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Manning KY, Jaffer A, Lebel C. Windows of opportunity: how age and sex shape the influence of prenatal depression on the child brain. Biol Psychiatry 2024:S0006-3223(24)01490-2. [PMID: 39117167 DOI: 10.1016/j.biopsych.2024.07.022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/05/2024] [Revised: 07/18/2024] [Accepted: 07/25/2024] [Indexed: 08/10/2024]
Abstract
Maternal prenatal depression can affect child brain and behavioural development. Specifically, altered limbic network structure and function is a likely mechanism through which prenatal depression impacts the life-long mental health of exposed children. While developmental trajectories are influenced by many factors that exacerbate risk or promote resiliency, the role of child age and sex in the relationship between prenatal depression and the child brain remains unclear. Here, we review studies of associations between prenatal depression and brain structure and function, with a focus on the role of age and sex in these relationships. After exposure to prenatal depression, altered amygdala, hippocampal and frontal cortical structure, as well as changes in functional and structural connectivity within the limbic network are evident during the fetal, infant, preschool, childhood, and adolescent stages of development. Sex appears to play a key role in this relationship, with evidence of differential findings particularly in infants, with males showing smaller and females larger hippocampal and amygdala volumes following prenatal depression. Longitudinal studies in this area have only begun to emerge within the last five years and will be key to understanding critical windows of opportunity. Future research focused on the role of age and sex in this relationship is essential to further inform screening, policy, and interventions for children exposed to prenatal depression, interrupt the intergenerational transmission of depression, and ultimately support healthy brain development.
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Affiliation(s)
- Kathryn Y Manning
- Department of Radiology, University of Calgary, Calgary, Alberta, Canada; Alberta Children's Hospital Research Institute, Calgary, Alberta, Canada; Hotchkiss Brain Institute, University of Calgary, Calgary, Alberta, Canada
| | - Aliza Jaffer
- Department of Radiology, University of Calgary, Calgary, Alberta, Canada
| | - Catherine Lebel
- Department of Radiology, University of Calgary, Calgary, Alberta, Canada; Alberta Children's Hospital Research Institute, Calgary, Alberta, Canada; Hotchkiss Brain Institute, University of Calgary, Calgary, Alberta, Canada.
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2
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Lyons-Ruth K, Chasson M, Khoury J, Ahtam B. Reconsidering the nature of threat in infancy: Integrating animal and human studies on neurobiological effects of infant stress. Neurosci Biobehav Rev 2024; 163:105746. [PMID: 38838878 DOI: 10.1016/j.neubiorev.2024.105746] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2024] [Revised: 05/25/2024] [Accepted: 06/01/2024] [Indexed: 06/07/2024]
Abstract
Early life stress has been associated with elevated risk for later psychopathology. One mechanism that may contribute to such long-term risk is alterations in amygdala development, a brain region critical to stress responsivity. Yet effects of stress on the amygdala during human infancy, a period of particularly rapid brain development, remain largely unstudied. In order to model how early stressors may affect infant amygdala development, several discrepancies across the existing literatures on early life stress among rodents and early threat versus deprivation among older human children and adults need to be reconciled. We briefly review the key findings of each of these literatures. We then consider them in light of emerging findings from studies of human infants regarding relations among maternal caregiving, infant cortisol response, and infant amygdala volume. Finally, we advance a developmental salience model of how early threat may impact the rapidly developing infant brain, a model with the potential to integrate across these divergent literatures. Future work to assess the value of this model is also proposed.
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Affiliation(s)
- Karlen Lyons-Ruth
- Department of Psychiatry, Cambridge Hospital, Harvard Medical School, 1493 Cambridge St, Cambridge, MA 02468, USA.
| | - Miriam Chasson
- Department of Psychiatry, Cambridge Hospital, Harvard Medical School, 1493 Cambridge St, Cambridge, MA 02468, USA.
| | - Jennifer Khoury
- Department of Psychiatry, Cambridge Hospital, Harvard Medical School, 1493 Cambridge St, Cambridge, MA 02468, USA.
| | - Banu Ahtam
- Fetal-Neonatal Neuroimaging & Developmental Science Center, Division of Newborn Medicine, Department of Pediatrics, Boston Children's Hospital, Harvard Medical School, 300 Longwood Ave, Boston, MA 02115, USA.
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3
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Herzberg MP, Smyser CD. Prenatal Social Determinants of Health: Narrative review of maternal environments and neonatal brain development. Pediatr Res 2024:10.1038/s41390-024-03345-7. [PMID: 38961164 DOI: 10.1038/s41390-024-03345-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/01/2024] [Revised: 05/29/2024] [Accepted: 06/04/2024] [Indexed: 07/05/2024]
Abstract
The Social Determinants of Health, a set of social factors including socioeconomic status, community context, and neighborhood safety among others, are well-known predictors of mental and physical health across the lifespan. Recent research has begun to establish the importance of these social factors at the earliest points of brain development, including during the prenatal period. Prenatal socioeconomic status, perceived stress, and neighborhood safety have all been reported to impact neonatal brain structure and function, with exploratory work suggesting subsequent effects on infant and child behavior. Secondary effects of the Social Determinants of Health, such as maternal sleep and psychopathology during pregnancy, have also been established as important predictors of infant brain development. This research not only establishes prenatal Social Determinants of Health as important predictors of future outcomes but may be effectively applied even before birth. Future research replicating and extending the effects in this nascent literature has great potential to produce more specific and mechanistic understanding of the social factors that shape early neurobehavioral development. IMPACT: This review synthesizes the research to date examining the effects of the Social Determinants of Health during the prenatal period and neonatal brain outcomes. Structural, functional, and diffusion-based imaging methodologies are included along with the limited literature assessing subsequent infant behavior. The degree to which results converge between studies is discussed, in combination with the methodological and sampling considerations that may contribute to divergence in study results. Several future directions are identified, including new theoretical approaches to assessing the impact of the Social Determinants of Health during the perinatal period.
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Affiliation(s)
- Max P Herzberg
- Department of Psychiatry, Washington University in St. Louis, Saint Louis, MO, USA
| | - Christopher D Smyser
- Department of Neurology, Pediatrics, and Radiology, Washington University in St. Louis, Saint Louis, MO, USA.
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4
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Shekhar S, Hirvi P, Maria A, Kotilahti K, Tuulari JJ, Karlsson L, Karlsson H, Nissilä I. Maternal prenatal depressive symptoms and child brain responses to affective touch at two years of age. J Affect Disord 2024; 356:177-189. [PMID: 38508459 DOI: 10.1016/j.jad.2024.03.092] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/04/2023] [Revised: 03/13/2024] [Accepted: 03/16/2024] [Indexed: 03/22/2024]
Abstract
BACKGROUND Touch is an essential form of mother-child interaction, instigating better social bonding and emotional stability. METHODS We used diffuse optical tomography to explore the relationship between total haemoglobin (HbT) responses to affective touch in the child's brain at two years of age and maternal self-reported prenatal depressive symptoms (EPDS). Affective touch was implemented via slow brushing of the child's right forearm at 3 cm/s and non-affective touch via fast brushing at 30 cm/s and HbT responses were recorded on the left hemisphere. RESULTS We discovered a cluster in the postcentral gyrus exhibiting a negative correlation (Pearson's r = -0.84, p = 0.015 corrected for multiple comparisons) between child HbT response to affective touch and EPDS at gestational week 34. Based on region of interest (ROI) analysis, we found negative correlations between child responses to affective touch and maternal prenatal EPDS at gestational week 14 in the precentral gyrus, Rolandic operculum and secondary somatosensory cortex. The responses to non-affective touch did not correlate with EPDS in these regions. LIMITATIONS The number of mother-child dyads was 16. However, by utilising high-density optode arrangements, individualised anatomical models, and video and accelerometry to monitor movement, we were able to minimize methodological sources of variability in the data. CONCLUSIONS The results show that maternal depressive symptoms during pregnancy may be associated with reduced child responses to affective touch in the temporoparietal cortex. Responses to affective touch may be considered as potential biomarkers for psychosocial development in children. Early identification of and intervention in maternal depression may be important already during early pregnancy.
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Affiliation(s)
- Shashank Shekhar
- Duke University School of Medicine, Department of Neurology, Durham, NC, USA; University of Turku, Department of Clinical Medicine, Turku Brain and Mind Center, FinnBrain Birth Cohort Study, Finland; University of Turku and Turku University Hospital, Department of Psychiatry, Finland
| | - Pauliina Hirvi
- Aalto University, Department of Neuroscience and Biomedical Engineering, Finland; Aalto University, Department of Mathematics and Systems Analysis, Finland
| | - Ambika Maria
- University of Turku, Department of Clinical Medicine, Turku Brain and Mind Center, FinnBrain Birth Cohort Study, Finland; University of Turku and Turku University Hospital, Department of Psychiatry, Finland
| | - Kalle Kotilahti
- Aalto University, Department of Neuroscience and Biomedical Engineering, Finland
| | - Jetro J Tuulari
- University of Turku, Department of Clinical Medicine, Turku Brain and Mind Center, FinnBrain Birth Cohort Study, Finland; University of Turku and Turku University Hospital, Department of Psychiatry, Finland; Turku Collegium for Science, Medicine and Technology, TCSMT, University of Turku, Finland
| | - Linnea Karlsson
- University of Turku, Department of Clinical Medicine, Turku Brain and Mind Center, FinnBrain Birth Cohort Study, Finland; University of Turku and Turku University Hospital, Department of Psychiatry, Finland; University of Turku and Turku University Hospital, Department of Paediatrics and Adolescent Medicine, Finland; Centre for Population Health Research, Turku University Hospital and University of Turku, Turku, Finland
| | - Hasse Karlsson
- University of Turku, Department of Clinical Medicine, Turku Brain and Mind Center, FinnBrain Birth Cohort Study, Finland; University of Turku and Turku University Hospital, Department of Psychiatry, Finland
| | - Ilkka Nissilä
- Aalto University, Department of Neuroscience and Biomedical Engineering, Finland.
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Lautarescu A, Bonthrone AF, Bos B, Barratt B, Counsell SJ. Advances in fetal and neonatal neuroimaging and everyday exposures. Pediatr Res 2024:10.1038/s41390-024-03294-1. [PMID: 38877283 DOI: 10.1038/s41390-024-03294-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/13/2024] [Revised: 04/25/2024] [Accepted: 04/29/2024] [Indexed: 06/16/2024]
Abstract
The complex, tightly regulated process of prenatal brain development may be adversely affected by "everyday exposures" such as stress and environmental pollutants. Researchers are only just beginning to understand the neural sequelae of such exposures, with advances in fetal and neonatal neuroimaging elucidating structural, microstructural, and functional correlates in the developing brain. This narrative review discusses the wide-ranging literature investigating the influence of parental stress on fetal and neonatal brain development as well as emerging literature assessing the impact of exposure to environmental toxicants such as lead and air pollution. These 'everyday exposures' can co-occur with other stressors such as social and financial deprivation, and therefore we include a brief discussion of neuroimaging studies assessing the effect of social disadvantage. Increased exposure to prenatal stressors is associated with alterations in the brain structure, microstructure and function, with some evidence these associations are moderated by factors such as infant sex. However, most studies examine only single exposures and the literature on the relationship between in utero exposure to pollutants and fetal or neonatal brain development is sparse. Large cohort studies are required that include evaluation of multiple co-occurring exposures in order to fully characterize their impact on early brain development. IMPACT: Increased prenatal exposure to parental stress and is associated with altered functional, macro and microstructural fetal and neonatal brain development. Exposure to air pollution and lead may also alter brain development in the fetal and neonatal period. Further research is needed to investigate the effect of multiple co-occurring exposures, including stress, environmental toxicants, and socioeconomic deprivation on early brain development.
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Affiliation(s)
- Alexandra Lautarescu
- Department of Perinatal Imaging and Health, Centre for the Developing Brain, School of Biomedical Engineering and Imaging Sciences, King's College London, London, UK
- Department of Psychology, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Alexandra F Bonthrone
- Department of Perinatal Imaging and Health, Centre for the Developing Brain, School of Biomedical Engineering and Imaging Sciences, King's College London, London, UK
| | - Brendan Bos
- MRC Centre for Environment and Health, Imperial College London, London, UK
| | - Ben Barratt
- MRC Centre for Environment and Health, Imperial College London, London, UK
| | - Serena J Counsell
- Department of Perinatal Imaging and Health, Centre for the Developing Brain, School of Biomedical Engineering and Imaging Sciences, King's College London, London, UK.
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6
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Mandl S, Alexopoulos J, Doering S, Wildner B, Seidl R, Bartha-Doering L. The effect of prenatal maternal distress on offspring brain development: A systematic review. Early Hum Dev 2024; 192:106009. [PMID: 38642513 DOI: 10.1016/j.earlhumdev.2024.106009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/11/2024] [Revised: 04/12/2024] [Accepted: 04/13/2024] [Indexed: 04/22/2024]
Abstract
BACKGROUND Prenatal maternal distress can negatively affect pregnancy outcomes, yet its impact on the offspring's brain structure and function remains unclear. This systematic review summarizes the available literature on the relationship between prenatal maternal distress and brain development in fetuses and infants up to 12 months of age. METHODS We searched Central, Embase, MEDLINE, PsycINFO, and PSYNDEXplus for studies published between database inception and December 2023. Studies were included if prenatal maternal anxiety, stress, and/or depression was assessed, neuroimaging was used to examine the offspring, and the offspring's brain was imaged within the first year of life. The quality of the included studies was evaluated using the Quality Assessment of Diagnostic Accuracy Studies-II. RESULTS Out of the 1516 studies retrieved, 71 met our inclusion criteria. Although the studies varied greatly in their methodology, the results generally pointed to structural and functional aberrations in the limbic system, prefrontal cortex, and insula in fetuses and infants prenatally exposed to maternal distress. CONCLUSIONS The hippocampus, amygdala, and prefrontal cortex have a high density of glucocorticoid receptors, which play a key role in adapting to stressors and maintaining stress-related homeostasis. We thus conclude that in utero exposure to maternal distress prompts these brain regions to adapt by undergoing structural and functional changes, with the consequence that these alterations increase the risk for developing a neuropsychiatric illness later on. Future research should investigate the effect of providing psychological support for pregnant women on the offspring's early brain development.
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Affiliation(s)
- Sophie Mandl
- Department of Pediatrics and Adolescent Medicine, Comprehensive Center for Pediatrics, Medical University of Vienna, Vienna, Austria.
| | - Johanna Alexopoulos
- Department of Pediatrics and Adolescent Medicine, Comprehensive Center for Pediatrics, Medical University of Vienna, Vienna, Austria; Department of Psychoanalysis and Psychotherapy, Medical University of Vienna, Vienna, Austria
| | - Stephan Doering
- Department of Psychoanalysis and Psychotherapy, Medical University of Vienna, Vienna, Austria
| | - Brigitte Wildner
- University Library, Medical University of Vienna, Vienna, Austria
| | - Rainer Seidl
- Department of Pediatrics and Adolescent Medicine, Comprehensive Center for Pediatrics, Medical University of Vienna, Vienna, Austria
| | - Lisa Bartha-Doering
- Department of Pediatrics and Adolescent Medicine, Comprehensive Center for Pediatrics, Medical University of Vienna, Vienna, Austria
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7
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Sun H, Mehta S, Khaitova M, Cheng B, Hao X, Spann M, Scheinost D. Brain age prediction and deviations from normative trajectories in the neonatal connectome. BIORXIV : THE PREPRINT SERVER FOR BIOLOGY 2024:2024.04.23.590811. [PMID: 38712238 PMCID: PMC11071351 DOI: 10.1101/2024.04.23.590811] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/08/2024]
Abstract
Structural and functional connectomes undergo rapid changes during the third trimester and the first month of postnatal life. Despite progress, our understanding of the developmental trajectories of the connectome in the perinatal period remains incomplete. Brain age prediction uses machine learning to estimate the brain's maturity relative to normative data. The difference between the individual's predicted and chronological age-or brain age gap (BAG)-represents the deviation from these normative trajectories. Here, we assess brain age prediction and BAGs using structural and functional connectomes for infants in the first month of life. We used resting-state fMRI and DTI data from 611 infants (174 preterm; 437 term) from the Developing Human Connectome Project (dHCP) and connectome-based predictive modeling to predict postmenstrual age (PMA). Structural and functional connectomes accurately predicted PMA for term and preterm infants. Predicted ages from each modality were correlated. At the network level, nearly all canonical brain networks-even putatively later developing ones-generated accurate PMA prediction. Additionally, BAGs were associated with perinatal exposures and toddler behavioral outcomes. Overall, our results underscore the importance of normative modeling and deviations from these models during the perinatal period.
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8
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Scheible K, Beblavy R, Sohn MB, Qui X, Gill AL, Narvaez-Miranda J, Brunner J, Miller RK, Barrett ES, O’Connor TG, Gill SR. Affective Symptoms in Pregnancy are Associated with the Vaginal Microbiome. BIORXIV : THE PREPRINT SERVER FOR BIOLOGY 2024:2024.04.12.589254. [PMID: 38645042 PMCID: PMC11030453 DOI: 10.1101/2024.04.12.589254] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/23/2024]
Abstract
Composition of the vaginal microbiome in pregnancy is associated with adverse maternal, obstetric, and child health outcomes. Identifying the sources of individual differences in the vaginal microbiome is therefore of considerable clinical and public health interest. The current study tested the hypothesis that vaginal microbiome composition during pregnancy is associated with an individual's experience of affective symptoms and stress exposure. Data were based on a prospective longitudinal study of a diverse and medically healthy community sample of 275 mother-infant pairs. Affective symptoms and stress exposure and select measures of associated biomarkers (diurnal salivary cortisol, serum measures of sex hormones) were collected at each trimester; self-report, clinical, and medical records were used to collect detailed data on socio-demographic factors and health behavior, including diet and sleep. Vaginal microbiome samples were collected in the third trimester (34-40 weeks) and characterized by 16S rRNA sequencing. Identified taxa were clustered into three community state types (CST1-3) based on dissimilarity of vaginal microbiota composition. Results indicate that depressive symptoms during pregnancy were reliably associated with individual taxa and CST3 in the third trimester. Prediction of functional potential from 16S taxonomy revealed a differential abundance of metabolic pathways in CST1-3 and individual taxa, including biosynthetic pathways for the neuroactive metabolites, serotonin and dopamine. With the exception of bioavailable testosterone, no significant associations were found between symptoms- and stress-related biomarkers and CSTs. Our results provide further evidence of how prenatal psychological distress during pregnancy alters the maternal-fetal microbiome ecosystem that may be important for understanding maternal and child health outcomes.
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Affiliation(s)
- Kristin Scheible
- Department of Microbiology and Immunology, University of Rochester School of Medicine and Dentistry, Rochester, New York, USA
- Department of Pediatrics, University of Rochester School of Medicine and Dentistry, Rochester, New York, USA
| | - Robert Beblavy
- Department of Biostatistics and Computational Biology, University of Rochester School of Medicine and Dentistry, Rochester, New York, USA
| | - Michael B. Sohn
- Department of Biostatistics and Computational Biology, University of Rochester School of Medicine and Dentistry, Rochester, New York, USA
| | - Xing Qui
- Department of Biostatistics and Computational Biology, University of Rochester School of Medicine and Dentistry, Rochester, New York, USA
| | - Ann L. Gill
- Department of Microbiology and Immunology, University of Rochester School of Medicine and Dentistry, Rochester, New York, USA
| | - Janiret Narvaez-Miranda
- Department of Microbiology and Immunology, University of Rochester School of Medicine and Dentistry, Rochester, New York, USA
| | - Jessica Brunner
- Department of Obstetrics and Gynecology, University of Rochester School of Medicine and Dentistry, Rochester, New York, USA
| | - Richard K. Miller
- Department of Obstetrics and Gynecology, University of Rochester School of Medicine and Dentistry, Rochester, New York, USA
| | - Emily S. Barrett
- Biostatistics and Epidemiology, Rutgers School of Public Health, Piscataway, New Jersey, USA
- Environmental and Occupational Health Sciences Institute, Rutgers University, Piscataway, New Jersey, USA
| | - Tom G. O’Connor
- Department of Psychiatry, University of Rochester School of Medicine and Dentistry, Rochester, New York, USA
- Department of Neuroscience, University of Rochester School of Medicine and Dentistry, Rochester, New York, USA
- Wynne Center for Family Research, University of Rochester School of Medicine and Dentistry, Rochester, New York, USA
| | - Steven R. Gill
- Department of Microbiology and Immunology, University of Rochester School of Medicine and Dentistry, Rochester, New York, USA
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9
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Wu Y, De Asis-Cruz J, Limperopoulos C. Brain structural and functional outcomes in the offspring of women experiencing psychological distress during pregnancy. Mol Psychiatry 2024:10.1038/s41380-024-02449-0. [PMID: 38418579 DOI: 10.1038/s41380-024-02449-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/17/2023] [Revised: 01/19/2024] [Accepted: 01/23/2024] [Indexed: 03/01/2024]
Abstract
In-utero exposure to maternal psychological distress is increasingly linked with disrupted fetal and neonatal brain development and long-term neurobehavioral dysfunction in children and adults. Elevated maternal psychological distress is associated with changes in fetal brain structure and function, including reduced hippocampal and cerebellar volumes, increased cerebral cortical gyrification and sulcal depth, decreased brain metabolites (e.g., choline and creatine levels), and disrupted functional connectivity. After birth, reduced cerebral and cerebellar gray matter volumes, increased cerebral cortical gyrification, altered amygdala and hippocampal volumes, and disturbed brain microstructure and functional connectivity have been reported in the offspring months or even years after exposure to maternal distress during pregnancy. Additionally, adverse child neurodevelopment outcomes such as cognitive, language, learning, memory, social-emotional problems, and neuropsychiatric dysfunction are being increasingly reported after prenatal exposure to maternal distress. The mechanisms by which prenatal maternal psychological distress influences early brain development include but are not limited to impaired placental function, disrupted fetal epigenetic regulation, altered microbiome and inflammation, dysregulated hypothalamic pituitary adrenal axis, altered distribution of the fetal cardiac output to the brain, and disrupted maternal sleep and appetite. This review will appraise the available literature on the brain structural and functional outcomes and neurodevelopmental outcomes in the offspring of pregnant women experiencing elevated psychological distress. In addition, it will also provide an overview of the mechanistic underpinnings of brain development changes in stress response and discuss current treatments for elevated maternal psychological distress, including pharmacotherapy (e.g., selective serotonin reuptake inhibitors) and non-pharmacotherapy (e.g., cognitive-behavior therapy). Finally, it will end with a consideration of future directions in the field.
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Affiliation(s)
- Yao Wu
- Developing Brain Institute, Children's National Hospital, Washington, DC, 20010, USA
| | | | - Catherine Limperopoulos
- Developing Brain Institute, Children's National Hospital, Washington, DC, 20010, USA.
- Department of Diagnostic Imaging and Radiology, Children's National Hospital, Washington, DC, 20010, USA.
