Perimenopausal Depression
Conditions
Keywords
Reproductive Affective Disorder, Depression, Perimenopause, Estrogen, Estradiol treatment, Mood Disorders, Estrogen Replacement Therapy, Sex Steroids, Depressive disorder, Mental Disorders, Estradiol, Hormones, Physiological effects of drugs, Reproductive Control Agents
Brief summary
Using neuroimaging, the investigator will study the effects of estrogen on mood and brain function in perimenopausal women either with or without depression.
Detailed description
Despite decades of research, affective disorders are prevalent and associated with significant morbidity and mortality. Unraveling the pathophysiology of affective disorders has been uniquely challenging because depressive syndromes are heterogeneous and have diverse etiologies. Thus, past studies aimed at identifying neural and genetic biomarkers that would improve the prediction of susceptibility, course of illness, and treatment response have yielded inconsistent results. The investigator proposes to address this problem by studying perimenopausal major depressive disorder (MDD), a depression subtype with a specific endocrine trigger (i.e., ovarian hormone withdrawal). Evidence supporting ovarian hormone withdrawal as a trigger for affective dysfunction in perimenopausal MDD includes the following: perimenopausal women show a temporal association between ovarian hormone withdrawal and the onset of mood symptoms; treatment with estrogen reduces mood symptoms; and blinded estradiol withdrawal re-precipitates depression in women with a history of perimenopausal MDD (manuscript in preparation). Focusing on perimenopausal MDD, a more homogeneous subtype with a specific endocrine trigger, will increase the likelihood of identifying meaningful neurobiological markers.One of the most powerful tools for understanding the neural mediators of MDD is brain imaging. Prior research suggests that the frontostriatal reward system is regulated by estradiol and implicated in MDD. However, neural mechanisms of perimenopausal MDD have never been studied. We will assess the neural reward system in perimenopausal women with and without MDD using functional magnetic resonance imaging (fMRI) at baseline and following estradiol treatment. The central hypothesis is that the neural reward system is hypoactive in perimenopausal MDD, and the antidepressant effects of a three-week transdermal estradiol intervention will be mediated by increased activity in the neural reward system, assessed using fMRI. The investigator will test the hypothesis by executing the following aims: Aim 1: To measure the frontostriatal response to reward in perimenopausal MDD and test the effects of estradiol on neural activation in perimenopausal women. The investigator will use fMRI at baseline and following estradiol treatment in women with and without MDD to probe frontostriatal reward circuitry. Aim 2: To quantify motivated behavior at baseline and following estradiol administration in perimenopausal women with and without MDD. Motivated behavior will be operationally defined as the response latency to reward versus non-reward during the fMRI reward task. Aim 3: To measure the psychological correlates of the frontostriatal response to reward in women with perimenopausal MDD at baseline and following estradiol administration. Depressive symptoms will be assessed at baseline and following estradiol administration. The results will provide critical information about the neuroendocrine pathophysiology of perimenopausal depression and may subsequently contribute to the development of novel pharmacologic interventions.
Interventions
DRUGEstradiol
Participants will receive transdermal estradiol (100μg/day) for 3 weeks
DRUGProgesterone
Participants will receive an additional week of combined estradiol and micronized progesterone (200 mg/day) at the end of the study to precipitate menstruation.
