1
|
Pawluski JL. The parental brain, perinatal mental illness, and treatment: A review of key structural and functional changes. Semin Perinatol 2024; 48:151951. [PMID: 39030131 DOI: 10.1016/j.semperi.2024.151951] [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] [Indexed: 07/21/2024]
Abstract
The transition to parenthood is perhaps the only time in adult life when the brain changes to such a significant degree in such a short period, particularly in birthing parents. It is also a time when there is an increased risk of developing a mental illness, which may be due, in part, to the increased neuroplasticity. Thus, we must develop interventions and treatments that support parents and promote parental brain health. This review will highlight key findings from current research on how human brain structure and function are modified with 1) the transition to parenthood, 2) parenting stress and perinatal mental illness, and 3) treatments aimed at promoting perinatal mental health. The focus will be on birthing parents and mothers, but brain changes in non-birthing parents will also be discussed. Improvements in our understanding of the parental brain, in health and with illness, will promote the well-being of generations to come.
Collapse
Affiliation(s)
- Jodi L Pawluski
- Univ Rennes, Inserm, EHESP, Irset (Institut de Recherche en Santé, Environnement et Travail), UMR_S 1085, F-35000, Rennes, France.
| |
Collapse
|
2
|
Bjertrup AJ, Kofoed J, Egmose I, Wendelboe K, Southgate V, Væver MS, Miskowiak KW. Prenatal affective cognitive training to reduce the risk of postpartum depression (PACT): study protocol for a randomized controlled trial. Trials 2024; 25:478. [PMID: 39010232 PMCID: PMC11247870 DOI: 10.1186/s13063-024-08316-1] [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] [Received: 10/23/2023] [Accepted: 07/03/2024] [Indexed: 07/17/2024] Open
Abstract
BACKGROUND Postpartum depression (PPD) affects 30-50% of women with a history of previous depression or bipolar disorder and 8% of women with no history of depression. Negative cognitive biases in the perception of infant cues and difficulties with emotion regulation are replicated risk factors. Current interventions focus on detecting and treating rather than preventing PPD. The aim of this randomized controlled intervention trial is therefore to investigate the potential prophylactic effects of prenatal affective cognitive training for pregnant women at heightened risk of PPD. METHODS The study will enrol a total of 292 pregnant women: 146 at high risk and 146 at low risk of PPD. Participants undergo comprehensive assessments of affective cognitive processing, clinical depressive symptoms, and complete questionnaires at baseline. Based on the responses, pregnant women will be categorized as either at high or low risk of PPD. High-risk participants will be randomized to either prenatal affective cognitive training (PACT) or care as usual (CAU) immediately after the baseline testing. The PACT intervention is based on emerging evidence for efficacy of affective cognitive training approaches in depression, including cognitive bias modification, attention bias modification, mindfulness-inspired emotion regulation exercises, and working memory training. Participants randomised to PACT will complete five individual computerised and virtual reality-based training sessions over 5 weeks. The primary outcome is the difference between intervention arms in the incidence of PPD, assessed with an interview 6 months after birth. We will also assess the severity of depressive symptoms, rated weekly online during the first 6 weeks postpartum. DISCUSSION The results will have implications for future early prophylactic interventions for pregnant women at heightened risk of PPD. If the PACT intervention reduces the incidence of PPD, it can become a feasible, non-invasive prophylactic strategy during pregnancy, with positive mental health implications for these women and their children. TRIAL REGISTRATION ClinicalTrials.gov NCT06046456 registered 21-09-2023, updated 08-07-2024.
Collapse
Affiliation(s)
- Anne J Bjertrup
- The Neurocognition and Emotion in Affective Disorders Centre (NEAD), Psychiatric Centre Copenhagen, Mental Health Services in the Capital Region of Denmark, Frederiksberg, Denmark.
| | - Jeanne Kofoed
- The Neurocognition and Emotion in Affective Disorders Centre (NEAD), Psychiatric Centre Copenhagen, Mental Health Services in the Capital Region of Denmark, Frederiksberg, Denmark
| | - Ida Egmose
- Department of Psychology, Faculty of Social Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Katrine Wendelboe
- Department of Psychology, Faculty of Social Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Victoria Southgate
- Department of Psychology, Faculty of Social Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Mette S Væver
- Department of Psychology, Faculty of Social Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Kamilla W Miskowiak
- The Neurocognition and Emotion in Affective Disorders Centre (NEAD), Psychiatric Centre Copenhagen, Mental Health Services in the Capital Region of Denmark, Frederiksberg, Denmark
- Department of Psychology, Faculty of Social Sciences, University of Copenhagen, Copenhagen, Denmark
| |
Collapse
|
3
|
Chen J, Zou Y, Jia YC, Ding FY, Luo J, Cheng G. Characteristics of the time processing of adults' strongest sustained attentional bias toward neutral infant faces. J Exp Child Psychol 2024; 243:105928. [PMID: 38643735 DOI: 10.1016/j.jecp.2024.105928] [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: 10/30/2023] [Revised: 02/16/2024] [Accepted: 03/20/2024] [Indexed: 04/23/2024]
Abstract
Previous studies have shown that adults exhibit the strongest attentional bias toward neutral infant faces when viewing faces with different expressions at different attentional processing stages due to different stimulus presentation times. However, it is not clear how the characteristics of the temporal processing associated with the strongest effect change over time. Thus, we combined a free-viewing task with eye-tracking technology to measure adults' attentional bias toward infant and adult faces with happy, neutral, and sad expressions of the same face. The results of the analysis of the total time course indicated that the strongest effect occurred during the strategic processing stage. However, the results of the analysis of the split time course revealed that sad infant faces first elicited adults' attentional bias at 0 to 500 ms, whereas the strongest effect of attentional bias toward neutral infant faces was observed at 1000 to 3000 ms, peaking at 1500 to 2000 ms. In addition, women and men had no differences in their responses to different expressions. In summary, this study provides further evidence that adults' attentional bias toward infant faces across stages of attention processing is modulated by expressions. Specifically, during automatic processing adults' attentional bias was directed toward sad infant faces, followed by a shift to the processing of neutral infant faces during strategic processing, which ultimately resulted in the strongest effect. These findings highlight that this strongest effect is dynamic and associated with a specific time window in the strategic process.