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10
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Sanders AFP, Tirado B, Seider NA, Triplett RL, Lean RE, Neil JJ, Miller JP, Tillman R, Smyser TA, Barch DM, Luby JL, Rogers CE, Smyser CD, Warner BB, Chen E, Miller GE. Prenatal exposure to maternal disadvantage-related inflammatory biomarkers: associations with neonatal white matter microstructure. Transl Psychiatry 2024; 14:72. [PMID: 38307841 PMCID: PMC10837200 DOI: 10.1038/s41398-024-02782-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/17/2023] [Revised: 01/11/2024] [Accepted: 01/15/2024] [Indexed: 02/04/2024] Open
Abstract
Prenatal exposure to heightened maternal inflammation has been associated with adverse neurodevelopmental outcomes, including atypical brain maturation and psychiatric illness. In mothers experiencing socioeconomic disadvantage, immune activation can be a product of the chronic stress inherent to such environmental hardship. While growing preclinical and clinical evidence has shown links between altered neonatal brain development and increased inflammatory states in utero, the potential mechanism by which socioeconomic disadvantage differentially impacts neural-immune crosstalk remains unclear. In the current study, we investigated associations between socioeconomic disadvantage, gestational inflammation, and neonatal white matter microstructure in 320 mother-infant dyads over-sampled for poverty. We analyzed maternal serum levels of four cytokines (IL-6, IL-8, IL-10, TNF-α) over the course of pregnancy in relation to offspring white matter microstructure and socioeconomic disadvantage. Higher average maternal IL-6 was associated with very low socioeconomic status (SES; INR < 200% poverty line) and lower neonatal corticospinal fractional anisotropy (FA) and lower uncinate axial diffusivity (AD). No other cytokine was associated with SES. Higher average maternal IL-10 was associated with lower FA and higher radial diffusivity (RD) in corpus callosum and corticospinal tracts, higher optic radiation RD, lower uncinate AD, and lower FA in inferior fronto-occipital fasciculus and anterior limb of internal capsule tracts. SES moderated the relationship between average maternal TNF-α levels during gestation and neonatal white matter diffusivity. When these interactions were decomposed, the patterns indicated that this association was significant and positive among very low SES neonates, whereby TNF-α was inversely and significantly associated with inferior cingulum AD. By contrast, among the more advantaged neonates (lower-to-higher SES [INR ≥ 200% poverty line]), TNF-α was positively and significantly associated with superior cingulum AD. Taken together, these findings suggest that the relationship between prenatal cytokine exposure and white matter microstructure differs as a function of SES. These patterns are consistent with a scenario where gestational inflammation's effects on white matter development diverge depending on the availability of foundational resources in utero.
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Affiliation(s)
- Ashley F P Sanders
- Department of Psychiatry, Washington University School of Medicine, St. Louis, MO, 63110, USA.
| | - Brian Tirado
- Department of Psychiatry, Washington University School of Medicine, St. Louis, MO, 63110, USA
| | - Nicole A Seider
- Department of Neurology, Washington University School of Medicine, St. Louis, MO, 63110, USA
| | - Regina L Triplett
- Department of Neurology, Washington University School of Medicine, St. Louis, MO, 63110, USA
| | - Rachel E Lean
- Department of Psychiatry, Washington University School of Medicine, St. Louis, MO, 63110, USA
| | - Jeffrey J Neil
- Department of Neurology, Washington University School of Medicine, St. Louis, MO, 63110, USA
| | - J Philip Miller
- Division of Biostatistics, Institute for Informatics, Washington University School of Medicine, St. Louis, MO, 63110, USA
| | - Rebecca Tillman
- Department of Psychiatry, Washington University School of Medicine, St. Louis, MO, 63110, USA
| | - Tara A Smyser
- Department of Psychiatry, Washington University School of Medicine, St. Louis, MO, 63110, USA
| | - Deanna M Barch
- Department of Psychiatry, Washington University School of Medicine, St. Louis, MO, 63110, USA
- Department of Psychological and Brain Sciences, Washington University School of Medicine, St. Louis, MO, 63130, USA
| | - Joan L Luby
- Department of Psychiatry, Washington University School of Medicine, St. Louis, MO, 63110, USA
| | - Cynthia E Rogers
- Department of Psychiatry, Washington University School of Medicine, St. Louis, MO, 63110, USA
- Department of Pediatrics, Washington University School of Medicine, St. Louis, MO, 63110, USA
| | - Christopher D Smyser
- Department of Neurology, Washington University School of Medicine, St. Louis, MO, 63110, USA
- Department of Pediatrics, Washington University School of Medicine, St. Louis, MO, 63110, USA
- Department of Radiology, Washington University School of Medicine, St. Louis, MO, 63110, USA
| | - Barbara B Warner
- Department of Pediatrics, Washington University School of Medicine, St. Louis, MO, 63110, USA
- Newborn Medicine, Washington University School of Medicine, St. Louis, MO, 63110, USA
| | - Edith Chen
- Institute for Policy Research, Northwestern University, Evanston, IL, 60208, USA
- Department of Psychology, Northwestern University, Evanston, IL, 60208, USA
| | - Gregory E Miller
- Institute for Policy Research, Northwestern University, Evanston, IL, 60208, USA
- Department of Psychology, Northwestern University, Evanston, IL, 60208, USA
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11
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Kumpulainen V, Copeland A, Pulli EP, Silver E, Kataja EL, Saukko E, Merisaari H, Lewis JD, Karlsson L, Karlsson H, Tuulari JJ. Prenatal and Postnatal Maternal Depressive Symptoms Are Associated With White Matter Integrity in 5-Year-Olds in a Sex-Specific Manner. Biol Psychiatry 2023; 94:924-935. [PMID: 37220833 DOI: 10.1016/j.biopsych.2023.05.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/30/2022] [Revised: 04/18/2023] [Accepted: 05/14/2023] [Indexed: 05/25/2023]
Abstract
BACKGROUND Prenatal and postnatal maternal psychological distress predicts various detrimental consequences on social, behavioral, and cognitive development of offspring, especially in girls. Maturation of white matter (WM) continues from prenatal development into adulthood and is thus susceptible to exposures both before and after birth. METHODS WM microstructural features of 130 children (mean age, 5.36 years; range, 5.04-5.79 years; 63 girls) and their association with maternal prenatal and postnatal depressive and anxiety symptoms were investigated with diffusion tensor imaging, tract-based spatial statistics, and regression analyses. Maternal questionnaires were collected during first, second, and third trimesters and at 3, 6, and 12 months postpartum with the Edinburgh Postnatal Depression Scale (EPDS) for depressive symptoms and Symptom Checklist-90 for general anxiety. Covariates included child's sex; child's age; maternal prepregnancy body mass index; maternal age; socioeconomic status; and exposures to smoking, selective serotonin reuptake inhibitors, and synthetic glucocorticoids during pregnancy. RESULTS Prenatal second-trimester EPDS scores were positively associated with fractional anisotropy in boys (p < .05, 5000 permutations) after controlling for EPDS scores 3 months postpartum. In contrast, postpartum EPDS scores at 3 months correlated negatively with fractional anisotropy (p < .01, 5000 permutations) in widespread areas only in girls after controlling for prenatal second-trimester EPDS scores. Perinatal anxiety was not associated with WM structure. CONCLUSIONS These results suggest that prenatal and postnatal maternal psychological distress is associated with brain WM tract developmental alterations in a sex- and timing-dependent manner. Future studies including behavioral data are required to consolidate associative outcomes for these alterations.
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Affiliation(s)
- Venla Kumpulainen
- FinnBrain Birth Cohort Study, Turku Brain and Mind Center, Department of Clinical Medicine, University of Turku, Turku, Finland; Centre for Population Health Research, Turku University Hospital and University of Turku, Turku, Finland.
| | - Anni Copeland
- FinnBrain Birth Cohort Study, Turku Brain and Mind Center, Department of Clinical Medicine, University of Turku, Turku, Finland; Centre for Population Health Research, Turku University Hospital and University of Turku, Turku, Finland
| | - Elmo P Pulli
- FinnBrain Birth Cohort Study, Turku Brain and Mind Center, Department of Clinical Medicine, University of Turku, Turku, Finland; Centre for Population Health Research, Turku University Hospital and University of Turku, Turku, Finland
| | - Eero Silver
- FinnBrain Birth Cohort Study, Turku Brain and Mind Center, Department of Clinical Medicine, University of Turku, Turku, Finland; Centre for Population Health Research, Turku University Hospital and University of Turku, Turku, Finland
| | - Eeva-Leena Kataja
- FinnBrain Birth Cohort Study, Turku Brain and Mind Center, Department of Clinical Medicine, University of Turku, Turku, Finland; Centre for Population Health Research, Turku University Hospital and University of Turku, Turku, Finland
| | - Ekaterina Saukko
- Department of Radiology, Turku University Hospital, Turku, Finland
| | - Harri Merisaari
- FinnBrain Birth Cohort Study, Turku Brain and Mind Center, Department of Clinical Medicine, University of Turku, Turku, Finland; Centre for Population Health Research, Turku University Hospital and University of Turku, Turku, Finland; Department of Radiology, Turku University Hospital, Turku, Finland
| | - John D Lewis
- Montreal Neurological Institute, McGill University, Montreal, Canada
| | - Linnea Karlsson
- FinnBrain Birth Cohort Study, Turku Brain and Mind Center, Department of Clinical Medicine, University of Turku, Turku, Finland; Centre for Population Health Research, Turku University Hospital and University of Turku, Turku, Finland; Department of Clinical Medicine, Paediatrics and Adolescent Medicine, Turku University Hospital and University of Turku, Turku, Finland
| | - Hasse Karlsson
- FinnBrain Birth Cohort Study, Turku Brain and Mind Center, Department of Clinical Medicine, University of Turku, Turku, Finland; Centre for Population Health Research, Turku University Hospital and University of Turku, Turku, Finland; Department of Psychiatry, Turku University Hospital and University of Turku, Turku, Finland
| | - Jetro J Tuulari
- FinnBrain Birth Cohort Study, Turku Brain and Mind Center, Department of Clinical Medicine, University of Turku, Turku, Finland; Centre for Population Health Research, Turku University Hospital and University of Turku, Turku, Finland; Department of Psychiatry, Turku University Hospital and University of Turku, Turku, Finland; Turku Collegium for Science, Medicine and Technology, University of Turku, Turku, Finland; Department of Psychiatry, University of Oxford, Oxford, United Kingdom
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12
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Turk E, van den Heuvel MI, Sleurs C, Billiet T, Uyttebroeck A, Sunaert S, Mennes M, Van den Bergh BRH. Maternal anxiety during pregnancy is associated with weaker prefrontal functional connectivity in adult offspring. Brain Imaging Behav 2023; 17:595-607. [PMID: 37380807 PMCID: PMC10733226 DOI: 10.1007/s11682-023-00787-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/18/2023] [Indexed: 06/30/2023]
Abstract
BACKGROUND The connectome, constituting a unique fingerprint of a person's brain, may be influenced by its prenatal environment, potentially affecting later-life resilience and mental health. METHODS We conducted a prospective resting-state functional Magnetic Resonance Imaging study in 28-year-old offspring (N = 49) of mothers whose anxiety was monitored during pregnancy. Two offspring anxiety subgroups were defined: "High anxiety" (n = 13) group versus "low-to-medium anxiety" (n = 36) group, based on maternal self-reported state anxiety at 12-22 weeks of gestation. To predict resting-state functional connectivity of 32 by 32 ROIs, maternal state anxiety during pregnancy was included as a predictor in general linear models for both ROI-to-ROI and graph theoretical metrics. Sex, birth weight and postnatal anxiety were included as covariates. RESULTS Higher maternal anxiety was associated with weaker functional connectivity of medial prefrontal cortex with left inferior frontal gyrus (t = 3.45, pFDR < 0.05). Moreover, network-based statistics (NBS) confirmed our finding and revealed an additional association of weaker connectivity between left lateral prefontal cortex with left somatosensory motor gyrus in the offspring. While our results showed a general pattern of lower functional connectivity in adults prenatally exposed to maternal anxiety, we did not observe significant differences in global brain networks between groups. CONCLUSIONS Weaker (medial) prefrontal cortex functional connectivity in the high anxiety adult offspring group suggests a long-term negative impact of prenatal exposure to high maternal anxiety, extending into adulthood. To prevent mental health problems at population level, universal primary prevention strategies should aim at lowering maternal anxiety during pregnancy.
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Affiliation(s)
- Elise Turk
- Department of Cognitive Neuropsychology, Tilburg University, Warandelaan 2, 5037AB, Tilburg, The Netherlands.
| | - Marion I van den Heuvel
- Department of Cognitive Neuropsychology, Tilburg University, Warandelaan 2, 5037AB, Tilburg, The Netherlands
| | - Charlotte Sleurs
- Department of Cognitive Neuropsychology, Tilburg University, Warandelaan 2, 5037AB, Tilburg, The Netherlands
- Department of Oncology, Catholic University of Leuven, KU Leuven, Leuven, Belgium
| | | | - Anne Uyttebroeck
- Department of Oncology, Catholic University of Leuven, KU Leuven, Leuven, Belgium
| | | | - Maarten Mennes
- Donders Institute for Brain, Cognition and Behaviour, Radboud University Nijmegen, Nijmegen, The Netherlands
| | - Bea R H Van den Bergh
- Health Psychology Research Group, Catholic University of Leuven, KU Leuven, Leuven, Belgium
- Department of Welfare, Public Health and Family, Flemish Government, Brussels, Belgium
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13
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Ravi S, Catalina Camacho M, Fleming B, Scudder MR, Humphreys KL. Concurrent and prospective associations between infant frontoparietal and default mode network connectivity and negative affectivity. Biol Psychol 2023; 184:108717. [PMID: 37924936 PMCID: PMC10762930 DOI: 10.1016/j.biopsycho.2023.108717] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2023] [Revised: 10/27/2023] [Accepted: 10/31/2023] [Indexed: 11/06/2023]
Abstract
Emotion dysregulation is linked to differences in frontoparietal (FPN) and default mode (DMN) brain network functioning. These differences may be identifiable early in development. Temperamental negative affectivity has been identified as a precursor to later emotion dysregulation, though the underlying neurodevelopmental mechanism is unknown. The present study explores concurrent and prospective associations between FPN and DMN connectivity in infants and measures of negative affectivity. 72 infants underwent 5.03-13.28 min of resting state fMRI during natural sleep (M±SD age=4.90 ± 0.84 weeks; 54% male; usable data=9.92 ± 2.15 min). FPN and DMN intra- and internetwork connectivity were computed using adult network assignments. Crying was obtained from both parent-report and day-long audio recordings. Temperamental negative affectivity was obtained from a parent-report questionnaire. In this preregistered study, based on analyses conducted with a subset of this data (N = 32), we hypothesized that greater functional connectivity within and between FPN and DMN would be associated with greater negative affectivity. In the full sample we did not find support for these hypotheses. Instead, greater DMN intranetwork connectivity at age one month was associated with lower concurrent parent-reported crying and temperamental negative affectivity at age six months (ßs>-0.35, ps<.025), but not crying at age six months. DMN intranetwork connectivity was also negatively associated with internalizing symptoms at age eighteen-months (ß=-0.58, p = .012). FPN intra- and internetwork connectivity was not associated with negative affectivity measures after accounting for covariates. This work furthers a neurodevelopmental model of emotion dysregulation by suggesting that infant functional connectivity at rest is associated with later emotional functioning.
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Affiliation(s)
- Sanjana Ravi
- Vanderbilt University, 230 Appleton Place, #552, Nashville, TN 37204, USA.
| | - M Catalina Camacho
- Washington University in St. Louis, One Brookings Drive, Campus Box 1125, St. Louis, MO 63130, USA
| | - Brooke Fleming
- Vanderbilt University, 230 Appleton Place, #552, Nashville, TN 37204, USA
| | - Michael R Scudder
- Vanderbilt University, 230 Appleton Place, #552, Nashville, TN 37204, USA
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14
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Marr MC, Graham AM, Feczko E, Nolvi S, Thomas E, Sturgeon D, Schifsky E, Rasmussen JM, Gilmore JH, Styner M, Entringer S, Wadhwa PD, Korja R, Karlsson H, Karlsson L, Buss C, Fair DA. Maternal Perinatal Stress Trajectories and Negative Affect and Amygdala Development in Offspring. Am J Psychiatry 2023; 180:766-777. [PMID: 37670606 DOI: 10.1176/appi.ajp.21111176] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 09/07/2023]
Abstract
OBJECTIVE Maternal psychological stress during pregnancy is a common risk factor for psychiatric disorders in offspring, but little is known about how heterogeneity of stress trajectories during pregnancy affect brain systems and behavioral phenotypes in infancy. This study was designed to address this gap in knowledge. METHODS Maternal anxiety, stress, and depression were assessed at multiple time points during pregnancy in two independent low-risk mother-infant cohorts (N=115 and N=2,156). Trajectories in maternal stress levels in relation to infant negative affect were examined in both cohorts. Neonatal amygdala resting-state functional connectivity MRI was examined in a subset of one cohort (N=60) to explore the potential relationship between maternal stress trajectories and brain systems in infants relevant to negative affect. RESULTS Four distinct trajectory clusters, characterized by changing patterns of stress over time, and two magnitude clusters, characterized by severity of stress, were identified in the original mother-infant cohort (N=115). The magnitude clusters were not associated with infant outcomes. The trajectory characterized by increasing stress in late pregnancy was associated with blunted development of infant negative affect. This relationship was replicated in the second, larger cohort (N=2,156). In addition, the trajectories that included increasing or peak maternal stress in late pregnancy were related to stronger neonatal amygdala functional connectivity to the anterior insula and the ventromedial prefrontal cortex in the exploratory analysis. CONCLUSIONS The trajectory of maternal stress appears to be important for offspring brain and behavioral development. Understanding heterogeneity in trajectories of maternal stress and their influence on infant brain and behavioral development is critical to developing targeted interventions.
