Antipsychotic effects of sex hormones and atypical hemispheric asymmetries

Abstract

Functional cerebral asymmetries (FCAs) are a fundamental principle of brain organisation. While specific patterns of asymmetry are characteristic of healthy human brains, atypical or reduced FCAs have been reported for several psychotic disorders, including schizophrenia and mood disorders. However, it is unclear whether atypical FCAs reflect a predisposition to psychotic disorders or a compensatory neural strategy for the progressive structural and functional changes in the brain associated with psychosis. A separate stream of research has demonstrated the antipsychotic effects of sex hormones in clinical populations. Moreover, modern neuroscience has shown that sex hormones, particularly estrogen and progesterone, can affect FCAs due to their organising effects (e.g. during prenatal development), and also by their activating effects throughout life (e.g. in younger women during the menstrual cycle or in post-menopausal women as a consequence of hormone therapy). By combining these research streams, this narrative literature review explores the relationship between the neuromodulatory properties of estrogen, FCAs and psychotic and psychotic-like symptoms. This research is not only of theoretical interest for the understanding of FCAs and psychotic symptoms, but might also be of clinical relevance for the development of stratified treatment approaches for women and men suffering from psychosis and mood disorders.

Brain Asymmetry: Towards an Asymmetrical Neurovisceral Integration

“…The authors concluded that the appearance of a post-stroke depression is more frequent in women who have suffered an accident in the left hemisphere than in the right. It is possible that gender differences in the consequences of unilateral accidents are partly due to inter-hemispheric differences in physiological endogenous or exogenous conditions, such as those that occur during the ovarian cycle [66,67] or those produced in both genders due to circadian rhythms [reviewed in 67]. On the other hand, it is necessary to take into account that, although there is a hemispheric dominance in brain functions, the left hemisphere for language and the right for visual-spatial functions, both functions are also elaborated, although to a lesser extent, in the contralateral hemisphere [68].…”

Estrogens in schizophrenia: progress, current challenges and opportunities

“…The authors attribute much of this effect to the modulation of D2 receptors by estrogen. Moreover, a recent review even argued that estrogen may act as an antipsychotic agent itself, considering that it targets dopamine signaling in a similar way as antipsychotics do [90 ▪ ].…”

The effect of sex and age on facial shape directional asymmetry in adults: A 3D landmarks-based method study

“…Apart from the faster right-sided head growth and subsequent increase of final proportions, there is another assumption for facial asymmetry with left-side deviation–mastication [ 49 ]. Side preference can vary from side to side [ 50 ], but a population trend is noticeable in our sample. Moreover, side preference for the mimic muscles could also affect facial soft-tissue asymmetry [ 33 ].…”