Sponsors
Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD)
National Institute of Mental Health (NIMH)
University of North Carolina, Chapel Hill
Study design
Allocation
NON_RANDOMIZED
Intervention model
PARALLEL
Primary purpose
BASIC_SCIENCE
Masking
NONE
Eligibility
Sex/Gender
FEMALE
Age
44 Years to 55 Years
Healthy volunteers
Yes
Inclusion criteria
1. Perimenopause Status: We will employ the Stages of Reproductive Aging Workshop (STRAW) criteria70 to confirm perimenopausal status. The stages are primarily based on the characteristics of the menstrual cycle and secondarily on follicle stimulating hormone (FSH) levels. The anchor for the staging system is the final menstrual period (FMP). We will enroll women who have ≥ 2 skipped cycles and an interval of amenorrhea ≥ 60 days, consistent with the late menopause transition (stage -1), and who demonstrate an FSH level \> 25 IU/mL. Because extremes of body weight (BMI \< 18 or \> 30 kg/m2) or a history of chronic menstrual cycle irregularity can contribute to inaccurate reproductive staging, these will serve as additional
Exclusion criteria
; 2. MDD Group Eligibility Criterion: current diagnosis of MDD with an onset associated with menstrual cycle irregularity, and no history of psychiatric illness during the 2 years before the onset of the current depressive episode as determined by the Structured Clinical Interview for DSM-IV-TR (Diagnostic and Statistical Manual-4-Text Revision) for Axis I Disorders (SCID); 3. Control Group Eligibility Criterion: absence of any past or present psychiatric disorder as assessed by the SCID.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Putamen Signal Intensity in Response to Reward During the MID fMRI Task Following Estradiol Treatment. | Post-treatment (visit 6) | Putamen reactivity to reward during the Monetary Incentive Delay (MID) task was measured between the two groups. During MID the task, participants respond to win trials by pressing a button on a button box in the MRI as quickly as possible when the see a target. Reactivity is measured by examining participant's change in blood-oxygen-level dependent (BOLD) (i.e., measurement of oxygen level that is carried to neurons by red blood cells since areas of the brain that are thought to be more active or involved in certain tasks require more oxygen) in response to a stimulus of interest (win trials) versus non-stimulus (non-win trials). Percent signal change in BOLD activation between monetary reward versus non-reward is the outcome of interest. Percent signal change is then compared between the two groups following treatment. |
| Putamen Signal Intensity in Response to Reward During the MID fMRI Task at Pre-treatment | Pre-treatment (visit 3) | Putamen reactivity to reward during the Monetary Incentive Delay (MID) task was measured between the two groups. During MID the task, participants respond to win trials by pressing a button on a button box in the MRI as quickly as possible when the see a target. Reactivity is measured by examining participant's change in blood-oxygen-level dependent (BOLD) (i.e., measurement of oxygen level that is carried to neurons by red blood cells since areas of the brain that are thought to be more active or involved in certain tasks require more oxygen) in response to a stimulus of interest (win trials) versus non-stimulus (non-win trials). Percent signal change in BOLD activation between monetary reward versus non-reward is the outcome of interest. Percent signal change is then compared between the two groups at pre-treatment. |
| Caudate Signal Intensity in Response to Reward During the MID fMRI Task Following Estradiol Treatment. | Post-treatment (visit 6) | Caudate reactivity to reward during the Monetary Incentive Delay (MID) task was measured between the two groups. During MID the task, participants respond to win trials by pressing a button on a button box in the MRI as quickly as possible when the see a target. Reactivity is measured by examining participant's change in blood-oxygen-level dependent (BOLD) (i.e., measurement of oxygen level that is carried to neurons by red blood cells since areas of the brain that are thought to be more active or involved in certain tasks require more oxygen) in response to a stimulus of interest (win trials) versus non-stimulus (non-win trials). Percent signal change in BOLD activation between monetary reward versus non-reward is the outcome of interest. Percent signal change is then compared between the two groups following treatment. |
| Nucleus Accumbens (NAcc) Signal Intensity in Response to Reward During the MID fMRI Task Following Estradiol Treatment. | Post-treatment (visit 6) | Nucleus accumbens (NAcc) reactivity to reward during the Monetary Incentive Delay (MID) task was measured between the two groups. During MID the task, participants respond to win trials by pressing a button on a button box in the MRI as quickly as possible when the see a target. Reactivity is measured by examining participant's change in blood-oxygen-level dependent (BOLD) (i.e., measurement of oxygen level that is carried to neurons by red blood cells since areas of the brain that are thought to be more active or involved in certain tasks require more oxygen) in response to a stimulus of interest (win trials) versus non-stimulus (non-win trials). Percent signal change in BOLD activation between monetary reward versus non-reward is the outcome of interest. Percent signal change is then compared between the two groups following treatment. |