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Affiliation(s)
- Mollie C Marr
- Department of Behavioral Neuroscience (Marr, Graham, Sturgeon, Schifsky, Fair) and Department of Psychiatry (Graham, Fair), Oregon Health and Science University School of Medicine, Portland; Department of Psychiatry, Massachusetts General Hospital, Boston (Marr); Department of Psychiatry, McLean Hospital, Belmont, Mass. (Marr); Masonic Institute for the Developing Brain, Institute of Child Development (Fair), and Department of Pediatrics (Feczko, Fair), University of Minnesota, Minneapolis; Department of Psychology and Speech-Language Pathology, University of Turku, Turku, Finland (Nolvi, Korja); Institute of Medical Psychology, Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin (Nolvi, Entringer, Buss); Department of Neuroscience, Earlham College, Richmond, Ind. (Thomas); Development, Health, and Disease Research Program and Departments of Pediatrics, Psychiatry and Human Behavior, Obstetrics and Gynecology, and Epidemiology, University of California, Irvine, School of Medicine, Irvine (Rasmussen, Entringer, Wadhwa, Buss); Department of Pediatrics, University of California, Irvine, School of Medicine, Orange (Rasmussen, Entringer, Wadhwa, Buss); Departments of Psychiatry and Human Behavior (Entringer, Wadhwa), Obstetrics and Gynecology (Wadhwa), and Epidemiology (Wadhwa), University of California, Irvine, School of Medicine, Orange; FinnBrain Birth Cohort Study, Turku Brain and Mind Center, Department of Clinical Medicine, University of Turku (Korja, H. Karlsson, L. Karlsson); Centre for Population Health Research, University of Turku and Turku University Hospital (Korja, H. Karlsson, L. Karlsson); Department of Paediatrics and Adolescent Medicine (L. Karlsson) and Department of Psychiatry (H. Karlsson), Department of Clinical Medicine, Turku University Hospital and University of Turku; Department of Psychiatry, University of North Carolina at Chapel Hill School of Medicine, Chapel Hill (Gilmore); Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill (Styner)
| | - Alice M Graham
- Department of Behavioral Neuroscience (Marr, Graham, Sturgeon, Schifsky, Fair) and Department of Psychiatry (Graham, Fair), Oregon Health and Science University School of Medicine, Portland; Department of Psychiatry, Massachusetts General Hospital, Boston (Marr); Department of Psychiatry, McLean Hospital, Belmont, Mass. (Marr); Masonic Institute for the Developing Brain, Institute of Child Development (Fair), and Department of Pediatrics (Feczko, Fair), University of Minnesota, Minneapolis; Department of Psychology and Speech-Language Pathology, University of Turku, Turku, Finland (Nolvi, Korja); Institute of Medical Psychology, Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin (Nolvi, Entringer, Buss); Department of Neuroscience, Earlham College, Richmond, Ind. (Thomas); Development, Health, and Disease Research Program and Departments of Pediatrics, Psychiatry and Human Behavior, Obstetrics and Gynecology, and Epidemiology, University of California, Irvine, School of Medicine, Irvine (Rasmussen, Entringer, Wadhwa, Buss); Department of Pediatrics, University of California, Irvine, School of Medicine, Orange (Rasmussen, Entringer, Wadhwa, Buss); Departments of Psychiatry and Human Behavior (Entringer, Wadhwa), Obstetrics and Gynecology (Wadhwa), and Epidemiology (Wadhwa), University of California, Irvine, School of Medicine, Orange; FinnBrain Birth Cohort Study, Turku Brain and Mind Center, Department of Clinical Medicine, University of Turku (Korja, H. Karlsson, L. Karlsson); Centre for Population Health Research, University of Turku and Turku University Hospital (Korja, H. Karlsson, L. Karlsson); Department of Paediatrics and Adolescent Medicine (L. Karlsson) and Department of Psychiatry (H. Karlsson), Department of Clinical Medicine, Turku University Hospital and University of Turku; Department of Psychiatry, University of North Carolina at Chapel Hill School of Medicine, Chapel Hill (Gilmore); Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill (Styner)
| | - Eric Feczko
- Department of Behavioral Neuroscience (Marr, Graham, Sturgeon, Schifsky, Fair) and Department of Psychiatry (Graham, Fair), Oregon Health and Science University School of Medicine, Portland; Department of Psychiatry, Massachusetts General Hospital, Boston (Marr); Department of Psychiatry, McLean Hospital, Belmont, Mass. (Marr); Masonic Institute for the Developing Brain, Institute of Child Development (Fair), and Department of Pediatrics (Feczko, Fair), University of Minnesota, Minneapolis; Department of Psychology and Speech-Language Pathology, University of Turku, Turku, Finland (Nolvi, Korja); Institute of Medical Psychology, Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin (Nolvi, Entringer, Buss); Department of Neuroscience, Earlham College, Richmond, Ind. (Thomas); Development, Health, and Disease Research Program and Departments of Pediatrics, Psychiatry and Human Behavior, Obstetrics and Gynecology, and Epidemiology, University of California, Irvine, School of Medicine, Irvine (Rasmussen, Entringer, Wadhwa, Buss); Department of Pediatrics, University of California, Irvine, School of Medicine, Orange (Rasmussen, Entringer, Wadhwa, Buss); Departments of Psychiatry and Human Behavior (Entringer, Wadhwa), Obstetrics and Gynecology (Wadhwa), and Epidemiology (Wadhwa), University of California, Irvine, School of Medicine, Orange; FinnBrain Birth Cohort Study, Turku Brain and Mind Center, Department of Clinical Medicine, University of Turku (Korja, H. Karlsson, L. Karlsson); Centre for Population Health Research, University of Turku and Turku University Hospital (Korja, H. Karlsson, L. Karlsson); Department of Paediatrics and Adolescent Medicine (L. Karlsson) and Department of Psychiatry (H. Karlsson), Department of Clinical Medicine, Turku University Hospital and University of Turku; Department of Psychiatry, University of North Carolina at Chapel Hill School of Medicine, Chapel Hill (Gilmore); Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill (Styner)
| | - Saara Nolvi
- Department of Behavioral Neuroscience (Marr, Graham, Sturgeon, Schifsky, Fair) and Department of Psychiatry (Graham, Fair), Oregon Health and Science University School of Medicine, Portland; Department of Psychiatry, Massachusetts General Hospital, Boston (Marr); Department of Psychiatry, McLean Hospital, Belmont, Mass. (Marr); Masonic Institute for the Developing Brain, Institute of Child Development (Fair), and Department of Pediatrics (Feczko, Fair), University of Minnesota, Minneapolis; Department of Psychology and Speech-Language Pathology, University of Turku, Turku, Finland (Nolvi, Korja); Institute of Medical Psychology, Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin (Nolvi, Entringer, Buss); Department of Neuroscience, Earlham College, Richmond, Ind. (Thomas); Development, Health, and Disease Research Program and Departments of Pediatrics, Psychiatry and Human Behavior, Obstetrics and Gynecology, and Epidemiology, University of California, Irvine, School of Medicine, Irvine (Rasmussen, Entringer, Wadhwa, Buss); Department of Pediatrics, University of California, Irvine, School of Medicine, Orange (Rasmussen, Entringer, Wadhwa, Buss); Departments of Psychiatry and Human Behavior (Entringer, Wadhwa), Obstetrics and Gynecology (Wadhwa), and Epidemiology (Wadhwa), University of California, Irvine, School of Medicine, Orange; FinnBrain Birth Cohort Study, Turku Brain and Mind Center, Department of Clinical Medicine, University of Turku (Korja, H. Karlsson, L. Karlsson); Centre for Population Health Research, University of Turku and Turku University Hospital (Korja, H. Karlsson, L. Karlsson); Department of Paediatrics and Adolescent Medicine (L. Karlsson) and Department of Psychiatry (H. Karlsson), Department of Clinical Medicine, Turku University Hospital and University of Turku; Department of Psychiatry, University of North Carolina at Chapel Hill School of Medicine, Chapel Hill (Gilmore); Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill (Styner)
| | - Elina Thomas
- Department of Behavioral Neuroscience (Marr, Graham, Sturgeon, Schifsky, Fair) and Department of Psychiatry (Graham, Fair), Oregon Health and Science University School of Medicine, Portland; Department of Psychiatry, Massachusetts General Hospital, Boston (Marr); Department of Psychiatry, McLean Hospital, Belmont, Mass. (Marr); Masonic Institute for the Developing Brain, Institute of Child Development (Fair), and Department of Pediatrics (Feczko, Fair), University of Minnesota, Minneapolis; Department of Psychology and Speech-Language Pathology, University of Turku, Turku, Finland (Nolvi, Korja); Institute of Medical Psychology, Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin (Nolvi, Entringer, Buss); Department of Neuroscience, Earlham College, Richmond, Ind. (Thomas); Development, Health, and Disease Research Program and Departments of Pediatrics, Psychiatry and Human Behavior, Obstetrics and Gynecology, and Epidemiology, University of California, Irvine, School of Medicine, Irvine (Rasmussen, Entringer, Wadhwa, Buss); Department of Pediatrics, University of California, Irvine, School of Medicine, Orange (Rasmussen, Entringer, Wadhwa, Buss); Departments of Psychiatry and Human Behavior (Entringer, Wadhwa), Obstetrics and Gynecology (Wadhwa), and Epidemiology (Wadhwa), University of California, Irvine, School of Medicine, Orange; FinnBrain Birth Cohort Study, Turku Brain and Mind Center, Department of Clinical Medicine, University of Turku (Korja, H. Karlsson, L. Karlsson); Centre for Population Health Research, University of Turku and Turku University Hospital (Korja, H. Karlsson, L. Karlsson); Department of Paediatrics and Adolescent Medicine (L. Karlsson) and Department of Psychiatry (H. Karlsson), Department of Clinical Medicine, Turku University Hospital and University of Turku; Department of Psychiatry, University of North Carolina at Chapel Hill School of Medicine, Chapel Hill (Gilmore); Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill (Styner)
| | - Darrick Sturgeon
- Department of Behavioral Neuroscience (Marr, Graham, Sturgeon, Schifsky, Fair) and Department of Psychiatry (Graham, Fair), Oregon Health and Science University School of Medicine, Portland; Department of Psychiatry, Massachusetts General Hospital, Boston (Marr); Department of Psychiatry, McLean Hospital, Belmont, Mass. (Marr); Masonic Institute for the Developing Brain, Institute of Child Development (Fair), and Department of Pediatrics (Feczko, Fair), University of Minnesota, Minneapolis; Department of Psychology and Speech-Language Pathology, University of Turku, Turku, Finland (Nolvi, Korja); Institute of Medical Psychology, Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin (Nolvi, Entringer, Buss); Department of Neuroscience, Earlham College, Richmond, Ind. (Thomas); Development, Health, and Disease Research Program and Departments of Pediatrics, Psychiatry and Human Behavior, Obstetrics and Gynecology, and Epidemiology, University of California, Irvine, School of Medicine, Irvine (Rasmussen, Entringer, Wadhwa, Buss); Department of Pediatrics, University of California, Irvine, School of Medicine, Orange (Rasmussen, Entringer, Wadhwa, Buss); Departments of Psychiatry and Human Behavior (Entringer, Wadhwa), Obstetrics and Gynecology (Wadhwa), and Epidemiology (Wadhwa), University of California, Irvine, School of Medicine, Orange; FinnBrain Birth Cohort Study, Turku Brain and Mind Center, Department of Clinical Medicine, University of Turku (Korja, H. Karlsson, L. Karlsson); Centre for Population Health Research, University of Turku and Turku University Hospital (Korja, H. Karlsson, L. Karlsson); Department of Paediatrics and Adolescent Medicine (L. Karlsson) and Department of Psychiatry (H. Karlsson), Department of Clinical Medicine, Turku University Hospital and University of Turku; Department of Psychiatry, University of North Carolina at Chapel Hill School of Medicine, Chapel Hill (Gilmore); Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill (Styner)
| | - Emma Schifsky
- Department of Behavioral Neuroscience (Marr, Graham, Sturgeon, Schifsky, Fair) and Department of Psychiatry (Graham, Fair), Oregon Health and Science University School of Medicine, Portland; Department of Psychiatry, Massachusetts General Hospital, Boston (Marr); Department of Psychiatry, McLean Hospital, Belmont, Mass. (Marr); Masonic Institute for the Developing Brain, Institute of Child Development (Fair), and Department of Pediatrics (Feczko, Fair), University of Minnesota, Minneapolis; Department of Psychology and Speech-Language Pathology, University of Turku, Turku, Finland (Nolvi, Korja); Institute of Medical Psychology, Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin (Nolvi, Entringer, Buss); Department of Neuroscience, Earlham College, Richmond, Ind. (Thomas); Development, Health, and Disease Research Program and Departments of Pediatrics, Psychiatry and Human Behavior, Obstetrics and Gynecology, and Epidemiology, University of California, Irvine, School of Medicine, Irvine (Rasmussen, Entringer, Wadhwa, Buss); Department of Pediatrics, University of California, Irvine, School of Medicine, Orange (Rasmussen, Entringer, Wadhwa, Buss); Departments of Psychiatry and Human Behavior (Entringer, Wadhwa), Obstetrics and Gynecology (Wadhwa), and Epidemiology (Wadhwa), University of California, Irvine, School of Medicine, Orange; FinnBrain Birth Cohort Study, Turku Brain and Mind Center, Department of Clinical Medicine, University of Turku (Korja, H. Karlsson, L. Karlsson); Centre for Population Health Research, University of Turku and Turku University Hospital (Korja, H. Karlsson, L. Karlsson); Department of Paediatrics and Adolescent Medicine (L. Karlsson) and Department of Psychiatry (H. Karlsson), Department of Clinical Medicine, Turku University Hospital and University of Turku; Department of Psychiatry, University of North Carolina at Chapel Hill School of Medicine, Chapel Hill (Gilmore); Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill (Styner)
| | - Jerod M Rasmussen
- Department of Behavioral Neuroscience (Marr, Graham, Sturgeon, Schifsky, Fair) and Department of Psychiatry (Graham, Fair), Oregon Health and Science University School of Medicine, Portland; Department of Psychiatry, Massachusetts General Hospital, Boston (Marr); Department of Psychiatry, McLean Hospital, Belmont, Mass. (Marr); Masonic Institute for the Developing Brain, Institute of Child Development (Fair), and Department of Pediatrics (Feczko, Fair), University of Minnesota, Minneapolis; Department of Psychology and Speech-Language Pathology, University of Turku, Turku, Finland (Nolvi, Korja); Institute of Medical Psychology, Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin (Nolvi, Entringer, Buss); Department of Neuroscience, Earlham College, Richmond, Ind. (Thomas); Development, Health, and Disease Research Program and Departments of Pediatrics, Psychiatry and Human Behavior, Obstetrics and Gynecology, and Epidemiology, University of California, Irvine, School of Medicine, Irvine (Rasmussen, Entringer, Wadhwa, Buss); Department of Pediatrics, University of California, Irvine, School of Medicine, Orange (Rasmussen, Entringer, Wadhwa, Buss); Departments of Psychiatry and Human Behavior (Entringer, Wadhwa), Obstetrics and Gynecology (Wadhwa), and Epidemiology (Wadhwa), University of California, Irvine, School of Medicine, Orange; FinnBrain Birth Cohort Study, Turku Brain and Mind Center, Department of Clinical Medicine, University of Turku (Korja, H. Karlsson, L. Karlsson); Centre for Population Health Research, University of Turku and Turku University Hospital (Korja, H. Karlsson, L. Karlsson); Department of Paediatrics and Adolescent Medicine (L. Karlsson) and Department of Psychiatry (H. Karlsson), Department of Clinical Medicine, Turku University Hospital and University of Turku; Department of Psychiatry, University of North Carolina at Chapel Hill School of Medicine, Chapel Hill (Gilmore); Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill (Styner)
| | - John H Gilmore
- Department of Behavioral Neuroscience (Marr, Graham, Sturgeon, Schifsky, Fair) and Department of Psychiatry (Graham, Fair), Oregon Health and Science University School of Medicine, Portland; Department of Psychiatry, Massachusetts General Hospital, Boston (Marr); Department of Psychiatry, McLean Hospital, Belmont, Mass. (Marr); Masonic Institute for the Developing Brain, Institute of Child Development (Fair), and Department of Pediatrics (Feczko, Fair), University of Minnesota, Minneapolis; Department of Psychology and Speech-Language Pathology, University of Turku, Turku, Finland (Nolvi, Korja); Institute of Medical Psychology, Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin (Nolvi, Entringer, Buss); Department of Neuroscience, Earlham College, Richmond, Ind. (Thomas); Development, Health, and Disease Research Program and Departments of Pediatrics, Psychiatry and Human Behavior, Obstetrics and Gynecology, and Epidemiology, University of California, Irvine, School of Medicine, Irvine (Rasmussen, Entringer, Wadhwa, Buss); Department of Pediatrics, University of California, Irvine, School of Medicine, Orange (Rasmussen, Entringer, Wadhwa, Buss); Departments of Psychiatry and Human Behavior (Entringer, Wadhwa), Obstetrics and Gynecology (Wadhwa), and Epidemiology (Wadhwa), University of California, Irvine, School of Medicine, Orange; FinnBrain Birth Cohort Study, Turku Brain and Mind Center, Department of Clinical Medicine, University of Turku (Korja, H. Karlsson, L. Karlsson); Centre for Population Health Research, University of Turku and Turku University Hospital (Korja, H. Karlsson, L. Karlsson); Department of Paediatrics and Adolescent Medicine (L. Karlsson) and Department of Psychiatry (H. Karlsson), Department of Clinical Medicine, Turku University Hospital and University of Turku; Department of Psychiatry, University of North Carolina at Chapel Hill School of Medicine, Chapel Hill (Gilmore); Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill (Styner)
| | - Martin Styner
- Department of Behavioral Neuroscience (Marr, Graham, Sturgeon, Schifsky, Fair) and Department of Psychiatry (Graham, Fair), Oregon Health and Science University School of Medicine, Portland; Department of Psychiatry, Massachusetts General Hospital, Boston (Marr); Department of Psychiatry, McLean Hospital, Belmont, Mass. (Marr); Masonic Institute for the Developing Brain, Institute of Child Development (Fair), and Department of Pediatrics (Feczko, Fair), University of Minnesota, Minneapolis; Department of Psychology and Speech-Language Pathology, University of Turku, Turku, Finland (Nolvi, Korja); Institute of Medical Psychology, Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin (Nolvi, Entringer, Buss); Department of Neuroscience, Earlham College, Richmond, Ind. (Thomas); Development, Health, and Disease Research Program and Departments of Pediatrics, Psychiatry and Human Behavior, Obstetrics and Gynecology, and Epidemiology, University of California, Irvine, School of Medicine, Irvine (Rasmussen, Entringer, Wadhwa, Buss); Department of Pediatrics, University of California, Irvine, School of Medicine, Orange (Rasmussen, Entringer, Wadhwa, Buss); Departments of Psychiatry and Human Behavior (Entringer, Wadhwa), Obstetrics and Gynecology (Wadhwa), and Epidemiology (Wadhwa), University of California, Irvine, School of Medicine, Orange; FinnBrain Birth Cohort Study, Turku Brain and Mind Center, Department of Clinical Medicine, University of Turku (Korja, H. Karlsson, L. Karlsson); Centre for Population Health Research, University of Turku and Turku University Hospital (Korja, H. Karlsson, L. Karlsson); Department of Paediatrics and Adolescent Medicine (L. Karlsson) and Department of Psychiatry (H. Karlsson), Department of Clinical Medicine, Turku University Hospital and University of Turku; Department of Psychiatry, University of North Carolina at Chapel Hill School of Medicine, Chapel Hill (Gilmore); Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill (Styner)
| | - Sonja Entringer
- Department of Behavioral Neuroscience (Marr, Graham, Sturgeon, Schifsky, Fair) and Department of Psychiatry (Graham, Fair), Oregon Health and Science University School of Medicine, Portland; Department of Psychiatry, Massachusetts General Hospital, Boston (Marr); Department of Psychiatry, McLean Hospital, Belmont, Mass. (Marr); Masonic Institute for the Developing Brain, Institute of Child Development (Fair), and Department of Pediatrics (Feczko, Fair), University of Minnesota, Minneapolis; Department of Psychology and Speech-Language Pathology, University of Turku, Turku, Finland (Nolvi, Korja); Institute of Medical Psychology, Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin (Nolvi, Entringer, Buss); Department of Neuroscience, Earlham College, Richmond, Ind. (Thomas); Development, Health, and Disease Research Program and Departments of Pediatrics, Psychiatry and Human Behavior, Obstetrics and Gynecology, and Epidemiology, University of California, Irvine, School of Medicine, Irvine (Rasmussen, Entringer, Wadhwa, Buss); Department of Pediatrics, University of California, Irvine, School of Medicine, Orange (Rasmussen, Entringer, Wadhwa, Buss); Departments of Psychiatry and Human Behavior (Entringer, Wadhwa), Obstetrics and Gynecology (Wadhwa), and Epidemiology (Wadhwa), University of California, Irvine, School of Medicine, Orange; FinnBrain Birth Cohort Study, Turku Brain and Mind Center, Department of Clinical Medicine, University of Turku (Korja, H. Karlsson, L. Karlsson); Centre for Population Health Research, University of Turku and Turku University Hospital (Korja, H. Karlsson, L. Karlsson); Department of Paediatrics and Adolescent Medicine (L. Karlsson) and Department of Psychiatry (H. Karlsson), Department of Clinical Medicine, Turku University Hospital and University of Turku; Department of Psychiatry, University of North Carolina at Chapel Hill School of Medicine, Chapel Hill (Gilmore); Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill (Styner)
| | - Pathik D Wadhwa
- Department of Behavioral Neuroscience (Marr, Graham, Sturgeon, Schifsky, Fair) and Department of Psychiatry (Graham, Fair), Oregon Health and Science University School of Medicine, Portland; Department of Psychiatry, Massachusetts General Hospital, Boston (Marr); Department of Psychiatry, McLean Hospital, Belmont, Mass. (Marr); Masonic Institute for the Developing Brain, Institute of Child Development (Fair), and Department of Pediatrics (Feczko, Fair), University of Minnesota, Minneapolis; Department of Psychology and Speech-Language Pathology, University of Turku, Turku, Finland (Nolvi, Korja); Institute of Medical Psychology, Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin (Nolvi, Entringer, Buss); Department of Neuroscience, Earlham College, Richmond, Ind. (Thomas); Development, Health, and Disease Research Program and Departments of Pediatrics, Psychiatry and Human Behavior, Obstetrics and Gynecology, and Epidemiology, University of California, Irvine, School of Medicine, Irvine (Rasmussen, Entringer, Wadhwa, Buss); Department of Pediatrics, University of California, Irvine, School of Medicine, Orange (Rasmussen, Entringer, Wadhwa, Buss); Departments of Psychiatry and Human Behavior (Entringer, Wadhwa), Obstetrics and Gynecology (Wadhwa), and Epidemiology (Wadhwa), University of California, Irvine, School of Medicine, Orange; FinnBrain Birth Cohort Study, Turku Brain and Mind Center, Department of Clinical Medicine, University of Turku (Korja, H. Karlsson, L. Karlsson); Centre for Population Health Research, University of Turku and Turku University Hospital (Korja, H. Karlsson, L. Karlsson); Department of Paediatrics and Adolescent Medicine (L. Karlsson) and Department of Psychiatry (H. Karlsson), Department of Clinical Medicine, Turku University Hospital and University of Turku; Department of Psychiatry, University of North Carolina at Chapel Hill School of Medicine, Chapel Hill (Gilmore); Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill (Styner)
| | - Riikka Korja
- Department of Behavioral Neuroscience (Marr, Graham, Sturgeon, Schifsky, Fair) and Department of Psychiatry (Graham, Fair), Oregon Health and Science University School of Medicine, Portland; Department of Psychiatry, Massachusetts General Hospital, Boston (Marr); Department of Psychiatry, McLean Hospital, Belmont, Mass. (Marr); Masonic Institute for the Developing Brain, Institute of Child Development (Fair), and Department of Pediatrics (Feczko, Fair), University of Minnesota, Minneapolis; Department of Psychology and Speech-Language Pathology, University of Turku, Turku, Finland (Nolvi, Korja); Institute of Medical Psychology, Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin (Nolvi, Entringer, Buss); Department of Neuroscience, Earlham College, Richmond, Ind. (Thomas); Development, Health, and Disease Research Program and Departments of Pediatrics, Psychiatry and Human Behavior, Obstetrics and Gynecology, and Epidemiology, University of California, Irvine, School of Medicine, Irvine (Rasmussen, Entringer, Wadhwa, Buss); Department of Pediatrics, University of California, Irvine, School of Medicine, Orange (Rasmussen, Entringer, Wadhwa, Buss); Departments of Psychiatry and Human Behavior (Entringer, Wadhwa), Obstetrics and Gynecology (Wadhwa), and Epidemiology (Wadhwa), University of California, Irvine, School of Medicine, Orange; FinnBrain Birth Cohort Study, Turku Brain and Mind Center, Department of Clinical Medicine, University of Turku (Korja, H. Karlsson, L. Karlsson); Centre for Population Health Research, University of Turku and Turku University Hospital (Korja, H. Karlsson, L. Karlsson); Department of Paediatrics and Adolescent Medicine (L. Karlsson) and Department of Psychiatry (H. Karlsson), Department of Clinical Medicine, Turku University Hospital and University of Turku; Department of Psychiatry, University of North Carolina at Chapel Hill School of Medicine, Chapel Hill (Gilmore); Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill (Styner)
| | - Hasse Karlsson
- Department of Behavioral Neuroscience (Marr, Graham, Sturgeon, Schifsky, Fair) and Department of Psychiatry (Graham, Fair), Oregon Health and Science University School of Medicine, Portland; Department of Psychiatry, Massachusetts General Hospital, Boston (Marr); Department of Psychiatry, McLean Hospital, Belmont, Mass. (Marr); Masonic Institute for the Developing Brain, Institute of Child Development (Fair), and Department of Pediatrics (Feczko, Fair), University of Minnesota, Minneapolis; Department of Psychology and Speech-Language Pathology, University of Turku, Turku, Finland (Nolvi, Korja); Institute of Medical Psychology, Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin (Nolvi, Entringer, Buss); Department of Neuroscience, Earlham College, Richmond, Ind. (Thomas); Development, Health, and Disease Research Program and Departments of Pediatrics, Psychiatry and Human Behavior, Obstetrics and Gynecology, and Epidemiology, University of California, Irvine, School of Medicine, Irvine (Rasmussen, Entringer, Wadhwa, Buss); Department of Pediatrics, University of California, Irvine, School of Medicine, Orange (Rasmussen, Entringer, Wadhwa, Buss); Departments of Psychiatry and Human Behavior (Entringer, Wadhwa), Obstetrics and Gynecology (Wadhwa), and Epidemiology (Wadhwa), University of California, Irvine, School of Medicine, Orange; FinnBrain Birth Cohort Study, Turku Brain and Mind Center, Department of Clinical Medicine, University of Turku (Korja, H. Karlsson, L. Karlsson); Centre for Population Health Research, University of Turku and Turku University Hospital (Korja, H. Karlsson, L. Karlsson); Department of Paediatrics and Adolescent Medicine (L. Karlsson) and Department of Psychiatry (H. Karlsson), Department of Clinical Medicine, Turku University Hospital and University of Turku; Department of Psychiatry, University of North Carolina at Chapel Hill School of Medicine, Chapel Hill (Gilmore); Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill (Styner)
| | - Linnea Karlsson
- Department of Behavioral Neuroscience (Marr, Graham, Sturgeon, Schifsky, Fair) and Department of Psychiatry (Graham, Fair), Oregon Health and Science University School of Medicine, Portland; Department of Psychiatry, Massachusetts General Hospital, Boston (Marr); Department of Psychiatry, McLean Hospital, Belmont, Mass. (Marr); Masonic Institute for the Developing Brain, Institute of Child Development (Fair), and Department of Pediatrics (Feczko, Fair), University of Minnesota, Minneapolis; Department of Psychology and Speech-Language Pathology, University of Turku, Turku, Finland (Nolvi, Korja); Institute of Medical Psychology, Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin (Nolvi, Entringer, Buss); Department of Neuroscience, Earlham College, Richmond, Ind. (Thomas); Development, Health, and Disease Research Program and Departments of Pediatrics, Psychiatry and Human Behavior, Obstetrics and Gynecology, and Epidemiology, University of California, Irvine, School of Medicine, Irvine (Rasmussen, Entringer, Wadhwa, Buss); Department of Pediatrics, University of California, Irvine, School of Medicine, Orange (Rasmussen, Entringer, Wadhwa, Buss); Departments of Psychiatry and Human Behavior (Entringer, Wadhwa), Obstetrics and Gynecology (Wadhwa), and Epidemiology (Wadhwa), University of California, Irvine, School of Medicine, Orange; FinnBrain Birth Cohort Study, Turku Brain and Mind Center, Department of Clinical Medicine, University of Turku (Korja, H. Karlsson, L. Karlsson); Centre for Population Health Research, University of Turku and Turku University Hospital (Korja, H. Karlsson, L. Karlsson); Department of Paediatrics and Adolescent Medicine (L. Karlsson) and Department of Psychiatry (H. Karlsson), Department of Clinical Medicine, Turku University Hospital and University of Turku; Department of Psychiatry, University of North Carolina at Chapel Hill School of Medicine, Chapel Hill (Gilmore); Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill (Styner)
| | - Claudia Buss
- Department of Behavioral Neuroscience (Marr, Graham, Sturgeon, Schifsky, Fair) and Department of Psychiatry (Graham, Fair), Oregon Health and Science University School of Medicine, Portland; Department of Psychiatry, Massachusetts General Hospital, Boston (Marr); Department of Psychiatry, McLean Hospital, Belmont, Mass. (Marr); Masonic Institute for the Developing Brain, Institute of Child Development (Fair), and Department of Pediatrics (Feczko, Fair), University of Minnesota, Minneapolis; Department of Psychology and Speech-Language Pathology, University of Turku, Turku, Finland (Nolvi, Korja); Institute of Medical Psychology, Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin (Nolvi, Entringer, Buss); Department of Neuroscience, Earlham College, Richmond, Ind. (Thomas); Development, Health, and Disease Research Program and Departments of Pediatrics, Psychiatry and Human Behavior, Obstetrics and Gynecology, and Epidemiology, University of California, Irvine, School of Medicine, Irvine (Rasmussen, Entringer, Wadhwa, Buss); Department of Pediatrics, University of California, Irvine, School of Medicine, Orange (Rasmussen, Entringer, Wadhwa, Buss); Departments of Psychiatry and Human Behavior (Entringer, Wadhwa), Obstetrics and Gynecology (Wadhwa), and Epidemiology (Wadhwa), University of California, Irvine, School of Medicine, Orange; FinnBrain Birth Cohort Study, Turku Brain and Mind Center, Department of Clinical Medicine, University of Turku (Korja, H. Karlsson, L. Karlsson); Centre for Population Health Research, University of Turku and Turku University Hospital (Korja, H. Karlsson, L. Karlsson); Department of Paediatrics and Adolescent Medicine (L. Karlsson) and Department of Psychiatry (H. Karlsson), Department of Clinical Medicine, Turku University Hospital and University of Turku; Department of Psychiatry, University of North Carolina at Chapel Hill School of Medicine, Chapel Hill (Gilmore); Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill (Styner)
| | - Damien A Fair
- Department of Behavioral Neuroscience (Marr, Graham, Sturgeon, Schifsky, Fair) and Department of Psychiatry (Graham, Fair), Oregon Health and Science University School of Medicine, Portland; Department of Psychiatry, Massachusetts General Hospital, Boston (Marr); Department of Psychiatry, McLean Hospital, Belmont, Mass. (Marr); Masonic Institute for the Developing Brain, Institute of Child Development (Fair), and Department of Pediatrics (Feczko, Fair), University of Minnesota, Minneapolis; Department of Psychology and Speech-Language Pathology, University of Turku, Turku, Finland (Nolvi, Korja); Institute of Medical Psychology, Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin (Nolvi, Entringer, Buss); Department of Neuroscience, Earlham College, Richmond, Ind. (Thomas); Development, Health, and Disease Research Program and Departments of Pediatrics, Psychiatry and Human Behavior, Obstetrics and Gynecology, and Epidemiology, University of California, Irvine, School of Medicine, Irvine (Rasmussen, Entringer, Wadhwa, Buss); Department of Pediatrics, University of California, Irvine, School of Medicine, Orange (Rasmussen, Entringer, Wadhwa, Buss); Departments of Psychiatry and Human Behavior (Entringer, Wadhwa), Obstetrics and Gynecology (Wadhwa), and Epidemiology (Wadhwa), University of California, Irvine, School of Medicine, Orange; FinnBrain Birth Cohort Study, Turku Brain and Mind Center, Department of Clinical Medicine, University of Turku (Korja, H. Karlsson, L. Karlsson); Centre for Population Health Research, University of Turku and Turku University Hospital (Korja, H. Karlsson, L. Karlsson); Department of Paediatrics and Adolescent Medicine (L. Karlsson) and Department of Psychiatry (H. Karlsson), Department of Clinical Medicine, Turku University Hospital and University of Turku; Department of Psychiatry, University of North Carolina at Chapel Hill School of Medicine, Chapel Hill (Gilmore); Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill (Styner)
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15
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De Asis-Cruz J, Kim JH, Krishnamurthy D, Lopez C, Kapse K, Andescavage N, Vezina G, Limperopoulos C. Examining the relationship between fetal cortical thickness, gestational age, and maternal psychological distress. Dev Cogn Neurosci 2023; 63:101282. [PMID: 37515833 PMCID: PMC10407290 DOI: 10.1016/j.dcn.2023.101282] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2022] [Revised: 07/18/2023] [Accepted: 07/19/2023] [Indexed: 07/31/2023] Open
Abstract
In utero exposure to maternal stress, anxiety, and depression has been associated with reduced cortical thickness (CT), and CT changes, in turn, to adverse neuropsychiatric outcomes. Here, we investigated global and regional (G/RCT) changes associated with fetal exposure to maternal psychological distress in 265 brain MRI studies from 177 healthy fetuses of low-risk pregnant women. GCT was measured from cortical gray matter (CGM) voxels; RCT was estimated from 82 cortical regions. GCT and RCT in 87% of regions strongly correlated with GA. Fetal exposure was most strongly associated with RCT in the parahippocampal region, ventromedial prefrontal cortex, and supramarginal gyrus suggesting that cortical alterations commonly associated with prenatal exposure could emerge in-utero. However, we note that while regional fetal brain involvement conformed to patterns observed in newborns and children exposed to prenatal maternal psychological distress, the reported associations did not survive multiple comparisons correction. This could be because the effects are more subtle in this early developmental window or because majority of the pregnant women in our study did not experience high levels of maternal distress. It is our hope that the current findings will spur future hypothesis-driven studies that include a full spectrum of maternal mental health scores.
