10.3389/fnins.2019.00817.s002 Maiko A. Schneider Maiko A. Schneider Poli M. Spritzer Poli M. Spritzer Luciano Minuzzi Luciano Minuzzi Benicio N. Frey Benicio N. Frey Sabrina K. Syan Sabrina K. Syan Tayane M. Fighera Tayane M. Fighera Karine Schwarz Karine Schwarz Ângelo B. Costa Ângelo B. Costa Dhiordan C. da Silva Dhiordan C. da Silva Cláudia C. G. Garcia Cláudia C. G. Garcia Anna M. V. Fontanari Anna M. V. Fontanari André G. Real André G. Real Maurício Anes Maurício Anes Juliana U. Castan Juliana U. Castan Fernanda R. Cunegatto Fernanda R. Cunegatto Maria I. R. Lobato Maria I. R. Lobato Image_2_Effects of Estradiol Therapy on Resting-State Functional Connectivity of Transgender Women After Gender-Affirming Related Gonadectomy.PNG Frontiers 2019 gender dysphoria hypogonadism estradiol functional connectivity sensorimotor cortex putamen thalamus 2019-08-07 09:51:45 Figure https://frontiersin.figshare.com/articles/figure/Image_2_Effects_of_Estradiol_Therapy_on_Resting-State_Functional_Connectivity_of_Transgender_Women_After_Gender-Affirming_Related_Gonadectomy_PNG/9303668 <p>An extreme incongruence between sex and gender identity leads individuals with gender dysphoria (GD) to seek cross-sex hormone therapy (CSHT), and gender-affirming surgery (GAS). Although few studies have investigated the effects of CSHT on the brain prior to GAS, no studies in the extant literature have evaluated its impact during hypogonadism in post-GAS individuals. Here, we aimed to evaluate the effects of estradiol on resting-state functional connectivity (rs-FC) of the sensorimotor cortex (SMC) and basal ganglia following surgical hypogonadism. Eighteen post-GAS (male-to-female) participants underwent functional magnetic resonance imaging (fMRI) and neuropsychiatric and hormonal assessment at two time points (t1, hormonal washout; t2, CSHT reintroduction). Based on the literature, the thalamus was selected as a seed, while the SMC and the dorsolateral striatum were targets for seed-based functional connectivity (sbFC). A second sbFC investigation consisted of a whole-brain voxel exploratory analysis again using the thalamus as a seed. A final complementary data-driven approach using multivoxel pattern analysis (MVPA) was conducted to identify a potential seed for further sbFC analyses. An increase in the rs-FC between the left thalamus and the left SCM/putamen followed CSHT. MVPA identified a cluster within the subcallosal cortex (SubCalC) representing the highest variation in peak activation between time points. Setting the SubCalC as a seed, whole-brain analysis showed a decoupling between the SubCalC and the medial frontal cortex during CSHT. These results indicate that CSHT with estradiol post-GAS, modulates rs-FC in regions engaged in cognitive, emotional, and sensorimotor processes.</p>