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Review
. 2018 May 18;20(6):40.
doi: 10.1007/s11920-018-0906-y.

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

Liisa Hantsoo  1 , Carla E M Golden  2   3 , Sara Kornfield  4 , Christian Grillon  5 , C Neill Epperson  4   6   7
Affiliations
Review

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

Liisa Hantsoo et al. Curr Psychiatry Rep. .

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. 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.

Keywords: Affect; Electromyography; Psychophysiology; Sex; Startle; Translational.

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Conflict of interest statement

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.

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