Physiological correlates of premenstrual dysphoric disorder (PMDD)

Abstract

Premenstrual dysphoric disorder (PMDD) is a mood disorder with onset of functionally impairing or distressing mood symptoms in the late luteal phase of the menstrual cycle. Psychophysiologic findings in PMDD broadly fall into two categories: vulnerability trait findings, thus categorized because they are present in the asymptomatic phases of the menstrual cycle, and state findings, which are only present in the symptomatic late luteal phase and which are potentially representative of the hormonal events and biological mechanisms that lead to PMDD. Trait vulnerability markers in PMDD include diminished cardiovascular stress responses, lower heart rate variability (reflecting increased vagal tone), and lower P300 amplitude, eventually suggesting that women with PMDD share a number of physiological correlates with related anxiety and mood disorders. State findings in PMDD include lower luteal phase prepulse inhibition and altered luteal phase emotion processing. Lower prepulse inhibition in the late luteal phase may be an important ovarian steroid-influenced indicative of altered serotonergic neurotransmission, of relevance for women with PMDD. Attempts to determine the neural correlates of emotion processing in the late luteal phase are thus far inconsistent, but promising.