title: Subcortical gray matter changes in transgender subjects after long-term cross-sex hormone administration.
abstract: Sex-steroid hormones are primarily involved in sexual differentiation and development and are thought to underlie processes related to cognition and emotion. However, divergent results have been reported concerning the effects of hormone administration on brain structure including side effects like brain atrophy and dementia. Cross-sex hormone therapy in transgender subjects offers a unique model for studying the effects of sex hormones on the living human brain. In this study, 25 Female-to-Male (FtM) and 14 Male-to-Female (MtF) subjects underwent MRI examinations at baseline and after a period of at least 4-months of continuous cross-sex hormone administration. While MtFs received estradiol and anti-androgens, FtM subjects underwent high-dose testosterone treatment. The longitudinal processing stream of the FreeSurfer software suite was used for the automated assessment and delineation of brain volumes to assess the structural changes over the treatment period of cross-sex hormone administration. Most prominent results were found for MtFs receiving estradiol and anti-androgens in the form of significant decreases in the hippocampal region. Further analysis revealed that these decreases were reflected by increases in the ventricles. Additionally, changes in progesterone levels correlated with changes in gray matter structures in MtF subjects. In line with prior studies, our results indicate hormonal influences on subcortical structures related to memory and emotional processing. Additionally, this study adds valuable knowledge that progesterone may play an important role in this process.
authors.affiliation: Department of Psychiatry and Psychotherapy, Medical University of Vienna, 1090 Vienna, Austria.
authors.forename: Rene
authors.initials: R
authors.lastname: Seiger
authors.affiliation: Department of Psychiatry and Psychotherapy, Medical University of Vienna, 1090 Vienna, Austria.
authors.forename: Andreas
authors.initials: A
authors.lastname: Hahn
authors.affiliation: MR Centre of Excellence, Center for Medical Physics and Biomedical Engineering, Medical University of Vienna, 1090 Vienna, Austria.
authors.forename: Allan
authors.initials: A
authors.lastname: Hummer
authors.affiliation: Department of Psychiatry and Psychotherapy, Medical University of Vienna, 1090 Vienna, Austria.
authors.forename: Georg S
authors.initials: GS
authors.lastname: Kranz
authors.affiliation: Department of Psychiatry and Psychotherapy, Medical University of Vienna, 1090 Vienna, Austria.
authors.forename: Sebastian
authors.initials: S
authors.lastname: Ganger
authors.affiliation: MR Centre of Excellence, Center for Medical Physics and Biomedical Engineering, Medical University of Vienna, 1090 Vienna, Austria.
authors.forename: Michael
authors.initials: M
authors.lastname: Woletz
authors.affiliation: Department of Psychiatry and Psychotherapy, Medical University of Vienna, 1090 Vienna, Austria.
authors.forename: Christoph
authors.initials: C
authors.lastname: Kraus
authors.affiliation: MR Centre of Excellence, Center for Medical Physics and Biomedical Engineering, Medical University of Vienna, 1090 Vienna, Austria.
authors.forename: Ronald
authors.initials: R
authors.lastname: Sladky
authors.affiliation: Department of Psychiatry and Psychotherapy, Medical University of Vienna, 1090 Vienna, Austria.
authors.forename: Alexander
authors.initials: A
authors.lastname: Kautzky
authors.affiliation: Department of Psychiatry and Psychotherapy, Medical University of Vienna, 1090 Vienna, Austria.
authors.forename: Siegfried
authors.initials: S
authors.lastname: Kasper
authors.affiliation: MR Centre of Excellence, Center for Medical Physics and Biomedical Engineering, Medical University of Vienna, 1090 Vienna, Austria.
authors.forename: Christian
authors.initials: C
authors.lastname: Windischberger
authors.affiliation: Department of Psychiatry and Psychotherapy, Medical University of Vienna, 1090 Vienna, Austria. Electronic address: rupert.lanzenberger@meduniwien.ac.at.
authors.forename: Rupert
authors.initials: R
authors.lastname: Lanzenberger
mesh_terms: D000328:Adult; D000726:Androgen Antagonists / Q000008:administration & dosage / Q000009:adverse effects / Q000494:pharmacology*; D004958:Estradiol / Q000008:administration & dosage / Q000009:adverse effects / Q000494:pharmacology*; D005260:Female; D005500:Follow-Up Studies; D012739:Gonadal Steroid Hormones / Q000008:administration & dosage / Q000009:adverse effects / Q000494:pharmacology*; D066128:Gray Matter / Q000000981:diagnostic imaging / Q000187:drug effects*; D006624:Hippocampus / Q000000981:diagnostic imaging / Q000187:drug effects*; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D011374:Progesterone / Q000097:blood*; D013739:Testosterone / Q000008:administration & dosage / Q000009:adverse effects / Q000494:pharmacology*; D063106:Transgender Persons; D014189:Transsexualism / Q000000981:diagnostic imaging / Q000378:metabolism; D055815:Young Adult
chemical_list: D000726:Androgen Antagonists; D012739:Gonadal Steroid Hormones; D013739:Testosterone; D011374:Progesterone; D004958:Estradiol
keywords: Gray matter volume; Hormone therapy; Hormones; Transgender; Transsexuals