to emulate two-session repeated measures typical studies. Neither a significant difference in reaction times or accuracy rates was found. Moreover no significant effect of lateral presentation was observed upon reaction times or accuracy rates although inter and intra individual variance was sizeable. We demonstrate that hormone concentrations alone cannot be used to predict the response times or accuracy rates. In contrast, we constructed a standard linear model using salivary estrogen, salivary progesterone and their respective derivative values and found these inputs to be very accurate for predicting variance observed in the reaction times for all stimuli and accuracy rates for right visual field stimuli but not left visual field stimuli. The identification of sex-hormone derivatives as predictors of cognitive behaviours is of importance. The finding suggests that there is a fundamental difference between the up-surge and decline of hormonal concentrations where previous studies typically assume all points near the peak of a hormonal surge are the same. How contradictory findings in sex-hormone research may have come about are discussed.

Menstrual cycle effects on selective attention and its underlying cortical networks

It was the aim of the present study to investigate menstrual cycle effects on selective attention and its underlying functional cerebral networks. Twenty-one healthy, right-handed, normally cycling women were investigated by means of functional magnetic resonance imaging using a go/no-go paradigm during the menstrual, follicular and luteal phase. On the behavioral level there was a significant interaction between visual half field and cycle phase with reaction times to right-sided compared to left-sided stimuli being faster in the menstrual compared to the follicular phase. These results might argue for a more pronounced functional cerebral asymmetry toward the left hemisphere in selective attention during the menstrual phase with low estradiol and progesterone levels. Functional imaging, however, did not reveal clear-cut menstrual phase-related changes in activation pattern in parallel to these behavioral findings. A functional connectivity analysis identified differences between the menstrual and the luteal phase: During the menstrual phase, left inferior parietal cortex showed a stronger negative correlation with the right middle frontal gyrus while the left medial frontal cortex showed a stronger negative correlation with the left middle frontal gyrus. These results can serve as further evidence of a modulatory effect of steroid hormones on networks of lateralized cognitive functions not only by interhemispheric inhibition but also by affecting intrahemispheric functional connectivity.

Multisensory integration across the menstrual cycle

Evidence suggests that spatial processing changes across time in naturally cycling women, which is likely due to neuromodulatory effects of steroid hormones. Yet, it is unknown whether crossmodal spatial processes depend on steroid hormones as well. In the present experiment, the crossmodal congruency task was used to assess visuo-tactile interactions in naturally cycling women, women using hormonal contraceptives and men. Participants adopted either a crossed or uncrossed hands posture. It was tested whether a postural effect of hand crossing on multisensory interactions in the crossmodal congruency task is modulated by women's cycle phase. We found that visuotactile interactions changed according to cycle phase. Naturally cycling women showed a significant difference between the menstrual and the luteal phase for crossed, but not for uncrossed hands postures. The two control groups showed no test sessions effects. Regression analysis revealed a positive relation between estradiol levels and the size of crossmodal congruency effects (CCE), indicating that estradiol seems to have a neuromodulatory effect on posture processing.

FOXP2 variation modulates functional hemispheric asymmetries for speech perception

Left-hemispheric language dominance is a well-known characteristic of the human language system, but the molecular mechanisms underlying this crucial feature of vocal communication are still far from being understood. The forkhead box P2 gene FOXP2, which has been related to speech development, constitutes an interesting candidate gene in this regard. Therefore, the present study was aimed at investigating effects of variation in FOXP2 on individual language dominance. To this end, we used a dichotic listening and a visual half-field task in a sample of 456 healthy adults. The FOXP2 SNPs rs2396753 and rs12533005 were found to be significantly associated with the distribution of correct answers on the dichotic listening task. These results show that variation in FOXP2 may contribute to the inter-individual variability in hemispheric asymmetries for speech perception.

