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Bannbers, Elin
Publications (10 of 12) Show all publications
Gingnell, M., Toffoletto, S., Wikström, J., Engman, J., Bannbers, E., Comasco, E. & Sundström Poromaa, I. (2017). Emotional anticipation after delivery - a longitudinal neuroimaging study of the postpartum period. Scientific Reports, 7, Article ID 114.
Open this publication in new window or tab >>Emotional anticipation after delivery - a longitudinal neuroimaging study of the postpartum period
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2017 (English)In: Scientific Reports, ISSN 2045-2322, E-ISSN 2045-2322, Vol. 7, article id 114Article in journal (Refereed) Published
Abstract [en]

Neuroimaging research has begun to unveil the mechanisms behind emotion processing during the postpartum period, which, in turn, may be of relevance for the development of postpartum depression. The present study sought to longitudinally investigate the neural correlates of emotion anticipation during the postpartum period in healthy women. Functional magnetic resonance imaging was employed to measure the blood oxygen level-dependent signal in the brain in response to anticipation of negative emotional stimuli and during processing of images with positive or negative valence. The participating women were scanned twice: the first scan occurred during the first 48 hours after delivery, and the second was performed 4-6 weeks after delivery. The early postpartum period was characterized by higher anterior cingulate cortex reactivity during anticipation of negative emotional stimuli than the late postpartum period. This was accompanied by a negative relationship with insular reactivity during the early postpartum period and a trend towards an increase in insular reactivity in the late postpartum period. Thus, during the first four weeks of the postpartum period, a diminished top-down regulatory feedback on emotion-related areas of the brain was noted. This finding suggests a physiologically important adaptation during the healthy postpartum period.

National Category
Obstetrics, Gynecology and Reproductive Medicine
Identifiers
urn:nbn:se:uu:diva-319610 (URN)10.1038/s41598-017-00146-3 (DOI)000425860900001 ()28273912 (PubMedID)
Funder
Swedish Research Council, K2014-54-20642-07-4
Available from: 2017-04-06 Created: 2017-04-06 Last updated: 2018-05-04Bibliographically approved
Comasco, E., Hahn, A., Ganger, S., Gingnell, M., Bannbers, E., Oreland, L., . . . Sundström-Poromaa, I. (2014). Emotional fronto-cingulate cortex activation and brain derived neurotrophic factor polymorphism in premenstrual dysphoric disorder. Human Brain Mapping, 35(9), 4450-4458
Open this publication in new window or tab >>Emotional fronto-cingulate cortex activation and brain derived neurotrophic factor polymorphism in premenstrual dysphoric disorder
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2014 (English)In: Human Brain Mapping, ISSN 1065-9471, E-ISSN 1097-0193, Vol. 35, no 9, p. 4450-4458Article in journal (Refereed) Published
Abstract [en]

Premenstrual dysphoric disorder (PMDD) is the prototypical sex-specific disorder in which symptom onset and offset require a particular hormonal milieu and for which there is moderate heritability. The present study investigated brain emotion processing in PMDD and healthy controls, as well as functional polymorphisms in two candidate genes for PMDD, the serotonin transporter (5-HTT) and brain derived neurotrophic factor (BDNF). The 5-HTT linked polymorphic region (5-HTTLPR) and BDNF Val66Met polymorphisms were genotyped in 31 patients with PMDD and 31 healthy controls. A subset of 16 patients and 15 controls participated in two functional magnetic resonance imaging-sessions performing an emotion processing task; once in the mid-follicular, and once in the late luteal phase which corresponds with maximum severity of mood symptoms. Genotypes were not directly associated with PMDD. A main effect of group was found in the whole brain analysis, with patients having lower activation of the pre-genual anterior cingulate and ventro-medial prefrontal cortex, independent of menstrual cycle phase. Post-hoc functional ROI analyses in the fronto-cingulate cluster showed no effect of 5-HTTLPR genotype but a genotype-by-group-by-phase interaction effect of BDNF Val66Met. Women with PMDD who were carriers of the Met-allele had lower fronto-cingulate cortex activation in the luteal phase compared to Met-allele carrying controls. The results provide suggestive evidence of impaired emotion-induced fronto-cingulate cortex activation in PMDD patients. Although limited by a small sample, the potential influence of BDNF Val66Met in PMDD is in line with preclinical findings. Hum Brain Mapp, 2014. 

