White matter microstructure and volume correlates of premenstrual dysphoric disorder.

Background: Premenstrual dysphoric disorder (PMDD) is a mood disorder characterized by psychological and physical symptoms. Differences in white matter have been associated with affective and anxiety disorders, which share some symptoms with PMDD. However, whether white matter structure differs between the brains of individuals with PMDD and healthy controls is not known, nor is its relation to symptom severity.
Methods: We performed tract-based spatial statistics and voxel-based morphometry analyses of diffusion tensor imaging metrics and white matter volume, using 2 neuroimaging data sets ( n = 67 and n = 131) and a combined whole-brain and region-of-interest approach. We performed correlation analyses to investigate the relationship between regions with different white matter microstructure and volume and PMDD symptom severity.
Results: We found greater fractional anisotropy in the left uncinate fasciculus ( d = 0.69) in individuals with PMDD compared to controls. Moreover, the volume of the right uncinate fasciculus was higher in individuals with PMDD compared to controls ( d = 0.40). As well, the severity of premenstrual depression was positively correlated with fractional anisotropy in the right superior longitudinal fasciculus ( r = 0.35).
Limitations: It is challenging to interpret group differences in diffusion tensor imaging metrics in terms of their underlying biophysical properties. The small size of the control group in the diffusion tensor imaging study may have prevented effects of interest from being detected.
Conclusion: The findings of the present study provide evidence of differential cerebral white matter structure associated with PMDD and its symptoms.
Competing Interests: Competing interests: R. Lanzenberger received support from Siemens Healthcare for clinical research using PET/MR, conference speaker honoraria and travel grants within the last 3 years from Bruker BioSpin MR and Heel, and he has been a shareholder of the start-up company BM Health GmbH since 2019. C.N. Epperson has received research grant support from Sage Therapeutics; he has served on an advisory board for Sage Therapeutics and has received honoraria and travel funding from Sage Therapeutics. I. Sundström-Poromaa was supported by a grant from the Swedish Research Council (2020-01801) and the Brain Foundation (F2020-0255), has served occasionally on advisory boards for Gedeon Richter and received honoraria as an invited speaker for Bayer Health Care, Gedeon Richter, Peptonics, Shire/Takeda, and Sandoz. E. Comasco receives funds from SciLifeLab. No other competing interests declared.
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