Sex hormonal modulation of interhemispheric transfer time

It is still a matter of debate whether functional cerebral asymmetries (FCA) of many cognitive processes are more pronounced in men than in women. Some evidence suggests that the apparent reduction in women's FCA is a result of the fluctuating levels of gonadal steroid hormones over the course of the menstrual cycle, making their FCA less static than for men. The degree of lateralization has been suggested to depend on interhemispheric communication that may be modulated by gonadal steroid hormones. Here, we employed visual-evoked EEG potentials to obtain a direct measure of interhemispheric communication during different phases of the menstrual cycle. The interhemispheric transfer time (IHTT) was estimated from the interhemispheric latency difference of the N170 component of the visual-evoked potential from either left or right visual field presentation. Nineteen right-handed women with regular menstrual cycles were tested twice, once during the menstrual phase, when progesterone and estradiol levels are low, and once during the luteal phase when progesterone and estradiol levels are high. Plasma steroid levels were determined by blood-based immunoassay at each session. It was found that IHTT, in particular from right-to-left, was generally longer during the luteal phase relative to the menstrual phase. This effect occurred as a consequence of a slowed absolute N170 latency of the indirect pathway (i.e. left hemispheric response after LVF stimulation) and, in particular, a shortened latency of the direct pathway (i.e. right hemispheric response after LVF stimulation) during the luteal phase. These results show that cycle-related effects are not restricted to modulation of processes between hemispheres but also apply to cortical interactions, especially within the right hemisphere. The findings support the view that plastic changes in the female brain occur during relatively short-term periods across the menstrual cycle.

Hemispheric specialization varies with EEG brain resting states and phase of menstrual cycle

A growing body of behavioral studies has demonstrated that women’s hemispheric specialization varies as a function of their menstrual cycle, with hemispheric specialization enhanced during their menstruation period. Our recent high-density electroencephalogram (EEG) study with lateralized emotional versus neutral words extended these behavioral results by showing that hemispheric specialization in men, but not in women under birth-control, depends upon specific EEG resting brain states at stimulus arrival, suggesting that hemispheric specialization may be pre-determined at the moment of the stimulus onset. To investigate whether EEG brain resting state for hemispheric specialization could vary as a function of the menstrual phase, we tested 12 right-handed healthy women over different phases of their menstrual cycle combining high-density EEG recordings and the same lateralized lexical decision paradigm with emotional versus neutral words. Results showed the presence of specific EEG resting brain states, associated with hemispheric specialization for emotional words, at the moment of the stimulus onset during the menstruation period only. These results suggest that the pre-stimulus EEG pattern influencing hemispheric specialization is modulated by the hormonal state.

Language lateralization and cognitive control across the menstrual cycle assessed with a dichotic-listening paradigm

Lateralization has been shown to vary across the menstrual cycle, however, the underlying mechanisms are not fully understood, and results are inconsistent. Additionally, it has been suggested that estradiol enhances cognitive control. By modulating attention in a consonant-vowel dichotic listening test, the current study aims to investigate the effects of cycle-related changes on language lateralization (non-forced condition), as well as the effects of estradiol-modulated cognitive control (forced left condition) on the ear advantage. Fifteen women and fifteen men tested three times on the dichotic listening test, women once in menstrual, follicular, and luteal phase (verified by hormone assays). Whereas the results from the non-forced and forced-right condition remained stable, results from the forced left condition changed across the cycle, where women in the follicular phase compared to both menstrual and luteal phases showed a stronger left ear advantage, i.e. better cognitive control performance. The increase in performance from menstrual to follicular phase correlated negatively with increase in estradiol levels, indicating a shift from a stimulus-driven right ear advantage (indicating a left hemispheric asymmetry for language) when estradiol levels were low toward a cognitively controlled left ear advantage when estradiol levels were high. This finding strongly suggests an active role of estradiol on cognitive control. The study further suggests that the degree of cognitive control demands of a given task is important to consider when investigating lateralization across the menstrual cycle.

Menstrual cycle-related changes of functional cerebral asymmetries in fine motor coordination

Fluctuating sex hormone levels during the menstrual cycle have been shown to affect functional cerebral asymmetries in cognitive domains. These effects seem to result from the neuromodulatory properties of sex hormones and their metabolites on interhemispheric processing. The present study was carried out to investigate whether functional cerebral asymmetries in fine motor coordination as reflected by manual asymmetries are also susceptible to natural sex hormonal variations during the menstrual cycle. Sixteen right-handed women with a regular menstrual cycle performed a finger tapping paradigm consisting of two conditions (simple, sequential) during the low hormone menstrual phase and the high estrogen and progesterone luteal phase. To validate the luteal phase, saliva levels of free progesterone (P) were analysed using chemiluminescence assays. As expected, normally cycling women showed a substantial decrease in manual asymmetries in a more demanding sequential tapping condition involving four fingers compared with simple (repetitive) finger tapping. This reduction in the degree of dominant (right) hand manual asymmetries was evident during the luteal phase. During the menstrual phase, however, manual asymmetries were even reversed in direction, indicating a slight advantage in favour of the non-dominant (left) hand. These findings suggest that functional cerebral asymmetries in fine motor coordination are affected by sex hormonal changes during the menstrual cycle, probably via hormonal modulations of interhemispheric interaction.