National Category
Neurosciences
Identifiers
urn:nbn:se:uu:diva-221880 (URN)10.1002/hbm.22486 (DOI)000339567000014 ()24615932 (PubMedID)
Available from: 2014-04-07 Created: 2014-04-07 Last updated: 2018-05-31Bibliographically approved
Gingnell, M., Ahlstedt, V., Bannbers, E., Wikström, J., Sundström-Poromaa, I. & Fredrikson, M. (2014). Social stimulation and corticolimbic reactivity in premenstrual dysphoric disorder: a preliminary study. Biology of Mood & Anxiety Disorders, 4(1), 3
Open this publication in new window or tab >>Social stimulation and corticolimbic reactivity in premenstrual dysphoric disorder: a preliminary study
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2014 (English)In: Biology of Mood & Anxiety Disorders, ISSN 2045-5380, Vol. 4, no 1, p. 3-Article in journal (Refereed) Published
Abstract [en]

BACKGROUND:

Premenstrual dysphoric disorder (PMDD), characterized by luteal phase-induced negative affect and loss of impulse control, often results in compromised social interactions. Although amygdala activation is generally linked to negative affect, increased amygdala reactivity to aversive stimuli in the luteal phase has not been consistently reported in PMDD. We tested the hypothesis that amygdala hyper-reactivity in PMDD is symptom specific, rather than generalized, and linked to socially relevant stimuli. Blood oxygenation level dependent signal changes during exposure to negative images with social and non-social content were evaluated in the mid-follicular and late luteal phase of the menstrual cycle. Fourteen women with PMDD and 13 healthy controls participated.

RESULTS:

When compared with healthy controls, women with PMDD in the luteal phase had enhanced reactivity to social stimuli compared to non-social stimuli in the amygdala and insula, but attenuated reactivity in the anterior cingulate cortex. Functional couplings between emotion processing and controlling areas were significantly different, being positive in women with PMDD and negative in healthy controls. Changes in progesterone levels in women with PMDD correlated positively with altered amygdala reactivity.

CONCLUSIONS:

Socially relevant aversive stimulation elicited enhanced activity in affective processing brain regions that were functionally coupled to compromised activity in cognitive control areas. Because increased reactivity correlated positively with alterations in ovarian steroid levels, data preliminary support the hypothesis that enhanced progesterone sensitivity in PMDD affects corticolimbic processing of social emotions.

National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:uu:diva-220411 (URN)10.1186/2045-5380-4-3 (DOI)24572042 (PubMedID)
Note

De två sista författarna delar sistaförfattarskapet.

Available from: 2014-03-13 Created: 2014-03-13 Last updated: 2017-12-05Bibliographically approved
Segebladh, B., Bannbers, E., Moby, L., Nyberg, S., Bixo, M., Bäckström, T. & Sundström Poromaa, I. (2013). Allopregnanolone serum concentrations and diurnal cortisol secretion in women with premenstrual dysphoric disorder. Archives of Women's Mental Health, 16(2), 131-137
Open this publication in new window or tab >>Allopregnanolone serum concentrations and diurnal cortisol secretion in women with premenstrual dysphoric disorder
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2013 (English)In: Archives of Women's Mental Health, ISSN 1434-1816, E-ISSN 1435-1102, Vol. 16, no 2, p. 131-137Article in journal (Refereed) Published
Abstract [en]

