Grant: Operating Grant

Depression is an important problem for women in the perimenopausal period with an incidence rate of 17% for full clinical depression and 16% having significant symptoms. This study will examine brain changes during perimenopause that may relate to greater risk for clinical depression and clinical symptoms. Social factors like stressful life events elevate the risk of a depressive episode, and it may be that drops in estrogen may also contribute to the risk of a depressive episode. This study will measure a brain protein called monoamine oxidase A (MAO-A) which increases after estrogen drops. MAO-A breaks down chemicals that maintain normal mood like serotonin. This study will use a brain imaging method to measure MAO-A levels in women in perimenopause. It will compare MAO-A levels during perimenopause to levels prior perimenopause and after perimenopause. It will determine if MAO-A levels are higher in women with full clinical depression with onset in perimenopause. It will also determine whether MAO-A levels are higher in women with some clinical depression symptoms during perimenopause. Should the results of the study show that MAO-A levels elevate more in perimenopause, particularly in those who have sad mood, and in those with clinical depression, it would argue that future treatments of clinical depression with perimenopausal onset should consider targeting MAO-A or compensating for effects of overly active MAO-A. In the case of people experiencing some mood symptoms but not a full clinical depression, this could involve dietary recommendations or natural health food products that contain the nutrients which become the mood maintaining chemicals like serotonin.For full clinical depression, it may be that MAO-A inhibiting treatments are superior but the clinical trial to test such treatments has not yet been done in clinical depression. The current research would guide selection of new treatments.