Menstrual Suppression in Adolescent and Young Adult Transgender Males.

OBJECTIVE: To describe time to cessation of menses in adolescent and young adult transgender males with testosterone and/or other hormonal therapies DESIGN: Retrospective chart review SETTING: Tertiary children's hospital PARTICIPANTS: Patients, aged 10-24, who began gender-affirming hormonal therapy between January 2013 and January 2019 (n = 220) INTERVENTION(S): None MAIN OUTCOME MEASURE(S): Time to cessation of menses RESULTS: Most patients identified as transgender male or transmasculine (211/220, 95.9%), with an average age of 15.8 (±1.9) years. Approximately 53.6% (118/220) of patients reported regular menstrual cycles; 18.2% (40/220) reported irregular cycles. Median time to cessation of menses for all patients was 182 days. Patients treated with testosterone alone (n = 105) reported a median time to cessation of menses of 151 days. Patients who concurrently began testosterone and norethindrone acetate (NETA) (n = 5) had a median time to cessation of menses of 188 days, compared with 168 days for those on testosterone and depot medroxyprogesterone acetate (DMPA, n = 15). In 15 patients who began testosterone, a progestin therapy was later added to induce menstrual suppression, and the median time to cessation of menses was 168 days (+DMPA, n = 4) or 56 days (+NETA, n = 11). Patients treated with NETA (n = 14) or depot leuprolide (n = 11) reported a median time to cessation of menses of 78 days or 77 days, respectively. Considerable variability in prescribing patterns was noted in the remaining 36.4% of patients (n = 80). CONCLUSION: Patients used a variety of different hormonal regimens for menstrual suppression. Less than half achieved cessation of menses within 6 months. NETA and depot leuprolide users reported the most rapid cessation of menses.

Are donor-conceived people willing to use donors themselves? Insights from individuals conceived via donor-assisted reproduction.

STUDY QUESTION: Are donor-conceived people (DCP) willing to utilize donor gametes themselves if unable to conceive spontaneously? SUMMARY ANSWER: The majority of DCP would consider or are undecided about utilizing donor gametes and those who would consider the utilization are more likely to have been told about their donor-conceived origins at a young age by a family member and have overall positive experiences as a DCP. WHAT IS KNOWN ALREADY: DCP view their donor conception as an important part of their self-identity and many desire contact with genetically related individuals. Additionally, many believe that sperm donation should only be practiced if identifying information on the donor is provided. STUDY DESIGN, SIZE, DURATION: This was a cross-sectional study using a Web-based survey that was disseminated from 6 March to 15 August 2021. A total of 528 participants completed the questionnaire. PARTICIPANTS/MATERIALS, SETTING, METHODS: The researcher-created survey was sent to registered users of the Donor Sibling Registry (DSR) who were conceived via donor-assisted reproduction and were 18 years of age or older. The survey was optional and anonymous, and the main outcome measure was the willingness to use donated gametes if unable to spontaneously conceive. MAIN RESULTS AND THE ROLE OF CHANCE: Of the 528 participants who completed the survey, 40.2% (212/528) have or would consider using donor gametes themselves if unable to conceive spontaneously and 24.6% (130/528) were undecided. Those who had used or were undecided about the utilization were significantly younger (26 years vs. 31 years, P < 0.001) and less likely to be married (32.7% vs. 47.3%, P < 0.001) than those who would not consider using donor gametes. They were also less likely to self-identify as female (78.9% vs. 86.6%, P = 0.03) but had no difference in sexual orientation (P = 0.13). Additionally, they were more likely to have known about their donor-conceived origins for more years (18 (0-50) vs. 11 (0-61), P = 0.004), be informed by a family member (75.5% vs. 65.6%, P = 0.001) and have overall positive feelings about being conceived using a donor (93.0% vs. 52.5%, P < 0.001). LIMITATIONS, REASONS FOR CAUTION: A major limitation is that DSR participants may not be representative of all DCP. Additionally, analyzing the DCP who stated that they were undecided about using donor gametes into the 'would consider' group may be overestimating the openness to utilization in this group. WIDER IMPLICATIONS OF THE FINDINGS: The findings from this study give new insight for health care workers to further counsel patients who are considering using third-party reproduction by providing reassurance that the majority of their future children would consider similar means, if needed, to achieve their family-building goals. STUDY FUNDING/COMPETING INTEREST(S): Funding for this study was received from the Department of Obstetrics and Gynecology Division of Reproductive Endocrinology and Infertility, University of Colorado. All authors declare that there are no conflicts of interest to disclose. TRIAL REGISTRATION NUMBER: N/A.