Most prior studies in patients with premenstrual dysphoric disorder (PMDD) indicate a blunted hypothalamus-pituitary-adrenal axis function. However, the relationship between neuroactive progesterone metabolites, such as allopregnanolone, and hypothalamus-pituitary-adrenal (HPA) axis function in PMDD patients is relatively sparsely studied. The primary aims of this study were to assess diurnal variation in circulating cortisol and low-dose dexamethasone suppression in PMDD patients and healthy controls, and the relationship between these two HPA axis indices and allopregnanolone serum concentrations. Twenty-six women with prospectively defined PMDD and 30 healthy controls were recruited. Participants underwent diurnal sampling for cortisol serum concentrations and a low-dose dexamethasone suppression test. In addition, morning allopregnanolone serum concentrations were determined. There was no difference in diurnal secretion of cortisol and degree of dexamethasone suppression of cortisol between PMDD patients and healthy controls. However, PMDD patients with high allopregnanolone levels displayed blunted nocturnal cortisol levels in comparison with healthy controls who had low allopregnanolone serum concentrations. In women with PMDD, diurnal secretion of cortisol may be influenced by allopregnanolone levels of the luteal phase. This finding may be attributed to timing of blood sampling in the late luteal phase as well as the individual level of allopregnanolone but could potentially explain the discrepancies in results between studies examining HPA axis function in women with PMDD.

National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:uu:diva-196612 (URN)10.1007/s00737-013-0327-1 (DOI)000316146300007 ()23329007 (PubMedID)
Available from: 2013-03-11 Created: 2013-03-11 Last updated: 2017-12-06Bibliographically approved
Bannbers, E., Gingnell, M., Engman, J., Morell, A., Sylvén, S., Skalkidou, A., . . . Sundström Poromaa, I. (2013). Prefrontal activity during response inhibition decreases over time in the postpartum period. Behavioural Brain Research, 241(1), 132-138
Open this publication in new window or tab >>Prefrontal activity during response inhibition decreases over time in the postpartum period
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2013 (English)In: Behavioural Brain Research, ISSN 0166-4328, E-ISSN 1872-7549, Vol. 241, no 1, p. 132-138Article in journal (Refereed) Published
Abstract [en]

The postpartum period is characterized by complex hormonal changes, but human imaging studies in the postpartum period have thus far predominantly focused on the neural correlates of maternal behavior or postpartum depression, whereas longitudinal studies on neural correlates of cognitive function across the postpartum period in healthy women are lacking. The aim of this study was to longitudinally examine response inhibition, as a measure of executive function, and its neural correlates in healthy postpartum women and non-postpartum controls. Thirteen healthy postpartum women underwent event-related functional magnetic resonance imaging while performing a Go/NoGo task. The first assessment was made within 48hours of delivery, and the second at 4-7 weeks postpartum. In addition, 13 healthy women examined twice during the menstrual cycle were included as non-postpartum controls. In postpartum women region of interest analyses revealed task-related decreased activations in the right inferior frontal gyrus, right anterior cingulate, and bilateral precentral gyri at the late postpartum assessment. Generally, postpartum women displayed lower activity during response inhibition in the bilateral inferior frontal gyri and precentral gyri compared to non-postpartum controls. No differences in response inhibition performance were found between time-points or between groups. In conclusion, this study has discovered that brain activity in prefrontal areas during a response inhibition task decreases throughout the course of the first postpartum weeks and is lower than in non-postpartum controls. Further studies on the normal adaptive brain activity changes that occur during the postpartum period are warranted.