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Affiliation(s)
| | - Jung-Hoon Kim
- Developing Brain Institute, Children's National, Washington, DC, USA
| | | | - Catherine Lopez
- Developing Brain Institute, Children's National, Washington, DC, USA
| | - Kushal Kapse
- Developing Brain Institute, Children's National, Washington, DC, USA
| | - Nickie Andescavage
- Developing Brain Institute, Children's National, Washington, DC, USA; Division of Neonatology, Children's National Medical Center, Washington, DC, USA
| | - Gilbert Vezina
- Division of Diagnostic Imaging and Radiology, Children's National, Washington, DC, USA
| | - Catherine Limperopoulos
- Developing Brain Institute, Children's National, Washington, DC, USA; Division of Diagnostic Imaging and Radiology, Children's National, Washington, DC, USA.
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16
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Lee VV, Vijayakumar S, Ng WY, Lau NY, Leong QY, Ooi DSQ, Su LL, Lee YS, Chan SY, Blasiak A, Ho D. Personalization and localization as key expectations of digital health intervention in women pre- to post-pregnancy. NPJ Digit Med 2023; 6:183. [PMID: 37775533 PMCID: PMC10541409 DOI: 10.1038/s41746-023-00924-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2023] [Accepted: 09/20/2023] [Indexed: 10/01/2023] Open
Abstract
Health behaviors before, during and after pregnancy can have lasting effects on maternal and infant health outcomes. Although digital health interventions (DHIs) have potential as a pertinent avenue to deliver mechanisms for a healthy behavior change, its success is reliant on addressing the user needs. Accordingly, the current study aimed to understand DHI needs and expectations of women before, during and after pregnancy to inform and optimize future DHI developments. Forty-four women (13 pre-, 16 during and 15 postpregnancy; age range = 21-40 years) completed a 60-minute, semistructured, qualitative interview exploring participant's experience in their current phase, experience with digital health tools, and their needs and expectations of DHIs. Interviews were audio-recorded, transcribed verbatim and thematically analyzed. From the interviews, two core concepts emerged-personalization and localization of DHI. Between both concepts, five themes and nine subthemes were identified. Themes and subthemes within personalization cover ideas of two-way interactivity, journey organization based on phases and circumstances, and privacy trade-off. Themes and subthemes within localization cover ideas of access to local health-related resources and information, and connecting to local communities through anecdotal stories. Here we report, through understanding user needs and expectations, the key elements for the development and optimization of a successful DHI for women before, during and after pregnancy. To potentially empower downstream DHI implementation and adoption, these insights can serve as a foundation in the initial innovation process for DHI developers and be further built upon through a continued co-design process.
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Affiliation(s)
- V Vien Lee
- The Institute for Digital Medicine (WisDM), Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore.
- The N.1 Institute for Health, National University of Singapore, Singapore, Singapore.
| | - Smrithi Vijayakumar
- The Institute for Digital Medicine (WisDM), Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
- The N.1 Institute for Health, National University of Singapore, Singapore, Singapore
| | - Wei Ying Ng
- The Institute for Digital Medicine (WisDM), Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
- The N.1 Institute for Health, National University of Singapore, Singapore, Singapore
| | - Ni Yin Lau
- The Institute for Digital Medicine (WisDM), Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
- The N.1 Institute for Health, National University of Singapore, Singapore, Singapore
| | - Qiao Ying Leong
- The Institute for Digital Medicine (WisDM), Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
- The N.1 Institute for Health, National University of Singapore, Singapore, Singapore
| | - Delicia Shu Qin Ooi
- Department of Paediatrics, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
- Division of Paediatric Endocrinology, Department of Paediatrics, Khoo Teck Puat-National University Children's Medical Institute, National University Hospital, National University Health System, Singapore, Singapore
| | - Lin Lin Su
- Department of Obstetrics & Gynaecology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
- Department of Obstetrics & Gynaecology, National University Hospital, Singapore, Singapore
| | - Yung Seng Lee
- Department of Paediatrics, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore.
- Division of Paediatric Endocrinology, Department of Paediatrics, Khoo Teck Puat-National University Children's Medical Institute, National University Hospital, National University Health System, Singapore, Singapore.
| | - Shiao-Yng Chan
- Department of Obstetrics & Gynaecology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore.
- Department of Obstetrics & Gynaecology, National University Hospital, Singapore, Singapore.
- Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research (A*STAR), Singapore, Singapore.
| | - Agata Blasiak
- The Institute for Digital Medicine (WisDM), Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore.
- The N.1 Institute for Health, National University of Singapore, Singapore, Singapore.
- Department of Biomedical Engineering, College of Design and Engineering, National University of Singapore, Singapore, Singapore.
- Department of Pharmacology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore.
| | - Dean Ho
- The Institute for Digital Medicine (WisDM), Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore.
- The N.1 Institute for Health, National University of Singapore, Singapore, Singapore.
- Department of Biomedical Engineering, College of Design and Engineering, National University of Singapore, Singapore, Singapore.
- Department of Pharmacology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore.
- The Bia-Echo Asia Centre for Reproductive Longevity and Equality, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore.
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17
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Ghosh S, Salan T, Riotti J, Ramachandran A, Gonzalez IA, Bandstra ES, Reyes FL, Andreansky SS, Govind V, Saigal G. Brain MRI segmentation of Zika-Exposed normocephalic infants shows smaller amygdala volumes. PLoS One 2023; 18:e0289227. [PMID: 37506075 PMCID: PMC10381087 DOI: 10.1371/journal.pone.0289227] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2023] [Accepted: 07/13/2023] [Indexed: 07/30/2023] Open
Abstract
BACKGROUND Infants with congenital Zika syndrome (CZS) are known to exhibit characteristic brain abnormalities. However, the brain anatomy of Zika virus (ZIKV)-exposed infants, born to ZIKV-positive pregnant mothers, who have normal-appearing head characteristics at birth, has not been evaluated in detail. The aim of this prospective study is, therefore, to compare the cortical and subcortical brain structural volume measures of ZIKV-exposed normocephalic infants to age-matched healthy controls. METHODS AND FINDINGS We acquired T2-MRI of the whole brain of 18 ZIKV-exposed infants and 8 normal controls on a 3T MRI scanner. The MR images were auto-segmented into eight tissue types and anatomical regions including the white matter, cortical grey matter, deep nuclear grey matter, corticospinal fluid, amygdala, hippocampus, cerebellum, and brainstem. We determined the volumes of these regions and calculated the total intracranial volume (TICV) and head circumference (HC). We compared these measurements between the two groups, controlling for infant age at scan, by first comparing results for all subjects in each group and secondly performing a subgroup analysis for subjects below 8 weeks of postnatal age at scan. ZIKV-exposed infants demonstrated a significant decrease in amygdala volume compared to the control group in both the group and subgroup comparisons (p<0.05, corrected for multiple comparisons using FDR). No significant volume differences were observed in TICV, HC, or any specific brain tissue structures or regions. Study limitations include small sample size, which was due to abrupt cessation of extramural funding as the ZIKV epidemic waned. CONCLUSION ZIKV-exposed infants exhibited smaller volumes in the amygdala, a brain region primarily involved in emotional and behavioral processing. This brain MRI finding may lead to poorer behavioral outcomes and warrants long-term monitoring of pediatric cases of infants with gestational exposure to Zika virus as well as other neurotropic viruses.
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Affiliation(s)
- Shanchita Ghosh
- Department of Radiology, University of California Davis, Sacramento, California, United States of America
| | - Teddy Salan
- Department of Radiology, Miller School of Medicine, University of Miami, Miami, Florida, United States of America
| | - Jessica Riotti
- Department of Radiology, Jackson Memorial Hospital, Miami, Florida, United States of America
| | - Amrutha Ramachandran
- Department of Radiology and Biomedical Imaging, University of California San Francisco, San Francisco, California, United States of America
| | - Ivan A Gonzalez
- Division of Pediatric Infectious Diseases, Department of Pediatrics, Miller School of Medicine, University of Miami, Miami, Florida, United States of America
| | - Emmalee S Bandstra
- Division of Neonatology, Department of Pediatrics, Miller School of Medicine, University of Miami, Miami, Florida, United States of America
| | - Fiama L Reyes
- Sylvester Comprehensive Cancer Center, Miller School of Medicine, University of Miami, Miami, Florida, United States of America
| | - Samita S Andreansky
- Sylvester Comprehensive Cancer Center, Miller School of Medicine, University of Miami, Miami, Florida, United States of America
| | - Varan Govind
- Department of Radiology, Miller School of Medicine, University of Miami, Miami, Florida, United States of America
| | - Gaurav Saigal
- Department of Radiology, Miller School of Medicine, University of Miami, Miami, Florida, United States of America
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18
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Delaney SW, Xerxa Y, Muetzel RL, White T, Haneuse S, Ressler KJ, Tiemeier H, Kubzansky LD. Long-term associations between early-life family functioning and preadolescent white matter microstructure. Psychol Med 2023; 53:4528-4538. [PMID: 35611817 PMCID: PMC10388303 DOI: 10.1017/s0033291722001404] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/12/2021] [Revised: 04/14/2022] [Accepted: 04/27/2022] [Indexed: 11/06/2022]
Abstract
BACKGROUND Causes of childhood behavior problems remain poorly understood. Enriched family environments and corresponding brain development may reduce the risk of their onset, but research investigating white matter neurodevelopmental pathways explaining associations between the family environment and behavior remains limited. We hypothesized that more positive prenatal and mid-childhood family functioning - a measure of a family's problem solving and supportive capacity - would be associated with two markers of preadolescent white matter neurodevelopment related to reduced behavior problems: higher global fractional anisotropy (FA) and lower global mean diffusivity (MD). METHODS Data are from 2727 families in the Generation R Study, the Netherlands. Mothers reported family functioning (McMaster Family Assessment Device, range 1-4, higher scores indicate healthier functioning) prenatally and in mid-childhood (mean age 6.1 years). In preadolescence (mean age 10.1), the study collected diffusion-weighted scans. We computed standardized global MD and FA values by averaging metrics from 27 white matter tracts, and we fit linear models adjusting for possible confounders to examine global and tract-specific outcomes. RESULTS Prenatal and mid-childhood family functioning scores were moderately correlated, r = 0.38. However, only prenatal family functioning - and not mid-childhood functioning - was associated with higher global FA and lower global MD in preadolescence in fully adjusted models: βglobal FA = 0.11 (95% CI 0.00, 0.21) and βglobal MD = -0.15 (95% CI -0.28, -0.03) per one-unit increase in functioning score. Sensitivity and tract-specific analyses supported these global findings. CONCLUSIONS These results suggest high-functioning prenatal or perinatal family environments may confer lasting white matter neurodevelopmental benefits into preadolescence.
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Affiliation(s)
- Scott W. Delaney
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, MA USA
- Department of Child and Adolescent Psychiatry, Erasmus University Medical Center, Rotterdam, the Netherlands
- Lee Kum Sheung Center for Health and Happiness, Harvard T.H. Chan School of Public Health, Boston, MA USA
| | - Yllza Xerxa
- Department of Child and Adolescent Psychiatry, Erasmus University Medical Center, Rotterdam, the Netherlands
- The Generation R Study Group, Erasmus University Medical Center, Rotterdam, the Netherlands
| | - Ryan L. Muetzel
- Department of Child and Adolescent Psychiatry, Erasmus University Medical Center, Rotterdam, the Netherlands
- Department of Epidemiology, Erasmus University Medical Center, Rotterdam, the Netherlands
| | - Tonya White
- Department of Child and Adolescent Psychiatry, Erasmus University Medical Center, Rotterdam, the Netherlands
- Department of Radiology and Nuclear Medicine, Erasmus University Medical Center, Rotterdam, the Netherlands
| | - Sebastien Haneuse
- Department of Biostatistics, Harvard T.H. Chan School of Public Health, Boston, MA USA
| | - Kerry J. Ressler
- Department of Psychiatry, McLean Hospital, Harvard Medical School, Belmont, MA USA
| | - Henning Tiemeier
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, MA USA
- Department of Child and Adolescent Psychiatry, Erasmus University Medical Center, Rotterdam, the Netherlands
| | - Laura D. Kubzansky
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, MA USA
- Lee Kum Sheung Center for Health and Happiness, Harvard T.H. Chan School of Public Health, Boston, MA USA
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Mestermann S, Fasching PA, Beckmann MW, Gerlach J, Kratz O, Moll GH, Kornhuber J, Eichler A. The Benefit of a Retrospective Pregnancy Anamnesis in Child and Adolescent Psychiatry: The Reliability of Maternal Self-Report during Childhood Development. CHILDREN (BASEL, SWITZERLAND) 2023; 10:children10050866. [PMID: 37238414 DOI: 10.3390/children10050866] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/17/2023] [Revised: 05/08/2023] [Accepted: 05/10/2023] [Indexed: 05/28/2023]
Abstract
Pregnancy anamnesis is a crucial part of child and adolescent psychiatry diagnostics. In previous works, the reliability of retrospective maternal self-report on perinatal characteristics was heterogeneous. This prospective longitudinal study aimed to evaluate women's recall of prenatal events in a within-subject design. A sample of 241 women gave a self-report on prenatal alcohol, smoking, partnership quality, pregnancy satisfaction, and obstetric complications during the 3rd trimester (t0), childhood (t1, 6-10 y), and adolescence (t2, 12-14 y). The intra-individual agreement was examined. The t0-t1-(t2) agreement was poor to substantial; this was highest for smoking and worst for obstetric complications, followed by alcohol (Fleiss' κ = 0.719 to -0.051). There were significant t0-t1-(t2) differences for all pregnancy variables (p < 0.017), except for 3rd trimester satisfaction (p = 0.256). For alcohol (t0 25.8%, t1 17.4%, t2 41.0%) and smoking (t0 11.9%, t1 16.4%, t2 22.6%), the highest self-reported rates were found during adolescence. During childhood, fewer obstetric complications (t0 84.9%, t1 42.2%) and worse partnerships were reported (t0 M = 8.86, t1 M = 7.89). Thought to be due to social stigmata and memory effects, pregnancy self-reports cannot be precisely reproduced. Creating a respectful and trusting atmosphere is essential for mothers to give honest self-reports that are in the best interest of their children.
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Affiliation(s)
- Stefan Mestermann
- Department of Child and Adolescent Mental Health, University Hospital Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), 91054 Erlangen, Germany
| | - Peter A Fasching
- Department of Obstetrics and Gynaecology, University Hospital Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), 91054 Erlangen, Germany
| | - Matthias W Beckmann
- Department of Obstetrics and Gynaecology, University Hospital Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), 91054 Erlangen, Germany
| | - Jennifer Gerlach
- Department of Child and Adolescent Mental Health, University Hospital Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), 91054 Erlangen, Germany
| | - Oliver Kratz
- Department of Child and Adolescent Mental Health, University Hospital Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), 91054 Erlangen, Germany
| | - Gunther H Moll
- Department of Child and Adolescent Mental Health, University Hospital Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), 91054 Erlangen, Germany
| | - Johannes Kornhuber
- Department of Psychiatry and Psychotherapy, University Hospital Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), 91054 Erlangen, Germany
| | - Anna Eichler
- Department of Child and Adolescent Mental Health, University Hospital Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), 91054 Erlangen, Germany
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20
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Planalp EM, Dowe KN, Alexander AL, Goldsmith HH, Davidson RJ, Dean DC. White matter microstructure predicts individual differences in infant fear (But not anger and sadness). Dev Sci 2023; 26:e13340. [PMID: 36367143 PMCID: PMC10079554 DOI: 10.1111/desc.13340] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2021] [Revised: 08/19/2022] [Accepted: 10/18/2022] [Indexed: 11/13/2022]
Abstract
We examine neural correlates of discrete expressions of negative emotionality in infants to determine whether the microstructure of white matter tracts at 1 month of age foreshadows the expression of specific negative emotions later in infancy. Infants (n = 103) underwent neuroimaging at 1-month, and mothers reported on infant fear, sadness, and anger at 6, 12, and 18 months using the Infant Behavior Questionnaire-Revised. Levels and developmental change in fear, sadness, and anger were estimated from mother reports. Relations between MRI and infant emotion indicated that 1-month white matter microstructure was differentially associated with level and change in infant fear, but not anger or sadness, in the left stria terminalis (p < 0.05, corrected), a tract that connects frontal and tempo-parietal regions and has been implicated in emerging psychopathology in adults. More relaxed constraints on significance (p < 0.10, corrected) revealed that fear was associated with lower white matter microstructure bilaterally in the inferior portion of the stria terminalis and regions within the sagittal stratum. Results suggest the neurobehavioral uniqueness of fear as early as 1 month of age in regions that are associated with potential longer-term outcomes. This work highlights the early neural precursors of fearfulness, adding to literature explaining the psychobiological accounts of affective development. HIGHLIGHTS: Expressions of infant fear and anger, but not sadness, increase from 6 to 18 months of age. Early neural architecture in the stria terminalis is related to higher initial levels and increasing fear in infancy. After accounting for fear, anger and sadness do not appear to be associated with differences in early white matter microstructure. This work identifies early neural precursors of fearfulness as early as 1-month of age.