Estrogen treatment affects brain functioning after menopause

Sex hormones have powerful neuromodulatory effects on functional brain organization and cognitive functioning. This paper reviews findings from studies investigating the influence of sex hormones in postmenopausal women with and without hormone therapy (HT). Functional brain organization was investigated using different behavioural tasks in postmenopausal women using either estrogen therapy or combined estrogen plus gestagen therapy and age- and IQ-matched postmenopausal women not taking HT. The results revealed HT-related modulations in specific aspects of functional brain organization including functional cerebral asymmetries and interhemispheric interaction. In contrast to younger women during the menstrual cycle, however, it seems that HT, and especially estrogen therapy, after menopause affects intrahemispheric processing rather than interhemispheric interaction. This might be explained by a faster and more pronounced age-related decline in intrahemispheric relative to interhemispheric functioning, which might be associated with higher sensitivity to HT. Taken together, the findings suggest that the female brain retains its plasticity even after reproductive age and remains susceptible to the effects of sex hormones throughout the lifetime, which might help to discover new clinical approaches in the hormonal treatment of neurological and psychiatric disorders.

Sex hormone therapy and functional brain plasticity in postmenopausal women

Several studies have shown that fluctuating levels of sex hormones (estrogen and progesterone) can affect fundamental principles of brain organization, including functional cerebral asymmetries (FCAs) and interhemispheric interactions. The majority of findings come from studies investigating younger women tested during distinct hormonal phases of the menstrual cycle, an approach that does not necessarily allow for conclusions about the causal relationship between hormonal changes and functional brain organization. An alternative approach is to manipulate the hormonal status of participants directly. This research focuses on the effects of hormone therapy (HT) on FCAs and interhemispheric interactions in postmenopausal women. Functional brain organization was tested in postmenopausal women using either estrogen therapy or combined estrogen plus gestagen therapy. The results are then compared to age- and IQ-matched postmenopausal women not taking HT. The results indicate HT-related modulations in both FCAs and interhemispheric interaction. In contrast to normally cycling women, however, it seems that HT, and especially estrogen therapy, after menopause affects intrahemispheric processing rather than interhemispheric crosstalk. The findings indicate a faster and more pronounced age-related decline in intrahemispheric relative to interhemispheric processing which seems to be accompanied by a higher sensitivity to HT. Aging processes together with differences in the hormonal status (exogenous changes as a result of HT vs. endogenous changes during the menstrual cycle) may also explain divergent (cognitive) behavioral outcomes in postmenopausal women and younger women. Taken together, the findings suggest that the female brain retains its plasticity even after reproductive age and remains susceptible to the effects of sex hormones throughout the lifetime. This article is part of a Special Issue entitled: Neuroactive Steroids: Focus on Human Brain.

Dynamic changes in functional cerebral connectivity of spatial cognition during the menstrual cycle

Functional cerebral asymmetries (FCAs) in women have been shown to vary with changing levels of sex hormones during the menstrual cycle. Previous studies have suggested that interhemispheric interaction forms a key component in generating FCAs and it has been shown behaviorally and by functional imaging that interhemispheric interaction changes during the menstrual cycle, at least for a left hemisphere dominant task. We used functional MRI and an analysis of functional connectivity to examine whether changes in right hemisphere advantage for a figure comparison task as found in behavioral studies, are based on comparable mechanisms like those identified for the verbal task. Women were examined three times during the menstrual cycle, during the menstrual, follicular and luteal phases. The behavioral data confirmed the right hemisphere advantage for the figure comparison task as well as changes of the right hemisphere advantage during the menstrual cycle. Imaging data showed cycle phase-related changes in lateralized brain activation within the task-dominant hemisphere and changes in connectivity between nonhomotopic areas of both hemispheres, suggesting that changes in functional brain organization in women during the menstrual cycle are not only restricted to hormone-related changes of interhemispheric inhibition between homotopic areas, as has been proposed earlier, but might additionally apply to changes of neuronal processes within the hemispheres which seem to be modulated by heterotopic functional connectivity between hemispheres.

