Functional and structural neuroimaging in premenstrual dysphoric disorder: A systematic review.

This systematic review aimed to summarize the most recent data on changes in brain structure and function in premenstrual dysphoric disorder (PMDD) as well as elucidate the possible correlations between these findings and symptom severity. Articles published in PubMed, EMBASE, ScienceDirect, PsycInfo, Web of Science, and Scopus from inception until April 2023 were systematically reviewed according to the PICO framework: population (women with PMDD), intervention (neuroimaging study), control (healthy subjects), and outcome (neuroimaging changes). In total, 1026 individuals were included from controlled (n = 22) and non-controlled (n = 2) trials. Among them, 608 had PMDD, and 418 were healthy controls. Different neuroimaging methods were addressed, such as task-based functional magnetic resonance imaging (MRI), resting-state functional MRI, proton magnetic resonance spectroscopy, diffusion tensor imaging, proton emission tomography, and structural MRI. Despite the absence of consensual results, several brain structures have been implicated in PMDD, including the prefrontal cortex, amygdala, hippocampus, insula, basal ganglia, and cerebellum. In addition, some brain changes are related to the intensity of symptoms and phases of the menstrual cycle, such as the correlation between depressive symptoms and increased serotonin transporter binding potential in the midbrain during the luteal phase. • Current findings suggest an impairment in the functioning of top-down emotional control in patients with PMDD. • Patient with PMDD demonstrates structural impairment of corticolimbic connections. • PMDD exhibited corticocortical hypoconnectivity and subcortical hyperconnectivity. • From the periovulatory to the premenstrual phase, patients with PMDD increased availability of the serotonin transporter. • Patients with PMDD have altered gray matter volume in the amygdala, hippocampus, striatum, and cerebellum. [ABSTRACT FROM AUTHOR]