Dense-Sampling the Menstrual Cycle Using EEG: Relating Markers of Cognitive Control and Mental Health

Women show susceptibility to depressive and anxiety symptoms during estradiol (E2) and progesterone (P4) fluctuations. Electrophysiological (EEG) markers including the error-related negativity (ERN) and theta/beta ratio (TBR) are emerging biomarkers of adverse mental health. The ERN is a transdiagnostic endophenotype indexing error-processing and is likely cycle-modulated, particularly during midluteal phase. High TBR indexes low attentional control. We tracked one healthy naturally-cycling woman for 30 days, collecting daily salivary E2 and P4, mental health indicators, and EEG. Performance monitoring (ERN) was assessed with a Flanker task and attentional control (TBR) with a resting-state recording. We provide a descriptive, visual demonstration to showcase a dense-sampling approach and dynamic time-warping (DTW) network analysis combination. Both EEG markers showed daily variation across the menstrual cycle. We observed a larger ERN around ovulation, coinciding with an E2 peak. Around midluteal phase the ERN was smaller, coinciding with a P4 peak. Partial correlations suggested an overall positive relation between ERN and E2 (controlling for P4) and an overall negative relation between ERN and P4 (controlling for E2). TBR showed most change during the early-follicular phase. Partial correlations suggested a weak positive relationship between P4 and TBR (controlling for E2), but no relationship between E2 and TBR (controlling for P4). The DTW networks suggested the ERN was most strongly and negatively related to positive affect (PA) and TBR was most strongly and negatively related to negative affect (NA). We provide proof-of-principle that cognitive control markers can vary across the menstrual cycle, and that they are important targets for further study regarding women’s mental health and precision medicine. In an affectively stable woman, two cognitive control markers exhibited considerable daily variability, underscoring the importance of accounting for such fluctuations in mental health research and more fundamentally oriented neurocognitive research.