| Caudate Signal Intensity in Response to Reward During the MID fMRI Task at Pre-treatment | Pre-treatment (visit 3) | Caudate reactivity to reward during the Monetary Incentive Delay (MID) task was measured between the two groups. During MID the task, participants respond to win trials by pressing a button on a button box in the MRI as quickly as possible when the see a target. Reactivity is measured by examining participant's change in blood-oxygen-level dependent (BOLD) (i.e., measurement of oxygen level that is carried to neurons by red blood cells since areas of the brain that are thought to be more active or involved in certain tasks require more oxygen) in response to a stimulus of interest (win trials) versus non-stimulus (non-win trials). Percent signal change in BOLD activation between monetary reward versus non-reward is the outcome of interest. Percent signal change is then compared between the two groups at pre-treatment. |
| Nucleus Accumbens (NAcc) Signal Intensity in Response to Reward During the MID fMRI Task at Pre-treatment | Pre-treatment (visit 3) | Nucleus Accumbens (NAcc) reactivity to reward during the Monetary Incentive Delay (MID) task was measured between the two groups. During MID the task, participants respond to win trials by pressing a button on a button box in the MRI as quickly as possible when the see a target. Reactivity is measured by examining participant's change in blood-oxygen-level dependent (BOLD) (i.e., measurement of oxygen level that is carried to neurons by red blood cells since areas of the brain that are thought to be more active or involved in certain tasks require more oxygen) in response to a stimulus of interest (win trials) versus non-stimulus (non-win trials). Percent signal change in BOLD activation between monetary reward versus non-reward is the outcome of interest. Percent signal change is then compared between the two groups at pre-treatment. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Response Latency to Reward During the MID fMRI Task Following Estradiol Treatment | Post-treatment (visit 6) | Time (ms) between stimulus and response will be measured during reward trials of the Monetary Incentive Delay (MID) task. During MID the task, participants need to select the correct response during win and lose conditions by pressing a button on a button box in the MRI. |
| Change in Inventory of Depression and Anxiety Symptoms (IDAS) Dysphoria Scores | Assessed at pre- and post-treatment (visits 3 and 6) | The Dysphoria Scale of the Inventory of Depression and Anxiety Symptoms (IDAS) will be used to assess the change in depressive symptom severity. The IDAS Dysphoria Scale consists of 10 items and uses a 5-point Likert-type scale, ranging from 1 to 5 with 1 indicating not at all and 5 indicating extremely. As such, the range of possible scores is 10 to 50. The Dysphoria scale includes items assessing feelings of depression, inadequacy, psychomotor agitation, guilt, discouragement, anhedonia, poor concentration, difficulty with decision-making, psychomotor retardation, and worry. Higher scores indicate worse depression symptoms. |
| Response Latency to Reward During the MID fMRI Task at Pre-treatment | Pre-treatment (visit 3) | Time (ms) between stimulus and response will be measured during the Monetary Incentive Delay (MID) task during the win trials. During MID the task, participants need to select the correct response during win and lose conditions by pressing a button on a button box in the MRI. |
Countries
United States
Participant flow
Recruitment details
The recruitment process included, social media advertising using Facebook, Instagram, and Craigslist; mass emailing using university wide emails and a database of select University of North Carolina (UNC) healthcare patients (Carolina data warehouse); and flyer advertisements placed in university buildings and local businesses.
Pre-assignment details
Enrolled participants were excluded prior to the start of study intervention due to: exclusionary psychiatric history (i.e. substance abuse, past hypomania, persistent depression), exclusionary gynecological history (i.e. fibroids, abnormal pap), exclusionary medical history (i.e. abnormal lab values), exclusionary medication, and imaging concerns.
Participants by arm
| Arm | Count |
|---|---|
| Perimenopausal Women, Depressed Participants will receive transdermal estradiol (100μg/day) for 3 weeks. Participants will receive an additional week of combined estradiol and micronized progesterone (200 mg/day) at the end of the study to precipitate menstruation.
Estradiol: Participants will receive transdermal estradiol (100μg/day) for 3 weeks
Progesterone: Participants will receive an additional week of combined estradiol and micronized progesterone (200 mg/day) at the end of the study to precipitate menstruation. | 33 |
| Perimenopausal Women, Non-depressed Participants will receive transdermal estradiol (100μg/day) for 3 weeks. Participants will receive an additional week of combined estradiol and micronized progesterone (200 mg/day) at the end of the study to precipitate menstruation.
