Metabolic and hormone influences on emotion processing during menopause.
Disturbances of emotion regulation and depressive symptoms are common during the menopause transition. Reproductive hormone levels are not directly correlated with depressive symptoms, and other factors may influence mood symptoms during menopause. In this study, we sought to determine the role of metabolic function in mood symptoms during menopause, hypothesizing an association with menopause status and long-term glucose load. We studied 54 women across three menopause transition stages (15 premenopause, 11 perimenopause, and 28 postmenopause), examining effects of age, hormones, and metabolism on mood and neural activation during emotional discrimination. We assessed participants using behavioral and functional MRI measures of negative emotion and emotion discrimination, and glycated hemoglobin A1c, to assess long-term glucose load. We found that emotionally unpleasant images activated emotion regulation (amygdala) and cognitive association brain regions (prefrontal cortex, posterior cingulate, temporal-parietal-occipital (TPO) junction, hippocampus). Cognitive association region activity increased with menopause stage. Perimenopausal women had left TPO junction activation, and postmenopausal women had prefrontal cortex, posterior cingulate, and TPO junction activation. Negative affect was associated with decreased amygdala activation, while depression symptoms and negative mood were associated with increased TPO junction activation. Hemoglobin A1c was associated with negative interpretation bias of neutral images and cognitive region recruitment during emotion discrimination. FSH levels, indicating menopause stage, were associated with negative mood. Age was not associated with any behavioral measures or activation patterns during the emotion task. Our results suggest that an interaction between metabolic and hormonal factors may influence emotion regulation, leading to increased risk for depression during menopause.
Department of Psychiatry, University of Michigan, Ann Arbor, MI 48109, USA. Electronic address: berent@umich.edu.
Alison
A
Berent-Spillson
Department of Obstetrics & Gynecology, University of Kansas, Kansas City, KS 66160, USA.
Courtney
C
Marsh
Department of Psychiatry, University of Michigan, Ann Arbor, MI 48109, USA.
Carol
C
Persad
Department of Obstetrics & Gynecology, University of Michigan, Ann Arbor, MI 48109, USA.
John
J
Randolph
Department of Psychiatry, University of Utah, Salt Lake City, UT 84108, USA.
Jon-Kar
JK
Zubieta
Department of Obstetrics & Gynecology, University of Michigan, Ann Arbor, MI 48109, USA.
Yolanda
Y
Smith
D000328:Adult; D000342:Affective Symptoms / Q000000981:diagnostic imaging / Q000378:metabolism / Q000503:physiopathology; D000679:Amygdala / Q000000981:diagnostic imaging / Q000502:physiology*; D002540:Cerebral Cortex / Q000000981:diagnostic imaging / Q000502:physiology*; D003657:Decision Making / Q000502:physiology*; D003863:Depression / Q000000981:diagnostic imaging / Q000378:metabolism / Q000503:physiopathology; D004644:Emotions / Q000502:physiology*; D005260:Female; D006442:Glycated Hemoglobin / Q000378:metabolism*; D006801:Humans; D008279:Magnetic Resonance Imaging; D008875:Middle Aged; D047648:Perimenopause / Q000378:metabolism / Q000502:physiology*; D017698:Postmenopause / Q000378:metabolism / Q000502:physiology*; D017697:Premenopause / Q000378:metabolism / Q000502:physiology*
D006442:Glycated Hemoglobin; C517652:hemoglobin A1c protein, human
Emotion regulation; Menopause; Metabolism; Perimenopause; fMRI