Collapse
Affiliation(s)
- Jia Chen
- School of Psychology, Guizhou Normal University, Guiyang 550025, China; Center for Rural Children and Adolescents Mental Health Education, Guizhou Normal University, Guiyang 550025, China
| | - Yan Zou
- Department of Women and Children, The Second People's Hospital of Guizhou Province, Guiyang 550000, China
| | - Yun Cheng Jia
- School of National Culture and Cognitive Science, Guizhou Minzu University, Guiyang 550029, China
| | - Fang Yuan Ding
- School of National Culture and Cognitive Science, Guizhou Minzu University, Guiyang 550029, China
| | - Jie Luo
- School of Psychology, Guizhou Normal University, Guiyang 550025, China
| | - Gang Cheng
- School of Psychology, Guizhou Normal University, Guiyang 550025, China; Center for Rural Children and Adolescents Mental Health Education, Guizhou Normal University, Guiyang 550025, China.
| |
Collapse
|
4
|
Kurata S, Nishitani S, Kawata NYS, Yao A, Fujisawa TX, Okazawa H, Tomoda A. Diffusion tensor imaging of white-matter structural features of maltreating mothers and their associations with intergenerational chain of childhood abuse. Sci Rep 2024; 14:5671. [PMID: 38453944 PMCID: PMC10920819 DOI: 10.1038/s41598-024-53666-0] [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] [Received: 07/16/2023] [Accepted: 02/03/2024] [Indexed: 03/09/2024] Open
Abstract
Child abuse causes lifelong adverse outcomes for both physical and mental health, although many are resilient. Efforts to prevent this issue from the parental side require an understanding of the neurobiological basis that leads abusive parents to perpetrate abuse and the influence of the intergenerational chain of childhood abuse. Therefore, this study was conducted to compare the brain white-matter fiber structures between 11 maltreating mothers who had been recognized as having conducted child abuse prior to the intervention and 40 age-matched control mothers using tract-based spatial statistics. There was a significantly reduced axial diffusivity (AD) and a similar trend in fractional anisotropy (FA) in the right corticospinal tract in maltreating mothers compared to control mothers. Therefore, maltreating mothers may have excessive control over the forcefulness of voluntary movements. These features also decreased as the number of childhood abuse experiences increased, suggesting that an intergenerational chain of child abuse may also be involved. Other aspects observed were that the higher the current depressive symptoms, the lower the AD and FA values; however, they were not related to parental practice or empathy. These results corroborate the neurobiological features that perpetrate behaviors in abusive mothers.
Collapse
Affiliation(s)
- Sawa Kurata
- Division of Developmental Higher Brain Functions, United Graduate School of Child Development, Osaka University, Osaka, Japan
- Kanazawa University, Kanazawa, Japan
- Hamamatsu University School of Medicine, Hamamatsu, Japan
- Chiba University, Chiba, Japan
- University of Fukui, Osaka, Japan
- Department of Child and Adolescent Psychological Medicine, University of Fukui Hospital, Fukui, Japan
- Research Center for Child Mental Development, University of Fukui, Fukui, Japan
| | - Shota Nishitani
- Division of Developmental Higher Brain Functions, United Graduate School of Child Development, Osaka University, Osaka, Japan.
- Kanazawa University, Kanazawa, Japan.
- Hamamatsu University School of Medicine, Hamamatsu, Japan.
- Chiba University, Chiba, Japan.
- University of Fukui, Osaka, Japan.
- Research Center for Child Mental Development, University of Fukui, Fukui, Japan.
- Life Science Innovation Center, School of Medical Sciences, University of Fukui, Fukui, Japan.
| | - Natasha Y S Kawata
- Research Center for Child Mental Development, University of Fukui, Fukui, Japan
| | - Akiko Yao
- Research Center for Child Mental Development, University of Fukui, Fukui, Japan
| | - Takashi X Fujisawa
- Division of Developmental Higher Brain Functions, United Graduate School of Child Development, Osaka University, Osaka, Japan
- Kanazawa University, Kanazawa, Japan
- Hamamatsu University School of Medicine, Hamamatsu, Japan
- Chiba University, Chiba, Japan
- University of Fukui, Osaka, Japan
- Research Center for Child Mental Development, University of Fukui, Fukui, Japan
- Life Science Innovation Center, School of Medical Sciences, University of Fukui, Fukui, Japan
| | - Hidehiko Okazawa
- Life Science Innovation Center, School of Medical Sciences, University of Fukui, Fukui, Japan
- Biomedical Imaging Research Center, University of Fukui, Fukui, Japan
| | - Akemi Tomoda
- Division of Developmental Higher Brain Functions, United Graduate School of Child Development, Osaka University, Osaka, Japan.
- Kanazawa University, Kanazawa, Japan.
- Hamamatsu University School of Medicine, Hamamatsu, Japan.
