151
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Tamnes CK, Roalf DR, Goddings AL, Lebel C. Diffusion MRI of white matter microstructure development in childhood and adolescence: Methods, challenges and progress. Dev Cogn Neurosci 2017; 33:161-175. [PMID: 29229299 PMCID: PMC6969268 DOI: 10.1016/j.dcn.2017.12.002] [Citation(s) in RCA: 101] [Impact Index Per Article: 14.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2017] [Revised: 05/18/2017] [Accepted: 12/04/2017] [Indexed: 12/13/2022] Open
Abstract
Diffusion magnetic resonance imaging (dMRI) continues to grow in popularity as a useful neuroimaging method to study brain development, and longitudinal studies that track the same individuals over time are emerging. Over the last decade, seminal work using dMRI has provided new insights into the development of brain white matter (WM) microstructure, connections and networks throughout childhood and adolescence. This review provides an introduction to dMRI, both diffusion tensor imaging (DTI) and other dMRI models, as well as common acquisition and analysis approaches. We highlight the difficulties associated with ascribing these imaging measurements and their changes over time to specific underlying cellular and molecular events. We also discuss selected methodological challenges that are of particular relevance for studies of development, including critical choices related to image acquisition, image analysis, quality control assessment, and the within-subject and longitudinal reliability of dMRI measurements. Next, we review the exciting progress in the characterization and understanding of brain development that has resulted from dMRI studies in childhood and adolescence, including brief overviews and discussions of studies focusing on sex and individual differences. Finally, we outline future directions that will be beneficial to the field.
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Affiliation(s)
| | - David R Roalf
- Department of Psychiatry, University of Pennsylvania, Philadelphia, PA, USA
| | | | - Catherine Lebel
- Department of Radiology, Cumming School of Medicine, and Alberta Children's Hospital Research Institute, University of Calgary, Calgary, Alberta, Canada
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152
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Smith B, Dubovsky SL. Pharmacotherapy of mood disorders and psychosis in pre- and post-natal women. Expert Opin Pharmacother 2017; 18:1703-1719. [DOI: 10.1080/14656566.2017.1391789] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Affiliation(s)
- Beth Smith
- Department of Psychiatry, State University of New York at Buffalo, Buffalo, NY, USA
| | - Steven L. Dubovsky
- Department of Psychiatry, State University of New York at Buffalo, Buffalo, NY, USA
- Departments of Psychiatry and Medicine, University of Colorado, Denver, CO, USA
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153
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Abstract
PURPOSE OF REVIEW This review evaluates the state of the research regarding the effects of postpartum mental illness on the developing infant. It defines the scope of these disorders in the literature, and includes the impact of disorders referred to as perinatal mood and anxiety disorders (PMADs) on infants. RECENT FINDINGS New research reveals that PMADs apply to not only mothers, but that fathers can also experience perinatal depression and anxiety. When untreated in a primary caregiver, PMADs adversely affect parental cognitions and beliefs, attachment to the infant, and the growing caregiver-infant relationship. PMADs affect early developmental outcomes of infants including neurosynaptic development, regulatory development, and developmental milestones. Early identification and treatment for PMADs are critical to ensure optimal infant development. Standardized and routine screening for PMADs, especially in the first 6 months postpartum, and cross-disciplinary communication among medical providers afford the best opportunity for early identification and treatment.
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Affiliation(s)
- Casey Hoffman
- Department of Child and Adolescent Psychiatry and Behavioral Sciences, Neonatal Follow-up Program, Newborn/Infant Intensive Care Unit, The Children's Hospital of Philadelphia, 3401 Civic Center Blvd, Philadelphia, PA, 19104, USA
| | - Dena M Dunn
- Department of Child and Adolescent Psychiatry and Behavioral Sciences, Neonatal Follow-up Program & Pediatric Feeding and Swallowing Center, The Children's Hospital of Philadelphia, Philadelphia, PA, USA
| | - Wanjiku F M Njoroge
- Department of Child and Adolescent Psychiatry and Behavioral Sciences, Young Child Clinic, Perelman School of Medicine at the University of Pennsylvania, 3440 Market Street, Suite 410, Philadelphia, PA, 19104, USA.
