Liisa Hantsoo, Ph.D.

Premenstrual dysphoric disorder (PMDD) is a mood disorder affecting millions of women worldwide. Symptoms include irritability, low mood, or anxiety, that are limited to the week or so prior to menses. The neurobiology of this disorder is grossly understudied. My work aims to examine the role of suboptimal central nervous system (CNS) sensitivity to neuroactive steroids (such as progesterone and its metabolites) in PMDD. Specifically, I am examining how neuroactive steroid modulation of physiologic stress response and arousal might vary in women who have PMDD compared with women who do not have PMDD. You can learn more about this research study here: www.pennpms.com.

This research is funded by my NIMH K23 Award and NARSAD Young Investigator Award.

RELEVANT PUBLICATIONS:

Hantsoo L., Golden C.E.M., Kornfield S., Grillon C., Epperson C.N. (2018). Startling Differences: Using the Acoustic Startle Response to Study Sex Differences and Neurosteroids in Affective Disorders. Current Psychiatry Reports. 2018 May 18;20(6):40.

Hantsoo L., Epperson C.N. (2017). Anxiety Disorders Among Women: A Female Lifespan Approach. American Psychiatric Association Focus:  The Journal of Lifelong Learning in Psychiatry, 15(2), 162-172.

Epperson, C.N., Hantsoo, L. (2016). Making Strides to Simplify Diagnosis of Premenstrual Dysphoric Mood Disorder. American Journal of Psychiatry, 174(1): 6–7.

Hantsoo L., Epperson C.N. (2015). Premenstrual Dysphoric Disorder: Epidemiology and Treatment. Current Psychiatry Reports, 17(11):87.

Epperson, C.N., Kim, D.R., Hantsoo, L. (2015). Premenstrual Dysphoric Mood Disorder. In Stolerman, I.P. and Price, L.H. (Eds.) Encyclopedia of Psychopharmacology. (2nd ed., pp 1348-1351). New York: Springer.

Epperson, C.N., Hantsoo, L. Menstruation and PMDD.  (2014). In D. Barnes (Ed.) Women’s Reproductive Mental Health Across the Lifespan (pp 49-72). New York: Springer.

RELEVANT PRESENTATIONS:

Hantsoo, L., Marks, J., McGeehan, B., Sammel, M.D., Grillon, C., Epperson, C.N. Anxiety-Potentiated Startle Reductions Correlate with Symptom Reduction by Sertraline in Premenstrual Dysphoric Disorder (PMDD). Annual Scientific Meeting of the Society of Biological Psychiatry (SOBP). May 10-12, 2018. New York, NY.

Hantsoo, L. Dysregulated Stress Reactivity in Premenstrual Dysphoric Disorder (PMDD): A Role for Neurosteroids? 2018 PMDD Annual Conference, Gia Allemand Foundation, Boca Raton, FL.

Photo by Verne Ho on Unsplash.

Work by my Ph.D. mentor, Dr. Janice Kiecolt-Glaser, shows that individuals who experienced significant stress as children have altered immune function and response to stress as adults. Recently, there has been interest in transgenerational effects of stress — how stress affects not only an individual, but her offspring. This is particularly relevant in pregnancy. My current work in this area examines the physiologic response to acute stress, particularly immune response, among pregnant women who had or had not experienced significant adversity in childhood.

I have also had the opportunity to work on Dr. Epperson’s P50 project examining how prepubertal adversity in women may reprogram the brain toward stress dysregulation, and whether this interacts with phases of dynamic hormonal flux across the female life span, particularly pregnancy. You can read more about Dr. Epperson’s “Prepubertal Stress, Windows of Risk & Sex Bias for Affective Disturbance” study here.

RELEVANT PUBLICATIONS:

Hantsoo L, Jašarević E, Criniti S, McGeehan B, Tanes C, Sammel MD, Elovitz MA, Compher C, Wu G, Epperson CN. (2019) Childhood adversity impact on gut microbiota and inflammatory response to stress during pregnancy. Brain Behav Immun. 2019 Jan;75:240-250. doi: 10.1016/j.bbi.2018.11.005. Epub 2018 Nov 3.

Hantsoo L, Kornfield S, Anguera MC, Epperson CN. Inflammation: A Proposed Intermediary Between Maternal Stress and Offspring Neuropsychiatric Risk. Biol Psychiatry. 2018 Sep 5. pii: S0006-3223(18)31795-5. doi: 10.1016/j.biopsych.2018.08.018

Morrison, K.E., Epperson, C.N., Sammel, M.D., Ewing, G., Podcasy, J.S., Hantsoo, L., Kim, D.R., Bale T.L. (2017). Preadolescent Adversity Programs a Disrupted Maternal Stress Reactivity in Humans and Mice. Biological Psychiatry, 2017 Apr 15;81(8):693-701.