National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:uu:diva-188503 (URN)10.1016/j.bbr.2012.12.003 (DOI)000315308700018 ()23238040 (PubMedID)
Available from: 2012-12-17 Created: 2012-12-17 Last updated: 2017-12-06Bibliographically approved
Gingnell, M., Bannbers, E., Wikström, J., Fredrikson, M. & Sundström Poromaa, I. (2013). Premenstrual dysphoric disorder and prefrontal reactivity during anticipation of emotional stimuli. European Neuropsychopharmacology, 23(11), 1474-1483
Open this publication in new window or tab >>Premenstrual dysphoric disorder and prefrontal reactivity during anticipation of emotional stimuli
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2013 (English)In: European Neuropsychopharmacology, ISSN 0924-977X, E-ISSN 1873-7862, Vol. 23, no 11, p. 1474-1483Article in journal (Refereed) Published
Abstract [en]

Premenstrual disorder (PMDD) affects around 5% of women in childbearing ages. An increased sensitivity in emotion processing areas of the brain to variations in ovarian steroid levels has been suggested as part of the pathophysiology in PMDD, but prior neuroimaging studies of emotion processing are yet inconclusive. Previous behavioral studies of women with PMDD have, however, reported enhanced luteal phase startle responsivity during emotional anticipation. Here we used functional magnetic resonance imaging (fMRI) to investigate central neural circuitry activity during anticipation of, and exposure to, emotional stimuli across the menstrual cycle in women with and without PMDD. As compared to healthy controls, women with PMDD displayed significantly enhanced reactivity in the prefrontal cortex during anticipation of, but not exposure to, negative emotional stimuli during the luteal phase. In PMDD patients, BOLD reactivity during anticipation or viewing of negative emotional stimuli was not dependent on absolute levels of estradiol or progesterone. However, progesterone levels were positively correlated with emotion-induced reactivity in the dorsolateral prefrontal cortex to positive emotional stimuli. These findings suggest that cortical emotional circuitry reactivity during anticipation is altered in PMDD during the luteal phase, which might be part of the pathophysiology behind the emotional symptoms or lack of emotional control reported by women with PMDD.

Keywords
fMRI, premenstrual dysphoric disorder, progesterone, estrogen, anticipation, emotion
National Category
Obstetrics, Gynecology and Reproductive Medicine
Identifiers
urn:nbn:se:uu:diva-199788 (URN)10.1016/j.euroneuro.2013.08.002 (DOI)000328014700016 ()24001875 (PubMedID)
Available from: 2013-05-14 Created: 2013-05-14 Last updated: 2017-12-06Bibliographically approved
Hellgren, C., Bannbers, E., Åkerud, H., Risbrough, V. & Sundström-Poromaa, I. (2012). Decreased startle modulation during anticipation in the postpartum period in comparison to late pregnancy. Archives of Women's Mental Health, 15(2), 87-94
Open this publication in new window or tab >>Decreased startle modulation during anticipation in the postpartum period in comparison to late pregnancy
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2012 (English)In: Archives of Women's Mental Health, ISSN 1434-1816, E-ISSN 1435-1102, Vol. 15, no 2, p. 87-94Article in journal (Refereed) Published
Abstract [en]

Knowledge about healthy women's psychophysiological adaptations during the large neuroendocrine changes of pregnancy and childbirth is essential in order to understand why these events have the potential to disrupt mental health in vulnerable individuals. This study aimed to compare startle response modulation, an objective psychophysiological measure demonstrated to be influenced by anxiety and depression, longitudinally across late pregnancy and the postpartum period. The acoustic startle response modulation was assessed during anticipation of affective images and during image viewing in 31 healthy women during gestational weeks 36-39 and again at 4 to 6 weeks postpartum. No startle modulation by affective images was observed at either time point. Significant modulation during anticipation stimuli was found at pregnancy assessment but was reduced in the postpartum period. The women rated the unpleasant images more negative and more arousing and the pleasant images more positive at the postpartum assessment. Self-reported anxiety and depressive symptoms did not change between assessments. The observed postpartum decrease in modulation of startle by anticipation suggests a relatively deactivated defense system in the postpartum period.