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154
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Wen DJ, Poh JS, Ni SN, Chong YS, Chen H, Kwek K, Shek LP, Gluckman PD, Fortier MV, Meaney MJ, Qiu A. Influences of prenatal and postnatal maternal depression on amygdala volume and microstructure in young children. Transl Psychiatry 2017; 7:e1103. [PMID: 28440816 PMCID: PMC5416711 DOI: 10.1038/tp.2017.74] [Citation(s) in RCA: 125] [Impact Index Per Article: 17.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/23/2016] [Revised: 02/22/2017] [Accepted: 02/23/2017] [Indexed: 02/07/2023] Open
Abstract
Maternal depressive symptoms influence neurodevelopment in the offspring. Such effects may appear to be gender-dependent. The present study examined contributions of prenatal and postnatal maternal depressive symptoms to the volume and microstructure of the amygdala in 4.5-year-old boys and girls. Prenatal maternal depressive symptoms were measured using the Edinburgh Postnatal Depression Scale (EPDS) at 26 weeks of gestation. Postnatal maternal depression was assessed at 3 months using the EPDS and at 1, 2, 3 and 4.5 years using the Beck's Depression Inventory-II. Structural magnetic resonance imaging and diffusion tensor imaging were performed with 4.5-year-old children to extract the volume and fractional anisotropy (FA) values of the amygdala. Our results showed that greater prenatal maternal depressive symptoms were associated with larger right amygdala volume in girls, but not in boys. Increased postnatal maternal depressive symptoms were associated with higher right amygdala FA in the overall sample and girls, but not in boys. These results support the role of variation in right amygdala structure in transmission of maternal depression to the offspring, particularly to girls. The differential effects of prenatal and postnatal maternal depressive symptoms on the volume and FA of the right amygdala suggest the importance of the timing of exposure to maternal depressive symptoms in brain development of girls. This further underscores the need for intervention targeting both prenatal and postnatal maternal depression to girls in preventing adverse child outcomes.
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Affiliation(s)
- D J Wen
- Department of Biomedical Engineering, Clinical Imaging Research Center, National University of Singapore, Singapore, Singapore
| | - J S Poh
- Singapore Institute for Clinical Sciences, Singapore, Singapore
| | - S N Ni
- Department of Biomedical Engineering, Clinical Imaging Research Center, National University of Singapore, Singapore, Singapore
| | - Y-S Chong
- Singapore Institute for Clinical Sciences, Singapore, Singapore
- Department of Obstetrics and Gynaecology, Yong Loo Lin School of Medicine, National University of Singapore, National University Health System, Singapore, Singapore
| | - H Chen
- KK Women's and Children's Hospital, Singapore, Singapore
| | - K Kwek
- KK Women's and Children's Hospital, Singapore, Singapore
| | - L P Shek
- Department of Pediatrics, Khoo Teck Puat – National University Children's Medical Institute, National University of Singapore, Singapore, Singapore
| | - P D Gluckman
- Singapore Institute for Clinical Sciences, Singapore, Singapore
| | - M V Fortier
- Department of Diagnostic and Interventional Imaging, KK Women's and Children's Hospital, Singapore, Singapore
| | - M J Meaney
- Singapore Institute for Clinical Sciences, Singapore, Singapore
- Ludmer Centre for Neuroinformatics and Mental Health, Douglas Mental Health University Institute, McGill University, Montreal, QC, Canada
- Sackler Program for Epigenetics and Psychobiology at McGill University, Montreal, QC, Canada
| | - A Qiu
- Department of Biomedical Engineering, Clinical Imaging Research Center, National University of Singapore, Singapore, Singapore
- Singapore Institute for Clinical Sciences, Singapore, Singapore
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155
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Hong DS. Here/In This Issue and There/Abstract Thinking: The First Year: Incorporating Maternal Mental Health Into Child Psychiatric Practice. J Am Acad Child Adolesc Psychiatry 2017; 56:183-184. [PMID: 28219481 DOI: 10.1016/j.jaac.2017.01.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/05/2017] [Accepted: 01/06/2017] [Indexed: 11/29/2022]
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156
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Field T. Prenatal Depression Risk Factors, Developmental Effects and Interventions: A Review. JOURNAL OF PREGNANCY AND CHILD HEALTH 2017; 4:301. [PMID: 28702506 PMCID: PMC5502770 DOI: 10.4172/2376-127x.1000301] [Citation(s) in RCA: 69] [Impact Index Per Article: 9.9] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
This narrative review based on a literature search in PubMed and PsycInfo on the two terms prenatal and antenatal depression includes empirical studies, reviews and meta-analyses that have been published during the last 5 years on risk factors, developmental effects and interventions for prenatal depression. Risk factor studies that met criteria feature demographic measures (lower socioeconomic status, less education, non-marital status, non-employment, less social support and health locus of control, unintended pregnancy, partner violence and history of child abuse) and physiological variables (cortisol, amylase, and pro-inflammatory cytokines and intrauterine artery resistance). The negative effects include postpartum depression, paternal depression, and prematurity and low birth weight. Negative effects on infants include greater right frontal EEG, amygdala connectivity, cortical thinning and more difficult temperament. In childhood, externalizing and internalizing problems have been reported. The data on prenatal antidepressants (specifically SSRIs) reveal negative effects including internalizing problems as well as a greater risk for autism spectrum disorder. Prenatal interventions that have been effective include interpersonal psychotherapy, peer support, massage therapy, yoga, tai chi, and aerobic exercise. Potential underlying mechanisms are discussed as well as methodological limitations including homogeneity of samples and lack of randomization to intervention groups. Despite these limitations, the literature highlights the need for prenatal depression screening and intervention.