RELEVANT PRESENTATIONS:

Hantsoo, L., Sammel, M.D., Ewing, G.E., Morrison, K., Elovitz, M., Bale, T., Epperson, C.N. Maternal Adverse Childhood Experiences: Impact on Perinatal Glucocorticoid-Inflammatory Stress Response and Offspring Hypothalamic Pituitary Adrenal (HPA) Axis Development. American College of Neuropsychopharmacology (ACNP) Annual Meeting, December 2017.

Hantsoo, L. Sex Differences in Structure and Function of Hypothalamic Pituitary Adrenal Axis (HPA-A) in Offspring of Women with Adverse Childhood Experiences.” Symposium Presentation at American Conference on Perinatal Mental Health, Chicago, IL. November 2017.

Hantsoo, L., Elovitz, M., Podcasy J.S., Epperson, C.N. (2017). Maternal Early Life Stress is Associated with Increased Interleukin-6 (IL-6) Response to Acute Stress During Pregnancy. Association for Psychological Science (APS) 29th Annual Convention. May 25-28, 2017. Boston, MA.

Hantsoo, L., Podcasy J.S., Elovitz, M., Epperson, C.N. (2017). Early Life Stress (ELS) is Associated with Heightened Inflammatory Response to Acute Stress Among Pregnant Women. Annual Scientific Meeting of the Society of Biological Psychiatry (SOBP). May 18-20, 2017. San Diego, CA.

Hantsoo, L., Sammel, M.D., Wang, E., Ewing, G., Epperson, C.N. (2017). Maternal early life stress (ELS) impact on offspring hypothalamic pituitary adrenal (HPA) axis:  Differential effects in male versus female fetal adrenal volume. Organization for the Study of Sex Differences (OSSD) Annual Meeting. May 15-18, 2017. Montreal, Quebec, Canada.

Hantsoo, L. Impact of Maternal Childhood Adversity on Maternal Stress Reactivity and Infant Outcomes. Symposium Presentation at Anxiety and Depression (ADAA) Annual Conference, Philadelphia, PA, March 2016.

Photo by Piepie on Pixabay

The human gut is populated by a diverse array of microbiota. These microorganisms play important roles, including regulating immune function. Recent work by our collaborators, using a mouse model, found that stress altered the gut microbiota of female mice during pregnancy, and that these alterations were also reflected in the offspring gut communities. My current research is examining the question of maternal stress and gut microbiome composition in humans.

This research was funded by a March of Dimes Early Career Investigator Award.

RELEVANT PUBLICATIONS:

Hantsoo L, Jašarević E, Criniti S, McGeehan B, Tanes C, Sammel MD, Elovitz MA, Compher C, Wu G, Epperson CN. (2019) Childhood adversity impact on gut microbiota and inflammatory response to stress during pregnancy. Brain Behav Immun. 2019 Jan;75:240-250.

RELEVANT PRESENTATIONS:

Hantsoo, L., Criniti, S., McGeehan, B., Tanes, C., Elovitz, M., Compher, C., Wu, G., Epperson, C.N. Adverse Childhood Experiences are Associated with Altered Human Adult Gut Microbiome.  Annual Scientific Meeting of the Society of Biological Psychiatry (SOBP). May 10-12, 2018. New York, NY.

Photo by Alex Block on Unsplash.

Polycystic ovary syndrome (PCOS) is a common endocrine disorder among women of reproductive age. Women with PCOS have hormonal irregularities accompanied by dysregulated menstrual cycle function, and are at risk for depression. I had the opportunity to work on a collaboration with Dr. Anuja Dokras, a PCOS expert, as her team looked at mental health and stress response among women with PCOS.

RELEVANT PUBLICATIONS:

Cooney, L.G., Milman, L.W., Hantsoo, L., et al. Cognitive behavioral therapy improves weight loss and quality of life in women with polycystic ovary syndrome: a randomized clinical trial. Fertil Steril. 2018 Jun 13. pii: S0015-0282(18)30283-8. doi: 10.1016/j.fertnstert.2018.03.028. [Epub ahead of print]

RELEVANT PRESENTATIONS:

Co-Chair, Symposium: “From the Pill to PCOS: Gonadal Steroids And Mood Symptoms Across The Reproductive Lifespan.”  North American Society for Psychosocial Obstetrics and Gynecology (NASPOG) Biennial Meeting, Philadelphia, PA.

Image by Roger A. Gorski, PhD, Professor of Neurobiology, Director Laboratory of Neuroendocrinology, Brain Research Institute, UCLA, via Health Education Assets Library (HEAL).