Estradiol: Participants will receive transdermal estradiol (100μg/day) for 3 weeks
Progesterone: Participants will receive an additional week of combined estradiol and micronized progesterone (200 mg/day) at the end of the study to precipitate menstruation. | 31 |
| Total | 64 |
Baseline characteristics
| Characteristic | Perimenopausal Women, Non-depressed | Total | Perimenopausal Women, Depressed |
|---|---|---|---|
| Age, Continuous Age | 50.76 years | 50.44 years | 50.13 years |
| Race/Ethnicity, Customized Race/Ethnicity Black or African American | 1 Participants | 9 Participants | 8 Participants |
| Race/Ethnicity, Customized Race/Ethnicity Cuban or Carribean | 0 Participants | 1 Participants | 1 Participants |
| Race/Ethnicity, Customized Race/Ethnicity Multi-Racial | 0 Participants | 1 Participants | 1 Participants |
| Race/Ethnicity, Customized Race/Ethnicity White or Caucasion | 30 Participants | 53 Participants | 23 Participants |
| Sex: Female, Male Female | 31 Participants | 64 Participants | 33 Participants |
| Sex: Female, Male Male | 0 Participants | 0 Participants | 0 Participants |
Adverse events
| Event type | EG000 affected / at risk | EG001 affected / at risk |
|---|---|---|
| deaths Total, all-cause mortality | 0 / 33 | 0 / 31 |
| other Total, other adverse events | 16 / 33 | 17 / 31 |
| serious Total, serious adverse events | 0 / 33 | 0 / 31 |
Outcome results
Primary
Caudate Signal Intensity in Response to Reward During the MID fMRI Task at Pre-treatment
Caudate reactivity to reward during the Monetary Incentive Delay (MID) task was measured between the two groups. During MID the task, participants respond to win trials by pressing a button on a button box in the MRI as quickly as possible when the see a target. Reactivity is measured by examining participant's change in blood-oxygen-level dependent (BOLD) (i.e., measurement of oxygen level that is carried to neurons by red blood cells since areas of the brain that are thought to be more active or involved in certain tasks require more oxygen) in response to a stimulus of interest (win trials) versus non-stimulus (non-win trials). Percent signal change in BOLD activation between monetary reward versus non-reward is the outcome of interest. Percent signal change is then compared between the two groups at pre-treatment.
Time frame: Pre-treatment (visit 3)
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| Perimenopausal Women, Depressed | Caudate Signal Intensity in Response to Reward During the MID fMRI Task at Pre-treatment | .027 percent signal change | Standard Deviation 0.105 |
| Perimenopausal Women, Non-depressed | Caudate Signal Intensity in Response to Reward During the MID fMRI Task at Pre-treatment | .043 percent signal change | Standard Deviation 0.074 |
p-value: 0.62t-test, 2 sided
Primary
Caudate Signal Intensity in Response to Reward During the MID fMRI Task Following Estradiol Treatment.
Caudate reactivity to reward during the Monetary Incentive Delay (MID) task was measured between the two groups. During MID the task, participants respond to win trials by pressing a button on a button box in the MRI as quickly as possible when the see a target. Reactivity is measured by examining participant's change in blood-oxygen-level dependent (BOLD) (i.e., measurement of oxygen level that is carried to neurons by red blood cells since areas of the brain that are thought to be more active or involved in certain tasks require more oxygen) in response to a stimulus of interest (win trials) versus non-stimulus (non-win trials). Percent signal change in BOLD activation between monetary reward versus non-reward is the outcome of interest. Percent signal change is then compared between the two groups following treatment.
