Mapping sex-specific hormone-metabolite coupling in the adolescent brain: a longitudinal whole-brain spectroscopic imaging study

Adolescence is marked by coordinated endocrine and brain maturation, yet how blood circulating steroid hormones relate to neurochemical change in the brain remains largely unknown. We combined longitudinal data from a novel fast whole-brain, high-resolution three-dimensional proton magnetic resonance spectroscopic imaging technique with repeated measurements of sexual hormones and adrenal steroids in the serum of 42 healthy adolescents (13-15 years; 24 females) totalizing 100 scan-visits. Longitudinal voxel-wise models separated within-individual changes from stable between-individual differences and controlled the false discovery rate across whole-brain tests. In the whole sample, increasing age was associated with higher N-acetylaspartate plus N-acetylaspartylglutamate within individuals, whereas age was positively associated with higher glutamate plus glutamine between individuals. We then observed a hormone-metabolite coupling that differed by sex and steroids. In males, within-individual increases in testosterone tracked frontal increases in glutamate plus glutamine and disseminated increases in total N-acetylaspartate. In females, higher mean estradiol between individuals was associated with higher frontal choline-containing compounds. Within-individual changes in cortisone were associated with myo-inositol and choline-containing compounds in a widespread sex-interaction effect, with positive coupling in males and negative in females. The cortisone/cortisol ratio showed a similar sex-interaction for choline-containing compounds. These findings reveal spatially distributed, sex-dependent links between steroid maturation and adolescent brain neurochemical composition and underscore the importance of differentiating within- and between-individual associations. These observational data extend predominantly structural descriptions of pubertal brain development by identifying distinct coupling of gonadal hormones with neuronal-metabolic markers and glucocorticoid interconversion with glia-weighted metabolites.