Marijuana use in young mothers and adverse pregnancy outcomes: a retrospective cohort study.

OBJECTIVE: To evaluate the association between marijuana use and a composite adverse pregnancy outcome using biological sampling. DESIGN: Retrospective cohort study. SETTING: Single tertiary center. POPULATION: Young women (13-22 years old) with singleton, non-anomalous pregnancies delivered from September 2011 to May 2017. METHODS: Exposure was defined as marijuana detected on universal urine toxicology testing or by self-report. Multivariable logistic regression modelling was used to estimate the effect of any marijuana use on the primary composite outcome. The effect of marijuana exposure was also estimated for self-reported use, toxicology-detected use, and multiple use detected by toxicology. MAIN OUTCOME MEASURE: The primary composite outcome included spontaneous preterm birth, hypertensive disorders of pregnancy, stillbirth, or small for gestational age. RESULTS: Of 1206 pregnant young women, 17.5% (n = 211) used marijuana. Among the women who used marijuana, 8.5% (n = 18) were identified by self-report alone, 63% (n = 133) by urine toxicology alone, and 28.4% (n = 60) by both. Urine toxicology testing results were available for 1092 (90.5%) births. The composite outcome occurred more frequently in pregnancies exposed to marijuana (46 versus 34%, P < 0.001). This remained significant after adjusting for race/ethnicity and tobacco in the multivariable model (adjusted OR 1.50, 95% CI 1.09-2.05). When marijuana exposure was defined by self-report only, the association with adverse pregnancy outcome became non-significant (adjusted OR 1.01, 95% CI 0.62-1.64). CONCLUSION: In a population of young women with nearly universal biological sampling, marijuana exposure was associated with adverse pregnancy outcomes. The heterogeneity of findings in existing studies evaluating the impact of marijuana on mothers and neonates may result from the incomplete ascertainment of exposure. TWEETABLE ABSTRACT: Marijuana use, as detected by universal urine testing, was associated with a composite adverse pregnancy outcome among young mothers.

Does the North American Society for Pediatric and Adolescent Gynecology Short Curriculum Increase Resident Knowledge in Pediatric and Adolescent Gynecology?

STUDY OBJECTIVE: To determine if the North American Society for Pediatric and Adolescent Gynecology (NASPAG) Short Curriculum improves self-reported knowledge in pediatric and adolescent gynecology (PAG) among obstetrics and gynecology (Ob/Gyn) residents, at programs without PAG-trained faculty. DESIGN: Prospective, cross-sectional exposure to the NASPAG short curriculum with a follow-up questionnaire. SETTING: Ob/Gyn residency training programs without PAG faculty. PARTICIPANTS: Ob/Gyn residents in training from February 2015 to June 2015. INTERVENTIONS: Exposure to the NASPAG Short Curriculum. MAIN OUTCOME MEASURES: Improvement in self-perceived knowledge after completion of curriculum. RESULTS: Two hundred twenty-seven residents met inclusion criteria; 34 completed the study (15% response). Less than 50% of residents reported adequate knowledge in the areas of prepubertal vaginal bleeding, vulvovaginitis, precocious and delayed puberty, Home environment, Education and Employment, Eating, peer-related Activities, Drugs, Sexuality, Suicide/depression, Safety from injury and violence (HEEADSSS) interview, pelvic pain, and bleeding management in teens with developmental delay. After completion of the curriculum, self-reported knowledge improved in 8 of 10 learning objectives, with no significant improvement in bleeding disorders or Müllerian anomalies. There was no association between pretest knowledge and level of residency training, type of residency program, previous exposure to PAG lectures, and previous exposure to patients with PAG complaints. CONCLUSION: Significant deficiencies exist regarding self-reported knowledge of core PAG topics among Ob/Gyn residents at programs without PAG-trained faculty. Use of the NASPAG Short Curriculum by residents without access to PAG-trained faculty resulted in improved self-reported knowledge in PAG.