Hormone therapy in postmenopausal women affects hemispheric asymmetries in fine motor coordination

Evidence exists that the functional differences between the left and right cerebral hemispheres are affected by age. One prominent hypothesis proposes that frontal activity during cognitive task performance tends to be less lateralized in older than in younger adults, a pattern that has also been reported for motor functioning. Moreover, functional cerebral asymmetries (FCAs) have been shown to be affected by sex hormonal manipulations via hormone therapy (HT) in older women. Here, we investigate whether FCAs in fine motor coordination, as reflected by manual asymmetries (MAs), are susceptible to HT in older women. Therefore, sixty-two postmenopausal women who received hormone therapy either with estrogen (E) alone (n=15), an E-gestagen combination (n=21) or without HT (control group, n=26) were tested. Saliva levels of free estradiol and progesterone (P) were analyzed using chemiluminescence assays. MAs were measured with a finger tapping paradigm consisting of two different tapping conditions. As expected, postmenopausal controls without HT showed reduced MAs in simple (repetitive) finger tapping. In a more demanding sequential condition involving four fingers, however, they revealed enhanced MAs in favour of the dominant hand. This finding suggests an insufficient recruitment of critical motor brain areas (especially when the nondominant hand is used), probably as a result of age-related changes in corticocortical connectivity between motor areas. In contrast, both HT groups revealed reduced MAs in sequential finger tapping but an asymmetrical tapping performance related to estradiol levels in simple finger tapping. A similar pattern has previously been found in younger participants. The results suggest that, HT, and E exposure in particular, exerts positive effects on the motor system thereby counteracting an age-related reorganization.

Estradiol levels during the menstrual cycle differentially affect latencies to right and left hemispheres during dichotic listening: an ERP study

Many behavioral studies have found high-estrogen phases of the menstrual cycle to be associated with enhanced left-hemisphere processing and low-estrogen phases to be associated with better right-hemisphere processing. This study examined the changing of hemispheric asymmetry during the menstrual cycle by analyzing event-related potential (ERP) data from midline and both hemispheres of 23 women during their performance of a dichotic tasks shown to elicit a left-hemisphere response (semantic categorization) and a right-hemisphere response (complex tones). Each woman was tested during her high-estrogen follicular phase and low-estrogen menstrual phase. Salivary assays of estradiol and progesterone were used to confirm cycle phase. Analyses of the ERP data revealed that latency for each hemisphere was differentially affected by phase and target side, such that latencies to the left hemisphere and from the right ear were shorter during the high-estrogen phase, and latencies to the right hemisphere and from the left ear were shorter during the low-estrogen phase. These findings supply electrophysiological correlates of the cyclically based interhemispheric differences evinced by behavioral studies.

Sexual Dimorphism in the Parietal Substrate Associated with Visuospatial Cognition Independent of General Intelligence

Sex differences in visuospatial cognition (VSC) with male advantage are frequently reported in the literature. There is evidence for sexual dimorphisms in the human brain, one of which postulates more gray matter (GM) in females and more white matter (WM) in males relative to total intracranial volume. We investigated the neuroanatomy of VSC independent of general intelligence (g) in sex-separated populations, homogenous in age, education, memory performance, a memory- and brain morphology-related gene, and g. VSC and g were assessed with the Wechsler adult intelligence scale. The influence of g on VSC was removed using a hierarchical factor analysis and the Schmid–Leiman solution. Structural high-resolution magnetic resonance images were acquired and analyzed with voxel-based morphometry. As hypothesized, the clusters of positive correlations between local volumes and VSC performance independent of g were found mainly in parietal areas, but also in pre- and postcentral regions, predominantly in the WM in males, whereas in females these correlations were located in parietal and superior temporal areas, predominantly in the GM. Our results suggest that VSC depends more strongly on parietal WM structures in males and on parietal GM structures in females. This sex difference might have to do with the increased axonal and decreased somatodendritic tissue in males relative to females. Whether such sex-specific implementations of the VSC network can be explained genetically as suggested in investigations into the Turner syndrome or as a result of structural neural plasticity upon different experience and usage remains to be shown.

