eRapport

"Sex and the Suffering Brain”: Linking Sex Hormone Actions with Psychiatric Illness in the Human Brain across the Lifespan

Prosjekt
Prosjektnummer
2022103
Ansvarlig person
Claudia Barth
Institusjon
Diakonhjemmet Sykehus AS
Prosjektkategori
Doktorgradsstipend
Helsekategori
Mental Health, Metabolic and Endocrine, Neurological
Forskningsaktivitet
1. Underpinning, 2. Aetiology
Rapporter
2024
For the second PhD project, the PhD candidate assesses whether sex moderates the link between polygenic risk scores for sex-biased disorders and brain aging in middle to older-aged British White adults, pooled both with and without the disorders of interest (Alzheimer’s Disease, Parkinson’s Disease, depression, and schizophrenia).This second PhD project is a follow-up to Study 1, assessing brain health and using the UK Biobank sample of middle- to older-aged adults while extending to both sexes. This study is titled, "Investigating the role of sex on the link between genetic risk for sex-biased disorders and brain age" and has been preregistered (https://osf.io/a8pt2/). Preregistration reflects commitment for transparency and the reduction of publication bias in scientific research. Analyses for this study are in progress, and the candidate is writing up the paper. Previous research shows that there are sex differences in several neurodegenerative and mental disorders which are known to impact brain health. The interaction between sex and genetics might play an important role in disease-related sex differences due to the modulating role of sex on gene expression. Therefore, we were interested in assessing whether there are sex differences in the link between genetic risk for sex-biased disorders and brain health. Disorders of interest include Alzheimer’s disease, Parkinson’s disease, major depressive disorder, and schizophrenia. The proxy measure of brain heath is brain age, derived from white matter and grey matter brain scans. Genetic risk was measured using polygenic risk scores, which are combined scores that estimate genetic vulnerability to a particular trait or disease. Polygenic risk scores are calculated based on genome-wide association studies, which identify the genes associated with the specific trait or disease of interest. However, these genome-wide association studies often remove the effects of sex. As such, critical information may be missing when using combined-sex polygenic risk scores. In this study we aim to ascertain whether sex moderates the link between polygenic risk and brain aging by comparing polygenic risk scores from a male-only sample, female-only sample, and combined samples. Unraveling the interplay between genetic predispositions and sex in brain aging may help uncover mechanisms driving sex-specific vulnerabilities, paving the way for more precise and effective interventions and treatments for these disorders. In 2024, the candidate got their first PhD paper published and additionally co-authored two empirical papers (1) titled, "Parental status and markers of brain and cellular age: A 3D convolutional network and classification study", which was published in Psychoneuroendocrinology; and (2) titled, "No Causal Links Between Lifetime Estradiol Exposure and Female’s Brain and Mental Health – A Mendelian Randomization Study", which is currently under review. Further, the candidate presented their research at the following conferences: Organization for the Study of Sex Differences (OSSD 2024, Bergen, Norway; poster), and Psychologie und Gehirn (PuG 2024, Hamburg, Germany; oral presentation). The presentation at PuG was part of the symposium, "The Brain on Sex Hormones: Uncovering the Interplay between Affect and Brain Dynamics", which they were invited to partake in. Further, the candidate participated in the Lorentz workshop, “Hormonal fluctuations across the female lifespan: Fostering mental health and wellbeing through all ages” in Leiden, Netherlands. During the workshop, the candidate was involved in launching an interdisciplinary network, the Female Lifespan Association for Mental Health and Neuroendocrinology (FLAME).