Long acting reversible contraception in postpartum adolescents: early initiation of etonogestrel implant is superior to IUDs in the outpatient setting.

STUDY OBJECTIVE: To evaluate the outpatient initiation of postpartum long-acting reversible contraception (LARC). DESIGN: Prospective cohort study of pregnant adolescents' prenatal contraceptive intentions and successful postpartum initiation of LARC. SETTING: Urban, university hospital-affiliated, adolescent outpatient clinic. PARTICIPANTS: Adolescents attending an integrated prenatal and postpartum maternity clinic. INTERVENTIONS: Data were collected via the electronic medical record and telephone interview. MAIN OUTCOME MEASURES: Contraceptive intentions during the third trimester, contraceptive methods used postpartum, timing of LARC initiation, timing of resumption of intercourse. RESULTS: 116 patients were enrolled; 75% intended LARC use postpartum. Of 38 implant-intenders, 14 received it within 14 days postpartum. All reported abstinence pre-placement. Mean time to insertion was 18±13 days. Of 37 IUD-intenders, only two received one by 8 weeks postpartum. By 14 weeks postpartum, 43% received one. Over half reported intercourse prior to insertion; the only method of contraception used was condoms. Mean time to insertion was 70±11 days. Resumption of intercourse prior to initiation of the intended LARC method was significantly higher in IUD recipients compared to those who intended and received the implant (RR 8.8; CI 1.3-57.5). CONCLUSION: In postpartum teens attending a clinic that prioritizes contraceptive use, the implant is far more likely to be received prior to resumption of sexual activity than the IUD. This may be due to more and earlier opportunities for placement, or waning commitment with time since delivery. Post-placental IUDs may be needed to equal the success of the implant in this patient population. Short-acting, reliable contraceptive methods should be implemented for postpartum adolescents preferring to wait for IUD insertion.

Reduced hippocampal volume in association with p50 nonsuppression following traumatic brain injury.

Traumatic brain injury (TBI) may produce persistently impaired auditory gating. This cholinergic-dependent, hippocampally mediated preattentive cognitive function that facilitates filtering of auditory stimuli may be indexed by the P50 evoked waveform to paired auditory stimuli. Abnormal P50 suppression post TBI is believed to result from injury to the hippocampus and/or its afferent cholinergic projections. This hypothesis was tested by comparing hippocampal and total brain volumes on MRI between ten P50-nonsuppressing TBI patients and ten normal control subjects matched for age, gender, and education. TBI subjects had highly significant bilateral hippocampal volume reductions, even when covaried for reductions in total brain volume. Degree of volume loss was not correlated with initial TBI severity. Findings support the hypothesis that hippocampal injury underlies P50 nonsuppression post TBI and suggest that such structural abnormalities may be observed even in "mildly" injured persons.

Fine structure of the auditory M100 in schizophrenia and schizoaffective disorder.

BACKGROUND: Several studies have demonstrated anomalous asymmetry of the 100-msec latency auditory-evoked field (M100) in schizophrenia. Recent evidence suggests this may be a compound component, however. Our study examines the localization of two M100 subcomponents in patients with schizophrenia and schizoaffective disorder. METHODS: Magnetoencephalographic recordings of auditory-evoked fields were obtained for 14 subjects with schizophrenia, 12 with schizoaffective disorder, and 23 control subjects. Two M100 subcomponents were identified and localized in each hemisphere. RESULTS: Both patient groups exhibited different lateralization compared with control subjects, with the second subcomponent tending to be less lateralized. CONCLUSIONS: The second subcomponent may be the major contributor to previously reported laterality differences. Future studies might benefit by separating M100 subcomponents so that specific functions could be addressed.