- Chiba University, Chiba, Japan.
- University of Fukui, Osaka, Japan.
- Department of Child and Adolescent Psychological Medicine, University of Fukui Hospital, Fukui, Japan.
- Research Center for Child Mental Development, University of Fukui, Fukui, Japan.
- Life Science Innovation Center, School of Medical Sciences, University of Fukui, Fukui, Japan.
| |
Collapse
|
5
|
Servin-Barthet C, Martínez-García M, Pretus C, Paternina-Die M, Soler A, Khymenets O, Pozo ÓJ, Leuner B, Vilarroya O, Carmona S. The transition to motherhood: linking hormones, brain and behaviour. Nat Rev Neurosci 2023; 24:605-619. [PMID: 37612425 DOI: 10.1038/s41583-023-00733-6] [Citation(s) in RCA: 13] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/28/2023] [Indexed: 08/25/2023]
Abstract
We are witnessing a stark increase in scientific interest in the neurobiological processes associated with pregnancy and maternity. Convergent evidence suggests that around the time of labour, first-time mothers experience a specific pattern of neuroanatomical changes that are associated with maternal behaviour. Here we provide an overview of the human neurobiological adaptations of motherhood, focusing on the interplay between pregnancy-related steroid and peptide hormones, and neuroplasticity in the brain. We discuss which brain plasticity mechanisms might underlie the structural changes detected by MRI, which hormonal systems are likely to contribute to such neuroanatomical changes and how these brain mechanisms may be linked to maternal behaviour. This Review offers an overarching framework that can serve as a roadmap for future investigations.
Collapse
Affiliation(s)
- Camila Servin-Barthet
- Unitat de Recerca en Neurociència Cognitiva, Departament de Psiquiatria i Medicina Legal, Universitat Autònoma de Barcelona, Barcelona, Spain
- Hospital del Mar Research Institute, Barcelona, Spain
| | - Magdalena Martínez-García
- Instituto de Investigación Sanitaria Gregorio Marañon, Madrid, Spain
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain
| | - Clara Pretus
- Hospital del Mar Research Institute, Barcelona, Spain
- Departament de Psicobiologia i de Metodologia de els Ciències de la Salut, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Maria Paternina-Die
- Instituto de Investigación Sanitaria Gregorio Marañon, Madrid, Spain
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain
| | - Anna Soler
- Unitat de Recerca en Neurociència Cognitiva, Departament de Psiquiatria i Medicina Legal, Universitat Autònoma de Barcelona, Barcelona, Spain
- Hospital del Mar Research Institute, Barcelona, Spain
| | | | - Óscar J Pozo
- Hospital del Mar Research Institute, Barcelona, Spain
| | - Benedetta Leuner
- Psychology Department, The Ohio State University, Columbus, OH, USA
| | - Oscar Vilarroya
- Unitat de Recerca en Neurociència Cognitiva, Departament de Psiquiatria i Medicina Legal, Universitat Autònoma de Barcelona, Barcelona, Spain.
- Hospital del Mar Research Institute, Barcelona, Spain.
| | - Susana Carmona
- Instituto de Investigación Sanitaria Gregorio Marañon, Madrid, Spain.
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain.
| |
Collapse
|
6
|
Powers S, Han X, Martinez J, Dufford AJ, Metz TD, Yeh T, Kim P. Cannabis use during pregnancy and hemodynamic responses to infant cues in pregnancy: an exploratory study. Front Psychiatry 2023; 14:1180947. [PMID: 37743996 PMCID: PMC10512021 DOI: 10.3389/fpsyt.2023.1180947] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/06/2023] [Accepted: 08/07/2023] [Indexed: 09/26/2023] Open
Abstract
Introduction Cannabis is one of the most commonly used substances during pregnancy and has the potential to negatively impact parent-infant relationships. The prefrontal cortex (PFC) response to infant cues during pregnancy has been associated with subsequent positive parenting behaviors. However, PFC activation is altered in individuals who use cannabis. As the potency of cannabis has changed over the years, little is known about the specific role of cannabis use on gestational parent brain responses to infant cues. Materials and methods Using functional Near-Infrared Spectroscopy (fNIRS) in the second trimester of pregnancy, we measured hemodynamic responses to an infant cry task and an infant faces task among individuals who were using cannabis (N = 14) and compared them with those who were not using cannabis (N = 45). For the infant cry task, pregnant individuals listened to cry sounds and matched white noise. For the infant faces task, they viewed happy, sad, and neutral faces. Results There was no significant difference between the two groups after adjusting for multiple comparisons. Without adjusting for multiple comparisons, we found preliminary evidence for the differences in the dorsomedial PFC associated with heightened response to infant cry among individuals who use cannabis. The groups were also different in the dorsolateral PFC associated with decreased response to infant sad faces among individuals who use cannabis. Discussion Our preliminary data suggests that cannabis use during pregnancy was associated with brain activation in the regions involved in the emotional regulation and information processes. However, the results did not survive after adjustment for multiple comparisons, thus future research with larger sample sizes is needed to confirm potential differences in brain function among cannabis-using pregnant individuals.