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Affiliation(s)
| | - Kristin N Dowe
- Waisman Center, University of Wisconsin-Madison, Madison, Wisconsin, USA
- Department of Psychology, University of Wisconsin-Madison, Madison, Wisconsin, USA
| | - Andrew L Alexander
- Waisman Center, University of Wisconsin-Madison, Madison, Wisconsin, USA
- Department of Medical Physics, University of Wisconsin-Madison, Madison, Wisconsin, USA
- Department of Psychiatry, University of Wisconsin-Madison, Madison, Wisconsin, USA
| | - H Hill Goldsmith
- Waisman Center, University of Wisconsin-Madison, Madison, Wisconsin, USA
- Department of Psychology, University of Wisconsin-Madison, Madison, Wisconsin, USA
| | - Richard J Davidson
- Waisman Center, University of Wisconsin-Madison, Madison, Wisconsin, USA
- Department of Psychology, University of Wisconsin-Madison, Madison, Wisconsin, USA
- Center for Healthy Minds, University of Wisconsin-Madison, Madison, Wisconsin, USA
| | - Douglas C Dean
- Waisman Center, University of Wisconsin-Madison, Madison, Wisconsin, USA
- Department of Medical Physics, University of Wisconsin-Madison, Madison, Wisconsin, USA
- Department of Pediatrics, University of Wisconsin-Madison, Madison, Wisconsin, USA
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21
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Poo ZX, Quah PL, Chen H, Wright A, Teoh TG, Tan LK, Tan KH. Knowledge, Attitude and Perceptions Around Perinatal Mental Health Among Doctors in an Obstetrics and Gynaecology Academic Department in Singapore. Cureus 2023; 15:e38906. [PMID: 37303430 PMCID: PMC10257555 DOI: 10.7759/cureus.38906] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/11/2023] [Indexed: 06/13/2023] Open
Abstract
Background Frontline healthcare professionals who provide regular care to women in the antenatal and postnatal period play a critical role in the early detection and management of maternal perinatal mental health (PMH). This study aimed to assess the knowledge, attitudes, and perceptions of doctors around perinatal mental health in an obstetrics and gynaecology (O&G) department in Singapore. Methods Using an online survey, data was collected from 55 doctors who participated in the Doctor's Knowledge, Attitudes and Perceptions of Perinatal Mental Health (I-DOC) study. The survey questions assessed the knowledge, attitudes, perceptions and practices in relation to PMH among doctors in the O&G specialty. Descriptive data was presented as means and standard deviations (SDs), or frequency and percentages. Results Out of the 55 doctors, more than half (60.0%) were not aware of the adverse impacts of poor PMH; 83.7% of doctors were not confident in providing PMH advice and 65.5% did not routinely screen patients for PMH disorders. There was a lower percentage of doctors (10.9% vs. 34.5%, p<0.001) who discussed PMH issues in the antenatal period compared to the postnatal period and this was statistically significant. Majority of doctors (98.2%) agreed that having standardised PMH guidelines will be useful. All doctors agreed on the benefits of having PMH guidelines, education and routine screening for patients. Conclusion There is inadequate PMH literacy among O&G doctors and lack of emphasis on antenatal PMH disorder. The findings highlighted the need for increased education and development of perinatal mental health guidelines.
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Affiliation(s)
- Zi Xi Poo
- Department of Maternal Fetal Medicine, Division of Obstetrics and Gynaecology, KK Women's and Children's Hospital, Singapore, SGP
| | - Phai Ling Quah
- Department of Maternal Fetal Medicine, Division of Obstetrics and Gynaecology, KK Women's and Children's Hospital, Singapore, SGP
| | - Helen Chen
- Department of Psychological Medicine, KK Women's and Children's Hospital, Singapore, SGP
| | - Ann Wright
- Department of Maternal Fetal Medicine, Division of Obstetrics and Gynaecology, KK Women's and Children's Hospital, Singapore, SGP
| | - Tiong Ghee Teoh
- Department of Maternal Fetal Medicine, Division of Obstetrics and Gynaecology, KK Women's and Children's Hospital, Singapore, SGP
| | - Lay Kok Tan
- Department of Maternal Fetal Medicine, Division of Obstetrics and Gynaecology, KK Women's and Children's Hospital, Singapore, SGP
| | - Kok Hian Tan
- Department of Maternal Fetal Medicine, Division of Obstetrics and Gynaecology, KK Women's and Children's Hospital, Singapore, SGP
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22
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Ayyash S, Sunderji A, Gallant HD, Hall A, Davis AD, Pokhvisneva I, Meaney MJ, Silveira PP, Sassi RB, Hall GB. Examining resting-state network connectivity in children exposed to perinatal maternal adversity using anatomically weighted functional connectivity (awFC) analyses; A preliminary report. Front Neurosci 2023; 17:1066373. [PMID: 37008220 PMCID: PMC10060836 DOI: 10.3389/fnins.2023.1066373] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2022] [Accepted: 02/16/2023] [Indexed: 03/18/2023] Open
Abstract
IntroductionEnvironmental perturbations during critical periods can have pervasive, organizational effects on neurodevelopment. To date, the literature examining the long-term impact of early life adversity has largely investigated structural and functional imaging data outcomes independently. However, emerging research points to a relationship between functional connectivity and the brain’s underlying structural architecture. For instance, functional connectivity can be mediated by the presence of direct or indirect anatomical pathways. Such evidence warrants the use of structural and functional imaging in tandem to study network maturation. Accordingly, this study examines the impact of poor maternal mental health and socioeconomic context during the perinatal period on network connectivity in middle childhood using an anatomically weighted functional connectivity (awFC) approach. awFC is a statistical model that identifies neural networks by incorporating information from both structural and functional imaging data.MethodsResting-state fMRI and DTI scans were acquired from children aged 7–9 years old.ResultsOur results indicate that maternal adversity during the perinatal period can affect offspring’s resting-state network connectivity during middle childhood. Specifically, in comparison to controls, children of mothers who had poor perinatal maternal mental health and/or low socioeconomic status exhibited greater awFC in the ventral attention network.DiscussionThese group differences were discussed in terms of the role this network plays in attention processing and maturational changes that may accompany the consolidation of a more adult-like functional cortical organization. Furthermore, our results suggest that there is value in using an awFC approach as it may be more sensitive in highlighting connectivity differences in developmental networks associated with higher-order cognitive and emotional processing, as compared to stand-alone FC or SC analyses.
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Affiliation(s)
- Sondos Ayyash
- School of Biomedical Engineering, McMaster University, Hamilton, ON, Canada
- Department of Psychology, Neuroscience & Behaviour, McMaster University, Hamilton, ON, Canada
| | - Aleeza Sunderji
- Department of Psychology, Neuroscience & Behaviour, McMaster University, Hamilton, ON, Canada
| | - Heather D. Gallant
- Department of Psychology, Neuroscience & Behaviour, McMaster University, Hamilton, ON, Canada
| | - Alexander Hall
- Department of Psychology, Neuroscience & Behaviour, McMaster University, Hamilton, ON, Canada
| | - Andrew D. Davis
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON, Canada
| | - Irina Pokhvisneva
- Ludmer Centre for Neuroinformatics and Mental Health, Douglas Mental Health University Institute, McGill University, Montreal, QC, Canada
| | - Michael J. Meaney
- Ludmer Centre for Neuroinformatics and Mental Health, Douglas Mental Health University Institute, McGill University, Montreal, QC, Canada
- Faculty of Medicine and Health Sciences, Department of Psychiatry, McGill University, Montreal, QC, Canada
- Translational Neuroscience Program, Agency for Science, Technology and Research (A*STAR), Singapore Yong Loo Lin School of Medicine, Singapore Institute for Clinical Sciences and Brain – Body Initiative, National University of Singapore, Singapore, Singapore
| | - Patricia Pelufo Silveira
- Ludmer Centre for Neuroinformatics and Mental Health, Douglas Mental Health University Institute, McGill University, Montreal, QC, Canada
- Faculty of Medicine and Health Sciences, Department of Psychiatry, McGill University, Montreal, QC, Canada
| | - Roberto B. Sassi
- Department of Psychiatry, The University of British Columbia, Vancouver, BC, Canada
| | - Geoffrey B. Hall
- School of Biomedical Engineering, McMaster University, Hamilton, ON, Canada
- Department of Psychology, Neuroscience & Behaviour, McMaster University, Hamilton, ON, Canada
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON, Canada
- *Correspondence: Geoffrey B. Hall,
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23
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Hiscox LV, Fairchild G, Donald KA, Groenewold NA, Koen N, Roos A, Narr KL, Lawrence M, Hoffman N, Wedderburn CJ, Barnett W, Zar HJ, Stein DJ, Halligan SL. Antenatal maternal intimate partner violence exposure is associated with sex-specific alterations in brain structure among young infants: Evidence from a South African birth cohort. Dev Cogn Neurosci 2023; 60:101210. [PMID: 36764039 PMCID: PMC9929680 DOI: 10.1016/j.dcn.2023.101210] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2022] [Revised: 02/02/2023] [Accepted: 02/04/2023] [Indexed: 02/09/2023] Open
Abstract
Maternal psychological distress during pregnancy has been linked to adverse outcomes in children with evidence of sex-specific effects on brain development. Here, we investigated whether in utero exposure to intimate partner violence (IPV), a particularly severe maternal stressor, is associated with brain structure in young infants from a South African birth cohort. Exposure to IPV during pregnancy was measured in 143 mothers at 28-32 weeks' gestation and infants underwent structural and diffusion magnetic resonance imaging (mean age 3 weeks). Subcortical volumetric estimates were compared between IPV-exposed (n = 63; 52% female) and unexposed infants (n = 80; 48% female), with white matter microstructure also examined in a subsample (IPV-exposed, n = 28, 54% female; unexposed infants, n = 42, 40% female). In confound adjusted analyses, maternal IPV exposure was associated with sexually dimorphic effects in brain volumes: IPV exposure predicted a larger caudate nucleus among males but not females, and smaller amygdala among females but not males. Diffusivity alterations within white matter tracts of interest were evident in males, but not females exposed to IPV. Results were robust to the removal of mother-infant pairs with pregnancy complications. Further research is required to understand how these early alterations are linked to the sex-bias in neuropsychiatric outcomes later observed in IPV-exposed children.
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Affiliation(s)
- Lucy V Hiscox
- Department of Psychology, University of Bath, Bath, UK.
| | | | - Kirsten A Donald
- Department of Pediatrics and Child Health, Red Cross War Memorial Children's Hospital and University of Cape Town, Cape Town, South Africa; The Neuroscience institute, University of Cape Town, Cape Town, South Africa
| | - Nynke A Groenewold
- Department of Pediatrics and Child Health, Red Cross War Memorial Children's Hospital and University of Cape Town, Cape Town, South Africa; The Neuroscience institute, University of Cape Town, Cape Town, South Africa; Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa
| | - Nastassja Koen
- The Neuroscience institute, University of Cape Town, Cape Town, South Africa; SA MRC Unit on Risk & Resilience in Mental Disorders, Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa
| | - Annerine Roos
- The Neuroscience institute, University of Cape Town, Cape Town, South Africa; Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa
| | - Katherine L Narr
- Departments of Neurology, Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, CA, USA
| | - Marina Lawrence
- Department of Pediatrics and Child Health, Red Cross War Memorial Children's Hospital and University of Cape Town, Cape Town, South Africa
| | - Nadia Hoffman
- Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa
| | - Catherine J Wedderburn
- Department of Pediatrics and Child Health, Red Cross War Memorial Children's Hospital and University of Cape Town, Cape Town, South Africa; The Neuroscience institute, University of Cape Town, Cape Town, South Africa; Department of Clinical Research, London School of Hygiene & Tropical Medicine, London, UK
| | - Whitney Barnett
- Department of Psychology and Human Development, Vanderbilt University, USA
| | - Heather J Zar
- Department of Pediatrics and Child Health, Red Cross War Memorial Children's Hospital and University of Cape Town, Cape Town, South Africa; SA MRC Unit on Child & Adolescent Health, University of Cape Town, Cape Town, South Africa
| | - Dan J Stein
- The Neuroscience institute, University of Cape Town, Cape Town, South Africa; SA MRC Unit on Risk & Resilience in Mental Disorders, Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa
| | - Sarah L Halligan
- Department of Psychology, University of Bath, Bath, UK; Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa; Department of Psychiatry, Stellenbosch University, Stellenbosch, South Africa
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24
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Nolvi S, Merz EC, Kataja EL, Parsons CE. Prenatal Stress and the Developing Brain: Postnatal Environments Promoting Resilience. Biol Psychiatry 2022; 93:942-952. [PMID: 36870895 DOI: 10.1016/j.biopsych.2022.11.023] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/30/2022] [Revised: 11/14/2022] [Accepted: 11/18/2022] [Indexed: 12/25/2022]
Abstract
Heightened maternal stress during pregnancy is associated with atypical brain development and an elevated risk for psychopathology in offspring. Supportive environments during early postnatal life may promote brain development and reverse atypical developmental trajectories induced by prenatal stress. We reviewed studies focused on the role of key early environmental factors in moderating associations between prenatal stress exposure and infant brain and neurocognitive outcomes. Specifically, we focused on the associations between parental caregiving quality, environmental enrichment, social support, and socioeconomic status with infant brain and neurocognitive outcomes. We examined the evidence that these factors may moderate the effects of prenatal stress on the developing brain. Complementing findings from translational models, human research suggests that high-quality early postnatal environments are associated with indices of infant neurodevelopment that have also been associated with prenatal stress, such as hippocampal volume and frontolimbic connectivity. Human studies also suggest that maternal sensitivity and higher socioeconomic status may attenuate the effects of prenatal stress on established neurocognitive and neuroendocrine mediators of risk for psychopathology, such as hypothalamic-pituitary-adrenal axis functioning. Biological pathways that may underlie the effects of positive early environments on the infant brain, including the epigenome, oxytocin, and inflammation, are also discussed. Future research in humans should examine resilience-promoting processes in relation to infant brain development using large sample sizes and longitudinal designs. The findings from this review could be incorporated into clinical models of risk and resilience during the perinatal period and used to design more effective early programs that reduce risk for psychopathology.
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Affiliation(s)
- Saara Nolvi
- Department of Psychology and Speech-Language Pathology, Turku Institute for Advanced Studies, University of Turku, Turku, Finland; Department of Clinical Medicine, FinnBrain Birth Cohort Study, Center for Population Health Research, University of Turku, Turku, Finland.
| | - Emily C Merz
- Department of Psychology, Colorado State University, Fort Collins, Colorado
| | - Eeva-Leena Kataja
- Department of Clinical Medicine, FinnBrain Birth Cohort Study, Center for Population Health Research, University of Turku, Turku, Finland
| | - Christine E Parsons
- Department of Clinical Medicine, Interacting Minds Center, Aarhus University, Aarhus, Denmark
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25
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Impact of the Timing of Maternal Peripartum Depression on Infant Social and Emotional Development at 18 Months. J Clin Med 2022; 11:jcm11236919. [PMID: 36498494 PMCID: PMC9735611 DOI: 10.3390/jcm11236919] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2022] [Revised: 11/20/2022] [Accepted: 11/21/2022] [Indexed: 11/27/2022] Open
Abstract
The study assessed how the timing of maternal perinatal depressive symptoms affects infant socio-emotional characteristics at age 18 months. The study was a longitudinal cohort study that included six assessment points from the third trimester of pregnancy up to age 18 months (±1 month). Assessment of mothers included the Edinburgh Postnatal Depression Scale and the State-Trait Anxiety Inventory, while assessments of infant included the Infant Toddler Social and Emotional Assessment (ITSEA) at 18 months. Mothers were categorized into one of the following groups: mothers who presented postnatal depression only (n = 19); mothers who presented both prenatal and postnatal depression (n = 14), and mothers who never showed perinatal depression symptoms (n = 38). Mothers who presented both prenatal and postnatal depression showed significantly higher levels of depressive score, reactivity to stress and level of anxiety trait compared to mothers of the two other groups. Infants of prenatally and postnatally depressed mothers had higher scores on the internalizing subscore of the ITSEA. The number of depression episodes during the study period was positively correlated with the externalizing and internalizing subscores of the ITSEA. These findings support the need to provide specific screening to identify women with prenatal depression.
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Jeličić L, Veselinović A, Ćirović M, Jakovljević V, Raičević S, Subotić M. Maternal Distress during Pregnancy and the Postpartum Period: Underlying Mechanisms and Child's Developmental Outcomes-A Narrative Review. Int J Mol Sci 2022; 23:ijms232213932. [PMID: 36430406 PMCID: PMC9692872 DOI: 10.3390/ijms232213932] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2022] [Revised: 11/06/2022] [Accepted: 11/07/2022] [Indexed: 11/16/2022] Open
Abstract
Maternal mental health may be considered a determining factor influencing fetal and child development. An essential factor with potentially negative consequences for a child's psychophysiological development is the presence of maternal distress during pregnancy and the postpartum period. The review is organized and presented to explore and describe the effects of anxiety, stress, and depression in pregnancy and the postpartum period on adverse child developmental outcomes. The neurobiology of maternal distress and the transmission mechanisms at the molecular level to the fetus and child are noted. In addition, the paper discusses the findings of longitudinal studies in which early child development is monitored concerning the presence of maternal distress in pregnancy and the postpartum period. This topic gained importance in the COVID-19 pandemic context, during which a higher frequency of maternal psychological disorders was observed. The need for further interdisciplinary research on the relationship between maternal mental health and fetal/child development was highlighted, especially on the biological mechanisms underlying the transmission of maternal distress to the (unborn) child, to achieve positive developmental outcomes and improve maternal and child well-being.
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Affiliation(s)
- Ljiljana Jeličić
- Cognitive Neuroscience Department, Research and Development Institute “Life Activities Advancement Institute”, 11000 Belgrade, Serbia
- Department of Speech, Language and Hearing Sciences, Institute for Experimental Phonetics and Speech Pathology, 11000 Belgrade, Serbia
- Correspondence: ; Tel.: +381-11-3208-519; Fax: +381-11-2624-168
| | - Aleksandra Veselinović
- Cognitive Neuroscience Department, Research and Development Institute “Life Activities Advancement Institute”, 11000 Belgrade, Serbia
- Department of Speech, Language and Hearing Sciences, Institute for Experimental Phonetics and Speech Pathology, 11000 Belgrade, Serbia
| | - Milica Ćirović
- Cognitive Neuroscience Department, Research and Development Institute “Life Activities Advancement Institute”, 11000 Belgrade, Serbia
- Department of Speech, Language and Hearing Sciences, Institute for Experimental Phonetics and Speech Pathology, 11000 Belgrade, Serbia
| | - Vladimir Jakovljević
- Department of Physiology, Faculty of Medical Sciences, University of Kragujevac, 34000 Kragujevac, Serbia
- Department of Human Pathology, I.M. Sechenov First Moscow State Medical University, 119991 Moscow, Russia
| | - Saša Raičević
- Department of Gynecology and Obstetrics, Faculty of Medicine, University of Montenegro, 81000 Podgorica, Montenegro
- Clinic of Gynecology and Obstetrics, Clinical Center of Montenegro, 81000 Podgorica, Montenegro
| | - Miško Subotić
- Cognitive Neuroscience Department, Research and Development Institute “Life Activities Advancement Institute”, 11000 Belgrade, Serbia
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Manning KY, Long X, Watts D, Tomfohr-Madsen L, Giesbrecht GF, Lebel C. Prenatal Maternal Distress During the COVID-19 Pandemic and Associations With Infant Brain Connectivity. Biol Psychiatry 2022; 92:701-708. [PMID: 35871095 PMCID: PMC9110020 DOI: 10.1016/j.biopsych.2022.05.011] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/21/2021] [Revised: 04/25/2022] [Accepted: 05/09/2022] [Indexed: 11/30/2022]
Abstract
BACKGROUND The COVID-19 pandemic has caused substantially elevated distress in pregnant individuals, which has the potential to affect the developing infant brain. Our main objective was to understand how prenatal distress was related to infant brain structure and function and whether social support moderated the associations. METHODS The Pregnancy during the COVID-19 Pandemic (PdP) cohort study collected Patient-Reported Outcomes Measurement Information System Anxiety scale, Edinburgh Postnatal Depression Scale, and Social Support Effectiveness Questionnaire data from a population-based sample of pregnant individuals living in Canada (N = 8602). For a subsample of participants, their infants (n = 75) underwent magnetic resonance imaging at 3 months of age to examine whether prenatal maternal distress was associated with infant brain architecture, including the role of social support as a potential protective factor. RESULTS Overall, 33.4% of participants demonstrated clinically elevated depression symptoms and 47.1% of participants demonstrated clinically elevated anxiety symptoms. We identified lower social support as a significant predictor of clinically elevated prenatal maternal distress (t8598 = -22.3, p < .001). Fifty-eight diffusion image datasets (20 female/38 male, 92 ± 14 days old) and 41 functional datasets (13 female/28 male, 92 ± 14 days old) were included in our analysis after removal of poor-quality images and infants without postpartum maternal distress scores. We found significant relationships between prenatal maternal distress and infant amygdala-prefrontal microstructural and functional connectivity measures, and we demonstrate for the first time that social support moderates these relationships. CONCLUSIONS Our findings suggest a potentially long-lasting impact of the COVID-19 pandemic on children and show that social support acts as a possible mediator not just for pregnant individuals but also developing infants. These findings provide timely evidence to inform clinical practice and policy surrounding the care of pregnant individuals and highlight the importance of social support.
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Affiliation(s)
- Kathryn Y Manning
- Department of Radiology, University of Calgary, Calgary, Alberta, Canada; Hotchkiss Brain Institute, University of Calgary, Calgary, Alberta, Canada; Alberta Children's Hospital Research Institute, University of Calgary, Calgary, Alberta, Canada
| | - Xiangyu Long
- Department of Radiology, University of Calgary, Calgary, Alberta, Canada; Hotchkiss Brain Institute, University of Calgary, Calgary, Alberta, Canada; Alberta Children's Hospital Research Institute, University of Calgary, Calgary, Alberta, Canada
| | - Dana Watts
- Department of Psychology, University of Calgary, Calgary, Alberta, Canada
| | - Lianne Tomfohr-Madsen
- Department of Psychology, University of Calgary, Calgary, Alberta, Canada; Department of Pediatrics, University of Calgary, Calgary, Alberta, Canada; Alberta Children's Hospital Research Institute, University of Calgary, Calgary, Alberta, Canada; Department of Educational and Counselling Psychology, University of British Columbia, Vancouver, British Columbia, Canada
| | - Gerald F Giesbrecht
- Department of Psychology, University of Calgary, Calgary, Alberta, Canada; Department of Pediatrics, University of Calgary, Calgary, Alberta, Canada; Department of Community Health Sciences, University of Calgary, Calgary, Alberta, Canada; Alberta Children's Hospital Research Institute, University of Calgary, Calgary, Alberta, Canada
| | - Catherine Lebel
- Department of Radiology, University of Calgary, Calgary, Alberta, Canada; Hotchkiss Brain Institute, University of Calgary, Calgary, Alberta, Canada; Alberta Children's Hospital Research Institute, University of Calgary, Calgary, Alberta, Canada.
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Lean RE, Smyser CD, Brady RG, Triplett RL, Kaplan S, Kenley JK, Shimony JS, Smyser TA, Miller JP, Barch DM, Luby JL, Warner BB, Rogers CE. Prenatal exposure to maternal social disadvantage and psychosocial stress and neonatal white matter connectivity at birth. Proc Natl Acad Sci U S A 2022; 119:e2204135119. [PMID: 36219693 PMCID: PMC9586270 DOI: 10.1073/pnas.2204135119] [Citation(s) in RCA: 17] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2022] [Accepted: 09/14/2022] [Indexed: 11/18/2022] Open
Abstract
Early life adversity (social disadvantage and psychosocial stressors) is associated with altered microstructure in fronto-limbic pathways important for socioemotional development. Understanding when these associations begin to emerge may inform the timing and design of preventative interventions. In this longitudinal study, 399 mothers were oversampled for low income and completed social background measures during pregnancy. Measures were analyzed with structural equation analysis resulting in two latent factors: social disadvantage (education, insurance status, income-to-needs ratio [INR], neighborhood deprivation, and nutrition) and psychosocial stress (depression, stress, life events, and racial discrimination). At birth, 289 healthy term-born neonates underwent a diffusion MRI (dMRI) scan. Mean diffusivity (MD) and fractional anisotropy (FA) were measured for the dorsal and inferior cingulum bundle (CB), uncinate, and fornix using probabilistic tractography in FSL. Social disadvantage and psychosocial stress were fitted to dMRI parameters using regression models adjusted for infant postmenstrual age at scan and sex. Social disadvantage, but not psychosocial stress, was independently associated with lower MD in the bilateral inferior CB and left uncinate, right fornix, and lower MD and higher FA in the right dorsal CB. Results persisted after accounting for maternal medical morbidities and prenatal drug exposure. In moderation analysis, psychosocial stress was associated with lower MD in the left inferior CB among the lower-to-higher socioeconomic status (SES) (INR ≥ 200%) group, but not the extremely low SES (INR < 200%) group. Increasing access to social welfare programs that reduce the burden of social disadvantage and related psychosocial stressors may be an important target to protect fetal brain development in fronto-limbic pathways.
