Abstract
Background
Premenstrual syndrome (PMS) involves an aberrant behavioral response to normal hormone
secretion. Pathogenetic theories posit abnormal modulation of γ-aminobutyric acid
(GABA) transmission in the brain by neuroactive metabolites of progesterone (neurosteroids).
In earlier transcranial magnetic stimulation (TMS) studies of the motor cortex, we
showed that inhibition increases in the luteal phase, consistent with neurosteroid
action at the GABAA receptor. Here, we studied women with PMS to see if their response to endogenous
progesterone differed from that of control subjects.
Methods
We studied nine women with PMS and 14 control subjects during the midfollicular and
luteal phases with paired TMS. Subthreshold conditioning TMS was followed by test
stimulation that produced a motor evoked potential (MEP) in a hand muscle. We gave
pairs at each of seven intervals (2–10 msec) and unconditioned stimuli, measuring
the amplitude ratio of the average MEP from the pairs at each interval to that from
the unconditioned stimuli (ratio < 1 = inhibition).
Results
Both groups showed the same follicular phase response to paired TMS. Control subjects
showed more inhibition in the luteal phase. Women with PMS showed relative facilitation.
Conclusions
This is the first physiological evidence for an abnormal brain response to progesterone
in PMS.
Keywords
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Article info
Publication history
Accepted:
November 15,
2002
Received in revised form:
November 11,
2002
Received:
August 27,
2002
Identification
Copyright
© 2003 Society of Biological Psychiatry. Published by Elsevier Inc. All rights reserved.