Collapse
Affiliation(s)
- Shannon Powers
- University of Denver, Psychology, Denver, CO, United States
| | - Xu Han
- University of Colorado, Computer Science, Boulder, CO, United States
| | | | - Alexander John Dufford
- Department of Medical Social Sciences and Institute for Innovations in Developmental Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, United States
| | - Torri D. Metz
- University of Utah Health, Obstetrics/Gynecology, Salt Lake City, UT, United States
| | - Tom Yeh
- University of Colorado, Computer Science, Boulder, CO, United States
| | - Pilyoung Kim
- University of Denver, Psychology, Denver, CO, United States
- Department of Psychology, Ewha Womans University, Seoul, South Korea
| |
Collapse
|
7
|
Della Vedova AM, Santoniccolo F, Sechi C, Trombetta T. Perinatal Depression and Anxiety Symptoms, Parental Bonding and Dyadic Sensitivity in Mother-Baby Interactions at Three Months Post-Partum. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:4253. [PMID: 36901263 PMCID: PMC10002080 DOI: 10.3390/ijerph20054253] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/20/2022] [Revised: 02/22/2023] [Accepted: 02/23/2023] [Indexed: 06/18/2023]
Abstract
The quality of the early parent-infant relationship is crucial for the child's optimal development, and parental sensitivity plays a key role in early interactions. The purpose of the study was to evaluate the influence of maternal perinatal depression and anxiety symptoms on dyadic sensitivity at three months post-partum, also considering a large set of maternal and infant variables. At the third trimester of pregnancy (T1) and at three months postpartum (T2), 43 primiparous women filled in a set of questionnaires evaluating symptoms of depression (CES-D) or anxiety (STAI), the woman's parental bonding experiences (PBI), alexithymia (TAS-20), maternal attachment to the baby (PAI, MPAS) and the perceived social support (MSPSS). At T2 mothers also completed a questionnaire on infant temperament and took part in the CARE-Index videotaped procedure. Dyadic sensitivity was predicted by higher maternal trait anxiety scores in pregnancy. In addition, the mother's experience of being cared for by her father in childhood was predictive of her infant's lower compulsivity, while paternal overprotection predicted higher unresponsiveness. The results highlight the influence of perinatal maternal psychological well-being and maternal childhood experiences on the quality of the dyadic relationship. The results may be useful to foster mother-child adjustment during the perinatal period.
Collapse
Affiliation(s)
- Anna Maria Della Vedova
- Department of Clinical and Experimental Sciences, University of Brescia, Viale Europa 11, 25123 Brescia, Italy
| | | | - Cristina Sechi
- Department of Pedagogy, Psychology and Philosophy, University of Cagliari, Via Is Mirrionis 1, 09126 Cagliari, Italy
| | - Tommaso Trombetta
- Department of Psychology, University of Turin, Via Verdi 10, 10124 Torino, Italy
| |
Collapse
|
8
|
Recio G, Surdzhiyska Y, Bagherzadeh-Azbari S, Hilpert P, Rostami HN, Xu Q, Sommer W. Deliberate control over facial expressions in motherhood. Evidence from a Stroop-like task. Acta Psychol (Amst) 2022; 228:103652. [PMID: 35753142 DOI: 10.1016/j.actpsy.2022.103652] [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: 04/28/2021] [Revised: 03/10/2022] [Accepted: 06/14/2022] [Indexed: 11/01/2022] Open
Abstract
The deliberate control of facial expressions is an important ability in human interactions, in particular for mothers with prelinguistic infants. Because research on this topic is still scarce, we investigated the control over facial expressions in a Stroop-like paradigm. Mothers of 2-6 months old infants and nullipara women produced smiles and frowns in response to verbal commands written on distractor faces of adults or infants showing expressions of happiness or anger/distress. Analyses of video recordings with a machine classifier for facial expression revealed pronounced effects of congruency between the expressions required by the participants and those displayed by the face stimuli on the onset latencies of the deliberate facial expressions. With adult distractor faces this Stroop effect was similar whether participants smiled or frowned. With infant distractor faces mothers and non-mothers showed indistinguishable Stroop effects on smile responses; however, for frown responses, the Stroop effect in mothers was smaller than in non-mothers. We suggest that for frown responses in mothers when facing infants, the effect of mimicry or stimulus response compatibility, leading to the Stroop effect, is offset by a caregiving response or empathy.
Collapse
Affiliation(s)
| | | | | | | | | | - Qiang Xu
- Humboldt Universität zu Berlin, Germany; Ningbo University, China
| | | |
Collapse
|
9
|
Pawluski JL, Hoekzema E, Leuner B, Lonstein JS. Less can be more: Fine tuning the maternal brain. Neurosci Biobehav Rev 2022; 133:104475. [PMID: 34864004 PMCID: PMC8807930 DOI: 10.1016/j.neubiorev.2021.11.045] [Citation(s) in RCA: 24] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2021] [Revised: 11/18/2021] [Accepted: 11/30/2021] [Indexed: 02/03/2023]
Abstract
PAWLUSKI, J.L., Hoekzema, E., Leuner, B., and Lonstein, J.S. Less can be more: Fine tuning the maternal brain. NEUROSCI BIOBEHAV REV (129) XXX-XXX, 2022. Plasticity in the female brain across the lifespan has recently become a growing field of scientific inquiry. This has led to the understanding that the transition to motherhood is marked by some of the most significant changes in brain plasticity in the adult female brain. Perhaps unexpectedly, plasticity occurring in the maternal brain often involves a decrease in brain volume, neurogenesis and glial cell density that presumably optimizes caregiving and other postpartum behaviors. This review summarizes what we know of the 'fine-tuning' of the female brain that accompanies motherhood and highlights the implications of these changes for maternal neurobehavioral health. The first part of the review summarizes structural and functional brain changes in humans during pregnancy and postpartum period with the remainder of the review focusing on neural and glial plasticity during the peripartum period in animal models. The aim of this review is to provide a clear understanding of when 'less is more' in maternal brain plasticity and where future research can focus to improve our understanding of the unique brain plasticity occurring during matrescence.