Menstrual cycle phase effects on memory and Stroop task performance

The present study examined differences in Stroop and memory task performances modulated by gonadal steroid hormones during the menstrual cycle in women. Thirty women with regular menstrual cycles performed a logical memory task (Wechsler Memory Scale) and the Stroop task. The results showed a significant difference in Stroop task performance between low and high levels of estradiol and progesterone during the menstrual cycle, but there was no significant difference in memory performance between the two phases, nor was there any significant mood change that might have influenced cognitive performance. These findings suggest that sex-related hormone modulation selectively affects cognitive functions depending on the type of task and low level secretion of estradiol appears to contribute to reducing the level of attention that relates to the prefrontal cortex.

Sex Hormones: Modulators of Interhemispheric Inhibition in the Human Brain

Functional cerebral asymmetries (FCAs), which constitute a basic principle of human brain organization, are supposedly generated by interhemispheric inhibition of the dominant on the nondominant hemisphere. It has repeatedly been shown that FCAs are sex specific: While they are relatively stable in men, they change during the menstrual cycle in women, indicating that sex hormones might play an important role in modulating functional brain organization and brain asymmetries in particular. Modern brain imaging techniques like functional magnetic resonance imaging (fMRI) allow for the noninvasive study of the mechanisms underlying changing FCAs. Imaging data show that in women the inhibitory influence of the dominant on the nondominant hemisphere is reduced with rising levels of sex hormones in the course of the menstrual cycle. Apart from modulating interhemispheric inhibition, sex hormones also seem to change functional organization within hemispheres. These results reveal a powerful neuromodulatory action of sex hormones on the dynamics of functional brain organization in the female brain. They may further contribute to the ongoing discussion of sex differences in brain function in that they help explain the dynamic part of functional brain organization in which the female differs from the male brain.

Estradiol modulates functional brain organization during the menstrual cycle: an analysis of interhemispheric inhibition

According to the hypothesis of progesterone-mediated interhemispheric decoupling (Hausmann and Güntürkün, 2000), functional cerebral asymmetries (FCAs), which are stable in men and change during the menstrual cycle in women, are generated by interhemispheric inhibition of the dominant on the nondominant hemisphere. The change of lateralization during the menstrual cycle in women might indicate that sex hormones play an important role in modulating FCAs. We used functional magnetic resonance imaging to examine the role of estradiol in determining cyclic changes of interhemispheric inhibition. Women performed a word-matching task, while they were scanned twice during the cycle, once during the menstrual and once during the follicular phase. By use of a connectivity analysis we found that the inhibitory influence of left-hemispheric language areas on homotopic areas of the right hemisphere is strongest during the menses, resulting in a pronounced lateralization. During the follicular phase, due to rising estradiol levels, inhibition and thus functional cerebral asymmetries are reduced. These results reveal a powerful neuromodulatory action of estradiol on the dynamics of functional brain organization in the female brain. They may further contribute to the ongoing discussion of sex differences in brain function in that they help explain the dynamic part of functional brain organization in which the female differs from the male brain.

Estrogen therapy affects right hemisphere functioning in postmenopausal women

It has been suggested that hormone therapy (HT) in postmenopausal women differentially affects verbal and visuo-spatial abilities which mainly rely on left hemisphere (LH) and right hemisphere (RH) functioning, respectively. Thus, it seems likely that HT-related effects on cognition are driven by associated hormonal changes and their impact on functional brain organization, and functional cerebral asymmetries (FCAs) in particular. The present study investigated HT-related effects on FCAs in sixty-seven postmenopausal women who received hormone therapy either with estrogen (E) alone (n=14), an E-gestagen combination (n=22) or without HT (control group, n=31). Saliva levels of free E and progesterone (P) were analyzed using chemiluminescence assays. FCAs were measured with the visual half-field (VHF) technique using a word matching and a figural comparison task. In agreement with previous results, a postmenopausal control group showed a left hemisphere (LH) advantage in the verbal task and a right hemisphere (RH) advantage in visuo-spatial processing. In contrast, both HT groups revealed significantly reduced FCAs in the figural comparison task as a result of an E-related decrease in RH performance. The findings suggest that E-therapy in postmenopausal women can affect visuo-spatial abilities by modulating the functional brain organization and RH functioning in particular.