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Affiliation(s)
- Rachel E. Lean
- Department of Psychiatry, Washington University School of Medicine in St. Louis, St. Louis, MO 63110
| | - Christopher D. Smyser
- Department of Pediatrics, Washington University School of Medicine in St. Louis, St. Louis, MO 63110
- Department of Radiology, Washington University School of Medicine in St. Louis, St. Louis, MO 63110
- Department of Neurology, Washington University School of Medicine in St. Louis, St. Louis, MO 63110
| | - Rebecca G. Brady
- Department of Neurology, Washington University School of Medicine in St. Louis, St. Louis, MO 63110
| | - Regina L. Triplett
- Department of Neurology, Washington University School of Medicine in St. Louis, St. Louis, MO 63110
| | - Sydney Kaplan
- Department of Neurology, Washington University School of Medicine in St. Louis, St. Louis, MO 63110
| | - Jeanette K. Kenley
- Department of Neurology, Washington University School of Medicine in St. Louis, St. Louis, MO 63110
| | - Joshua S. Shimony
- Department of Radiology, Washington University School of Medicine in St. Louis, St. Louis, MO 63110
| | - Tara A. Smyser
- Department of Psychiatry, Washington University School of Medicine in St. Louis, St. Louis, MO 63110
| | - J. Phillip Miller
- Department of Biostatistics, Institute for Informatics, Washington University School of Medicine in St. Louis, St. Louis, MO 63110
| | - Deanna M. Barch
- Department of Psychiatry, Washington University School of Medicine in St. Louis, St. Louis, MO 63110
- Department of Radiology, Washington University School of Medicine in St. Louis, St. Louis, MO 63110
- Department of Psychological and Brain Sciences, Washington University School of Medicine in St. Louis, St. Louis, MO 63130
| | - Joan L. Luby
- Department of Psychiatry, Washington University School of Medicine in St. Louis, St. Louis, MO 63110
| | - Barbara B. Warner
- Department of Pediatrics, Washington University School of Medicine in St. Louis, St. Louis, MO 63110
- Department of Newborn Medicine, Washington University School of Medicine in St. Louis, St. Louis, MO 63110
| | - Cynthia E. Rogers
- Department of Psychiatry, Washington University School of Medicine in St. Louis, St. Louis, MO 63110
- Department of Pediatrics, Washington University School of Medicine in St. Louis, St. Louis, MO 63110
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29
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Perinatal and early childhood biomarkers of psychosocial stress and adverse experiences. Pediatr Res 2022; 92:956-965. [PMID: 35091705 DOI: 10.1038/s41390-022-01933-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/05/2020] [Revised: 11/15/2021] [Accepted: 11/26/2021] [Indexed: 01/23/2023]
Abstract
The human brain develops through a complex interplay of genetic and environmental influences. During critical periods of development, experiences shape brain architecture, often with long-lasting effects. If experiences are adverse, the effects may include the risk of mental and physical disease, whereas positive environments may increase the likelihood of healthy outcomes. Understanding how psychosocial stress and adverse experiences are embedded in biological systems and how we can identify markers of risk may lead to discovering new approaches to improve patient care and outcomes. Biomarkers can be used to identify specific intervention targets and at-risk children early when physiological system malleability increases the likelihood of intervention success. However, identifying reliable biomarkers has been challenging, particularly in the perinatal period and the first years of life, including in preterm infants. This review explores the landscape of psychosocial stress and adverse experience biomarkers. We highlight potential benefits and challenges of identifying risk clinically and different sub-signatures of stress, and in their ability to inform targeted interventions. Finally, we propose that the combination of preterm birth and adversity amplifies the risk for abnormal development and calls for a focus on this group of infants within the field of psychosocial stress and adverse experience biomarkers. IMPACT: Reviews the landscape of biomarkers of psychosocial stress and adverse experiences in the perinatal period and early childhood and highlights the potential benefits and challenges of their clinical utility in identifying risk status in children, and in developing targeted interventions. Explores associations between psychosocial stress and adverse experiences in childhood with prematurity and identifies potential areas of assessment and intervention to improve outcomes in this at-risk group.
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30
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Lautarescu A, Bonthrone AF, Pietsch M, Batalle D, Cordero-Grande L, Tournier JD, Christiaens D, Hajnal JV, Chew A, Falconer S, Nosarti C, Victor S, Craig MC, Edwards AD, Counsell SJ. Maternal depressive symptoms, neonatal white matter, and toddler social-emotional development. Transl Psychiatry 2022; 12:323. [PMID: 35945202 PMCID: PMC9363426 DOI: 10.1038/s41398-022-02073-y] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/02/2022] [Revised: 07/01/2022] [Accepted: 07/18/2022] [Indexed: 11/25/2022] Open
Abstract
Maternal prenatal depression is associated with increased likelihood of neurodevelopmental and psychiatric conditions in offspring. The relationship between maternal depression and offspring outcome may be mediated by in-utero changes in brain development. Recent advances in magnetic resonance imaging (MRI) have enabled in vivo investigations of neonatal brains, minimising the effect of postnatal influences. The aim of this study was to examine associations between maternal prenatal depressive symptoms, infant white matter, and toddler behaviour. 413 mother-infant dyads enrolled in the developing Human Connectome Project. Mothers completed the Edinburgh Postnatal Depression Scale (median = 5, range = 0-28, n = 52 scores ≥ 11). Infants (n = 223 male) (median gestational age at birth = 40 weeks, range 32.14-42.29) underwent MRI (median postmenstrual age at scan = 41.29 weeks, range 36.57-44.71). Fixel-based fibre metrics (mean fibre density, fibre cross-section, and fibre density modulated by cross-section) were calculated from diffusion imaging data in the left and right uncinate fasciculi and cingulum bundle. For n = 311, internalising and externalising behaviour, and social-emotional abilities were reported at a median corrected age of 18 months (range 17-24). Statistical analysis used multiple linear regression and mediation analysis with bootstrapping. Maternal depressive symptoms were positively associated with infant fibre density in the left (B = 0.0005, p = 0.003, q = 0.027) and right (B = 0.0006, p = 0.003, q = 0.027) uncinate fasciculus, with left uncinate fasciculus fibre density, in turn, positively associated with social-emotional abilities in toddlerhood (B = 105.70, p = 0.0007, q = 0.004). In a mediation analysis, higher maternal depressive symptoms predicted toddler social-emotional difficulties (B = 0.342, t(307) = 3.003, p = 0.003), but this relationship was not mediated by fibre density in the left uncinate fasciculus (Sobel test p = 0.143, bootstrapped indirect effect = 0.035, SE = 0.02, 95% CI: [-0.01, 0.08]). There was no evidence of an association between maternal depressive and cingulum fibre properties. These findings suggest that maternal perinatal depressive symptoms are associated with neonatal uncinate fasciculi microstructure, but not fibre bundle size, and toddler behaviour.
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Affiliation(s)
- Alexandra Lautarescu
- Centre for the Developing Brain, Department of Perinatal Imaging and Health, School of Biomedical Engineering and Imaging Sciences, King's College London, St Thomas' Hospital, London, UK.
- Department of Forensic and Neurodevelopmental Sciences, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.
| | - Alexandra F Bonthrone
- Centre for the Developing Brain, Department of Perinatal Imaging and Health, School of Biomedical Engineering and Imaging Sciences, King's College London, St Thomas' Hospital, London, UK
| | - Maximilian Pietsch
- Centre for the Developing Brain, Department of Perinatal Imaging and Health, School of Biomedical Engineering and Imaging Sciences, King's College London, St Thomas' Hospital, London, UK
- Department of Forensic and Neurodevelopmental Sciences, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Dafnis Batalle
- Centre for the Developing Brain, Department of Perinatal Imaging and Health, School of Biomedical Engineering and Imaging Sciences, King's College London, St Thomas' Hospital, London, UK
- Department of Forensic and Neurodevelopmental Sciences, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Lucilio Cordero-Grande
- Centre for the Developing Brain, Department of Perinatal Imaging and Health, School of Biomedical Engineering and Imaging Sciences, King's College London, St Thomas' Hospital, London, UK
- CIBER de Bioingeniería, Biomateriales y Nanomedicina, Instituto de Salud Carlos III, Madrid, Spain
- Biomedical Image Technologies, ETSI Telecomunicación, Universidad Politécnica de Madrid, Madrid, Spain
| | - J-Donald Tournier
- Centre for the Developing Brain, Department of Perinatal Imaging and Health, School of Biomedical Engineering and Imaging Sciences, King's College London, St Thomas' Hospital, London, UK
| | - Daan Christiaens
- Centre for the Developing Brain, Department of Perinatal Imaging and Health, School of Biomedical Engineering and Imaging Sciences, King's College London, St Thomas' Hospital, London, UK
- Department of Electrical Engineering, ESAT/PSI, KU Leuven, Leuven, Belgium
| | - Joseph V Hajnal
- Centre for the Developing Brain, Department of Perinatal Imaging and Health, School of Biomedical Engineering and Imaging Sciences, King's College London, St Thomas' Hospital, London, UK
| | - Andrew Chew
- Centre for the Developing Brain, Department of Perinatal Imaging and Health, School of Biomedical Engineering and Imaging Sciences, King's College London, St Thomas' Hospital, London, UK
| | - Shona Falconer
- Centre for the Developing Brain, Department of Perinatal Imaging and Health, School of Biomedical Engineering and Imaging Sciences, King's College London, St Thomas' Hospital, London, UK
| | - Chiara Nosarti
- Centre for the Developing Brain, Department of Perinatal Imaging and Health, School of Biomedical Engineering and Imaging Sciences, King's College London, St Thomas' Hospital, London, UK
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Suresh Victor
- Centre for the Developing Brain, Department of Perinatal Imaging and Health, School of Biomedical Engineering and Imaging Sciences, King's College London, St Thomas' Hospital, London, UK
- Neonatal Unit, Evelina London Children's Hospital, London, UK
| | - Michael C Craig
- Department of Forensic and Neurodevelopmental Sciences, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
- National Female Hormone Clinic, South London and Maudsley National Health Service Foundation Trust, London, UK
| | - A David Edwards
- Centre for the Developing Brain, Department of Perinatal Imaging and Health, School of Biomedical Engineering and Imaging Sciences, King's College London, St Thomas' Hospital, London, UK
- Neonatal Unit, Evelina London Children's Hospital, London, UK
- MRC Centre for Neurodevelopmental Disorders, King's College London, London, UK
- EPSRC/Wellcome Centre for Medical Engineering, King's College London, London, UK
| | - Serena J Counsell
- Centre for the Developing Brain, Department of Perinatal Imaging and Health, School of Biomedical Engineering and Imaging Sciences, King's College London, St Thomas' Hospital, London, UK
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"The Mental Health Piece is Huge": perspectives on developing a prenatal maternal psychological intervention for congenital heart disease. Cardiol Young 2022; 32:1268-1275. [PMID: 34588092 DOI: 10.1017/s1047951121004030] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
OBJECTIVES Women carrying a fetus diagnosed with congenital heart disease often experience significant distress because of their medical diagnosis. Given the well-documented impact associated with elevated prenatal stress and critical importance of developing targeted interventions, this study aims to examine stressors, coping and resilience resources, and mental health treatment preferences in pregnant women receiving a congenital heart disease diagnosis to inform the development of a psychological intervention to reduce maternal distress prenatally. METHODS Three groups of participants were included consisting of two pregnant women carrying a fetus with congenital heart disease, five women of children (4-16 months) with congenital heart disease, and five paediatric cardiology medical providers. Responses were gathered via semi-structured interviews and analysed using qualitative thematic analysis. RESULTS Information regarding four broad areas were analysed of emotional distress during pregnancy; experience of initial diagnosis; coping and resilience; and perspectives on a mental health intervention in pregnancy. Anxiety regarding baby's future, guilt following diagnosis, and various coping strategies emerged as primary themes among the participant sample. Medical staff corroborated mothers' heightened anxiety and viewed a psychotherapeutic intervention during the prenatal period as essential and complimentary to standard of care. CONCLUSION We identified salient themes and preferred components for a future psychological intervention delivered prenatally. PRACTICE IMPLICATIONS Patients' and providers' perspectives regarding the nature of maternal distress, resilience and treatment preferences can inform the development of interventions to support the emotional well-being of pregnant women carrying a fetus with congenital heart disease to optimise care and potentially improve outcomes for fetal brain development.
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32
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Craig MC, Sethna V, Gudbrandsen M, Pariante CM, Seneviratne T, Stoencheva V, Sethi A, Catani M, Brammer M, Murphy DGM, Daly E. Birth of the blues: emotional sound processing in infants exposed to prenatal maternal depression. Psychol Med 2022; 52:2017-2023. [PMID: 35786785 PMCID: PMC9386434 DOI: 10.1017/s0033291720002688] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/15/2019] [Revised: 03/16/2020] [Accepted: 07/09/2020] [Indexed: 12/24/2022]
Abstract
BACKGROUND Offspring exposed to prenatal maternal depression (PMD) are vulnerable to depression across their lifespan. The underlying cause(s) for this elevated intergenerational risk is most likely complex. However, depression is underpinned by a dysfunctional frontal-limbic network, associated with core information processing biases (e.g. attending more to sad stimuli). Aberrations in this network might mediate transmission of this vulnerability in infants exposed to PMD. In this study, we aimed to explore the association between foetal exposure to PMD and frontal-limbic network function in infancy, hypothesising that, in response to emotional sounds, infants exposed to PMD would exhibit atypical activity in these regions, relative to those not exposed to PMD. METHOD We employed a novel functional magnetic resonance imaging sequence to compare brain function, whilst listening to emotional sounds, in 78 full-term infants (3-6 months of age) born to mothers with and without a diagnosis of PMD. RESULTS After exclusion of 19 datasets due to infants waking up, or moving excessively, we report between-group brain activity differences, between 29 infants exposed to PMD and 29 infants not exposed to PMD, occurring in temporal, striatal, amygdala/parahippocampal and frontal regions (p < 0.005). The offspring exposed to PMD exhibited a relative increase in activation to sad sounds and reduced (or unchanged) activation to happy sounds in frontal-limbic clusters. CONCLUSIONS Findings of a differential response to positive and negative valanced sounds by 3-6 months of age may have significant implications for our understanding of neural mechanisms that underpin the increased risk for later-life depression in this population.
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Affiliation(s)
- Michael C. Craig
- Department of Forensic & Neurodevelopmental Sciences, Sackler Institute for Translational Neurodevelopment, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
- Natbrainlab, Department of Forensic & Neurodevelopmental Sciences, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
- National Female Hormone Clinic, Maudsley Hospital, SLAM NHS Foundation Trust, London, UK
| | - Vaheshta Sethna
- Department of Forensic & Neurodevelopmental Sciences, Sackler Institute for Translational Neurodevelopment, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - Maria Gudbrandsen
- Department of Forensic & Neurodevelopmental Sciences, Sackler Institute for Translational Neurodevelopment, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - Carmine M. Pariante
- Stress, Psychiatry and Immunology & Perinatal Psychiatry Laboratory, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - Trudi Seneviratne
- Perinatal Services, Maudsley Hospital, SLAM NHS Foundation Trust, London, UK
| | - Vladimira Stoencheva
- Department of Forensic & Neurodevelopmental Sciences, Sackler Institute for Translational Neurodevelopment, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - Arjun Sethi
- Department of Forensic & Neurodevelopmental Sciences, Sackler Institute for Translational Neurodevelopment, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
- Natbrainlab, Department of Forensic & Neurodevelopmental Sciences, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - Marco Catani
- Department of Forensic & Neurodevelopmental Sciences, Sackler Institute for Translational Neurodevelopment, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
- Natbrainlab, Department of Forensic & Neurodevelopmental Sciences, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - Mick Brammer
- Department of Forensic & Neurodevelopmental Sciences, Sackler Institute for Translational Neurodevelopment, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - Declan G. M. Murphy
- Department of Forensic & Neurodevelopmental Sciences, Sackler Institute for Translational Neurodevelopment, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - Eileen Daly
- Department of Forensic & Neurodevelopmental Sciences, Sackler Institute for Translational Neurodevelopment, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
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Deutsch AR, Vargas MC, Lucchini M, Brink LT, Odendaal HJ, Elliott AJ. Effect of individual or comorbid antenatal depression and anxiety on birth outcomes and moderation by maternal traumatic experiences and resilience. JOURNAL OF AFFECTIVE DISORDERS REPORTS 2022; 9:100365. [PMID: 35966253 PMCID: PMC9373828 DOI: 10.1016/j.jadr.2022.100365] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Background Although antenatal depression and anxiety (e.g., negative antenatal mental health; NAMH) are individually associated with preterm birth (PTB) and infant neurological impairment, few studies account for comorbidity. Understanding how NAMH impacts PTB and infant neurological functioning by either singular (depression or anxiety) or comorbid status, as well as the way in which these effects can be moderated by additional risk or protective factors (traumatic experiences and trait resiliency) can contribute further understanding of NAMH effects on birth outcomes. Methods The sample included 3042 mother-infant dyads from U.S. and South Africa cohorts of the Safe Passage Study (N = 3042). A four-category NAMH variable was created to categorize depression-only, anxiety-only, comorbid, or no NAMH statuses. Results There were no NAMH main effects on PTB, however, anxiety-only and comorbid NAMH increased odds of PTB for mothers with higher rates of traumatic life experiences. Anxiety-only and comorbid NAMH were associated with increased odds of newborn neurological impairment, and the effect of comorbid NAMH was stronger for mothers with higher rates of traumatic experiences. Resiliency decreased odds of neurological impairment for mothers who reported depression-only or anxiety-only NAMH. Limitations Limitations included potential artefacts of two cohorts that differed in rates of almost all variables, a single time point for measuring NAMH, and lack of pregnancy-specific NAMH measures. Conclusions Especially when compared to mothers with no NAMH, comorbidity or singular-condition NAMH statuses associate with negative birth outcomes in nuanced ways, especially when considering additional contexts that may foster or protect against NAMH.
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Affiliation(s)
- Arielle R. Deutsch
- Avera Research Institute
- University of South Dakota School of Medicine, Department of Pediatrics
| | | | - Maristella Lucchini
- Columbia University Irving Medical Center, Department of Psychiatry
- New York State Psychiatric Institute, Division of Developmental Neuroscience
| | - Lucy T. Brink
- Stellenbosch University, School of Medicine and Health Science, Department of Obstetrics and Gynaecology
| | - Hein J. Odendaal
- Stellenbosch University, School of Medicine and Health Science, Department of Obstetrics and Gynaecology
| | - Amy J. Elliott
- Avera Research Institute
- University of South Dakota School of Medicine, Department of Pediatrics
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34
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Kemp JVA, Bernier E, Lebel C, Kopala-Sibley DC. Associations Between Parental Mood and Anxiety Psychopathology and Offspring Brain Structure: A Scoping Review. Clin Child Fam Psychol Rev 2022; 25:222-247. [PMID: 35201543 DOI: 10.1007/s10567-022-00393-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/14/2022] [Indexed: 12/22/2022]
Abstract
A family history of mood and anxiety disorders is one of the most well-established risk factors for these disorders in offspring. A family history of these disorders has also been linked to alterations in brain regions involved in cognitive-affective processes broadly, and mood and anxiety disorders specifically. Results from studies of brain structure of children of parents with a history of mood or anxiety disorders (high-risk offspring) have been inconsistent. We followed the PRISMA protocol to conduct a scoping review of the literature linking parental mood and anxiety disorders to offspring brain structure to examine which structures in offspring brains are linked to parental major depressive disorder (MDD), anxiety, or bipolar disorder (BD). Studies included were published in peer-reviewed journals between January 2000 and July 2021. Thirty-nine studies were included. Significant associations between parental BD and offspring caudate volume, inferior frontal gyrus thickness, and anterior cingulate cortex thickness were found. Associations were also identified between parental MDD and offspring amygdala and hippocampal volumes, fusiform thickness, and thickness in temporoparietal regions. Few studies have examined associations between parental anxiety and high-risk offspring brain structure; however, one study found associations between parental anxiety symptoms and offspring amygdala structure, and another found similar associations with the hippocampus. The direction of grey matter change across studies was inconsistent, potentially due to the large age ranges for each study and the non-linear development of the brain. Children of parents with MDD and bipolar disorders, or elevated anxiety symptoms, show alterations in a range of brain regions. Results may further efforts to identify children at high risk for affective disorders and may elucidate whether alterations in specific brain regions represent premorbid markers of risk for mood and anxiety disorders.
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Affiliation(s)
- Jennifer V A Kemp
- Department of Psychiatry, University of Calgary, Calgary, AB, Canada. .,Hotchkiss Brain Institute, Calgary, AB, Canada. .,Mathison Centre for Mental Health Research & Education, Calgary, AB, Canada. .,Faculty of Cumming School of Medicine, University of Calgary, Foothills Hospital Teaching Research and Wellness Building, 3280 Hospital Dr NW, Calgary, AB, T2N 4Z6, Canada.
| | - Emily Bernier
- Department of Psychiatry, University of Calgary, Calgary, AB, Canada.,Hotchkiss Brain Institute, Calgary, AB, Canada.,Mathison Centre for Mental Health Research & Education, Calgary, AB, Canada
| | - Catherine Lebel
- Alberta Children's Hospital Research Institute, Calgary, AB, Canada.,Hotchkiss Brain Institute, Calgary, AB, Canada.,Mathison Centre for Mental Health Research & Education, Calgary, AB, Canada.,Department of Radiology, University of Calgary, Calgary, AB, Canada
| | - Daniel C Kopala-Sibley
- Department of Psychiatry, University of Calgary, Calgary, AB, Canada.,Alberta Children's Hospital Research Institute, Calgary, AB, Canada.,Hotchkiss Brain Institute, Calgary, AB, Canada.,Mathison Centre for Mental Health Research & Education, Calgary, AB, Canada
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35
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Bowman LC, McCormick SA, Kane-Grade F, Xie W, Enlow MB, Nelson CA. Infants' neural responses to emotional faces are related to maternal anxiety. J Child Psychol Psychiatry 2022; 63:152-164. [PMID: 33993507 PMCID: PMC9644832 DOI: 10.1111/jcpp.13429] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 03/11/2021] [Indexed: 12/01/2022]
Abstract
BACKGROUND Postnatal maternal anxiety is common (estimates as high as 40% prevalence) and is associated with altered mother-infant interactions (e.g., reduced maternal emotional expression and engagement). Neural circuitry supporting infants' face and emotion processing develops in their first year. Thus, early exposure to maternal anxiety may impact infants' developing understanding of emotional displays. We examine whether maternal anxiety is associated with individual differences in typically developing infants' neural responses to emotional faces. METHODS One hundred and forty two mother-infant dyads were assessed when infants were 5, 7, or 12 months old. Infants' electroencephalographic (EEG) data were recorded while passively viewing female happy, fearful, and angry faces. Three event-related potential (ERP) components, each linked to face and emotion processing, were evaluated: NC, N290, and P400. Infant ERP amplitude was related to concurrent maternal-report anxiety assessed with the Spielberger State-Trait Anxiety Inventory (Trait form). RESULTS Greater maternal anxiety predicted more negative NC amplitude for happy and fearful faces in left and mid-central scalp regions, beyond covarying influences of maternal depression symptoms, infant negative emotionality, and infant age. CONCLUSIONS Postnatal maternal anxiety is related to infants' neural processing of emotional expressions. Infants of mothers endorsing high trait anxiety may need additional attentional resources to process happy and fearful faces (expressions less likely experienced in mother-infant interactions). Future research should investigate mechanisms underlying this association, given possibilities include experiential, genetic, and prenatal factors.