Keywords
Acoustic startle response, Affective modulation, Anticipation, Postpartum, Pregnancy
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:uu:diva-175634 (URN)10.1007/s00737-012-0261-7 (DOI)000304169100002 ()
Available from: 2012-06-12 Created: 2012-06-11 Last updated: 2017-12-07Bibliographically approved
Gingnell, M., Morell, A., Bannbers, E., Wikström, J. & Sundström Poromaa, I. (2012). Menstrual cycle effects on amygdala reactivity to emotional stimulation in premenstrual dysphoric disorder. Hormones and Behavior, 62(4), 400-406
Open this publication in new window or tab >>Menstrual cycle effects on amygdala reactivity to emotional stimulation in premenstrual dysphoric disorder
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2012 (English)In: Hormones and Behavior, ISSN 0018-506X, E-ISSN 1095-6867, Vol. 62, no 4, p. 400-406Article in journal (Refereed) Published
Abstract [en]

Premenstrual dysphoric disorder (PMDD) with luteal phase related anxiety and mood swings compromise quality of life in around 4% of reproductive women. While anxiety is related to amygdala function, prior studies on amygdala reactivity both in healthy controls and women with PMDD are inconsistent with respect to menstrual cycle effects. Here women with PMDD and healthy controls were exposed to emotional faces during the mid-follicular and late luteal phase, and mean blood-oxygen-level dependence (BOLD) signal changes in the amygdala were determined with functional magnetic resonance imaging (fMRI). Women with PMDD had enhanced bilateral amygdala reactivity in the follicular phase in comparison with healthy controls, but there was no difference between groups during the luteal phase. In contrast, healthy controls displayed higher left amygdala reactivity in the luteal than in their follicular phase. However, among women with PMDD follicular phase progesterone serum concentrations were positively correlated with bilateral amygdala reactivity while depression scores were positively correlated with right amygdala reactivity in the luteal phase. In addition, women with PMDD and high scores on trait anxiety had increased right amygdala reactivity in the luteal as compared to the follicular phase. Finally, amygdala reactivity was more prone to habituation in women with PMDD, as they had enhanced amygdala reactivity in comparison with controls at the first, but not the second scanning session. Thus, while the study failed to indicate increased luteal phase amygdala reactivity in women with PMDD, our findings suggest that anxiety proneness and progesterone levels modulate menstrual cycle related amygdala reactivity in women with PMDD.

National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:uu:diva-183654 (URN)10.1016/j.yhbeh.2012.07.005 (DOI)000310654100006 ()22814368 (PubMedID)
Available from: 2012-10-31 Created: 2012-10-31 Last updated: 2017-12-07Bibliographically approved
Bannbers, E., Gingnell, M., Engman, J., Morell, A., Comasco, E., Kask, K., . . . Sundström Poromaa, I. (2012). The effect of premenstrual dysphoric disorder and menstrual cycle phase on brain activity during response inhibition. Journal of Affective Disorders, 142(1-3), 347-350
Open this publication in new window or tab >>The effect of premenstrual dysphoric disorder and menstrual cycle phase on brain activity during response inhibition
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2012 (English)In: Journal of Affective Disorders, ISSN 0165-0327, E-ISSN 1573-2517, Vol. 142, no 1-3, p. 347-350Article in journal (Refereed) Published
Abstract [en]

BACKGROUND:

Premenstrual dysphoric disorder (PMDD) has generally not been associated with impulsive behavior. However, some studies suggest that women with PMDD have higher impulsivity scores than healthy controls and that brain activity during response inhibition may vary across the menstrual cycle. Therefore, our aim was to unravel potentially important cognitive aspects of PMDD by investigating brain activity during response inhibition in women with PMDD and healthy controls in relation to menstrual cycle phase.

METHODS:

Fourteen PMDD patients and 13 healthy controls performed a Go/NoGo task to measure brain activity during response inhibition by use of event-related functional magnetic resonance imaging.

RESULTS:

Women with PMDD displayed decreased activity during both menstrual cycle phases compared to healthy controls in several task-related parietal areas. A significant group by phase interactions was found in the left insula, driven by enhanced activity among healthy controls in the follicular phase and by enhanced insula activity during the luteal phase among PMDD patients.