Estrogen replacement therapy induces functional asymmetry on an odor memory/discrimination test

The secondary afferents of the olfactory system largely project to the ipsilateral cortex without synapsing in the thalamus, making unilateral olfactory testing a useful probe of ipsilateral hemispheric activity. In light of evidence that lateralized performance on some perceptual tasks may be influenced by estrogen, we assessed left:right nostril differences in two measures of olfactory function in 14 post-menopausal women receiving estrogen replacement therapy (ERT) and 48 post-menopausal women receiving no such therapy. Relative to women not taking ERT, those receiving ERT exhibited better performance in the left nostril and poorer performance in the right nostril on an odor memory/discrimination test. Similar laterality effects were not observed for an odor detection threshold test employing phenyl ethyl alcohol. These results suggest that estrogen influences the lateralization of an odor memory/discrimination task and that hormone replacement therapy in the menopause may be an excellent paradigm for understanding lateralizing effects of hormones on some sensory processes.

The functional anatomy of semantic retrieval is influenced by gender, menstrual cycle, and sex hormones

This study examines the neurobiology of semantic retrieval and describes the influence of gender, menstrual cycle, and sex hormones on semantic networks. Healthy right-handed subjects (12 men, 12 women) were investigated with 3T-fMRI during synonym generation. Behavioral performance and sex hormone levels were assessed. Women were examined during the early follicular and midluteal cycle phase. The activation pattern in all groups involved left frontal and temporal as well as bilateral medial frontal, cingulate, occipital, basal ganglia, and cerebellar regions. Men showed greater left frontal activation than women in both menstrual cycle phases. Women yielded high correlations of left prefrontal activation with estradiol in the midluteal phase and with progesterone in both phases. Testosterone levels correlated highly with left prefrontal activation in all three groups. In all, we describe a cerebral network involved in semantic processing and demonstrate that it is significantly affected by gender and sex steroid hormones.

Study of otoacoustic emissions during the female hormonal cycle

The hormonal changes that occur in a short time span promote modifications all over the woman's body, with physical and emotional manifestations which are frequently observed.

Aim

to evaluate the activity of the external ciliated cells in women during their menstrual cycle, observing the effect of hormonal changes caused by the cycle in their 3 phases.

Methods

this is a longitudinal prospective study where 21 women between 20 and 35 years old who did not take any contraceptive medicine were assessed. Transient otoacoustic emissions were evaluated by distortion product during the 3 phases of the menstrual cycle (luteal, follicular and ovulatory phases). The SPSS 13.0 software was used to analyze the data.

Results

the phases of menstrual cycle do not alter the amplitude and reproducibility values of the transient otoacoustic emissions. We noticed a difference between the ears in the frequency of 1.5 KHz in the amplitude of emissions by distortion product, and the right ear showed the highest values.

Conclusion

There are no significant differences in transient otoacoustic emissions and distortion products in the phases of the menstrual cycle.

The role of imitation in the stabilization of handedness during infancy

Only about 50% of infants appear to be right-handed in their first year, yet only 10-12% ultimately become left-handed. Several parameters may control early changes in handedness, and we investigated the role of imitation. We wanted to see if infants, when choosing the hand to manipulate an object, were influenced by the hand used by the experimenter when demonstrating the target action. We observed infants, seated either opposite or on the lap of the experimenter who used either left or right hand. The results show that when a left-handed experimenter demonstrated the action, none of the infants consistently used a right-handed strategy to manipulate the objects, regardless of the position (lap vs. opposite), and even though most infants had shown right-handedness when first grasping the objects. Imitation may thus be part of the parameters that stabilize infant right-handedness, or, on the contrary, that drive infants towards left-handedness.

