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Startling Differences: Using the Acoustic Startle Response to Study Sex Differences and Neurosteroids in Affective Disorders

  • Sex and Gender Issues in Behavioral Health (CN Epperson and L Hantsoo, Section Editors)
  • Published:
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Abstract

Purpose of Review

Neuroactive steroid hormones, such as estradiol and progesterone, likely play a role in the pathophysiology of female-specific psychiatric disorders such as premenstrual dysphoric disorder (PMDD) and postpartum depression and may contribute to the marked sex differences observed in the incidence and presentation of affective disorders. However, few tools are available to study the precise contributions of these neuroactive steroids (NSs). In this review, we propose that the acoustic startle response (ASR), an objective measure of an organism’s response to an emotional context or stressor, is sensitive to NSs. As such, the ASR represents a unique translational tool that may help to elucidate the contribution of NSs to sex differences in psychiatric disorders.

Recent Findings

Findings suggest that anxiety-potentiated startle (APS) and prepulse inhibition of startle (PPI) are the most robust ASR paradigms for assessing contribution of NSs to affective disorders, while affective startle response modulation (ASRM) appears less diagnostic of sex or menstrual cycle (MC) effects. However, few studies have appropriately used ASR to test a priori hypotheses about sex or MC differences.

Summary

We recommend that ASR studies account for sex as a biological variable (SABV) and hormonal status to further knowledge of NS contribution to affective disorders.

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Acknowledgements

The editors would like to thank Dr. Bradley Gaynes for taking the time to review this article.

Funding

The authors are supported by the Intramural Research Program of the National Institute of Mental Health (K23MH107831 Hantsoo; F31MH115656 Golden; MH002798 Grillon; K23MH102360 Kornfield; P50 MH099910 Epperson & Hantsoo), Brain & Behavior Research Foundation NARSAD Young Investigator Award (Hantsoo), and Office of Research on Women’s Health (P50 MH099919 Epperson & Hantsoo; K12HD085848).

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Authors and Affiliations

  1. Department of Psychiatry, Perelman School of Medicine at the University of Pennsylvania, 3535 Market Street, Philadelphia, PA, 19104, USA

    Liisa Hantsoo, Sara Kornfield & C. Neill Epperson

  2. Seaver Autism Center for Research and Treatment, Icahn School of Medicine at Mount Sinai, New York, NY, USA

    Carla E. M. Golden

  3. Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA

    Carla E. M. Golden

  4. National Institutes of Health, National Institute of Mental Health, Bethesda, MD, USA

    Christian Grillon

  5. Department of Obstetrics and Gynecology, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA

    C. Neill Epperson

  6. Penn PROMOTES Research on Sex and Gender in Health, University of Pennsylvania, Philadelphia, PA, USA

    C. Neill Epperson

Authors
  1. Liisa Hantsoo
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  2. Carla E. M. Golden
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  3. Sara Kornfield
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  4. Christian Grillon
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  5. C. Neill Epperson
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Corresponding author

Correspondence to Liisa Hantsoo.

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Conflict of Interest

Carla Golden, Sara Kornfield, and Christian Grillon, each declare no potential conflicts of interest.

Liisa Hantsoo and C. Neill Epperson are section editors for Current Psychiatry Reports.

Human and Animal Rights and Informed Consent

This article does not contain any studies with human or animal subjects performed by any of the authors.

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This article is part of the Topical Collection on Sex and Gender Issues in Behavioral Health

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Hantsoo, L., Golden, C.E.M., Kornfield, S. et al. Startling Differences: Using the Acoustic Startle Response to Study Sex Differences and Neurosteroids in Affective Disorders. Curr Psychiatry Rep 20, 40 (2018). https://doi.org/10.1007/s11920-018-0906-y

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  • DOI: https://doi.org/10.1007/s11920-018-0906-y

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