Collapse
Affiliation(s)
- Jodi L. Pawluski
- Univ Rennes, Inserm, EHESP, Irset (Institut de Recherche en Santé, Environnement et Travail), UMR_S 1085, F-35000, Rennes, France.,Corresponding author: Jodi L. Pawluski, University of Rennes 1, Irset (Institut de Recherche en Santé, Environnement et Travail), UMR_S 1085, F-35000, Rennes, France.
| | - Elseline Hoekzema
- Brain and Development Laboratory, Leiden Institute for Brain and Cognition (LIBC), Leiden University, Leiden, The Netherlands.,Hoekzema Lab, Amsterdam University Medical Center, Amsterdam, The Netherlands
| | - Benedetta Leuner
- The Ohio State University, Department of Psychology & Department of Neuroscience Columbus, OH, USA
| | - Joseph S. Lonstein
- Neuroscience Program & Department of Psychology, Michigan State University, East Lansing, MI 48824, USA
| |
Collapse
|
10
|
Martínez-García M, Cardenas SI, Pawluski J, Carmona S, Saxbe DE. Recent Neuroscience Advances in Human Parenting. ADVANCES IN NEUROBIOLOGY 2022; 27:239-267. [PMID: 36169818 DOI: 10.1007/978-3-030-97762-7_8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
The transition to parenthood entails brain adaptations to the demands of caring for a newborn. This chapter reviews recent neuroscience findings on human parenting, focusing on neuroimaging studies. First, we describe the brain circuits underlying human maternal behavior, which comprise ancient subcortical circuits and more sophisticated cortical regions. Then, we present the short-term and long-term functional and structural brain adaptations that characterize the transition to motherhood, discuss the long-term effects of parenthood on the brain, and propose several underlying neural mechanisms. We also review neuroimaging findings in biological fathers and alloparents (such as other relatives or adoptive parents), who engage in parenting without directly experiencing pregnancy or childbirth. Finally, we describe perinatal mental illnesses and discuss the neural responses associated with such disorders. To date, studies indicate that parenthood is a period of enhanced brain plasticity within brain areas critical for cognitive and social processing and that both parenting experience and gestational-related factors can prime such plasticity.
Collapse
Affiliation(s)
- Magdalena Martínez-García
- Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain.
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain.
| | - Sofia I Cardenas
- Department of Psychology, University of Southern California, Los Angeles, CA, USA
| | - Jodi Pawluski
- Univ Rennes, Inserm, EHESP, Irset (Institut de Recherche en Santé, Environnement et Travail), Rennes, France
| | - Susanna Carmona
- Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain
| | - Darby E Saxbe
- Department of Psychology, University of Southern California, Los Angeles, CA, USA
| |
Collapse
|
11
|
Bjertrup A, Macoveanu J, Laurent H, Moszkowicz M, Finnegan MK, Egmose I, Fisher PM, Nielsen RE, Pagsberg AK, Kessing LV, Væver M, Miskowiak K. Reduced prefrontal cortex response to own vs. unknown emotional infant faces in mothers with bipolar disorder. Eur Neuropsychopharmacol 2022; 54:7-20. [PMID: 34706300 DOI: 10.1016/j.euroneuro.2021.09.011] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/25/2021] [Revised: 09/27/2021] [Accepted: 09/30/2021] [Indexed: 11/04/2022]
Abstract
Motherhood involves functional brain adaptations within a broad neural network purported to underlie sensitive caregiving behavior. Bipolar disorder (BD) is associated with aberrant brain response to emotional faces within a similar network, which may influence BD mothers' sensitivity to infant faces. This functional magnetic resonance imaging (fMRI) study aimed to investigate whether mothers with BD display aberrant neural responses to own infant faces compared to healthy mothers. Twenty-six mothers with BD in remission and 35 healthy mothers underwent fMRI during which they viewed happy and distressed still facial photographs of their own and of unknown infants. After the scan, mothers viewed the pictures again on a computer screen and rated the intensity of infants' facial emotions and their own emotional response to infant face images. Mothers with BD displayed lower left dorsolateral prefrontal cortex (dlPFC) response compared to healthy mothers to own vs. unknown infant faces specifically and abnormal positive functional connectivity between the left and right amygdala and prefrontal regions. BD mothers further displayed stronger deactivation of precuneus and occipital regions to all happy vs. distressed infant faces. After the scan, they rated their infants' distress and own response to their infants' distressed faces less negatively than healthy mothers. Blunted dlPFC response and aberrant fronto-limbic connectivity while viewing own infant faces and less negative ratings of own infants' distress in BD mothers may affect their responses to their own infants in real-life mother-infant interactions.