Neuromagnetic alpha suppression during an auditory sternberg task. Evidence for a serial, self-terminating search of short-term memory.

Reaction times (RT) during the Sternberg memory paradigm generally increase with memory set size, but do not differ for positive and negative probe stimuli. Sternberg proposed that this indicated that short-term memory (STM) scanning is both exhaustive and serial. However, this notion has received much criticism, primarily because RT must also reflect response selection factors. Magnetoencephalographic (MEG) recordings of auditory alpha-suppression have previously demonstrated that suppression duration is correlated with set size, potentially providing a physiological index of memory scanning time related specifically to sensory cortices. The current study expands earlier research into this metric by separately analyzing positive and negative probes. Thirteen normal adults participated in an auditory Sternberg paradigm. Pure tones were presented in memory set/probe combinations where the probe had a 50 percent chance of being within the memory set, and RT and accuracy were measured. Magnetic alpha-band activity (8-12 Hz) was quantified for pre- and post-stimulus regions. Although RT did not differ for positive and negative probes, alpha-suppression duration was greater for negative probes than positive ones, potentially indicating that scanning time was slightly faster in the positive condition. This may indicate that STM scanning is serial, but self-terminates when matching occurs.

A longitudinal study of T1 hypointense lesions in relapsing MS: MSCRG trial of interferon beta-1a. Multiple Sclerosis Collaborative Research Group.

BACKGROUND: T1 hypointense lesions (T1 black holes) are focal areas of relatively severe CNS tissue damage detected by MRI in patients with MS. OBJECTIVE: To determine the natural history of T1 hypointense lesions in relapsing MS and the utility of T1 hypointense lesions as outcome measures in MS clinical trials. METHODS: MR studies were from the Multiple Sclerosis Collaborative Research Group trial. Longitudinal results are reported in 80 placebo- and 80 interferon beta-1a (IFNbeta-1a)-treated patients with mild to moderate disability relapsing-remitting MS. RESULTS: There was a small but significant correlation between T1 hypointense lesion volume and disability at baseline and on trial (r = 0.22, r = 0.28). In placebo patients there was a 29.2% increase in the mean volume of T1 hypointense lesions (median 124.5 mm3) over 2 years (p < 0.001 for change from baseline), as compared to an 11.8% increase (median 40 mm3) in the IFNbeta-1a-treated patients (change from baseline not significant). These treatment group comparisons did not quite reach significance. The most significant contributor to change in T1 hypointense lesions was the baseline number of enhancing lesions (model r2 = 0.554). Placebo patients with more active disease, defined by enhancing lesions at baseline, were the only group to show a significant increase in T1 hypointense lesion volume from baseline. CONCLUSION: The development of T1 hypointense lesions is strongly influenced by prior inflammatory disease activity, as indicated by enhancing lesions. These results suggest that treatment with once weekly IM IFNbeta-1a (30 mcg) slows the 2-year accumulation of these lesions in the brain.

Sex differences in the refractory period of the 100 ms auditory evoked magnetic field.

The 100 ms latency auditory evoked magnetic response (M100) has been implicated in the earliest stage of acoustic memory encoding in the brain. Sex differences in this response have been found in its location within the brain and its functional properties. We recorded the M100 in 25 adults in response to changes in interstimulus interval of an auditory stimulus. Response amplitudes of the M100 were used to compute a measure of the M100 refractory period, which has been proposed to index the decay time constant of echoic memory. This time constant was significantly longer in both hemispheres of the female participants when compared to the male participants. Possible implications of this for behavioral sex differences in human memory performance are discussed.

Hippocampal to pituitary volume ratio: a specific measure of reciprocal neuroendocrine alterations in alcohol dependence.