Gender-specific cerebral activation during cognitive tasks using functional MRI: comparison of women in mid-luteal phase and men

Previous studies of gender-specific differences in functional imaging during spatial and language tasks have been inconclusive. Furthermore, among women, such differences may occur during mid-luteal phase compared to the rest of the menstrual cycle. In order to examine further gender differences, functional MRI was performed in 12 male volunteers and 12 female volunteers (in the mid-luteal phase) during mental rotation and verb-generation tests. Two-sample t-tests with uncorrected P values of <0.001 for the specific regions of interest (ROIs) revealed cerebral activation differences in both stimuli. During mental rotation tests, higher levels of activation were noted in the right medial frontal, precentral, and bilateral inferior parietal cortex, while in women this occurred in the right inferior and medial temporal, right superior frontal cortex, and left fusiform gyrus. During verb-generation tests, higher levels of activation in men was found in the left medial temporal and precentral cortex. Our results indicate that differences in cerebral activity during cognitive tasks can be shown between men and women in the mid-luteal phase. Gender differences while performing a mental rotation task were more prominent than during a verb-generation task.

The neurobiology of postpartum depression

Postpartum psychiatric changes can range from maternity blues to psychosis. Causality is still undetermined, but explanations for these disturbances often focus on hormonal changes and dysregulation. Researchers have begun the process of delineating what neurobiological factors may be associated with depressive disorders in pregnancy and the postpartum. This article reviews the current literature on the roles of gonadal and pituitary hormones in the psychopathophysiology of postpartum mood disorders. Other biological factors, such as biogenic amines, neuroactive steroids, cholesterol, and fatty acids, are also discussed. The potential benefits of neuroimaging to aid in understanding neuropsychiatric changes that occur in the context of postpartum depression are also considered.

Sex hormonal modulation of hemispheric asymmetries in the attentional blink

The present study examines differences in functional cerebral asymmetries modulated by gonadal steroid hormones during the menstrual cycle in women. Twenty-one right-handed women with regular menstrual cycles performed a double-stream rapid serial visual presentation (RSVP) task, with one stream in each visual field, during the low steroid menses and the high steroid midluteal phase. They were required to detect a target item, and then a probe item, each of which could appear in either stream. If the probe item appeared 200 ms after the target, detection of the probe was impaired-a phenomenon known as the "attentional blink." This occurred in both streams in the midluteal phase, but only in the right visual field during menses. Thus low steroid levels appeared to restrict the attentional blink to the left hemisphere, while high levels of estradiol and progesterone in the midluteal phase appeared to reduce functional asymmetries by selectively increasing the attentional blink in the right hemisphere. This effect appears to be mediated by estradiol rather than progesterone, and it is compatible with the assumption of a hormone-related suppression of right hemisphere functions during the midluteal phase.

Hemispheric asymmetry in spatial attention across the menstrual cycle

Functional cerebral asymmetries (FCAs) are known to fluctuate across the menstrual cycle. The mechanisms of these sex hormonal modulations are poorly understood. It has been suggested that gonadal steroid hormones might suppress or specifically activate one hemisphere. However, recent studies suggest that high levels of gonadal steroid hormones reduce FCAs by its modulating effects on cortico-cortical transmission. To investigate the activating effects of gonadal steroid hormones on the interhemispheric interaction, a visual line-bisection task was administered to normally cycling women during menses and the midluteal cycle phase as well as to similar-aged healthy men. The results replicate previous findings of a sex difference in line-bisection as a function of hand-use and show that the hand-use effect fluctuates across the menstrual cycle. High levels of estradiol during the midluteal phase were related to a decrease of the hand-use effect. It is concluded that cycle-related fluctuations in levels of gonadal steroid hormones affect hemispheric asymmetry of spatial attention, presumably by interhemispheric spreading of neuronal activation.

What the little differences between men and women tells us about the BOLD response

We analyzed the functional MRI signal of 15 men and 15 women. All had been presented with a flashed and a reversing, radial checkerboard stimulus. We investigated both positive and negative blood oxygenation level-dependent (BOLD) responses. The extent of activation and the change in the neuronal activity were examined. The former, by counting the number of activated voxels, the latter by using deltaR2* as an indicator of the change in the local deoxyhemoglobin (HbR) concentration. We examined both the positive and the negative BOLD response. Positive BOLD response: The flashed checkerboard gave rise to a larger number of activated voxels than for the reversing checkerboard. The mean number of activated pixels did not differ between men and women. The peak deltaR2* was significantly larger to the flashed than the reversing checkerboard, but did not reveal a gender-related difference. We noted an attenuation of the BOLD signal amplitude with time. This attenuation was larger in women than in men. Negative BOLD response: The attenuation was also larger for the flashed than the reversing stimulus and more pronounced in the chromatic contrast compared to the luminance contrast stimulus. The extent of activation was larger for the flashed than the reversing checkerboard, but did not differ between the sexes. The deltaR2* for the chromatic contrast checkerboard was larger in men than in women. No other significant differences were found. We conclude that the difference in the extent of activation between men and women is the result of our ability to detect activated pixels using statistical methods and not the result of a difference in the processing between the sexes.