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Affiliation(s)
- Tiffany Field
- University of Miami/Miller School of Medicine, Fielding Graduate University, USA
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157
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Davis EP, Head K, Buss C, Sandman CA. Prenatal maternal cortisol concentrations predict neurodevelopment in middle childhood. Psychoneuroendocrinology 2017; 75:56-63. [PMID: 27771566 PMCID: PMC5505265 DOI: 10.1016/j.psyneuen.2016.10.005] [Citation(s) in RCA: 58] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/29/2016] [Revised: 10/07/2016] [Accepted: 10/11/2016] [Indexed: 12/20/2022]
Abstract
Glucocorticoids (cortisol in humans) are the end product of the hypothalamic-pituitary-adrenocortical (HPA) axis and are proposed as a key mechanism for programming fetal brain development. The present prospective longitudinal study evaluates the association between prenatal maternal cortisol concentrations and child neurodevelopment. Participants included a low risk sample of 91 mother-child pairs. Prenatal maternal plasma cortisol concentrations were measured at 19 and 31 gestational weeks. Brain development and cognitive functioning were assessed when children were 6-9 years of age. Structural magnetic resonance imaging scans were acquired and cortical thickness was determined. Child cognitive functioning was evaluated using standardized measures (Wechsler Intelligence Scale for Children IV and Expressive Vocabulary Test, Second Edition). Higher maternal cortisol concentrations during the third trimester were associated with greater child cortical thickness primarily in frontal regions. No significant associations were observed between prenatal maternal cortisol concentrations and child cortical thinning. Elevated third trimester maternal cortisol additionally was associated with enhanced child cognitive performance. Findings in this normative sample of typically developing children suggest that elevated maternal cortisol during late gestation exert lasting benefits for brain development and cognitive functioning 6-9 years later. The benefits of fetal exposure to higher maternal cortisol during the third trimester for child neurodevelopment are consistent with the role cortisol plays in maturation of the human fetus. It is plausible that more extreme elevations in maternal cortisol concentrations late in gestation, as well as exposure to pharmacological levels of synthetic glucocorticoids, may have neurotoxic effects on the developing fetal brain.
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Affiliation(s)
- Elysia Poggi Davis
- Department of Psychology, University of Denver, Denver, CO, 80210, United States; Women and Children's Health and Well-Being Project, Department of Psychiatry and Human Behavior, University of California, Irvine, Irvine, California, 92868, United States.
