Research group
Women's mental health and brain function General psychiatry and psychotherapy with outpatient clinic

The aim of this DFG-funded study is to investigate the connection between energy metabolism, motivation, and behavior over an extended period. It remains unclear whether changes in metabolism can also influence disturbances in behavioral regulation and mood. In particular, the role of hunger in human reward learning and its connection with metabolic states has not been sufficiently researched. Together with Prof. Nils Krömer and his team (Universities of Tübingen & Bonn), we aim to fill this gap through a detailed investigation of dopamine-mediated reward learning in various metabolic states in both women and men.

We use a newly developed online game to study the learning of food and money rewards over a month, taking into account natural fluctuations in the female menstrual cycle. At the same time, we continuously measure glucose levels and conduct experimental tests to capture changes in reward-related prediction errors using functional magnetic resonance imaging (fMRI).

Our goal is to gain new insights into how energy metabolism influences learning and motivation, particularly through dopamine release in the brain. These findings could help improve the treatment of disorders such as obesity, which are associated with changes in reward processing. Additionally, we aim to examine possible gender and cycle effects in the metabolic adaptation of reward signals to gain new insights into risk factors for eating disorders or affective disorders.

This project is funded by the DFG (project duration 2021-2025) and is a collaborative project with Prof. Nils B. Krömer (University of Tübingen & University of Bonn).

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A number of hormones are released via the hypothalamic-pituitary-adrenal (HPA) axis to regulate stress. Cortisol as its end product is necessary for an adaptive response to stressful situations. Healthy women and men differ in their cortisol reactivity. This project investigates whether brain structure, function and connectivity differ between the sexes in relation to cortisol levels. In addition, cortisol levels will be analyzed in a gender comparison in patients diagnosed with depression and schizophrenia, as dysregulation of the HPA axis is an important factor in the development, maintenance and symptom intensity of stress-related mental illness. In relation to stress, the hippocampus and the amygdala are relevant regions of the brain for the stress response. However, it is unclear whether gender moderates the relationship between cortisol and the stress-relevant brain regions. The aim of this study is therefore to investigate how these physiological and psychological factors interact to influence the volume of the hippocampus and amygdala, and whether there are differences between the sexes. This study follows on from a previous DFG project (DE2319/6-1, running 2017-2021) and utilizes the data collected in that framework.

The former DFG project was a cooperation project with the Department of Psychiatry, Psychotherapy and Psychosomatics, RWTH Aachen (Prof. Dr Ute Habel) and Prof. Dr Vanessa Nieratschker (Psychiatry, Tübingen). Rui Wang is funded by the Chinese Scholarship Council.

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The sex assigned at birth and the gender identity, which is referred to as transgender, do not always match. Transgender people are often subject to severe discrimination and have a higher risk of poorer mental and physical health. More and more transgender people are undergoing gender-affirming hormone therapy (GAHT), which affects quality of life, mental health and self-esteem, among other things. With regard to the influence of hormone therapy on brain structure, function and connectivity, very little longitudinal data is available to date. Here, a formerly DFG-funded project had started and collected data at two locations in Germany - RWTH Aachen University and the University of Tübingen - before the start and 6 months under hormone therapy (DE2319/2-4, duration 2020-2024, TRANSIT). 

This project pursued a longitudinal approach to quantify the effects of opposite-sex hormone therapy on brain and behaviour by recording brain structure and function over a period of six months after the start of therapy. In addition to psychopathological ratings and questionnaires on stress, emotions and subjective well-being as well as quality of life, behaviour and neural correlates were also measured using paradigms for discrimination of female and male voices and faces. Furthermore, we will test the hypothesis of a neurobiological gender continuum in the human brain, which questions the validity of a binary gender conceptualisation. Based on functional connectivity and questionnaire data, we will use data-driven machine learning algorithms to classify each person's gender identity independently of their biological sex. We hope that such bio-behavioural markers of gender identity will advance clinically and socially relevant knowledge in the field of transgender research. These data are currently being analysed and prepared for publication.