No

2023
The PhD candidate co-authored two review papers and two empirical studies, and preregistered and preprinted the first PhD study as first-author. The candidate further completed a research stay in Lausanne, Switzerland, to learn and apply brain age prediction in large datasets. Lastly, the candidate presented their work at ECNP (Barcelona, Spain).The PhD candidate successfully preregistered and preprinted their first PhD study, titled “Linking menopause, history of depression, and proxies of biological aging in the UK Biobank Cohort” (https://osf.io/3k5a2/). The practice of preregistration promotes openness, transparency, and reproducibility by preventing p-hacking (i.e., selective reporting of significant result) and HARKing (i.e., presenting a post hoc hypothesis in the introduction of a research study as if it were an a priori hypothesis). In their first PhD study, the candidate investigated the associations between menopause-related factors and proxies of cellular and brain aging in 13,780 middle- to older-aged females from the UK Biobank. The proxy of cellular aging was leukocyte telomere length, a marker derived from DNA extracted from peripheral blood leukocytes, and the proxy for brain aging was grey and white matter brain age gap, derived from T1- and diffusion weighted brain scans, respectively. The candidate acquired the technical skills to apply brain age prediction in the UK Biobank during their research stay at the FemiLab in Lausanne, Switzerland. Conducting the study, the candidate found that postmenopausal status and older age at natural menopause were linked to lower rates of cellular and brain aging. Surgical menopause and longer natural reproductive span were also associated with lower rates of cellular aging but not brain aging. Cellular and brain aging were not statistically associated with each other. The greatest variance in each proxy of biological aging was most consistently explained by statistical models including both a history of depression and APOE e4 genotype, a known risk factor for Alzheimer’s disease. Overall, the study demonstrates a complex interplay between menopause-related factors, depression, APOE e4 genotype and proxies of biological aging. Some of the results were unexpected and were likely influenced by a disproportionate number of healthier participants among postmenopausal females. To overcome this healthy participant bias in cross-sectional aging cohorts, we highlight the need of longitudinal studies with diverse participants. The manuscript will be submitted to a special issue on menopause and the brain in Hormones and Behavior. This works has been presented as a poster at ECNP 2023 in Barcelona (Spain). The candidate is currently working on preregistering their second PhD study. In addition to the above-mentioned work, the project manager and the PhD candidate co-authored (1) a review paper, titled “Recommendations for a Better Understanding of Sex and Gender in the Neuroscience of Mental Health, published in Biological Psychiatry Global Open Science; (2) an empirical study, titled "Cardiometabolic health across menopausal years is linked to white matter hyperintensities up to a decade later", published in Frontiers in Global Women's Health, and (3) a paper on the association between parental status and brain and cellular aging, currently under review in Psychoneuroendocrinology. Lastly, the project manager and the PhD candidate led a commissioned narrative review paper, titled “Sex steroids and the female brain across the lifespan: insights into risk of depression and Alzheimer’s disease”, published October 2023 in Lancet Diabetes and Endocrinology.

The PhD candidate received a three-month mobility grant to stay with the FemiLab (PI: Ann-Marie G. de Lange) and the larger research group, Laboratoire de recherche en neuroimagerie (LREN), at Lausanne University Hospital in Switzerland. The primary goal of the research visit was to train the candidate in applying novel machine learning techniques (i.e. brain age prediction using XGBoost Regressor Models) to large-scale datasets, which is not only a relevant skill for the candidate’s PhD project, but also a valuable tool for future studies. By the end of the research stay, the candidate had refined their statistical, neuroimaging, and computational skills to build strong methodological foundations for current and future studies. Furthermore, the candidate strengthened personal academic relationships and international ties with the FemiLab/LREN.

2022
The project team successfully hired a suitable PhD candidate for the research grant in 2022. After obtaining a valid visa, the PhD candidate relocated from Canada to Norway beginning of November 2022, and officially started the position November 15th.Project scope: Numerous psychiatric illnesses affecting the brain show prominent sexual dimorphism in prevalence and representation. For instance, females are twice as likely as males to suffer from depression, and males are more severely afflicted by schizophrenia than females. Yet, the study of sex differences has largely been neglected in basic and preclinical research. This is a critical gap, as assessing patients through a sex (and gender) lens is an important step towards personalized health care. Benefiting from the excellent research infrastructure provided by NORMENT, the proposed PhD project will utilize readily available datasets to help close this knowledge gap by (1) investigating sex hormone receptor expression in males and females, and its functional significance to psychiatric illnesses in postmortem human brain tissue from the prenatal period to late adulthood, and (2) by examining the sex-dependent effects of circulating sex hormone levels on brain morphology at two key hormonal inflection points with a heightened susceptibility for psychiatric illnesses: adolescence and menopause. Zeroing in on early onset psychosis during adolescence and depressive symptoms during transition to menopause, the PhD project will elucidate the effects of sex hormones on disease risk in the developing and aging brain, respectively. This knowledge provides the potential to improve therapeutic approaches and clinical outcomes for both sexes. What has been done so far: From November 14th to 18th, the main supervisor/project manager and the PhD candidate participated in a Lorentz Workshop on "Rethinking Sex in Neuroscience of Mental Health"(https://www.lorentzcenter.nl/site/index.php?pntHandler=WorkshopTemplatePage&pntType=ConPagina&id=1794) in Leiden, the Netherlands. During the workshop, the participants developed a road map for future research on sex and gender research in relation to mental health, which will be disseminated through an opinion article (in preparation) and a podcast. The PhD candidate and the main supervisor/project manager will co-author the opinion article, and the main supervisor/project manager was featured in the already published podcast ( Episode 1, Part 1/2 https://open.spotify.com/show/7JvVcV03EaxZDSsA6y6CKo). Furthermore, the PhD candidate successfully submitted the application for the PhD programme in medicine and health sciences, University of Oslo, in January 2023, and is currently working on preregistering the first PhD paper on Open Science Framework (https://osf.io).