| | - Kevin Head
- Department of Psychology, University of Denver, Denver, CO, 80210, United States
| | - Claudia Buss
- Department of Medical Psychology, Charité Universitätsmedizin Berlin, Germany
| | - Curt A. Sandman
- Women and Children’s Health and Well-Being Project, Department of Psychiatry and Human Behavior, University of California, Irvine, Irvine, California, 92868, United States
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158
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Chang L, Oishi K, Skranes J, Buchthal S, Cunningham E, Yamakawa R, Hayama S, Jiang CS, Alicata D, Hernandez A, Cloak C, Wright T, Ernst T. Sex-Specific Alterations of White Matter Developmental Trajectories in Infants With Prenatal Exposure to Methamphetamine and Tobacco. JAMA Psychiatry 2016; 73:1217-1227. [PMID: 27829078 PMCID: PMC6467201 DOI: 10.1001/jamapsychiatry.2016.2794] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
IMPORTANCE Methamphetamine is a common illicit drug used worldwide. Methamphetamine and/or tobacco use by pregnant women remains prevalent. However, little is known about the effect of comorbid methamphetamine and tobacco use on human fetal brain development. OBJECTIVE To investigate whether microstructural brain abnormalities reported in children with prenatal methamphetamine and/or tobacco exposure are present at birth before childhood environmental influences. DESIGN, SETTING, AND PARTICIPANTS A prospective, longitudinal study was conducted between September 17, 2008, and February 28, 2015, at an ambulatory academic medical center. A total of 752 infant-mother dyads were screened and 139 of 195 qualified neonates were evaluated (36 methamphetamine/tobacco exposed, 32 tobacco exposed, and 71 unexposed controls). They were recruited consecutively from the community. EXPOSURES Prenatal methamphetamine and/or tobacco exposure. MAIN OUTCOMES AND MEASURES Quantitative neurologic examination and diffusion tensor imaging performed 1 to 3 times through age 4 months; diffusivities and fractional anisotropy (FA) assessed in 7 white matter tracts and 4 subcortical brain regions using an automated atlas-based method. RESULTS Of the 139 infants evaluated, 72 were female (51.8%); the mean (SE) postmenstrual age at baseline was 41.5 (0.27) weeks. Methamphetamine/tobacco-exposed infants showed delayed developmental trajectories on active muscle tone (group × age, P < .001) and total neurologic scores (group × age, P = .01) that normalized by ages 3 to 4 months. Only methamphetamine/tobacco-exposed boys had lower FA (group × age, P = .02) and higher diffusivities in superior (SCR) and posterior corona radiatae (PCR) (group × age × sex, P = .002; group × age × sex, P = .01) at baseline that normalized by age 3 months. Only methamphetamine/tobacco- and tobacco-exposed girls showed persistently lower FA in anterior corona radiata (ACR) (group, P = .04; group × age × sex, P = .01). Tobacco-exposed infants showed persistently lower axial diffusion in the thalamus and internal capsule across groups (P = .02). CONCLUSIONS AND RELEVANCE Prenatal methamphetamine/tobacco exposure may lead to delays in motor development, with less coherent fibers and less myelination in SCR and PCR only in male infants, but these abnormalities may normalize by ages 3 to 4 months after cessation of stimulant exposure. In contrast, persistently less coherent ACR fibers were observed in methamphetamine/tobacco- and tobacco-exposed girls, possibly from increased dendritic branching or spine density due to epigenetic influences. Persistently lower diffusivity in the thalamus and internal capsule of all tobacco-exposed infants suggests aberrant axonal development. Collectively, prenatal methamphetamine and/or tobacco exposure may lead to delayed motor development and white matter maturation in sex- and regional-specific manners.
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Affiliation(s)
- Linda Chang
- Department of Medicine, John A. Burns School of Medicine, University of Hawaii at Manoa, Honolulu
| | - Kenichi Oishi
- Department of Radiology, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Jon Skranes
- Department of Pediatrics, Sørlandet Hospital, Arendal, Norway, Department of Laboratory Medicine, Children’s and Women’s Health, Norwegian University of Science and Technology, Trondheim, Norway
| | - Steven Buchthal
- Department of Medicine, John A. Burns School of Medicine, University of Hawaii at Manoa, Honolulu
| | - Eric Cunningham
- Department of Medicine, John A. Burns School of Medicine, University of Hawaii at Manoa, Honolulu
| | - Robyn Yamakawa
- Department of Medicine, John A. Burns School of Medicine, University of Hawaii at Manoa, Honolulu
| | - Sara Hayama
- Department of Medicine, John A. Burns School of Medicine, University of Hawaii at Manoa, Honolulu
| | - Caroline S. Jiang
- Department of Medicine, John A. Burns School of Medicine, University of Hawaii at Manoa, Honolulu
| | - Daniel Alicata
- Department of Psychiatry, John A. Burns School of Medicine, University of Hawaii at Manoa, Honolulu
| | - Antonette Hernandez
- Department of Medicine, John A. Burns School of Medicine, University of Hawaii at Manoa, Honolulu
| | - Christine Cloak
- Department of Medicine, John A. Burns School of Medicine, University of Hawaii at Manoa, Honolulu
| | - Tricia Wright
- Department of Obstetrics, Gynecology and Women’s Health, John A. Burns School of Medicine, University of Hawaii at Manoa, Honolulu
| | - Thomas Ernst
- Department of Medicine, John A. Burns School of Medicine, University of Hawaii at Manoa, Honolulu
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159
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Londono Tobon A, Diaz Stransky A, Ross DA, Stevens HE. Effects of Maternal Prenatal Stress: Mechanisms, Implications, and Novel Therapeutic Interventions. Biol Psychiatry 2016; 80:e85-e87. [PMID: 27968727 PMCID: PMC5374858 DOI: 10.1016/j.biopsych.2016.09.011] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/14/2016] [Revised: 09/15/2016] [Accepted: 09/16/2016] [Indexed: 11/16/2022]
Affiliation(s)
- Amalia Londono Tobon
- Yale University Child Study Center, Yale University, New Haven, Connecticut; Department of Psychiatry, Yale University, New Haven, Connecticut.
