Xenia Protopopescu conducted her thesis work in the brain imaging laboratory of Drs. Emily Stern and David Silbersweig at Weill Medical College and in collaboration with the McEwen Laboratory, which provided the basic neuroendocrine background for Dr. Protopopescu’s studies of menstrual cycle variations in brain function and, in particular, the differences in brain activity associated with premenstrual dysphoric disorder (PMDD).

Up to 75 percent of women complain of premenstrual symptoms; 20 to 40 percent have difficulty with them; and up to 10 percent have the severe symptoms of PMDD, with disruptions in their work and relationships. Ms. Protopopescu’s work has begun to define the mechanistic, systems-level neurobiology of this spectrum. She is the first to use functional magnetic resonance imaging (fMRI) with emotional probes in the form of words. She found distinct cycle-related changes in the orbitofrontal cortex in response to emotionally laden words stimuli, even in women with no reported mood changes. Women with the more severe PMDD showed a failure of this orbitofrontal modulatory circuitry premenstrually, with accompanying increased amygdalar activation to negative stimuli and decreased ventral striatal activation to positive stimuli. These findings provide a neural circuitry model for the emotional and behavioral disturbances in PMDD as well as indications of how this circuit changes in the normal menstrual cycle.

Xenia’s work lays a foundation for the development of future, targeted diagnostic and therapeutic strategies. The work also has methodological implications, for all brain imaging studies of
emotional function that involve women (which now need to
consider taking menstrual cycle phase into account). Finally, the work has societal implications, as the public becomes more
educated about the biological underpinnings of premenstrual
symptomatology.

Xenia has a wonderful combination of being easygoing and intellectually intense, with a broad perspective. Colleagues look to her for incisive thinking on any complex scientific problem, and she graciously offers her time, insights and considerable knowledge. We look forward eagerly to seeing her career unfold!