Collapse
Affiliation(s)
- Anne Bjertrup
- Copenhagen Affective Disorders research Center (CADIC), Psychiatric Centre Copenhagen, Mental Health Services, Denmark; Department of Psychology, Faculty of Social Sciences, University of Copenhagen, Denmark
| | - Julian Macoveanu
- Copenhagen Affective Disorders research Center (CADIC), Psychiatric Centre Copenhagen, Mental Health Services, Denmark
| | | | - Mala Moszkowicz
- Child- and Adolescent Mental Health Center, Infant Psychiatric Unit, Mental Health Services, Denmark; Institute of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Denmark
| | | | - Ida Egmose
- Center for Early Intervention and Family Studies, Department of Psychology, Faculty of Social Sciences, University of Copenhagen, Denmark
| | | | - René Ernst Nielsen
- Aalborg University Hospital, Psychiatry, Aalborg, Denmark, Department of Clinical Medicine, Aalborg University, Denmark
| | - Anne Katrine Pagsberg
- Child- and Adolescent Mental Health Center, Infant Psychiatric Unit, Mental Health Services, Denmark; Institute of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Denmark
| | - Lars Vedel Kessing
- Copenhagen Affective Disorders research Center (CADIC), Psychiatric Centre Copenhagen, Mental Health Services, Denmark; Institute of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Denmark
| | - Mette Væver
- Center for Early Intervention and Family Studies, Department of Psychology, Faculty of Social Sciences, University of Copenhagen, Denmark
| | - Kamilla Miskowiak
- Copenhagen Affective Disorders research Center (CADIC), Psychiatric Centre Copenhagen, Mental Health Services, Denmark; Department of Psychology, Faculty of Social Sciences, University of Copenhagen, Denmark.
| |
Collapse
|
12
|
Martínez-García M, Paternina-Die M, Desco M, Vilarroya O, Carmona S. Characterizing the Brain Structural Adaptations Across the Motherhood Transition. Front Glob Womens Health 2021; 2:742775. [PMID: 34816246 PMCID: PMC8593951 DOI: 10.3389/fgwh.2021.742775] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2021] [Accepted: 09/10/2021] [Indexed: 12/23/2022] Open
Abstract
Women that become mothers face notable physiological adaptations during this life-period. Neuroimaging studies of the last decade have provided grounded evidence that women's brains structurally change across the transition into motherhood. The characterization of this brain remodeling is currently in its early years of research. The current article reviews this scientific field by focusing on our longitudinal (pre-to-post pregnancy) Magnetic Resonance Imaging (MRI) studies in first-time parents and other longitudinal and cross-sectional studies of parents. We present the questions that are currently being answered by the parental brain literature and point out those that have not yet been explored. We also highlight potential confounding variables that need to be considered when analyzing and interpreting brain changes observed during motherhood.
Collapse
Affiliation(s)
- Magdalena Martínez-García
- Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain.,Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain
| | - María Paternina-Die
- Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain.,Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain
| | - Manuel Desco
- Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain.,Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain.,Departamento de Bioingeniería e Ingeniería Aeroespacial, Universidad Carlos III de Madrid, Madrid, Spain.,Centro Nacional de Investigaciones Cardiovasculares (CNIC), Madrid, Spain
| | - Oscar Vilarroya
- Department of Psychiatry and Legal Medicine, Autonomous University of Barcelona, Barcelona, Spain.,Hospital del Mar Medical Research Institute, Barcelona, Spain
| | - Susanna Carmona
- Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain.,Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain
| |
Collapse
|
13
|
Yatziv T, Vancor EA, Bunderson M, Rutherford HJV. Maternal perinatal anxiety and neural responding to infant affective signals: Insights, challenges, and a road map for neuroimaging research. Neurosci Biobehav Rev 2021; 131:387-399. [PMID: 34563563 DOI: 10.1016/j.neubiorev.2021.09.043] [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: 02/26/2021] [Revised: 09/02/2021] [Accepted: 09/22/2021] [Indexed: 11/28/2022]
Abstract
Anxiety symptoms are common among women during pregnancy and the postpartum period, potentially having detrimental effects on both mother and child's well-being. Perinatal maternal anxiety interferes with a core facet of adaptive caregiving: mothers' sensitive responsiveness to infant affective communicative 'cues.' This review summarizes the current research on the neural correlates of maternal processing of infant cues in the presence of perinatal anxiety, outlines its limitations, and offers next steps to advance future research. Functional neuroimaging studies examining the neural circuitry involved in, and electrophysiological studies examining the temporal dynamics of, processing infant cues during pregnancy and postpartum are reviewed. Studies have generally indicated mixed findings, although emerging themes suggest that anxiety may be implicated in several stages of processing infant cues- detection, interpretation, and reaction- contingent upon cue valence. Limitations include inconsistent designs, lack of differentiation between anxiety and depression symptoms, and limited consideration of parenting-specific (versus domain-general) anxiety. Future studies should incorporate longitudinal investigation of multiple levels of analysis spanning neural, cognitive, and observed aspects of sensitive caregiving.
Collapse
|
14
|
Jia YC, Ding FY, Cheng G, Liu Y, Yu W, Zou Y, Zhang DJ. Infants' neutral facial expressions elicit the strongest initial attentional bias in adults: Behavioral and electrophysiological evidence. Psychophysiology 2021; 59:e13944. [PMID: 34553377 DOI: 10.1111/psyp.13944] [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: 03/24/2021] [Revised: 07/24/2021] [Accepted: 09/02/2021] [Indexed: 02/02/2023]
Abstract
Recent studies that used adult faces as the baseline have revealed that attentional bias toward infant faces is the strongest for neutral expressions than for happy and sad expressions. However, the time course of the strongest attentional bias toward infant neutral expressions is unclear. To clarify this time course, we combined a behavioral dot-probe task with electrophysiological event-related potentials (ERPs) to measure adults' responses to infant and adult faces with happy, neutral, and sad expressions derived from the same face. The results indicated that compared with the corresponding expressions in adult faces, attentional bias toward infant faces with various expressions resulted in different patterns during rapid and prolonged attention stages. In particular, first, neutral expressions in infant faces elicited greater behavioral attentional bias and P1 responses than happy and sad ones did. Second, sad expressions in infant faces elicited greater N170 responses than neutral and happy ones did; notably, sad expressions elicited greater N170 responses in the left hemisphere in women than in men. Third, late positive potential (LPP) responses were greater for infant faces than for adult faces under each expression condition. Thus, we propose a three-stage model of attentional allocation patterns that reveals the time course of attentional bias toward infant faces with various expressions. This model highlights the prominent role of neutral facial expressions in the attentional bias toward infant faces.