Building on this, we now want to learn more about the long-term changes in brain structure, function and connectivity and the connection with mental health. In this study, we will therefore continue to observe the participants who took part in our transit study. To do this, we will invite the participants back to the lab for a structural and functional MRI measurement, blood sampling and mood and well-being questionnaires. In this way, we hope to further assess the effects of GAHT on physical and mental well-being in this cohort.

The study is a collaborative project with the Department of Psychiatry, Psychotherapy and Psychosomatics, RWTH Aachen University (Prof Dr Ute Habel). The study is currently being supported by the Interdisciplinary Doctoral Programme of the Faculty of Medicine (IZKF) (funding for David Maier's medical doctoral thesis).

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Special consultation hours for trans*gender and gender incongruence:

Dr. Nora Naib Majani

transgender@med.uni-tuebingen.de

Every day, we are confronted with numerous situations in which we are judged by others. Inappropriate handling of judgements by others (e.g. with sentences such as ‘You did that badly’) is a central problem for many patients with mental disorders.

The aim of the study is to record individual subjective, peripheral physiological and neuronal reactions to social videos in order to adapt these videos so that they can be used in a clinical context. In addition, effects on functional connectivity in the brain will be recorded using functional magnetic resonance imaging (fMRI). The data will be used to further improve interventions for dealing with social judgement for patients. 

The project was funded by the Medical Faculty of Tübingen (fortüne, to Dr Lydia Kogler). As part of the project, we cooperated with Prof Jens Blechert (Salzburg, Austria) and Prof Carmen Morawetz (Innsbruck, Austria).

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When it comes to moral dilemmas, there is often a moral dichotomy to resolve them. The infamous trolley and bridge problems illustrate the conflict: if an out-of-control tram is travelling towards five track workers on the track, both deontologists (rule-based morality) and utilitarians (outcome-based morality) would divert the trolley onto a track with only one worker. But if a tram is travelling towards five track workers on the track, deontologists would forbid pushing a very large man onto the track to stop the trolley, while utilitarians would allow this action as morally permissible. Understanding how our moral decision-making is processed in our brains during dilemmas is crucial for both social and clinical reasons.

Neuroimaging studies have found that two different neural activation pathways contribute to the moral dichotomy: stronger activations in emotion-associated regions occur more often deontologically in response to dilemmas, while stronger activations in cognition-associated regions - utilitarian. Personal characteristics (e.g. empathy, prosociality, risk-taking) and gender also contribute to differences in the neurobiological realization of moral decision-making. In behavioral studies, utilitarian responses have been negatively associated with trait empathy and humanized sacrifice in dilemma scenarios and positively associated with psychopathy or deficits in empathy.

In this project, we address the following questions:

1. What are the neuronal foundations of moral decisions and to what extent do they overlap with the neuronal correlates of risky vs. ambivalent decisions? We conducted a meta-analysis on this topic.
2. Can gender differences in moral sensitivity or decision-making be demonstrated and how are these influenced by personal characteristics such as empathy, prosociality and risk-taking? We attempt to clarify this question within the framework of a behavioral study.
3. How stable are moral decisions? Here we have collected data several times before and after the COVID pandemic using online surveys to investigate whether the pandemic has had an impact on moral sensitivity and decisions.

In this project we collaborate with Prof. Hong Yu Wong (Tübingen) and Dr. Veronika Müller (Research Center Jülich).