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Affiliation(s)
- Lindsay C. Bowman
- Center for Mind and Brain and Department of Psychology, University of California Davis, Davis, CA,Correspondence to: Lindsay C. Bowman, Center for Mind and Brain at UC Davis, 267 Cousteau Place, Davis, CA, USA, 95616
| | - Sarah A. McCormick
- Department of Psychology and Brain Sciences, University of Massachusetts, Amherst, MA
| | - Finola Kane-Grade
- Laboratories of Cognitive Neuroscience, Division of Developmental Medicine, Boston Children’s Hospital, Boston, MA
| | - Wanze Xie
- Laboratories of Cognitive Neuroscience, Division of Developmental Medicine, Boston Children’s Hospital, Boston, MA,Department of Pediatrics, Harvard Medical School, Boston, MA
| | - Michelle Bosquet Enlow
- Department of Psychiatry, Boston Children’s Hospital, Boston, MA,Department of Psychiatry, Harvard Medical School, Boston, MA
| | - Charles A. Nelson
- Laboratories of Cognitive Neuroscience, Division of Developmental Medicine, Boston Children’s Hospital, Boston, MA,Department of Pediatrics, Harvard Medical School, Boston, MA,Harvard Graduate School of Education, Cambridge, MA
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36
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McGill MG, Pokhvisneva I, Clappison AS, McEwen LM, Beijers R, Tollenaar MS, Pham H, Kee MZL, Garg E, de Mendonça Filho EJ, Karnani N, Silveira PP, Kobor MS, de Weerth C, Meaney MJ, O'Donnell KJ. Maternal Prenatal Anxiety and the Fetal Origins of Epigenetic Aging. Biol Psychiatry 2022; 91:303-312. [PMID: 34756561 DOI: 10.1016/j.biopsych.2021.07.025] [Citation(s) in RCA: 31] [Impact Index Per Article: 15.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/11/2021] [Revised: 07/19/2021] [Accepted: 07/20/2021] [Indexed: 11/29/2022]
Abstract
BACKGROUND The fetal origins of mental health is a well-established framework that currently lacks a robust index of the biological embedding of prenatal adversity. The Pediatric-Buccal-Epigenetic (PedBE) clock is a novel epigenetic tool that associates with aspects of the prenatal environment, but additional validation in longitudinal datasets is required. Likewise, the relationship between prenatal maternal mental health and the PedBE clock has not been described. METHODS Longitudinal cohorts from the Netherlands (Basal Influences on Baby Development [BIBO] n = 165) and Singapore (Growing Up in Singapore Towards Healthy Outcomes [GUSTO] n = 340) provided data on prenatal maternal anxiety and longitudinal assessments of buccal cell-derived genome-wide DNA methylation assessed at 6 and 10 years of age in BIBO, and at 3, 9, and 48 months of age in GUSTO. Measures of epigenetic age acceleration were calculated using the PedBE clock and benchmarked against an established multi-tissue epigenetic predictor. RESULTS Prenatal maternal anxiety predicted child PedBE epigenetic age acceleration in both cohorts, with effects largely restricted to males and not females. These results were independent of obstetric, socioeconomic, and genetic risk factors, with a larger effect size for prenatal anxiety than depression. PedBE age acceleration predicted increased externalizing symptoms in males from mid- to late childhood in the BIBO cohort only. CONCLUSIONS These findings point to the fetal origins of epigenetic age acceleration and reveal an increased sensitivity in males. Convergent evidence underscores the societal importance of providing timely and effective mental health support to pregnant individuals, which may have lasting consequences for both mother and child.
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Affiliation(s)
- Megan G McGill
- Douglas Hospital Research Centre, McGill University, Montreal, Quebec, Canada; Department of Psychiatry, and Ludmer Centre for Neuroinformatics and Mental Health, McGill University, Montreal, Quebec, Canada
| | - Irina Pokhvisneva
- Douglas Hospital Research Centre, McGill University, Montreal, Quebec, Canada; Department of Psychiatry, and Ludmer Centre for Neuroinformatics and Mental Health, McGill University, Montreal, Quebec, Canada
| | - Andrew S Clappison
- Douglas Hospital Research Centre, McGill University, Montreal, Quebec, Canada; Department of Psychiatry, and Ludmer Centre for Neuroinformatics and Mental Health, McGill University, Montreal, Quebec, Canada
| | - Lisa M McEwen
- Centre for Molecular Medicine and Therapeutics, University of British Columbia, Vancouver, British Columbia, Canada
| | - Roseriet Beijers
- Department of Developmental Psychology, Radboud University, Nijmegen, the Netherlands; Department of Cognitive Neuroscience, Donders Institute for Brain, Cognition and Behaviour, Radboudumc, Nijmegen, the Netherlands
| | - Marieke S Tollenaar
- Department of Clinical Psychology, Institute of Psychology and Leiden Institute for Brain and Cognition, Leiden University, Leiden, the Netherlands
| | - Hung Pham
- Yale Child Study Center and Department of Obstetrics, Gynecology, and Reproductive Sciences, Yale School of Medicine, Yale University, New Haven, Connecticut
| | | | - Elika Garg
- Douglas Hospital Research Centre, McGill University, Montreal, Quebec, Canada; Department of Psychiatry, and Ludmer Centre for Neuroinformatics and Mental Health, McGill University, Montreal, Quebec, Canada
| | | | - Neerja Karnani
- Department of Biochemistry, Yong Loo Lin School of Medicine, National University of Singapore, Singapore; Department of Biochemistry, Yong Loo Lin School of Medicine, National University of Singapore, Singapore; Bioinformatics Institute, Agency for Science, Technology, and Research, Singapore
| | - Patricia P Silveira
- Douglas Hospital Research Centre, McGill University, Montreal, Quebec, Canada; Department of Psychiatry, and Ludmer Centre for Neuroinformatics and Mental Health, McGill University, Montreal, Quebec, Canada
| | - Michael S Kobor
- Centre for Molecular Medicine and Therapeutics, University of British Columbia, Vancouver, British Columbia, Canada; Child and Brain Development Program, Canadian Institute for Advanced Research, Toronto, Ontario, Canada
| | - Carolina de Weerth
- Department of Cognitive Neuroscience, Donders Institute for Brain, Cognition and Behaviour, Radboudumc, Nijmegen, the Netherlands
| | - Michael J Meaney
- Douglas Hospital Research Centre, McGill University, Montreal, Quebec, Canada; Department of Psychiatry, and Ludmer Centre for Neuroinformatics and Mental Health, McGill University, Montreal, Quebec, Canada; Singapore Institute for Clinical Sciences, Singapore; Child and Brain Development Program, Canadian Institute for Advanced Research, Toronto, Ontario, Canada; Department of Paediatrics, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Kieran J O'Donnell
- Douglas Hospital Research Centre, McGill University, Montreal, Quebec, Canada; Department of Psychiatry, and Ludmer Centre for Neuroinformatics and Mental Health, McGill University, Montreal, Quebec, Canada; Yale Child Study Center and Department of Obstetrics, Gynecology, and Reproductive Sciences, Yale School of Medicine, Yale University, New Haven, Connecticut; Child and Brain Development Program, Canadian Institute for Advanced Research, Toronto, Ontario, Canada.
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37
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Dufford AJ, Spann M, Scheinost D. How prenatal exposures shape the infant brain: Insights from infant neuroimaging studies. Neurosci Biobehav Rev 2021; 131:47-58. [PMID: 34536461 DOI: 10.1016/j.neubiorev.2021.09.017] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2021] [Revised: 07/30/2021] [Accepted: 09/12/2021] [Indexed: 10/20/2022]
Abstract
Brain development during the prenatal period is rapid and unparalleled by any other time during development. Biological systems undergoing rapid development are at higher risk for disorganizing influences. Therefore, certain prenatal exposures impact brain development, increasing risk for negative neurodevelopmental outcome. While prenatal exposures have been associated with cognitive and behavioral outcomes later in life, the underlying macroscopic brain pathways remain unclear. Here, we review magnetic resonance imaging (MRI) studies investigating the association between prenatal exposures and infant brain development focusing on prenatal exposures via maternal physical health factors, maternal mental health factors, and maternal drug and medication use. Further, we discuss the need for studies to consider multiple prenatal exposures in parallel and suggest future directions for this body of research.
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Affiliation(s)
| | - Marisa Spann
- Columbia University Irving Medical Center, 622 West 168th Street, New York, NY, 10032, USA
| | - Dustin Scheinost
- Child Study Center, Yale School of Medicine, New Haven, CT, USA; Department of Radiology and Biomedical Imaging, Yale School of Medicine, USA; Department of Statistics and Data Science, Yale University, New Haven, CT, USA; Interdepartmental Neuroscience Program, Yale University, New Haven, CT, USA
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38
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Demers CH, Bagonis MM, Al-Ali K, Garcia SE, Styner MA, Gilmore JH, Hoffman MC, Hankin BL, Davis EP. Exposure to prenatal maternal distress and infant white matter neurodevelopment. Dev Psychopathol 2021; 33:1526-1538. [PMID: 35586027 PMCID: PMC9109943 DOI: 10.1017/s0954579421000742] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
The prenatal period represents a critical time for brain growth and development. These rapid neurological advances render the fetus susceptible to various influences with life-long implications for mental health. Maternal distress signals are a dominant early life influence, contributing to birth outcomes and risk for offspring psychopathology. This prospective longitudinal study evaluated the association between prenatal maternal distress and infant white matter microstructure. Participants included a racially and socioeconomically diverse sample of 85 mother-infant dyads. Prenatal distress was assessed at 17 and 29 weeks' gestational age (GA). Infant structural data were collected via diffusion tensor imaging at 42-45 weeks' postconceptional age. Findings demonstrated that higher prenatal maternal distress at 29 weeks' GA was associated with increased fractional anisotropy (b = .283, t(64) = 2.319, p = .024) and with increased axial diffusivity (b = .254, t(64) = 2.067, p = .043) within the right anterior cingulate white matter tract. No other significant associations were found with prenatal distress exposure and tract fractional anisotropy or axial diffusivity at 29 weeks' GA, nor earlier in gestation.
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Affiliation(s)
- Catherine H. Demers
- Department of Psychology University of Denver, Denver CO,
USA
- Department of Psychiatry, University of Colorado Anschutz
Medical Campus, Aurora CO, USA
| | - Maria M. Bagonis
- Department of Psychiatry, University of North Carolina at
Chapel Hill, Chapel Hill NC, USA
| | - Khalid Al-Ali
- Department of Psychiatry, University of North Carolina at
Chapel Hill, Chapel Hill NC, USA
| | - Sarah E. Garcia
- Department of Psychology University of Denver, Denver CO,
USA
| | - Martin A. Styner
- Department of Psychiatry, University of North Carolina at
Chapel Hill, Chapel Hill NC, USA
- Department of Computer Science, University of North
Carolina at Chapel Hill, Chapel Hill NC, USA
| | - John H. Gilmore
- Department of Psychiatry, University of North Carolina at
Chapel Hill, Chapel Hill NC, USA
| | - M. Camille Hoffman
- Department of Psychiatry, University of Colorado Anschutz
Medical Campus, Aurora CO, USA
- Department of Obstetrics and Gynecology, Division of
Maternal and Fetal Medicine, University of Colorado Denver School of Medicine,
Aurora, Colorado, USA
| | - Benjamin L. Hankin
- Department of Psychology, University of Illinois at
Urbana-Champaign, Champaign IL, USA
| | - Elysia Poggi Davis
- Department of Psychology University of Denver, Denver CO,
USA
- Department of Psychiatry and Human Behavior, University of
California, Irvine, CA, USA
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Crombie GK, Palliser HK, Shaw JC, Hodgson DM, Walker DW, Hirst JJ. Neurosteroid-based intervention using Ganaxolone and Emapunil for improving stress-induced myelination deficits and neurobehavioural disorders. Psychoneuroendocrinology 2021; 133:105423. [PMID: 34601389 DOI: 10.1016/j.psyneuen.2021.105423] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/02/2021] [Revised: 09/11/2021] [Accepted: 09/19/2021] [Indexed: 10/20/2022]
Abstract
BACKGROUND Prenatal stress is associated with long-term disturbances in white matter development and behaviour in children, such as attention deficit hyperactivity disorder (ADHD) and anxiety. Oligodendrocyte maturation and myelin formation is a tightly orchestrated process beginning during gestation, and therefore is very vulnerable to the effects of maternal prenatal stresses in mid-late pregnancy. The current study aimed to examine the effects of prenatal stress on components of the oligodendrocyte lineage to identify the key processes that are disrupted and to determine if postnatal therapies directed at ameliorating white matter deficits also improve behavioural outcomes. METHODS Pregnant guinea pig dams were exposed to control-handling or prenatal stress with strobe light exposure for 2hrs/day on gestational age (GA) 50, 55, 60 and 65, and allowed to spontaneously deliver ~GA70. Pups were administered oral ganaxolone (5 mg/kg/day in 45% cyclodextrin) or the TSPO agonist, emapunil (XBD173; 0.3 mg/kg/day in 1% tragacanth gum) or vehicle, on postnatal days (PND) 1-7. Behavioural outcomes were assessed using open field and elevated plus maze testing on PND7 and PND27. Hippocampal samples were collected at PND30 to assess markers of oligodendrocyte development through assessment of total oligodendrocytes (OLIG2) and mature cells (myelin basic protein; MBP), and total neurons (NeuN) by immunostaining. Real-time PCR was conducted on hippocampal regions to assess markers of the oligodendrocyte lineage, markers of neurogenesis and components of the neurosteroidogenesis pathway. Plasma samples were collected for steroid quantification of cortisol, allopregnanolone, progesterone and testosterone by ELISA. RESULTS Prenatal stress resulted in hyperactivity in male offspring, and anxiety-like behaviour in female offspring in the guinea pig at an age equivalent to late childhood. Postnatal ganaxolone and emapunil treatment after prenatal stress restored the behavioural phenotype to that of control in females only. The oligodendrocyte maturation lineage, translation of MBP mRNA-to-protein, and neurogenesis were disrupted in prenatally-stressed offspring, resulting in a decreased amount of mature myelin. Emapunil treatment restored mature myelin levels in both sexes, and reversed disruptions to the oligodendrocyte lineage in female offspring, an effect not seen with ganaxolone treatment. CONCLUSION The marked and persisting behavioural and white matter perturbations observed in a clinically relevant guinea pig model of prenatal stress highlights the need for postnatal interventions that increase myelin repair and improve long-term outcomes. The effectiveness of emapunil treatment in restoring female offspring behaviour, and promoting maturation of myelin indicates that early therapeutic interventions can reverse the damaging effects of major stressful events in pregnancy. Further studies optimising target mechanisms and dosing are warranted.
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Affiliation(s)
- Gabrielle K Crombie
- Mothers and Babies Research Centre, Hunter Medical Research Institute, Newcastle, NSW, Australia; School of Biomedical Sciences and Pharmacy, University of Newcastle, NSW, Australia.
| | - Hannah K Palliser
- Mothers and Babies Research Centre, Hunter Medical Research Institute, Newcastle, NSW, Australia; School of Biomedical Sciences and Pharmacy, University of Newcastle, NSW, Australia
| | - Julia C Shaw
- Mothers and Babies Research Centre, Hunter Medical Research Institute, Newcastle, NSW, Australia; School of Biomedical Sciences and Pharmacy, University of Newcastle, NSW, Australia
| | | | - David W Walker
- School of Health and Biomedical Sciences, RMIT University, VIC, Australia
| | - Jonathan J Hirst
- Mothers and Babies Research Centre, Hunter Medical Research Institute, Newcastle, NSW, Australia; School of Biomedical Sciences and Pharmacy, University of Newcastle, NSW, Australia
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40
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Dufford AJ, Salzwedel AP, Gilmore JH, Gao W, Kim P. Maternal trait anxiety symptoms, frontolimbic resting-state functional connectivity, and cognitive development in infancy. Dev Psychobiol 2021; 63:e22166. [PMID: 34292595 PMCID: PMC10775911 DOI: 10.1002/dev.22166] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2019] [Revised: 06/13/2021] [Accepted: 06/22/2021] [Indexed: 11/07/2022]
Abstract
Exposure to maternal anxiety symptoms during infancy has been associated with difficulties in development and greater risk for developing anxiety later in life. Although previous studies have examined associations between prenatal maternal distress, infant brain development, and developmental outcomes, it is still largely unclear if there are associations between postnatal anxiety, infant brain development, and cognitive development in infancy. In this study, we used resting-state functional magnetic resonance imaging to examine the association between maternal anxiety symptoms and resting-state functional connectivity in the first year of life. We also examine the association between frontolimbic functional connectivity and infant cognitive development. The sample consisted of 21 infants (mean age = 24.15 months, SD = 4.17) that were scanned during their natural sleep using. We test the associations between maternal trait anxiety symptoms and amygdala-anterior cingulate cortex (ACC) functional connectivity, a neural circuit implicated in early life stress exposure. We also test the associations between amygdala-ACC connectivity and cognitive development. We found a significant negative association between maternal trait anxiety symptoms and left amygdala-right ACC functional connectivity (p < .05, false discovery rate corrected). We found a significant negative association between left amygdala-right ACC functional connectivity and infant cognitive development (p < .05). These findings have potential implications for understanding the role of postpartum maternal anxiety symptoms in functional brain and cognitive development in infancy.
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Affiliation(s)
| | - Andrew P. Salzwedel
- Biomedical Imaging Research Institute, Cedars-Sinai Medical Center, Los Angeles, California, USA
| | - John H. Gilmore
- Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Wei Gao
- Biomedical Imaging Research Institute, Cedars-Sinai Medical Center, Los Angeles, California, USA
| | - Pilyoung Kim
- Department of Psychology, University of Denver, Denver, Colorado, USA
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41
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Mareckova K, Marecek R, Andryskova L, Brazdil M, Nikolova YS. Impact of prenatal stress on amygdala anatomy in young adulthood: Timing and location matter. BIOLOGICAL PSYCHIATRY: COGNITIVE NEUROSCIENCE AND NEUROIMAGING 2021; 7:231-238. [PMID: 34358683 DOI: 10.1016/j.bpsc.2021.07.009] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/18/2021] [Revised: 07/15/2021] [Accepted: 07/20/2021] [Indexed: 12/21/2022]
Abstract
BACKGROUND Exposure to maternal stress in utero has long-term implications for the developing brain and has been linked with a higher risk of depression. The amygdala, which develops during the early embryonic stage and is critical for emotion processing, might be particularly sensitive. METHODS Using data from a neuroimaging follow-up of the ELSPAC prenatal birth cohort (n=129, 47% men, 23-24 years old), we studied the impact of prenatal stress during the first and second half of pregnancy on the volume of the amygdala and its nuclei in young adult offspring. We further evaluated the relationship between amygdala anatomy and offspring depressive symptomatology. Amygdala nuclei were parcellated using FreeSurfer's automated segmentation pipeline. Depressive symptoms were measured via self-report using the Beck Depression Inventory (BDI). RESULTS Exposure to stress during the first half of pregnancy was associated with smaller accessory basal (Cohen's f2=0.27, p(FDR)=0.03) and cortical (Cohen's f2=0.29, p(FDR)=0.03) nuclei volumes. This effect remained significant after correcting for sex, stress during the second half of pregnancy, as well as maternal age at birth, birth weight, maternal education, and offspring's age at MRI. These two nuclei showed a quadratic relationship with BDI scores in young adulthood, where both smaller and larger volume was associated with more depressive symptoms (Accessory basal nucleus: Adj R2=0.05. p(FDR)=0.015; Cortical nucleus: Adj R2=0.04, p(FDR)=0.015). CONCLUSIONS We conclude that exposure to stress during the first half of pregnancy might have long-term implications for amygdala anatomy, which may in turn predict the experience of depressive symptoms in young adulthood.
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Affiliation(s)
- Klara Mareckova
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Ontario, Canada; Brain and Mind Research, Central European Institute of Technology, Masaryk University, Brno, Czech Republic.
| | - Radek Marecek
- Brain and Mind Research, Central European Institute of Technology, Masaryk University, Brno, Czech Republic
| | - Lenka Andryskova
- RECETOX, Faculty of Science, Masaryk University, Brno, Czech Republic
| | - Milan Brazdil
- Brain and Mind Research, Central European Institute of Technology, Masaryk University, Brno, Czech Republic
| | - Yuliya S Nikolova
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Ontario, Canada; Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada.
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42
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Nolvi S, Tuulari JJ, Lavonius T, Scheinin NM, Lehtola SJ, Lavonius M, Merisaari H, Saunavaara J, Korja R, Kataja EL, Pelto J, Parkkola R, Karlsson L, Karlsson H. Newborn white matter microstructure moderates the association between maternal postpartum depressive symptoms and infant negative reactivity. Soc Cogn Affect Neurosci 2021; 15:649-660. [PMID: 32577747 PMCID: PMC7393309 DOI: 10.1093/scan/nsaa081] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2020] [Revised: 04/29/2020] [Accepted: 06/08/2020] [Indexed: 12/20/2022] Open
Abstract
Maternal postpartum depression is a prominent risk factor for aberrant child socioemotional development, but there is little understanding about the neural phenotypes that underlie infant sensitivity to maternal depression. We examined whether newborn white matter fractional anisotropy (FA), a measure of white matter maturity, moderates the association between maternal postpartum depressive symptoms and infant negative reactivity at 6 months. Participants were 80 mother–infant dyads participating in a prospective population-based cohort, and included families whose newborns underwent a magnetic resonance/diffusion tensor imaging scan at 2–5 weeks of age and whose mothers reported their own depressive symptoms at 3 and 6 months postpartum and infant negative emotional reactivity at 6 months. The whole-brain FA moderated the association between maternal depressive symptoms and mother-reported infant negative reactivity at 6 months after adjusting for the covariates. Maternal depressive symptoms were positively related to infant negative reactivity among infants with high or average FA in the whole brain and in corpus callosum and cingulum, but not among those with low FA. The link between maternal depressive symptoms and infant negative reactivity was moderated by newborn FA. The variation in white matter microstructure might play a role in child susceptibility to parental distress.
