Changes in Frontal Brain Asymmetry Associated with Premenstrual Dysphoric Disorder: A Single Case Study

Abstract

Background. In a pilot study, Baehr (2001) reports changes in frontal cortical alpha asymmetry during the luteal phase of the menstrual cycle were documented in five depressed women who also experienced Premenstrual Dysphoric Disorder (PMDD). In this paper, detailed data is presented for one of these subjects and two comparison subjects who were part of the first study. The goal was two-fold: (a) to study how patterns of mood changes during the luteal phase of the menstrual cycle correlated with changes in frontal alpha brain wave asymmetry, and (b) to determine whether treatment strategies, tailored to ameliorate symptoms, would be reflected in brainwave changes. Method. Neurofeedback, medical interventions, and prospective charting were collected over a period of six months for one patient. These data were compared with data collected for two monthly cycles from two non-PMDD comparison subjects. Results. The patient responded well to the neurofeedback protocol for depression and was normalizing her scores by the second week in treatment except for setbacks which occurred during the luteal phase of her menstrual cycle. Extreme mood changes correlated with changes in brain wave asymmetry during this period. A combination of neurofeedback and medication worked to stabilize her mood swings and asymmetry scores. Conclusion. This case study demonstrated how brainwave changes in frontal alpha asymmetry occurred during the luteal phase of the menstrual cycle in a woman who suffered from PMDD. Two comparison subjects, who were undergoing similar treatment for depression but did not suffer from PMDD, had stable alpha asymmetry scores during the entire menstrual cycle. Anomalies in serotonergic and /or gabergic function in the luteal phases of PMDD are pinpointed as possible underlying factors in this disorder.