LIMITATIONS:

The limitations of the present study are the relatively limited sample size, the relatively small number of NoGo trials and the lack of a baseline contrast for the NoGo trials.

CONCLUSIONS:

During response inhibition women with PMDD have reduced activity in areas associated with attention and motor function which is unrelated to menstrual cycle phase. Insular cortex activity, involved in both affective and cognitive processing, was significantly activated during the luteal phase among PMDD women. These findings are relevant for the understanding of how ovarian steroids influence mood symptoms in women.

National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:uu:diva-183655 (URN)10.1016/j.jad.2012.04.006 (DOI)000310565900051 ()22840469 (PubMedID)
Available from: 2012-10-31 Created: 2012-10-31 Last updated: 2017-12-07Bibliographically approved
Bannbers, E. (2012). The Effect of Steroid Hormones in the Female Brain During Different Reproductive States. (Doctoral dissertation). Uppsala: Acta Universitatis Upsaliensis
Open this publication in new window or tab >>The Effect of Steroid Hormones in the Female Brain During Different Reproductive States
2012 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

Women are twice as likely as men to suffer from depression and anxiety disorders and have an increased risk of onset during periods associated with hormonal changes, such as the postpartum period and the menopausal transition. Furthermore, some women seem more sensitive to normal hormone fluctuations across the menstrual cycle, since approximately 3-5% suffers from premenstrual dysphoric disorder (PMDD). Why these disorders are so common in women has not been established but there is a probable involvement of the ovarian hormones.

The aim of this thesis was to investigate the effect of the ovarian hormones on the female brain during different reproductive states using psychological tests known to affect brain activity in different ways.

Paper one examined the effect of the ovarian hormones on prepulse inhibition (PPI) on the acoustic startle response (ASR) and comprised cycling women and postmenopausal women. The cycling women had lower levels of PPI compared to postmenopausal women and postmenopausal women with moderate estradiol levels had lower PPI compared to postmenopausal women with low estradiol levels.

Paper two examined the effect of anticipation and affective modulation on the ASR in women with PMDD and healthy controls. Women with PMDD have an increased modulation during anticipation of affective pictures compared to healthy controls during the luteal phase of the menstrual cycle.

Paper three examined brain activity during response inhibition among women with PMDD and healthy controls by the use of a Go/NoGo task and fMRI. Women with PMDD displayed a decreased activity in the left insula during follicular phase and an increased activity during the luteal phase compared to controls.

Paper four comprised women in the postpartum period and non-pregnant controls to examine brain activity during response inhibition. While this study revealed decreased activity at 4 weeks postpartum compared to 48 hours postpartum we cannot ascertain the role of the ovarian steroids, since none of the significant brain areas correlated with ovarian steroid or neurosteroid serum concentrations.

The results of this thesis demonstrate that the ovarian hormones, or at least various hormonal states, have a probable impact on how the female brain works.

Place, publisher, year, edition, pages
Uppsala: Acta Universitatis Upsaliensis, 2012. p. 85
Series
Digital Comprehensive Summaries of Uppsala Dissertations from the Faculty of Medicine, ISSN 1651-6206 ; 787
Keywords
Premenstrual dysphoric disorder, Postpartum, Estradiol, Progesterone, Menstrual cycle, Functional magnetic resonance imaging, Response inhibition, Prepulse inhibition, Startle response
National Category
Obstetrics, Gynecology and Reproductive Medicine
Research subject
Medical Science
Identifiers
urn:nbn:se:uu:diva-175409 (URN)978-91-554-8402-6 (ISBN)
Public defence
2012-09-14, Gustavianum, Auditorium Minus, Akademigatan 3, Uppsala, 09:00 (Swedish)
Opponent
Supervisors
Available from: 2012-08-22 Created: 2012-06-06 Last updated: 2013-07-22
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