OBJECTIVE: Studies to date provide conflicting views of the relationship between corticosteroids and decreased hippocampal volume in alcoholism. If this were mediated through the hypothalamic-pituitary-adrenal (HPA) axis, enlarged pituitary volumes relative to hippocampal volumes might be expected and be measurable using the hippocampus to pituitary volume (H:P) ratio. METHOD: Using magnetic resonance imaging (MRI), we performed volumetric analysis of the pituitary and hippocampus on 10 subjects with alcohol dependence (AD) and on 10 normal control subjects. RESULTS: Compared to normal controls, AD subjects demonstrated a trend towards decreased hippocampal volume (p < .06) and increased pituitary volume (p < .07). More importantly, H:P ratios were significantly smaller in AD subjects (p < .01). This observation persisted even when covaried for age. CONCLUSIONS: Reduced H:P ratio fits the hypothesis that ethanol stimulates pituitary corticotrophs resulting in elevated corticosteroid levels and possible injury to the hippocampus. If replicated, reduced H:P ratio may serve as a clinical measure of reciprocal neuroendocrine changes in chronic heavy ethanol use.

Bipolar disorder: anomalous brain asymmetry associated with psychosis.

OBJECTIVE: Anomalous cerebral asymmetry in schizophreniform disorders has been described, but its presence in psychotic mood disorders has not been established. Measures of cerebral asymmetry may distinguish patients with psychotic mood disorders from those with nonpsychotic mood disorders and from comparison subjects. To test this hypothesis, the authors examined functional cerebral asymmetry by using a metric based on magnetic source imaging. METHOD: A total of 33 subjects participated. Nine were patients with bipolar I disorder and a negative history of psychotic symptoms during mood disorder episodes, 12 were patients with bipolar I disorder and a positive history of psychotic symptoms during mood disorder episodes, and 12 were nonpsychiatric comparison subjects. Equivalent current dipole generators in both hemispheres were estimated for the 20-msec-latency somatosensory evoked field (M20) component produced by stimulation of the contralateral median nerve. RESULTS: The comparison subjects demonstrated asymmetry in anterior-posterior equivalent current dipole locations of the M20 (right anterior to left), and the bipolar subjects with no history of psychosis were similarly asymmetric. The bipolar subjects with a history of psychosis during mood episodes, however, demonstrated a reversal of cerebral asymmetry of the M20 (left anterior to right). CONCLUSIONS: Cerebral lateralization of the M20 distinguished bipolar subjects with psychosis from those without psychosis and comparison subjects. The M20 is generated in area 3b of the postcentral gyrus. These findings suggest anatomical displacement of the postcentral gyrus in psychotic disorders and support the hypothesis that anomalous cerebral asymmetry is a feature of psychotic disorders generally, including psychotic mood disorders.

Schizoaffective disorder: evidence for reversed cerebral asymmetry.

BACKGROUND: Schizoaffective disorder is one of the most severe of the affective psychoses, but its pathophysiology is poorly understood. Because cerebral lateralization may be disturbed in psychotic disorders generally, studies examining cerebral asymmetry may improve understanding of the neurobiology specific to schizoaffective disorder. This study examines cerebral lateralization in this patient population using magnetic source localization. METHODS: We studied 16 subjects with schizoaffective disorder and 16 controls. Magnetic source localization was used to identify the location of the 20 msec latency somatosensory evoked field component (M20). RESULTS: In control subjects, the source location was further anterior in the right hemisphere. The subjects with schizoaffective disorder were reverse lateralized. CONCLUSIONS: The findings of a reversed asymmetry of the M20 in patients with schizoaffective disorder suggest an anatomical shift in the placement of the post central gyrus in this disorder, compatible with a disorder of cerebral lateralization. Whether this finding converges or diverges with measurement of the M20 in other psychotic disorders will require further investigation.

The thalamus and the schizophrenia phenotype: failure to replicate reduced volume.