Time frame: Post-treatment (visit 6)
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| Perimenopausal Women, Depressed | Caudate Signal Intensity in Response to Reward During the MID fMRI Task Following Estradiol Treatment. | .005 percent signal change | Standard Deviation 0.079 |
| Perimenopausal Women, Non-depressed | Caudate Signal Intensity in Response to Reward During the MID fMRI Task Following Estradiol Treatment. | .026 percent signal change | Standard Deviation 0.103 |
p-value: 0.518t-test, 2 sided
Primary
Nucleus Accumbens (NAcc) Signal Intensity in Response to Reward During the MID fMRI Task at Pre-treatment
Nucleus Accumbens (NAcc) reactivity to reward during the Monetary Incentive Delay (MID) task was measured between the two groups. During MID the task, participants respond to win trials by pressing a button on a button box in the MRI as quickly as possible when the see a target. Reactivity is measured by examining participant's change in blood-oxygen-level dependent (BOLD) (i.e., measurement of oxygen level that is carried to neurons by red blood cells since areas of the brain that are thought to be more active or involved in certain tasks require more oxygen) in response to a stimulus of interest (win trials) versus non-stimulus (non-win trials). Percent signal change in BOLD activation between monetary reward versus non-reward is the outcome of interest. Percent signal change is then compared between the two groups at pre-treatment.
Time frame: Pre-treatment (visit 3)
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| Perimenopausal Women, Depressed | Nucleus Accumbens (NAcc) Signal Intensity in Response to Reward During the MID fMRI Task at Pre-treatment | .045 percent signal change | Standard Deviation 0.117 |
| Perimenopausal Women, Non-depressed | Nucleus Accumbens (NAcc) Signal Intensity in Response to Reward During the MID fMRI Task at Pre-treatment | .052 percent signal change | Standard Deviation 0.108 |
p-value: 0.855t-test, 2 sided
Primary
Nucleus Accumbens (NAcc) Signal Intensity in Response to Reward During the MID fMRI Task Following Estradiol Treatment.
Nucleus accumbens (NAcc) reactivity to reward during the Monetary Incentive Delay (MID) task was measured between the two groups. During MID the task, participants respond to win trials by pressing a button on a button box in the MRI as quickly as possible when the see a target. Reactivity is measured by examining participant's change in blood-oxygen-level dependent (BOLD) (i.e., measurement of oxygen level that is carried to neurons by red blood cells since areas of the brain that are thought to be more active or involved in certain tasks require more oxygen) in response to a stimulus of interest (win trials) versus non-stimulus (non-win trials). Percent signal change in BOLD activation between monetary reward versus non-reward is the outcome of interest. Percent signal change is then compared between the two groups following treatment.
Time frame: Post-treatment (visit 6)
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| Perimenopausal Women, Depressed | Nucleus Accumbens (NAcc) Signal Intensity in Response to Reward During the MID fMRI Task Following Estradiol Treatment. | .040 percent signal change | Standard Deviation 0.11 |
| Perimenopausal Women, Non-depressed | Nucleus Accumbens (NAcc) Signal Intensity in Response to Reward During the MID fMRI Task Following Estradiol Treatment. | .059 percent signal change | Standard Deviation 0.118 |
p-value: 0.645t-test, 2 sided
Primary
Putamen Signal Intensity in Response to Reward During the MID fMRI Task at Pre-treatment
Putamen reactivity to reward during the Monetary Incentive Delay (MID) task was measured between the two groups. During MID the task, participants respond to win trials by pressing a button on a button box in the MRI as quickly as possible when the see a target. Reactivity is measured by examining participant's change in blood-oxygen-level dependent (BOLD) (i.e., measurement of oxygen level that is carried to neurons by red blood cells since areas of the brain that are thought to be more active or involved in certain tasks require more oxygen) in response to a stimulus of interest (win trials) versus non-stimulus (non-win trials). Percent signal change in BOLD activation between monetary reward versus non-reward is the outcome of interest. Percent signal change is then compared between the two groups at pre-treatment.
Time frame: Pre-treatment (visit 3)
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| Perimenopausal Women, Depressed | Putamen Signal Intensity in Response to Reward During the MID fMRI Task at Pre-treatment | .015 percent signal change | Standard Deviation 0.103 |
| Perimenopausal Women, Non-depressed | Putamen Signal Intensity in Response to Reward During the MID fMRI Task at Pre-treatment | .004 percent signal change | Standard Deviation 0.093 |
p-value: 0.758t-test, 2 sided
Primary
Putamen Signal Intensity in Response to Reward During the MID fMRI Task Following Estradiol Treatment.