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With the increasingly widespread use of hormonal contraceptives, it is important to understand their effects on the body and brain. Studies on oral contraceptives (OCs) focus mainly on their physical effects. A few studies also show effects on the brain, stress reactivity or emotional regulation. In addition, their use is repeatedly linked to mental disorders, although the direction of the link is not clear. Studies on the influence of the hormonal intra-uterine-device (LNG-IUS) are even rarer. In this study, we therefore investigate the relationship between stress reactivity and the use of hormonal contraceptives (OC and LNG-IUS). The endocrine systems through which stress hormones and sex hormones are controlled - the hypothalamic-pituitary-adrenal (HPA) axis and the hypothalamic-pituitary-gonadal (HPG) axis - interact with each other. A better understanding of the underlying mechanisms of stress reactivity is of utmost importance. Furthermore, the data should help to clarify why stress-related mental disorders such as depression and anxiety occur more frequently in women and how they are related to hormonal contraception and hormone balance. This project therefore has enormous social relevance, as women around the world should also be informed about the influence of hormonal contraceptive methods on stress reactions. 

Funded by the Luxemburg National Research Fund (FNR, funding period 2020-2024).

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Pregnancy is one of the major hormonal transition phases in a woman's life and represents a sensitive time window for mental health. Initial studies show that brain activity and brain structure as well as affective processes change during pregnancy due to various factors such as the sharp rise in hormones. The hormone estradiol is associated with emotion regulation, brain activity, brain connectivity and brain structure. Due to the importance of emotion regulation for mental health, in this project we are investigating how emotion regulation changes during pregnancy and how this is related to the brain.

The study was conducted as part of the MINI Research Training Group ‘Pregnancy & the Brain’ funded by the Centre for Integrative Neuroscience (CIN, EXC 307). This project is a cooperation with Prof Carmen Morawetz, University of Innsbruck, Austria and colleagues from Uppsala University, Sweden.

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Our research is based on data from two large cohort studies conducted in Sweden: the BASIC and U-Birth studies. In this project, we investigate the impact of prenatal stress on the infant's development during the postpartum period. Our focus is on prenatal depression and anxiety disorders, which are common mental disorders during the perinatal period. We are particularly interested in the infant's temperament and behavioural problems, as these factors can be early indicators of later behavioural and neuropsychiatric problems.

The study is a collaborative project with the Department of Neuropaediatrics at the University of Tübingen (Prof. Dr Ingeborg Krägeloh-Mann) and colleagues at Uppsala University, Sweden.

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Pregnancy and the postpartum period, technically known as the peripartum phase, are times of profound and rapid change. During this time, a woman's body not only undergoes numerous changes, but her hormone levels are also subject to major fluctuations. Familiar routines and daily life change and a new role emerges that is associated with great responsibility and requires vigilance. It is these factors in particular that make pregnancy and the postnatal period a turbulent experience, often accompanied by significant mood swings and psychological challenges. Chief among these challenges are increased rates of depression and anxiety, which are the most common clinical disorders during the peripartum period. In this study, we are interested in the course of possible changes in mood, behaviour and sleep patterns in the first weeks after birth. In addition, we would like to investigate the effect of a new potential therapeutic treatment method, transcutaneous vagus nerve stimulation (tVNS). To do this, we compare the results of psychological questionnaires, physical signals that we record using a smartwatch, hair samples and short daily surveys of your mood and similar parameters using an app on your mobile phone, as well as neuropsychological tests. The aim is to deepen the investigation of mood swings and mood disorders after birth. We want to better analyse the time course and determine the influence of new treatment methods. Pregnancy and childbirth bring significant changes, and despite great improvement in recent years, there is still a lack of adequate support methods for women's mental health during this phase.

This study is a cooperation project with Prof. Nils B. Krömer (Universities of Tübingen & Bonn), Prof. Alireza Gharabaghi (Tübingen) and Prof. Claudia Plappert (Tübingen) and is funded by the German Centre for Mental Health (DZPG).

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Study participation: 

postpartum@med.uni-tuebingen.de

Women are confronted with different hormonal fluctuations throughout their lives, e.g. during the menstrual cycle or during the menopause (menopausal transition). These hormonal fluctuations affect emotional regulation, stress reactivity and cognitive performance, among other things. Impairments in emotion regulation and stress reactivity represent a risk factor for mental illnesses such as depression or anxiety disorders. The female sex hormone estradiol influences different cognitive functions and the underlying brain activity, connectivity and structure. This project has two aims: To investigate the influence of estradiol on 1) pre-menopausal emotion regulation and 2) cognitive performance and associated brain changes in pre- and post-menopausal women. For the first objective, data from an already completed study are being analyzed (Rehbein et al., 2021), while data for the second objective are currently being collected.