BACKGROUND: Thalamic abnormalities resulting in impaired attention and information processing may form a foundation for cognitive and perceptual disturbances in schizophrenia. Measurements of the thalamus in patients with schizophrenia have shown reductions relative to normal comparison subjects. METHODS: In the current project, magnetic resonance images of the brain were obtained in 10 male and 11 female subjects with paranoid-type schizophrenia, and 15 male and 12 female normal comparison subjects. Total brain and bilateral thalamic volumes were calculated. RESULTS: There were no significant diagnosis, hemisphere, or gender differences in thalamic volumes. CONCLUSIONS: Structural thalamic abnormalities are not likely to universally and parsimoniously explain the schizophrenia phenotype. Abnormal thalamic size in patients with schizophrenia should be understood as reflecting one of several possible structural abnormalities contributing to production of the schizophrenia phenotype, but must be regarded with caution unless paired with functional studies.

Sequential source of the M100 exhibits inter-hemispheric asymmetry.

The most prominent auditory evoked field component occurs at about 100 ms latency and is termed the M100. We recorded M100 data from 20 subjects, in both hemispheres. We modeled the generators with a single equivalent current dipole in a 10 ms sliding window from 0 to 245 ms post-stimulus. A residual error curve was plotted, and a search for local minima identified two latencies at about 75 and 100 ms. In the left hemisphere, the early generator was about 6 mm above the later source; in the right hemisphere the early source was about 3 mm above the later, and 11 mm posterior. The M100 is a compound source, and the model may provide additional information in cases with reported laterality differences.

Developmental changes in refractoriness of the neuromagnetic M100 in children.

Considerable evidence exists for developmental changes in latency and amplitude of the auditory evoked potential termed N100. However, it is widely recognized that the N100 wave comprises multiple, temporally overlapping neural generators, and few data are available addressing either individual generator development or mechanisms behind such change. Using magnetoencelphalographic (MEG) measurements of the magnetic analog of the N100 termed the M100, which derives primarily from supra-temporal auditory generators, it is demonstrated here that changes in the response of that waveform to manipulation of interstimulus interval (ISI) occur between the ages of 6 and 18 years of age.

White matter disease induced by high-dose chemotherapy: longitudinal study with MR imaging and proton spectroscopy.

PURPOSE: The purpose of this study was to determine the time course for development of white matter changes induced by high-dose chemotherapy. METHODS: Eight patients with advanced breast cancer were entered into a prospective, longitudinal trial that included examination by MR imaging and proton MR spectroscopy before chemotherapy and through 12 months after treatment with carmustine, cyclophosphamide, and cisplatin, combined with autologous hematopoietic progenitor cell support (AHPCS). RESULTS: Six patients completed induction chemotherapy, at which time all MR imaging studies appeared normal. At 3 months after the conclusion of high-dose chemotherapy and beyond, three of the four patients remaining in the study showed an increasing volume of white matter changes, which appeared to stabilize during the period from 6 months to 1 year. Maximal volumes of abnormal white matter ranged from 73 to 166 cm3. MR spectroscopy showed little or no change in metabolic ratios through the period of observation, although there was a suggestion of small transient treatment-related decreases in the ratio of N-acetyl aspartate (NAA) to creatine. CONCLUSION: White matter changes are common sequelae of treatment with high-dose chemotherapy combined with AHPCS, occurring early in the period following high-dose chemotherapy, with a rapid and progressive accumulation to about 6 months, but not accompanied by persistent neurologic symptoms. The MR spectroscopic analyses suggest a minimal disturbance of the neuronal marker NAA, a finding that may in part explain the good neurologic outcome.

Magnetic resonance studies of intramuscular interferon beta-1a for relapsing multiple sclerosis. The Multiple Sclerosis Collaborative Research Group.