No

Vitenskapelige artikler
de Lange AG, Leonardsen EH, Barth C, Schindler LS, Crestol A, Holm MC, Subramaniapillai S, Hill D, Alnæs D, Westlye LT

Parental status and markers of brain and cellular age: A 3D convolutional network and classification study.

Psychoneuroendocrinology 2024 Jul;165():107040. Epub 2024 apr 2

PMID: 38636355

Crestol A, de Lange AG, Schindler L, Subramaniapillai S, Nerland S, Oppenheimer H, Westlye LT, Andreassen OA, Agartz I, Tamnes CK, Barth C

Linking menopause-related factors, history of depression, APOE ε4, and proxies of biological aging in the UK biobank cohort.

Horm Behav 2024 Aug;164():105596. Epub 2024 jun 29

PMID: 38944998 - Inngår i doktorgradsavhandlingen

Barth C, Crestol A, de Lange AG, Galea LAM

Sex steroids and the female brain across the lifespan: insights into risk of depression and Alzheimer's disease.

Lancet Diabetes Endocrinol 2023 Dec;11(12):926. Epub 2023 okt 18

PMID: 37865102

Schindler LS, Subramaniapillai S, Ambikairajah A, Barth C, Crestol A, Voldsbekk I, Beck D, Gurholt TP, Topiwala A, Suri S, Ebmeier KP, Andreassen OA, Draganski B, Westlye LT, de Lange AG

Cardiometabolic health across menopausal years is linked to white matter hyperintensities up to a decade later.

Front Glob Womens Health 2023;4():1320640. Epub 2023 des 21

PMID: 38213741

Oppenheimer H, van der Meer D, Schindler L, Crestol A, Westlye LT, de Lange AG, Barth C.

No Causal Links Between Lifetime Estradiol Exposure and Female’s Brain and Mental Health – A Mendelian Randomization Study

Preprint

Wierenga L, Ruigrok A, Aksnes E, Barth C, Beck D, Burke S, Crestol A, van Drunen L, Ferrara M, Galea L, Goddings AL, Hausmann M, Homanen I, Klinge I, de Lange AG, Ouwerkerk L, van der Miesen A, Proppert RKK, Rieble C, Tamnes C, Bos M

Recommendations for a Better Understanding of Sex and Gender in the Neuroscience of Mental Health

Biological Psychiatry: Global Open Science, 2023

Crestol A, de Lange AG, Schindler L, Subramaniapillai S, Nerland S, Oppenheimer H, Westlye LT, Andreassen OA, Agartz I, Tamnes CK, Barth C.

Linking menopause-related factors, depression, APOE ε4, and proxies of biological aging in the UK Biobank cohort.

Preregistration 2023, Preprint, 2024

Deltagere
  • Ann-Marie Glasø de Lange Internasjonal samarbeidspartner
  • Ingrid Agartz Medveileder
  • Christian Krog Tamnes Medveileder
  • Ole Andreas Andreassen Medveileder
  • Arielle Crestol Doktorgradsstipendiat (finansiert av denne bevilgning)
  • Claudia Barth Hovedveileder
  • Jaroslav Rokicki Prosjektdeltaker
  • Daniel Quintana Prosjektdeltaker
  • Lars Tjelta Westlye Prosjektdeltaker

eRapport er utarbeidet av Sølvi Lerfald og Reidar Thorstensen, Regionalt kompetansesenter for klinisk forskning, Helse Vest RHF, og videreutvikles av de fire RHF-ene i fellesskap, med støtte fra Helse Vest IKT

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