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Neuroendocrine risk factors for PTSD in women

PI: Jennifer Stevens, PhD
Co-Investigators: Vasiliki Michopoulos, PhD &
Sanne van Rooij, PhD

The majority of Americans will experience a traumatic event during their lifetimes, but women are twice as likely as men to experience negative psychiatric outcomes following trauma. This can include greater risk of  post-traumatic stress disorder (PTSD) and depression. The reason for the increased prevalence in women is unclear, partially because of the historical lack of investigation of females in both human and preclinical animal research.

In this project, we will investigate the role of sex hormones in contributing to women’s risk for PTSD. The gonadal hormone estradiol (E2) has previously been associated with emotion regulation and  memory in rodent and healthy human studies, mediated by plasticity in pathways between the amygdala and regulatory inputs from the prefrontal cortex and hippocampus. Women with PTSD often experience changes to their emotional reactions  and memory, following trauma. It may be that E2 levels play an important role in these changes. 

We will use a randomized double-blind, placebo-controlled, within-subjects crossover design, with E2/placebo given to naturally-cycling women during the early follicular phase of the cycle (during menses) when endogenous E2 is lowest. Participants will be randomized to receive either E2 or placebo at the first MRI scan, and will cross over to the other condition for a second scan during their next  menstrual cycle.

Secondly, we will test this E2 administration in the luteal phase (after ovulation) to observe the effects of changes in the E2 and its levels relative to rising progesterone during this menstrual cycle phase.  Findings from this study may aid in the development of new treatments and interventions to improve women’s mental health outcomes following trauma.

As part of this study,  participants can expect to experience:

  • Clinical Interviews - Clinical interviews are used to learn how people react to stressful life events and their coping strategies. They consist of questions regarding life events, related emotions,  and medical history. All answers are confidential and identified by a number (not names) to protect the privacy of our participants.

  • Estrogen and Placebo Patch Applications - Participants will wear either an estrogen or placebo patch during two points study visits, removing the patch after 24-48 hours. The patch is about the size of a small sticky note and will be placed on the participant’s lower abdomen  and covered with a bandage by a research assistant. 

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  • MRI Scans - Magnetic Resonance Imaging (MRI) uses a large magnet to take detailed internal pictures of the body and brain. By looking at the magnetic properties of blood as it reaches different areas in the brain, functional MRI can be used to observe brain activity. 

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  • Skin Conductance Measurements - In response to a surprising environmental cue, the body responds by increasing sweat levels. This response can be measured by placing two sensors on the palm or fingers of one hand and recording the electrical properties of your sweat. 

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