The Multiple Sclerosis Collaborative Research Group trial was a double-blind, randomized, multicenter, phase III, placebo-controlled study of interferon beta-1a (IFNbeta-1a; AVONEX) in relapsing forms of multiple sclerosis. Initial magnetic resonance imaging results have been published; this report provides additional results. Treatment with IFNbeta-1a, 30 microg once weekly by intramuscular injection, resulted in a significant decrease in the number of new, enlarging, and new plus enlarging T2 lesions over 2 years. The median increase in T2 lesion volume in placebo and IFNbeta-1a patients was 455 and 152 mm3, respectively, at 1 year and 1,410 and 628 mm3 at 2 years, although the treatment group differences did not reach statistical significance. For active patients, defined as those with gadolinium enhancement at baseline, the median change in T2 lesion volume in placebo and IFNbeta-1a patients was 1,578 and -12 mm3 and 2,980 and 1,285 mm3 at 1 and 2 years, respectively. Except for a minimal correlation of 0.30 between relapse rate and the number of gadolinium-enhanced lesions, correlations between MR and clinical measures at baseline and throughout the study were in general poor. Once weekly intramuscular IFNbeta-1a appears to impede the development of multiple sclerosis lesions at an early stage and has a favorable impact on the long-term sequelae of these inflammatory events as indicated by the slowed accumulation of T2 lesions.

Sex-specific expression of Heschl's gyrus functional and structural abnormalities in paranoid schizophrenia.

OBJECTIVE: Evidence supports abnormal temporal lobe structure and function in schizophrenia. Some abnormalities, particularly involving the auditory cortex, appear to be sex specific. These findings were extended to anatomical and physiological descriptors. METHOD: The authors quantified the volume, surface area, and three-dimensional location of Heschl's gyri on magnetic resonance imaging (MRI) images of 21 patients with paranoid schizophrenia and 24 healthy comparison subjects. Neuromagnetic localizations of the 100-msec latency auditory evoked field (M100) were compared with MRI-determined locations of Heschl's gyri, computed as the geometric center of mass of the volume. RESULTS: Volumetric measures revealed small Heschl's gyri only in male patients. Asymmetry was found in the location of the Heschl's gyrus centroid (more anterior on the right) across all groups. Male comparison subjects had M100 locations posterior to the Heschl's gyrus centroid in the left hemisphere and close to the Heschl's gyrus centroid on the right, while male patients had M100 sources anterior to the Heschl's gyrus centroid on the left. All women had M100 locations posterior to the Heschl's gyrus centroid on the left and anterior to it on the right. CONCLUSIONS: These results demonstrate that some temporal lobe abnormalities in schizophrenia are sex specific. They also suggest that the anomalous lateralization of the auditory evoked field cannot be explained by a shift in the underlying anatomy, since the anatomical substrate is lateralized in both comparison subjects and patients of both sexes. These findings may indicate a sex-specific functional reorganization in the auditory cortex in schizophrenia.

Magnetic source imaging evidence of sex differences in cerebral lateralization in schizophrenia.

BACKGROUND: It has been postulated that schizophrenia represents a disorder of anomalous cerebral lateralization. This study is a replication of earlier preliminary findings using a multichannel neuromagnetometer, suggesting altered lateralization in schizophrenia in male subjects, with an extension of the findings to female subjects. METHODS: We used magnetoencephalography-based magnetic source imaging to estimate the intracranial location of the 100-millisecond latency auditory-evoked field component (M100) in both left and right hemispheres of 20 patients with paranoid schizophrenia and 20 controls without schizophrenia. Neuroanatomical data were obtained by means of magnetic resonance imaging, from which we segmented and computed volumes of both total brain and left and right superior temporal gyri. RESULTS: Locations of M100 source were compatible with neuronal generators located in the transverse gyri of Heschl on the superior temporal gyri in both study groups; M100 sources were asymmetric in all the control subjects. The male patient subgroup exhibited significantly less asymmetry than the control group, while the female patient subgroup actually showed significantly more asymmetry. The male patient subgroup generally had smaller superior temporal gyri than the control group. No evidence of total brain volume differences was observed. CONCLUSIONS: Our findings support previous magnetoencephalography-based studies suggesting anomalous cerebral lateralization in schizophrenia. Further, in extending our studies to female patients, our data suggest that the nature of this anomaly is sex specific, a finding that, to our knowledge, has not previously been reported.