Putamen reactivity to reward during the Monetary Incentive Delay (MID) task was measured between the two groups. During MID the task, participants respond to win trials by pressing a button on a button box in the MRI as quickly as possible when the see a target. Reactivity is measured by examining participant's change in blood-oxygen-level dependent (BOLD) (i.e., measurement of oxygen level that is carried to neurons by red blood cells since areas of the brain that are thought to be more active or involved in certain tasks require more oxygen) in response to a stimulus of interest (win trials) versus non-stimulus (non-win trials). Percent signal change in BOLD activation between monetary reward versus non-reward is the outcome of interest. Percent signal change is then compared between the two groups following treatment.
Time frame: Post-treatment (visit 6)
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| Perimenopausal Women, Depressed | Putamen Signal Intensity in Response to Reward During the MID fMRI Task Following Estradiol Treatment. | -.030 percent signal change | Standard Deviation 0.068 |
| Perimenopausal Women, Non-depressed | Putamen Signal Intensity in Response to Reward During the MID fMRI Task Following Estradiol Treatment. | .032 percent signal change | Standard Deviation 0.073 |
p-value: 0.015t-test, 2 sided
Secondary
Change in Inventory of Depression and Anxiety Symptoms (IDAS) Dysphoria Scores
The Dysphoria Scale of the Inventory of Depression and Anxiety Symptoms (IDAS) will be used to assess the change in depressive symptom severity. The IDAS Dysphoria Scale consists of 10 items and uses a 5-point Likert-type scale, ranging from 1 to 5 with 1 indicating not at all and 5 indicating extremely. As such, the range of possible scores is 10 to 50. The Dysphoria scale includes items assessing feelings of depression, inadequacy, psychomotor agitation, guilt, discouragement, anhedonia, poor concentration, difficulty with decision-making, psychomotor retardation, and worry. Higher scores indicate worse depression symptoms.
Time frame: Assessed at pre- and post-treatment (visits 3 and 6)
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| Perimenopausal Women, Depressed | Change in Inventory of Depression and Anxiety Symptoms (IDAS) Dysphoria Scores | 24.56 score on a scale | Standard Error 1.47 |
| Perimenopausal Women, Non-depressed | Change in Inventory of Depression and Anxiety Symptoms (IDAS) Dysphoria Scores | 13.79 score on a scale | Standard Error 1.35 |
| Perimenopausal Women, Depressed, Following Estradiol Treatment | Change in Inventory of Depression and Anxiety Symptoms (IDAS) Dysphoria Scores | 15.25 score on a scale | Standard Error 1.13 |
| Perimenopausal Women, Non-depressed, Following Estradiol | Change in Inventory of Depression and Anxiety Symptoms (IDAS) Dysphoria Scores | 11.84 score on a scale | Standard Error 1.04 |
p-value: 0.0002Repeated measures ANOVA
Secondary
Response Latency to Reward During the MID fMRI Task at Pre-treatment
Time (ms) between stimulus and response will be measured during the Monetary Incentive Delay (MID) task during the win trials. During MID the task, participants need to select the correct response during win and lose conditions by pressing a button on a button box in the MRI.
Time frame: Pre-treatment (visit 3)
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| Perimenopausal Women, Depressed | Response Latency to Reward During the MID fMRI Task at Pre-treatment | 204.17 Milliseconds | Standard Deviation 25.11 |
| Perimenopausal Women, Non-depressed | Response Latency to Reward During the MID fMRI Task at Pre-treatment | 209.63 Milliseconds | Standard Deviation 20.71 |
p-value: 0.486t-test, 2 sided
Secondary
Response Latency to Reward During the MID fMRI Task Following Estradiol Treatment
Time (ms) between stimulus and response will be measured during reward trials of the Monetary Incentive Delay (MID) task. During MID the task, participants need to select the correct response during win and lose conditions by pressing a button on a button box in the MRI.
Time frame: Post-treatment (visit 6)
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| Perimenopausal Women, Depressed | Response Latency to Reward During the MID fMRI Task Following Estradiol Treatment | 190.68 Milliseconds | Standard Deviation 34.98 |
| Perimenopausal Women, Non-depressed | Response Latency to Reward During the MID fMRI Task Following Estradiol Treatment | 193.43 Milliseconds | Standard Deviation 39.6 |
p-value: 0.831t-test, 2 sided