--- title: Does SPRM treatment change white matter volume in the brain in women with PMDD? description: No. The study found no change in white matter volume with treatment, which is a fairly confident finding from a controlled trial, though the sample size was n url: https://niyora.com/research/papers/white-matter-volume-and-treatment-with-selective-progesterone-receptor-modulator-2024/ --- - [Niyora](https://niyora.com/) - [Research](https://niyora.com/research/) - [Library](https://niyora.com/research/library/) - Does SPRM treatment change white matter volume in the brain in women with PMDD? Randomised trial, 2024 # Does SPRM treatment change white matter volume in the brain in women with PMDD? No. The study found no change in white matter volume with treatment, which is a fairly confident finding from a controlled trial, though the sample size was not reported in the abstract. Moderate study design Women with PMDD (exact number not reported in the abstract) ## What they did Randomized controlled trial where women with PMDD had brain MRI scans before and after 3 months of treatment with either a progesterone-blocking drug (ulipristal acetate) or placebo. ## What they found No white matter volume changes were found in any brain region in either the treatment or placebo group after 3 months. Researchers examined 8 specific white matter pathways but found no differences in any of them. ## What it means for you White matter volume probably does not explain how SPRM drugs help PMDD symptoms. The study had solid design but only examined one specific type of brain structure. It did not look at other types of brain changes that might explain how the drug works. 3 months Duration of treatment 8 White matter brain regions examined ## About the study Original title White matter volume and treatment with selective progesterone receptor modulator in patients with premenstrual dysphoric disorder Authors Kaltsouni E, Wikström J, Lanzenberger R et al. Journal Psychoneuroendocrinology Year 2024 Study design Randomised trial What was tested Ulipristal acetate (a progesterone-blocking drug) versus placebo for 3 months Open access Yes Read the paper [doi.org/10.1016/j.psyneuen.2024.106977](https://doi.org/10.1016/j.psyneuen.2024.106977) Original abstract Premenstrual dysphoric disorder (PMDD) is a mood disorder for which selective progesterone receptor modulator (SPRM) treatment has been demonstrated to be beneficial. The neural signatures of this treatment have been so far identified as greater fronto-cingulate reactivity during aggressive response to provocation, but no changes in terms of gray matter structure. White matter has recently been found to differ between patients with PMDD and healthy controls. The present study thus sought to investigate the relationship between white matter volume and SPRM treatment in patients with PMDD. A pharmaco-neuroimaging study was conducted on patients with PMDD participating in a randomized controlled trial. Participants underwent magnetic resonance imaging before and after treatment randomization to ulipristal acetate (an SPRM), or placebo, for three months. The interaction effect of treatment by time on white matter volume (WMV) was assessed. Voxel based morphometry analyses were performed on both a whole brain exploratory level and on regions of interest. No treatment effect was observed on WMV in any region, including the anterior thalamic radiations, cingulum, forceps minor, fornix, inferior fronto-occipital fasciculus, superior cerebellar peduncle, superior longitudinal fasciculus, and uncinate fasciculus. This is the first finding to indicate that no white matter volume alterations follow three-month progesterone antagonism, suggesting that white matter volume does not participate in symptom relief upon SPRM treatment for PMDD. Reproduced under CC-BY. ## Topics [Premenstrual dysphoric disorder (PMDD)](https://niyora.com/research/topics/condition-pmdd/)[Low mood and depression](https://niyora.com/research/topics/symptom-depression-mood/)[Estradiol, progesterone and hormone therapy](https://niyora.com/research/topics/treatment-hormone-therapy/) Research tells you what helps on average. Niyora helps on the day it hits. Calm down, see it another way, and decide what to say, with a PMS and PMDD app built by a doctor. ## Related studies Survey study, 2022 What causes PMS and PMDD and what new treatments are being studied? Randomised trial, 2021 Does ulipristal acetate (a progesterone blocker) treat PMDD? Study, 2021 Does ulipristal acetate help women with PMDD? Systematic review, 2014 Do estrogen and progesterone change how the brain processes emotions and decisions? Systematic review, 2008 What treatments work best for PMS and PMDD? Randomised trial, 2003 What treatments work for PMS and PMDD? Ask AI about this page Copy prompt ChatGPT ↗ Claude ↗ Perplexity ↗ Google AI Mode ↗ Grok ↗