Collapse
Affiliation(s)
- Yun Cheng Jia
- School of Psychology, Guizhou Normal University, Guiyang, China.,Faculty of Psychology, Southwest University, Chongqing, China.,Center for Rural Children and Adolescents Mental Health Education, Guizhou Normal University, Guiyang, China
| | - Fang Yuan Ding
- School of Psychology, Guizhou Normal University, Guiyang, China.,Faculty of Psychology, Southwest University, Chongqing, China.,Center for Rural Children and Adolescents Mental Health Education, Guizhou Normal University, Guiyang, China
| | - Gang Cheng
- School of Psychology, Guizhou Normal University, Guiyang, China.,Center for Rural Children and Adolescents Mental Health Education, Guizhou Normal University, Guiyang, China
| | - Yong Liu
- Faculty of Psychology, Southwest University, Chongqing, China
| | - Wei Yu
- School of Psychology, Guizhou Normal University, Guiyang, China.,Center for Rural Children and Adolescents Mental Health Education, Guizhou Normal University, Guiyang, China
| | - Yan Zou
- School of Psychology, Guizhou Normal University, Guiyang, China.,Center for Rural Children and Adolescents Mental Health Education, Guizhou Normal University, Guiyang, China
| | - Da Jun Zhang
- Faculty of Psychology, Southwest University, Chongqing, China
| |
Collapse
|
15
|
Morgan JK, Santosa H, Fridley RM, Conner KK, Hipwell AE, Forbes EE, Huppert TJ. Postpartum Depression Is Associated With Altered Neural Connectivity Between Affective and Mentalizing Regions During Mother-Infant Interactions. Front Glob Womens Health 2021; 2:744649. [PMID: 34816247 PMCID: PMC8593996 DOI: 10.3389/fgwh.2021.744649] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2021] [Accepted: 08/24/2021] [Indexed: 11/28/2022] Open
Abstract
Although there has been growing interest in mood-related neural alterations in women in the initial weeks postpartum, recent work has demonstrated that postpartum depression often lingers for months or years following birth. However, research evaluating the impact of depression on maternal brain function during mother-infant interactions in the late postpartum period is lacking. The current study tested the hypothesis that depressive symptoms at 12-months postpartum are associated with neural alterations in affective and social neural regions, using near-infrared spectroscopy during in vivo mother-infant interactions. Participants were 23 birth mothers of 12-month-old infants (60% boys). While undergoing near-infrared spectroscopy, mothers engaged in an ecologically valid interactive task in which they looked at an age-appropriate book with their infants. Mothers also reported on their depressive symptoms in the past week and were rated on their observed levels of maternal sensitivity during mother-infant play. Greater depressive severity at 12-months postpartum was related to lower connectivity between the right temporoparietal junction and the lateral prefrontal cortex, but greater connectivity between the right temporoparietal junction and anterior medial prefrontal cortex during mother-infant interaction. Given the putative functions of these neural regions within the maternal brain network, our findings suggest that in the context of depression, postpartum mothers' mentalizing about her infants' thoughts and feelings may be related to lower ability to express and regulate her own emotions, but greater ability to engage in emotional bonding with her infant. Future work should explore how connectivity among these regions is associated with longitudinal changes in maternal behavior, especially in the context of changes in mothers' depressive symptoms (e.g., with treatment) over time.
Collapse
Affiliation(s)
- Judith K. Morgan
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA, United States
- Department of Psychology, University of Pittsburgh, Pittsburgh, PA, United States
| | - Hendrik Santosa
- Department of Radiology, University of Pittsburgh, Pittsburgh, PA, United States
| | - Rachel M. Fridley
- University of Pittsburgh Medical Center, Pittsburgh, PA, United States
| | - Kaetlyn K. Conner
- University of Pittsburgh Medical Center, Pittsburgh, PA, United States
| | - Alison E. Hipwell
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA, United States
- Department of Psychology, University of Pittsburgh, Pittsburgh, PA, United States
| | - Erika E. Forbes
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA, United States
- Department of Psychology, University of Pittsburgh, Pittsburgh, PA, United States
| | - Theodore J. Huppert
- Department of Electrical and Computer Engineering, University of Pittsburgh, Pittsburgh, PA, United States
| |
Collapse
|
16
|
Grumi S, Cappagli G, Aprile G, Mascherpa E, Gori M, Provenzi L, Signorini S. Togetherness, beyond the eyes: A systematic review on the interaction between visually impaired children and their parents. Infant Behav Dev 2021; 64:101590. [PMID: 34062369 DOI: 10.1016/j.infbeh.2021.101590] [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: 10/19/2020] [Revised: 05/23/2021] [Accepted: 05/24/2021] [Indexed: 10/21/2022]
Abstract
BACKGROUND Parent-child interaction is essential to promote adaptive emotional, cognitive, and social development. The majority of previous research on parent-child interaction is largely dependent on face-to-face exchanges that require the interactive partners to visually recognize reciprocal communicative bids. Therefore, previous findings in the field can only partially apply to the early interactive patterns occurring between visually impaired infants and their parents. The present study was aimed to systematically review the available evidence on parent-child interaction in the context of developmental visual impairment. METHODS Fourteen papers were finally selected after literature search on PubMed and Scopus. Data synthesis was focused on three core topics: visually impaired children's contribution to the interaction, parental caregiving behaviors with visually impaired children, and the association between parents' behaviors and the developmental outcomes of children with visual impairment. RESULTS Visually impaired children may exhibit reduced reactivity to maternal stimuli and less-than-optimal levels of interactive initiations in social exchanges. Parents of children with visual impairment may use more descriptive communicative acts and greater directiveness compared to mothers of sighted counterparts. Specific caregiving behaviors (e.g., responsiveness and goal setting) of parents of children with visual impairment may significantly support language and socio-emotional development as well as sensorimotor integration. DISCUSSION Children with visual impairment may be less responsive and they may produce less clear communicative bids while interacting with their parents. Their parents may face specific challenges while engaging with them and they may become increasingly directive and intrusive. Nonetheless, even in the presence of visual impairment, the quality of parental caregiving behaviors appears to play a potential preventive role in the face of children's socio-emotional and cognitive outcomes. These results suggest that early interventions focused on parent-child interactions are especially needed in this population.