Integrating mobile health (mHealth) — the use of mobile phones and wireless technology — in mental healthcare is an interest of mine. Most of my work in the mHealth realm has focused on use of mobile or computer-assisted technology to assist pregnant women with mental health concerns and limited access to care.

RELEVANT PUBLICATIONS:

Hantsoo, L., Podcasy, J.S., Sammel, M.D., Epperson, C.N., Kim, D.R. (2017). Pregnancy and the Acceptability of Computer-Based versus Traditional Mental Health Treatments. Journal of Women’s Health, 2017 Oct;26(10):1106-1113.

Hantsoo, L., Criniti, S., Khan, A., Epperson, Moseley, M., Kincler, N., Faherty, L.J., Epperson, C.N., Bennett, I.M. (2017). A mobile application for monitoring and management of depressed mood in a vulnerable pregnant population. Psychiatric Services, 2017 Oct 16.

Faherty, L.J., Hantsoo, L., Appleby, D., Sammel, M.D., Bennett, I.M., Wiebe, D.J. (2017). Movement Patterns in Women at Risk for Perinatal Depression: Use of a Mood-Monitoring Mobile Application in Pregnancy. Journal of the American Medical Informatics Association. 2017 Jul 1;24(4):746-753.

Kim, D.R., Hantsoo, L., Thase, M., Sammel, M.D., Epperson, C.N. (2014). Computer-Assisted Cognitive Behavioral Therapy for Pregnant Women with Major Depressive Disorder. Journal of Womens Health (Larchmt), 23(10):842-8.

Hantsoo L, Epperson CN, Thase ME, Kim DR. (2013). Antepartum depression: treatment with computer-assisted cognitive-behavioral therapy. Am J Psychiatry, 170(8):929-30.

Bennett, I.M., Palmer, S.C., Nicholson, J., Hantsoo, L., Rinaldi, J., Coyne, J.  (2009). "One end has nothing to do with the other": Patient attitudes regarding help seeking intention for depression in gynecologic and obstetric settings. Archives of Women's Mental Health, 12, 301–308.

Photo by Lauren Mancke on Unsplash.

Hormones such as estradiol and testosterone can influence mood, behavior and physiology. This is particularly relevant when considering sex differences in psychiatric disorders. (For instance, women are roughly twice as likely to have depressive disorders as men.) NIH recently called for closer consideration of sex as a biological variable in clinical research. In my work, I am interested in how sex and hormonal status influence response to stress, which is often a contributing factor to depression.

RELEVANT PUBLICATIONS

Nguyen, H.B., Loughead, J., Lipner, E., Hantsoo, L., Kornfield, S., Epperson, C.N. (2018) What Has Sex Got To Do With It? The Role of Hormones in the Transgender Brain. Neuropsychopharmacology, 2018 Jul 5. doi: 10.1038/s41386-018-0140-7.

Nguyen HB, Chavez AM, Lipner E, Hantsoo L, Kornfield SL, Davies RD, Epperson CN. (2018). Gender-Affirming Hormone Use in Transgender Individuals: Impact on Behavioral Health and Cognition. Curr Psychiatry Rep. 2018 Oct 11;20(12):110.

Hantsoo L, Golden CEM, Kornfield S, Grillon C, Epperson CN. (2018). Startling Differences: Using the Acoustic Startle Response to Study Sex Differences and Neurosteroids in Affective Disorders. Curr Psychiatry Rep. 2018 May 18;20(6):40.

Kornfield SL, Hantsoo L, Epperson CN. (2018). What Does Sex Have to Do with It? The Role of Sex as a Biological Variable in the Development of Posttraumatic Stress Disorder. Curr Psychiatry Rep. 2018 May 18;20(6):39.

Morrison KE, Epperson CN, Sammel MD, Ewing G, Podcasy JS, Hantsoo L, Kim DR, Bale TL. (2017). Preadolescent Adversity Programs a Disrupted Maternal Stress Reactivity in Humans and Mice. Biol Psychiatry. 2017 Apr 15;81(8):693-701.

Hantsoo L, Czarkowski KA, Child J, Howes C, Epperson CN. (2014). Selective serotonin reuptake inhibitors and endothelial function in women. J Womens Health (Larchmt). 2014 Jul;23(7):613-8.

Hantsoo L, Khou CS, White CN, Ong JC. (2013). Gender and cognitive-emotional factors as predictors of pre-sleep arousal and trait hyperarousal in insomnia. J Psychosom Res. 2013 Apr;74(4):283-9.

Photo by Amy Shamblen on Unsplash.