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Affiliation(s)
- Saara Nolvi
- FinnBrain Birth Cohort Study, Turku Brain and Mind Center, Department of Clinical Medicine, University of Turku, Turku, Finland.,Department of Medical Psychology, Charité - Universitätsmedizin Berlin, Berlin, Germany.,Department of Psychology and Speech-Language Pathology, University of Turku, Turku, Finland.,Turku Institute for Advanced Studies, University of Turku, Turku, Finland
| | - Jetro J Tuulari
- FinnBrain Birth Cohort Study, Turku Brain and Mind Center, Department of Clinical Medicine, University of Turku, Turku, Finland.,Department of Psychiatry, Turku University Hospital and University of Turku, Turku, Finland.,Department of Psychiatry, University of Oxford, Oxford, UK
| | - Tuomas Lavonius
- FinnBrain Birth Cohort Study, Turku Brain and Mind Center, Department of Clinical Medicine, University of Turku, Turku, Finland
| | - Noora M Scheinin
- FinnBrain Birth Cohort Study, Turku Brain and Mind Center, Department of Clinical Medicine, University of Turku, Turku, Finland.,Department of Psychiatry, Turku University Hospital and University of Turku, Turku, Finland
| | - Satu J Lehtola
- FinnBrain Birth Cohort Study, Turku Brain and Mind Center, Department of Clinical Medicine, University of Turku, Turku, Finland
| | - Maria Lavonius
- FinnBrain Birth Cohort Study, Turku Brain and Mind Center, Department of Clinical Medicine, University of Turku, Turku, Finland
| | - Harri Merisaari
- FinnBrain Birth Cohort Study, Turku Brain and Mind Center, Department of Clinical Medicine, University of Turku, Turku, Finland.,Department of Future Technologies, University of Turku, Turku, Finland.,Department of Biomedical Engineering, Case Western Reserve University, Cleveland, OH, USA
| | - Jani Saunavaara
- Department of Medical Physics, Turku University Hospital, Turku, Finland
| | - Riikka Korja
- FinnBrain Birth Cohort Study, Turku Brain and Mind Center, Department of Clinical Medicine, University of Turku, Turku, Finland.,Department of Psychology and Speech-Language Pathology, University of Turku, Turku, Finland
| | - Eeva-Leena Kataja
- FinnBrain Birth Cohort Study, Turku Brain and Mind Center, Department of Clinical Medicine, University of Turku, Turku, Finland.,Department of Psychology and Speech-Language Pathology, University of Turku, Turku, Finland
| | - Juho Pelto
- FinnBrain Birth Cohort Study, Turku Brain and Mind Center, Department of Clinical Medicine, University of Turku, Turku, Finland
| | - Riitta Parkkola
- FinnBrain Birth Cohort Study, Turku Brain and Mind Center, Department of Clinical Medicine, University of Turku, Turku, Finland.,Department of Radiology, Turku University Hospital and University of Turku, Turku, Finland
| | - Linnea Karlsson
- FinnBrain Birth Cohort Study, Turku Brain and Mind Center, Department of Clinical Medicine, University of Turku, Turku, Finland.,Department of Child Psychiatry, Turku University Hospital and University of Turku, Turku, Finland.,Centre for Population Health Research, University of Turku and Turku University Hospital, Turku, Finland
| | - Hasse Karlsson
- FinnBrain Birth Cohort Study, Turku Brain and Mind Center, Department of Clinical Medicine, University of Turku, Turku, Finland.,Department of Psychiatry, Turku University Hospital and University of Turku, Turku, Finland.,Centre for Population Health Research, University of Turku and Turku University Hospital, Turku, Finland
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43
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Dean DC, Madrid A, Planalp EM, Moody JF, Papale LA, Knobel KM, Wood EK, McAdams RM, Coe CL, Hill Goldsmith H, Davidson RJ, Alisch RS, Kling PJ. Cord blood DNA methylation modifications in infants are associated with white matter microstructure in the context of prenatal maternal depression and anxiety. Sci Rep 2021; 11:12181. [PMID: 34108589 PMCID: PMC8190282 DOI: 10.1038/s41598-021-91642-0] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2020] [Accepted: 05/17/2021] [Indexed: 12/12/2022] Open
Abstract
Maternal and environmental factors influence brain networks and architecture via both physiological pathways and epigenetic modifications. In particular, prenatal maternal depression and anxiety symptoms appear to impact infant white matter (WM) microstructure, leading us to investigate whether epigenetic modifications (i.e., DNA methylation) contribute to these WM differences. To determine if infants of women with depression and anxiety symptoms exhibit epigenetic modifications linked to neurodevelopmental changes, 52 umbilical cord bloods (CBs) were profiled. We observed 219 differentially methylated genomic positions (DMPs; FDR p < 0.05) in CB that were associated with magnetic resonance imaging measures of WM microstructure at 1 month of age and in regions previously described to be related to maternal depression and anxiety symptoms. Genomic characterization of these associated DMPs revealed 143 unique genes with significant relationships to processes involved in neurodevelopment, GTPase activity, or the canonical Wnt signaling pathway. Separate regression models for female (n = 24) and male (n = 28) infants found 142 associated DMPs in females and 116 associated DMPs in males (nominal p value < 0.001, R > 0.5), which were annotated to 98 and 81 genes, respectively. Together, these findings suggest that umbilical CB DNA methylation levels at birth are associated with 1-month WM microstructure.
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Affiliation(s)
- Douglas C Dean
- Department of Pediatrics, School of Medicine & Public Health, University of Wisconsin-Madison, Madison, USA.,Department of Medical Physics, School of Medicine & Public Health, University of Wisconsin-Madison, Madison, WI, USA.,Waisman Center, School of Medicine & Public Health, University of Wisconsin-Madison, Madison, WI, USA
| | - Andy Madrid
- Department of Neurosurgery, School of Medicine & Public Health, University of Wisconsin-Madison, Madison, WI, USA
| | - Elizabeth M Planalp
- Waisman Center, School of Medicine & Public Health, University of Wisconsin-Madison, Madison, WI, USA.,Department of Psychology, School of Medicine & Public Health, University of Wisconsin-Madison, Madison, WI, USA
| | - Jason F Moody
- Department of Medical Physics, School of Medicine & Public Health, University of Wisconsin-Madison, Madison, WI, USA
| | - Ligia A Papale
- Department of Neurosurgery, School of Medicine & Public Health, University of Wisconsin-Madison, Madison, WI, USA
| | - Karla M Knobel
- Waisman Center, School of Medicine & Public Health, University of Wisconsin-Madison, Madison, WI, USA
| | - Elizabeth K Wood
- Harlow Center for Biological Psychology, School of Medicine & Public Health, University of Wisconsin-Madison, Madison, WI, USA
| | - Ryan M McAdams
- Department of Pediatrics, School of Medicine & Public Health, University of Wisconsin-Madison, Madison, USA
| | - Christopher L Coe
- Waisman Center, School of Medicine & Public Health, University of Wisconsin-Madison, Madison, WI, USA.,Department of Psychology, School of Medicine & Public Health, University of Wisconsin-Madison, Madison, WI, USA.,Harlow Center for Biological Psychology, School of Medicine & Public Health, University of Wisconsin-Madison, Madison, WI, USA
| | - H Hill Goldsmith
- Waisman Center, School of Medicine & Public Health, University of Wisconsin-Madison, Madison, WI, USA.,Department of Psychology, School of Medicine & Public Health, University of Wisconsin-Madison, Madison, WI, USA
| | - Richard J Davidson
- Waisman Center, School of Medicine & Public Health, University of Wisconsin-Madison, Madison, WI, USA.,Department of Psychology, School of Medicine & Public Health, University of Wisconsin-Madison, Madison, WI, USA.,Center for Healthy Minds, School of Medicine & Public Health, University of Wisconsin-Madison, Madison, WI, USA.,Department of Psychiatry, School of Medicine & Public Health, University of Wisconsin-Madison, Madison, WI, USA
| | - Reid S Alisch
- Department of Neurosurgery, School of Medicine & Public Health, University of Wisconsin-Madison, Madison, WI, USA.
| | - Pamela J Kling
- Department of Pediatrics, School of Medicine & Public Health, University of Wisconsin-Madison, Madison, USA
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44
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Campbell KSJ, Williams LJ, Bjornson BH, Weik E, Brain U, Grunau RE, Miller SP, Oberlander TF. Prenatal antidepressant exposure and sex differences in neonatal corpus callosum microstructure. Dev Psychobiol 2021; 63:e22125. [PMID: 33942888 DOI: 10.1002/dev.22125] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2020] [Revised: 03/31/2021] [Accepted: 04/01/2021] [Indexed: 11/09/2022]
Abstract
Prenatal exposure to selective serotonin reuptake inhibitor (SSRI) antidepressants may influence white matter (WM) development, as previous studies report widespread microstructural alterations and reduced interhemispheric connectivity in SSRI-exposed infants. In rodents, perinatal SSRIs had sex-specific disruptions in corpus callosum (CC) axon architecture and connectivity; yet it is unknown whether SSRI-related brain outcomes in humans are sex specific. In this study, the neonate CC was selected as a region-of-interest to investigate whether prenatal SSRI exposure has sex-specific effects on early WM microstructure. On postnatal day 7, diffusion tensor imaging was used to assess WM microstructure in SSRI-exposed (n = 24; 12 male) and nonexposed (n = 48; 28 male) term-born neonates. Fractional anisotropy was extracted from CC voxels and a multivariate discriminant analysis was used to identify latent patterns differing between neonates grouped by SSRI-exposure and sex. Analysis revealed localized variations in CC fractional anisotropy that significantly discriminated neonate groups and correctly predicted group membership with an 82% accuracy. Such effects were identified across three dimensions, representing sex differences in SSRI-exposed neonates (genu, splenium), SSRI-related effects independent of sex (genu-to-rostral body), and sex differences in nonexposed neonates (isthmus-splenium, posterior midbody). Our findings suggest that CC microstructure may have a sex-specific, localized, developmental sensitivity to prenatal SSRI exposure.
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Affiliation(s)
- Kayleigh S J Campbell
- BC Children's Hospital Research Institute, Vancouver, Canada.,Department of Obstetrics & Gynaecology, University of British Columbia, Vancouver, Canada
| | | | - Bruce H Bjornson
- BC Children's Hospital Research Institute, Vancouver, Canada.,Department of Pediatrics, University of British Columbia, Vancouver, Canada
| | - Ella Weik
- BC Children's Hospital Research Institute, Vancouver, Canada
| | - Ursula Brain
- BC Children's Hospital Research Institute, Vancouver, Canada.,Department of Pediatrics, University of British Columbia, Vancouver, Canada
| | - Ruth E Grunau
- BC Children's Hospital Research Institute, Vancouver, Canada.,Department of Pediatrics, University of British Columbia, Vancouver, Canada
| | - Steven P Miller
- Department of Pediatrics, The Hospital for Sick Children and the University of Toronto, Toronto, Canada
| | - Tim F Oberlander
- BC Children's Hospital Research Institute, Vancouver, Canada.,Department of Pediatrics, University of British Columbia, Vancouver, Canada
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45
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Mennes M, Stiers P, Lagae L, Van den Bergh BRH. Antenatal maternal anxiety modulates the BOLD response in 20-year-old men during endogenous cognitive control. Brain Imaging Behav 2021; 14:830-846. [PMID: 30617784 DOI: 10.1007/s11682-018-0027-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Evidence is building for an association between the level of anxiety experienced by a mother during pregnancy and offspring cognition and structural and functional brain correlates. The current study uses fMRI to examine the association between prenatal exposure to maternal anxiety and brain activity associated with endogenous versus exogenous cognitive control in 20-year-old males. Endogenous cognitive control refers to the ability to generate control over decisions, strategies, conflicting information and so on, from within oneself without external signals, while exogenous control is triggered by external signals. In line with previous results of this long-term follow-up study we found that 20-year-olds of mothers reporting high levels of anxiety during weeks 12-22 of pregnancy exhibited a different pattern of decision making in a Gambling paradigm requiring endogenous cognitive control, compared to adults of mothers reporting low to average levels of anxiety. Moreover, the blood oxygenation level dependent (BOLD) response in a number of prefrontal cortical areas was modulated by the level of antenatal maternal anxiety. In particular, a number of right lateralized clusters including inferior frontal junction, that were modulated in the adults of mothers reporting low to average levels of anxiety during pregnancy by a task manipulation of cognitive control, were not modulated by this manipulation in the adults of mothers reporting high levels of anxiety during pregnancy. These differences in brain functional correlates provide a neurobiological underpinning for the hypothesis of an association between exposure to maternal anxiety in the prenatal life period and a deficit in endogenous cognitive control in early adulthood.
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Affiliation(s)
- Maarten Mennes
- Donders Institute for Brain, Cognition, and Behavior, Radboud University, Nijmegen, The Netherlands
| | - Peter Stiers
- Department of Neuropsychology and Psychopharmacology, Maastricht University, Maastricht, The Netherlands
| | - Lieven Lagae
- Section Paediatric Neurology, Department Development and Regeneration, University Hospitals KU Leuven, Leuven, Belgium
| | - Bea R H Van den Bergh
- Health Psychology, Faculty of Psychology and Educational Sciences, University of Leuven - KU Leuven, Tiensestraat 102 - bus 3726, 3000, Leuven, Belgium. .,Department of Welfare, Public Health and Family, Flemish Government, Brussels, Belgium.
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46
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Lautarescu A, Hadaya L, Craig MC, Makropoulos A, Batalle D, Nosarti C, Edwards AD, Counsell SJ, Victor S. Exploring the relationship between maternal prenatal stress and brain structure in premature neonates. PLoS One 2021; 16:e0250413. [PMID: 33882071 PMCID: PMC8059832 DOI: 10.1371/journal.pone.0250413] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2020] [Accepted: 04/06/2021] [Indexed: 11/20/2022] Open
Abstract
BACKGROUND Exposure to maternal stress in utero is associated with a range of adverse outcomes. We previously observed an association between maternal stress and white matter microstructure in a sample of infants born prematurely. In this study, we aimed to investigate the relationship between maternal trait anxiety, stressful life events and brain volumes. METHODS 221 infants (114 males, 107 females) born prematurely (median gestational age = 30.43 weeks [range 23.57-32.86]) underwent magnetic resonance imaging around term-equivalent age (mean = 42.20 weeks, SD = 1.60). Brain volumes were extracted for the following regions of interest: frontal lobe, temporal lobe, amygdala, hippocampus, thalamus and normalized to total brain volume. Multiple linear regressions were conducted to investigate the relationship between maternal anxiety/stress and brain volumes, controlling for gestational age at birth, postmenstrual age at scan, socioeconomic status, sex, days on total parenteral nutrition. Additional exploratory Tensor Based Morphometry analyses were performed to obtain voxel-wise brain volume changes from Jacobian determinant maps. RESULTS AND CONCLUSION In this large prospective study, we did not find evidence of a relationship between maternal prenatal stress or trait anxiety and brain volumes. This was the case for both the main analysis using a region-of-interest approach, and for the exploratory analysis using Jacobian determinant maps. We discuss these results in the context of conflicting evidence from previous studies and highlight the need for further research on premature infants, particularly including term-born controls.
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Affiliation(s)
- Alexandra Lautarescu
- Department of Perinatal Imaging and Health, Centre for the Developing Brain, School of Biomedical Engineering and Imaging Sciences, King’s College London, London, United Kingdom
- Department of Forensic and Neurodevelopmental Sciences, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, United Kingdom
| | - Laila Hadaya
- Department of Perinatal Imaging and Health, Centre for the Developing Brain, School of Biomedical Engineering and Imaging Sciences, King’s College London, London, United Kingdom
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, United Kingdom
| | - Michael C. Craig
- Department of Forensic and Neurodevelopmental Sciences, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, United Kingdom
- National Female Hormone Clinic, South London and Maudsley National Health Service Foundation Trust, London, United Kingdom
| | - Antonis Makropoulos
- Department of Perinatal Imaging and Health, Centre for the Developing Brain, School of Biomedical Engineering and Imaging Sciences, King’s College London, London, United Kingdom
| | - Dafnis Batalle
- Department of Perinatal Imaging and Health, Centre for the Developing Brain, School of Biomedical Engineering and Imaging Sciences, King’s College London, London, United Kingdom
- Department of Forensic and Neurodevelopmental Sciences, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, United Kingdom
| | - Chiara Nosarti
- Department of Perinatal Imaging and Health, Centre for the Developing Brain, School of Biomedical Engineering and Imaging Sciences, King’s College London, London, United Kingdom
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, United Kingdom
| | - A. David Edwards
- Department of Perinatal Imaging and Health, Centre for the Developing Brain, School of Biomedical Engineering and Imaging Sciences, King’s College London, London, United Kingdom
| | - Serena J. Counsell
- Department of Perinatal Imaging and Health, Centre for the Developing Brain, School of Biomedical Engineering and Imaging Sciences, King’s College London, London, United Kingdom
| | - Suresh Victor
- Department of Perinatal Imaging and Health, Centre for the Developing Brain, School of Biomedical Engineering and Imaging Sciences, King’s College London, London, United Kingdom
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47
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Emerging Evidence for Putative Neural Networks and Antecedents of Pediatric Anxiety in the Fetal, Neonatal, and Infant Periods. Biol Psychiatry 2021; 89:672-680. [PMID: 33518264 PMCID: PMC8087150 DOI: 10.1016/j.biopsych.2020.11.020] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/09/2020] [Revised: 11/12/2020] [Accepted: 11/22/2020] [Indexed: 12/20/2022]
Abstract
Anxiety disorders are the most prevalent psychiatric disorders in youth and are associated with profound individual impairment and public health costs. Research shows that clinically significant anxiety symptoms manifest in preschool-aged children, and correlates of anxiety symptoms are observable in infancy. Yet, predicting who is at risk for developing anxiety remains an enduring challenge. Predictive biomarkers of anxiety are needed before school age when anxiety symptoms typically consolidate into diagnostic profiles. Increasing evidence indicates that early neural measures implicated in anxiety and anxious temperament may be incorporated with traditional measures of behavioral risk (i.e., behavioral inhibition) to provide more robust classification of pediatric anxiety problems. This review examines the phenomenology of anxiety disorders in early life, highlighting developmental research that interrogates the putative neurocircuitry of pediatric anxiety. First, we discuss enduring challenges in identifying and predicting risk for pediatric anxiety. Second, we summarize emerging evidence for putative neural antecedents and networks underlying risk for pediatric anxiety in the fetal, neonatal, and infant periods that represent novel potential avenues for risk identification and prediction. We focus on evidence examining the importance of early amygdala and extended amygdala circuitry development to the emergence of anxiety. Finally, we discuss the utility of integrating developmental psychopathology and neuroscience to facilitate future research and clinical work.
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48
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Donnici C, Long X, Dewey D, Letourneau N, Landman B, Huo Y, Lebel C. Prenatal and postnatal maternal anxiety and amygdala structure and function in young children. Sci Rep 2021; 11:4019. [PMID: 33597557 PMCID: PMC7889894 DOI: 10.1038/s41598-021-83249-2] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2020] [Accepted: 02/01/2021] [Indexed: 12/19/2022] Open
Abstract
Anxiety symptoms are relatively common during pregnancy and are associated with behavioural problems in children. The amygdala is involved in emotion regulation, and its volume and function are associated with exposure to prenatal maternal depression. The associations between perinatal maternal anxiety and children's amygdala structure and function remain unclear. The objective of this study was to determine associations between prenatal and postnatal maternal anxiety and amygdala structure and function in children. Maternal anxiety was measured during the second trimester of pregnancy and 12 weeks postpartum. T1-weighted anatomical data and functional magnetic resonance imaging data were collected from 54 children (25 females), between the ages of 3-7 years. Amygdala volume was calculated and functional connectivity maps were created between the amygdalae and the rest of the brain. Spearman correlations were used to test associations between amygdala volume/functional connectivity and maternal anxiety symptoms, controlling for maternal depression symptoms. Second trimester maternal anxiety symptoms were negatively associated with functional connectivity between the left amygdala and clusters in bilateral parietal regions; higher maternal anxiety was associated with increased negative connectivity. Postnatal maternal anxiety symptoms were positively associated with child amygdala volume, but this finding did not remain significant while controlling for total brain volume. These functional connectivity differences may underlie behavioral outcomes in children exposed to maternal anxiety during pregnancy.
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Affiliation(s)
- Claire Donnici
- Neuroscience Program, University of Calgary, Calgary, AB, Canada
- Alberta Children's Hospital Research Institute, Calgary, AB, Canada
- Hotchkiss Brain Institute, Calgary, AB, Canada
| | - Xiangyu Long
- Alberta Children's Hospital Research Institute, Calgary, AB, Canada
- Department of Radiology, University of Calgary, Calgary, AB, Canada
| | - Deborah Dewey
- Alberta Children's Hospital Research Institute, Calgary, AB, Canada
- Department of Pediatrics, University of Calgary, Calgary, AB, Canada
- Hotchkiss Brain Institute, Calgary, AB, Canada
- Department of Community Health Sciences, University of Calgary, Calgary, AB, Canada
| | - Nicole Letourneau
- Alberta Children's Hospital Research Institute, Calgary, AB, Canada
- Department of Pediatrics, University of Calgary, Calgary, AB, Canada
- Department of Community Health Sciences, University of Calgary, Calgary, AB, Canada
- Faculty of Nursing, University of Calgary, Calgary, AB, Canada
| | - Bennett Landman
- Department of Electrical Engineering & Computer Science, Vanderbilt University, Nashville, TN, USA
| | - Yuankai Huo
- Department of Electrical Engineering & Computer Science, Vanderbilt University, Nashville, TN, USA
| | - Catherine Lebel
- Alberta Children's Hospital Research Institute, Calgary, AB, Canada.
- Department of Radiology, University of Calgary, Calgary, AB, Canada.
- Hotchkiss Brain Institute, Calgary, AB, Canada.
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49
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Income disparity in school readiness and the mediating role of perinatal maternal mental health: a longitudinal birth cohort study. Epidemiol Psychiatr Sci 2021; 30:e6. [PMID: 33416045 PMCID: PMC8057379 DOI: 10.1017/s204579602000102x] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
AIMS There is compelling evidence for gradient effects of household income on school readiness. Potential mechanisms are described, yet the growth curve trajectory of maternal mental health in a child's early life has not been thoroughly investigated. We aimed to examine the relationships between household incomes, maternal mental health trajectories from antenatal to the postnatal period, and school readiness. METHODS Prospective data from 505 mother-child dyads in a birth cohort in Singapore were used, including household income, repeated measures of maternal mental health from pregnancy to 2-years postpartum, and a range of child behavioural, socio-emotional and cognitive outcomes from 2 to 6 years of age. Antenatal mental health and its trajectory were tested as mediators in the latent growth curve models. RESULTS Household income was a robust predictor of antenatal maternal mental health and all child outcomes. Between children from the bottom and top household income quartiles, four dimensions of school readiness skills differed by a range of 0.52 (95% Cl: 0.23, 0.67) to 1.21 s.d. (95% CI: 1.02, 1.40). Thirty-eight percent of pregnant mothers in this cohort were found to have perinatal depressive and anxiety symptoms in the subclinical and clinical ranges. Poorer school readiness skills were found in children of these mothers when compared to those of mothers with little or no symptoms. After adjustment of unmeasured confounding on the indirect effect, antenatal maternal mental health provided a robust mediating path between household income and multiple school readiness outcomes (χ2 126.05, df 63, p < 0.001; RMSEA = 0.031, CFI = 0.980, SRMR = 0.034). CONCLUSIONS Pregnant mothers with mental health symptoms, particularly those from economically-challenged households, are potential targets for intervention to level the playing field of their children.
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50
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Abstract
Perinatal maternal symptoms of depression and anxiety compromise psychosocial function and influence developmental outcomes in the offspring. The onset of symptoms remains unclear with findings that suggest a preconceptual origin. We addressed this issue with a prospective analysis of anxiety and depressive symptom profiles from preconception through to parturition. Women were recruited into a preconception study to assess (a) variation in symptom levels of depression and anxiety from pre- to post-conception and (b) if the symptom network profiles of depression and anxiety change from pre-conception to post-conception. A within-subject intraclass correlation analyses revealed that symptoms of depression or anxiety in the preconception phase strongly predicted those across pregnancy and into the early postnatal period. The symptom network analysis revealed that the symptom profiles remained largely unchanged from preconception into the second trimester. Our findings suggest that for a significant portion of women, maternal mental health remains stable from preconception into pregnancy. This finding highlights the need for early intervention studies on women's mental health to be targeted during the preconception period and to be extended across the population.
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