| | - Andrea Diaz Stransky
- Yale University Child Study Center, Yale University, New Haven, Connecticut; Department of Psychiatry, Yale University, New Haven, Connecticut
| | - David A Ross
- Department of Psychiatry, Yale University, New Haven, Connecticut
| | - Hanna E Stevens
- Department of Psychiatry, University of Iowa, Iowa City, Iowa
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160
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Bandoli G, Coles CD, Kable JA, Wertelecki W, Granovska IV, Pashtepa AO, Chambers CD. Assessing the Independent and Joint Effects of Unmedicated Prenatal Depressive Symptoms and Alcohol Consumption in Pregnancy and Infant Neurodevelopmental Outcomes. Alcohol Clin Exp Res 2016; 40:1304-11. [PMID: 27129610 DOI: 10.1111/acer.13081] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2016] [Accepted: 03/28/2016] [Indexed: 02/06/2023]
Abstract
BACKGROUND Prenatal alcohol exposure (PAE) is an established risk factor for neurodevelopmental deficits in the offspring. Prenatal depression has been associated with neurodevelopmental deficits in the offspring, although investigations into unmedicated prenatal depression have been inconsistent. We hypothesized that unmedicated prenatal depressive symptoms would independently and jointly with PAE predict neurodevelopmental outcomes in infant offspring. METHODS We studied 344 participants from a randomized clinical trial of multivitamin supplements in pregnant women in Ukraine. Women were recruited based upon periconceptional alcohol use and followed up to 12 months postpartum. Prenatal depressive symptoms were assessed at approximately 32 weeks of gestation using the Beck Depression Inventory score. Neurodevelopment was assessed with the Bayley Scales of Infant Development II Mental Development Index (MDI) and Psychomotor Development Index (PDI) at 6 and 12 months postpartum. Generalized linear regression models were constructed to assess the independent and joint effects of prenatal depressive symptoms and PAE in models adjusted for sociodemographic and pregnancy characteristics. RESULTS PAE was independently associated with deficits in neurodevelopmental outcomes at 6 and 12 months, however, level of prenatal depressive symptoms was not. We found marginal evidence of synergism of depressive symptoms and PAE, with larger deficits in those with both exposures observed for the PDI-6 months (p = 0.05) and MDI-12 months (p = 0.09). Additionally, there was a suggestion of sexual dimorphism; females had stronger deficits from joint exposures than males (depressive symptom [MDI-6 months] female: -8.28, 95% CI -13.06, -3.49; male: 0.68, 95% CI -4.58, 5.94; p for interaction 0.04). While not statistically significant for the MDI or PDI at 12 months, the trend persisted. CONCLUSIONS Infants exposed to PAE and prenatal depression may be at an increased risk of neurodevelopmental deficits. Healthcare providers should be aware of this possible synergism in their efforts to mitigate the neurodevelopmental effects of these co-occurring exposures.
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Affiliation(s)
- Gretchen Bandoli
- Department of Pediatrics, University of California, San Diego, San Diego, California
| | - Claire D Coles
- Departments of Psychiatry and Pediatrics, Emory University School of Medicine, Atlanta, Georgia
| | - Julie A Kable
- Departments of Psychiatry and Pediatrics, Emory University School of Medicine, Atlanta, Georgia
| | - Wladimir Wertelecki
- Department of Pediatrics, University of California, San Diego, San Diego, California.,OMNI-Net for Children International Charitable Fund, Rivne Regional Medical Diagnostic Center, Rivne, Ukraine.,OMNI-Net for Children International Charitable Fund, Khmelnytsky Perinatal Center, Khmelnytsky, Ukraine.,Department of Medical Genetics, University of South Alabama, Mobile, Alabama
| | - Irina V Granovska
- OMNI-Net for Children International Charitable Fund, Rivne Regional Medical Diagnostic Center, Rivne, Ukraine
| | - Alla O Pashtepa
- OMNI-Net for Children International Charitable Fund, Khmelnytsky Perinatal Center, Khmelnytsky, Ukraine
| | - Christina D Chambers
- Department of Pediatrics, University of California, San Diego, San Diego, California
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