Personality, manual preference and neuroendocrine reactivity in hirsute subjects

Behavioral and neuroendocrine differences may be postulated in hirsute subjects since central effects of gonadal steroids are well established. We conducted a controlled clinical study with 25 consecutive young hirsute participants compared with 20 consecutive controls. Neuropsychological evaluation included the Minnesota Multiphasic Personality Inventory (MMPI) and the Edinburgh Inventory of Manual Preference (EIMP). Neuroendocrine reactivity was assessed by the adrenocorticotropic hormone (ACTH) and cortisol responses to corticotropin releasing hormone (CRH). Hirsute participants presented a flattened personality profile with lower neurotic triad scores--146 +/- 20 versus 166 +/- 28. Left-hand preference was more common in hirsute participants--4/21 versus 0/20. Decreased ACTH [area under the curve (AUC)--36 +/-2 8 vs. 72 +/- 63 pg/ml h] and cortisol (AUC--18 +/- 4 vs. 25 +/- 10 microg/dl h) responses to CRH were found in the hirsute group. In the hirsute group, higher manual preference scores were associated with lower ACTH responses to CRH, while the opposite association was found in the control group. In the hirsute group, the hyporeactive hypothalamic-pituitary-adrenal (HPA) axis was associated with lower behavior-deviant scores, while in the control group, the hyporeactive HPA axis was associated with more psychopathology. We conclude that personality and HPA axis reactivity are different in hirsute female participants when compared with controls, with a trend for differences regarding handedness. Personality and handedness are differently associated with HPA reactivity. Distinctive features in hirsute participants are probably established very early during ontogenic development.

Interhemispheric integration during the menstrual cycle: failure to confirm progesterone-mediated interhemispheric decoupling

A recent theory proposed that high levels of progesterone during the menstrual cycle may lead to functional decoupling of the cerebral hemispheres [Neuropsychologia 38 (2000) 1362]. The present study tested this theory with a well-validated behavioral measure of interhemispheric communication administered to 55 naturally-cycling women at the luteal or menstrual phase of the cycle. Neither between-subjects nor within-subjects analyses found significant differences in interhemispheric communication between the menstrual and luteal phases (F < 1). Correlations between salivary progesterone levels and interhemispheric communication also failed to support the theory. Although negative affect (NA) was associated with decreased effectiveness of interhemispheric communication, mood variables could not account for the lack of relationship between hormonal and interhemispheric variables. In summary, despite a rigorous and valid test, the theory that progesterone leads to interhemispheric decoupling found no support.

Cerebral correlates of selective attention in schizophrenic patients with formal thought disorder: a controlled H2 15O-PET study

There is a widespread belief that formal thought disorders may be associated with disturbed selective attention in schizophrenia. Two hypotheses are derived: (1) patients with slightly pronounced formal thought disorders should differ from those with severely expressed formal thought disorders in terms of selective attention; and (2) the cerebral correlates of selective attention should be organised differently in mildly versus severely thought-disordered patients. We compared 20 female schizophrenic patients, one-half with mild, one-half with obvious formal thought disorders, and 10 control subjects on a neuropsychological battery and a cognitive activation task for selective attention (Go/NoGo) for the assessment of rCBF using H2 15O-PET. While the first hypothesis has not been confirmed, we found that the cerebral regions activated by selective attention in the two patient groups showed completely differing organisations. Low degrees of formal thought disorders were associated with significant activations in frontal superior gyrus and ventral anterior thalamic nucleus whereas high degrees of formal thought disorders were accompanied by significant activations in fusiform gyrus and precuneus. We suggest that differing task-solving strategies are applied by both clinical subgroups to achieve comparable results on the selective attention paradigm.