This study is part of the IRTG 2804 (project 02) and is a joint project with colleagues from Uppsala University, Sweden. The data on estradiol and emotion regulation were collected as part of a study in the MINI Research Training Group ‘Pregnancy & the Brain’ funded by the Centre for Integrative Neuroscience (CIN, EXC 307).

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Further information

https://irtg2804.de/studien/

If you are interested in the study, please contact Anna Denninger.

Our aim is to investigate reward behavior and sexual arousal in women and to determine whether and how these are influenced at different stages of the female lifespan. Reward behavior and sexual arousal play a central role in women's (mental) health and general well-being. There is increasing evidence that hormones have an influence, especially in so-called transitional phases such as the menopause. However, too little data is available so far to draw clear conclusions. In this study, we are interested in differences and similarities in hormone levels, behavior and brain function between women before the menopause (BEFORE), women during the menopause (DURING) and women after the menopause (AFTER). We also want to investigate the effect of hormone therapy during the menopause. For this purpose, the results of questionnaires, blood samples, behavioural tests and brain functions will be compared between these groups. 

This study is part of the IRTG 2804 (project 07) and is a joint project with colleagues from Uppsala University, Sweden.

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Further information:

https://irtg2804.de/studien/

Study participation:

menopause@med.uni-tuebingen.de

Breast cancer is the most common cancer in women worldwide. For women, the disease represents a life-changing situation, as the female breasts fulfil several functions. A diagnosis of breast cancer can therefore have a serious impact on a woman's life. Treatment can have side effects on a woman's psychological stability, mental health, brain structure and function, as well as her social and relationship life. For example, anti-estrogenic therapy as a breast cancer treatment can cause significant consequences and distress in the women affected. Similarities and differences in brain function and structure, psychosexual health and psychosocial experiences between women diagnosed with breast cancer in the reproductive phase (and receiving anti-estrogen treatment) and menopausal women have been little reported in the literature. In addition, few fMRI studies have been conducted to investigate the effects of hormone therapy on women with breast cancer. The main aim of this study is to systematically investigate the effects of anti-estrogen therapy on brain architecture, psychosexual health and quality of life in women with breast cancer in the reproductive phase compared to menopausal women. Three groups are being investigated: (1) premenopausal women diagnosed with breast cancer who are receiving anti-estrogenic therapy, (2) postmenopausal women diagnosed with breast cancer with and without prior hormone replacement therapy who are receiving anti-estrogenic therapy, and (3) healthy pre- and post-menopausal women. During the fMRI, all women will complete a money and food reward task. In addition, we will measure brain volume and functional connectivity at rest, perform diffusion tensor imaging (DTI), and examine various hormonal and psychometric variables. The present research project aims to assess the effects of breast cancer treatment on brain architecture, female reward processing, psychosexual health and quality of life throughout the reproductive lifespan.

This study is being conducted as part of the IRTG 2804 and is a joint project with the University Women's Hospital Tübingen (Prof Sara Brucker, Prof Markus Hahn) and colleagues from Uppsala University, Sweden.

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Further information

https://irtg2804.de/studien/

If you are interested in the study, please contact Serenay Yazici Sarikaya.

Historically, ‘the pill’ has had a significant influence on social structures and the emancipation of women and is taken by more than 150 million women worldwide every day. Despite growing concern about psychological side effects, surprisingly little research has been done into the possible psychological and neurobiological effects of the pill. Initial studies indicate changes in the well-being and social behavior of women with possible individual and social consequences. An important aspect regarding social behavior and possible effects of oral contraceptives (OCs) is female sexual behavior. In fact, initial studies indicate changes in partner preference, sexual desire and reward processing when taking OCs. However, the extent to which OC use also influences sexual appetence and the associated approach and avoidance behavior was previously unknown. The aim of this project was therefore to use a multimodal approach (by integrating behavioral data, subjective information and hormonal and neuronal parameters) to investigate the possible effects of OC use on general aspects of psychological well-being and socio-emotional abilities such as mood, emotion recognition and empathy, and on sexual appetence. To better understand how the brain functions in connection with socio-emotional behavior, it is essential to consider the effect of artificial sex hormones such as those contained in the pill. We have laid the foundation for this and for the first time investigated and demonstrated cross-sectional and longitudinal relationships between artificial sex hormone levels and socio-affective brain function. Status of OC intake and artificial sex hormone levels were associated with (1) changes in explicit sexual approach behavior and processing of positive (sexual) stimuli, (2) changes in mood and neuronal connectivity of mood-related brain regions, and (3) lower empathic behavior and brain activity. Emotion recognition, on the other hand, appears to be relatively robust against possible effects of the artificial sex hormones contained in the pill. Ultimately, the results may help to support women in making decisions about contraceptive methods and promote the development of improved preparations and personalized medicine in the field of contraception.

This study was funded by the DFG (DE2319/9-1, duration 2017-2022) and Ann-Christin Kimmig was also funded by the German National Academic Foundation. She is currently a postdoctoral researcher in the International Research Training Group 2804.

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DFG project DE2319/2-4, duration 2020-2023. 

Information see under current projects.

This project is the result of an ongoing cooperation with Prof. Dr Ute Habel (Department of Psychiatry, Psychotherapy and Psychosomatics, RWTH Aachen University).

Stress is ubiquitous in our everyday lives as well as in clinical research and plays a role in the development and maintenance of a variety of mental illnesses. Nevertheless, our understanding of the underlying mechanisms and inter-individual differences in the response to acute stress is still insufficient. In particular, the neural processing of acute psychosocial stress has not been adequately investigated and little data from large samples are available. The aim of this project was to focus on two sources of inter-individual differences: gender and genetic influences through the so-called serotonin transporter gene. We defined stress as a multidimensional construct that includes different systems with different time courses within the individual. In two experimental studies, we showed that these different dimensions are influenced to varying degrees by the type of stressor as well as the genetic make-up and gender of the individual. Our results emphasize the importance of the subjective perception of stress and contribute to the scientific basis of personalized therapy options.

This project was funded by the DFG (DE 2319/6-1) and was a collaborative project with Prof Dr Vanessa Nieratschker (Molecular Psychiatry Group, Tübingen) and Prof Dr Ute Habel (Department of Psychiatry, Psychotherapy and Psychosomatics, RWTH Aachen University). We also collaborated with Prof Michael Lämmerhofer (Pharmacy, Tübingen).

Visual attention processes are essential for interpersonal interaction. In this respect, gender and the female menstrual cycle are influencing factors. Androstadienone, a socially relevant human odorant, influences attentional processes by directing them towards emotional stimuli. However, the exact role of socially relevant odorants in human interaction has been little studied and the neurobiological basis of attentional modulation in women and men is unknown. Therefore, the present project aims to analyse the effect of androstadienone on selective attention and attentional biases and their neural basis in relation to gender and menstrual cycle phase. All participants will undergo two fMRI examinations (androstadienone vs. placebo). Androstadienone is expected to significantly modulate both attentional processes, with gender and cycle phase playing a decisive role. The modulation of emotional-cognitive processes by sex, menstrual cycle phase or socially relevant odorants such as androstadienone has so far been insufficiently investigated. There is a great need to investigate these effects in order to be able to draw conclusions about gender-specific behaviour and prevalence rates (e.g. depression in women) as well as starting points for specific therapeutic interventions.

The project was funded by the Medical Faculty of Tübingen (fortüne DE2319). As part of the project, we cooperated with Prof. Jessica Freiherr (Erlangen) and Prof. Sandra Soares (Aveiro, Portugal).