Collapse
Affiliation(s)
- Serena Grumi
- Child Neurology and Psychiatry Unit, IRCCS Mondino Foundation, Pavia, Italy
| | - Giulia Cappagli
- Center of Child Neuro-Ophthalmology, IRCCS Mondino Foundation, Pavia, Italy; Unit for Visually Impaired People, Istituto Italiano di Tecnologia, Genoa, Italy
| | - Giorgia Aprile
- Center of Child Neuro-Ophthalmology, IRCCS Mondino Foundation, Pavia, Italy
| | - Eleonora Mascherpa
- Center of Child Neuro-Ophthalmology, IRCCS Mondino Foundation, Pavia, Italy
| | - Monica Gori
- Unit for Visually Impaired People, Istituto Italiano di Tecnologia, Genoa, Italy
| | - Livio Provenzi
- Child Neurology and Psychiatry Unit, IRCCS Mondino Foundation, Pavia, Italy.
| | - Sabrina Signorini
- Center of Child Neuro-Ophthalmology, IRCCS Mondino Foundation, Pavia, Italy
| |
Collapse
|
17
|
Bjertrup A, Friis N, Væver M, Miskowiak K. Neurocognitive processing of infant stimuli in mothers and non-mothers: psychophysiological, cognitive and neuroimaging evidence. Soc Cogn Affect Neurosci 2021; 16:428-438. [PMID: 33420780 PMCID: PMC7990066 DOI: 10.1093/scan/nsab002] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2020] [Revised: 12/16/2020] [Accepted: 01/08/2021] [Indexed: 11/12/2022] Open
Abstract
Emerging evidence indicates that mothers and non-mothers show different neurocognitive responses to infant stimuli. This study investigated mothers' psychophysiological, cognitive and neuronal responses to emotional infant stimuli. A total of 35 mothers with 4-month-old infants and 18 control women without young children underwent computerized tests assessing neurocognitive processing of infant stimuli. Their eye gazes and eye fixations, galvanic skin responses (GSRs) and facial expressions towards infant emotional stimuli were recorded during the tasks. Participants underwent functional magnetic resonance imaging during which they viewed pictures of an unknown infant and, for mothers, their own infants. Mothers gazed more and had increased GSR towards infant stimuli and displayed more positive facial expressions to infant laughter, and self-reported more positive ratings of infant vocalizations than control women. At a neural level, mothers showed greater neural response in insula, dorsolateral prefrontal cortex and occipital brain regions within a predefined 'maternal neural network' while watching images of their own vs unknown infants. This specific neural response to own infants correlated with less negative ratings of own vs unknown infants' signals of distress. Differences between mothers and control women without young children could be interpreted as neurocognitive adaptation to motherhood in the mothers.
Collapse
Affiliation(s)
- Anne Bjertrup
- Copenhagen Affective Disorders research Center (CADIC), Psychiatric Centre Copenhagen, Mental Health Services, Capital Region of Denmark, 2100 Copenhagen, Denmark
- Department of Psychology, Faculty of Social Sciences, University of Copenhagen, 1355 Copenhagen, Denmark
| | - Nellie Friis
- Copenhagen Affective Disorders research Center (CADIC), Psychiatric Centre Copenhagen, Mental Health Services, Capital Region of Denmark, 2100 Copenhagen, Denmark
- Department of Psychology, Faculty of Social Sciences, University of Copenhagen, 1355 Copenhagen, Denmark
| | - Mette Væver
- Center for Early Intervention and Family Studies, Department of Psychology, Faculty of Social Sciences, University of Copenhagen, 1355 Copenhagen, Denmark
| | - Kamilla Miskowiak
- Copenhagen Affective Disorders research Center (CADIC), Psychiatric Centre Copenhagen, Mental Health Services, Capital Region of Denmark, 2100 Copenhagen, Denmark
- Department of Psychology, Faculty of Social Sciences, University of Copenhagen, 1355 Copenhagen, Denmark
| |
Collapse
|
18
|
Kim P. How stress can influence brain adaptations to motherhood. Front Neuroendocrinol 2021; 60:100875. [PMID: 33038383 PMCID: PMC7539902 DOI: 10.1016/j.yfrne.2020.100875] [Citation(s) in RCA: 34] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/18/2020] [Revised: 10/02/2020] [Accepted: 10/04/2020] [Indexed: 12/15/2022]
Abstract
Research shows that a woman's brain and body undergo drastic changes to support her transition to parenthood during the perinatal period. The presence of this plasticity suggests that mothers' brains may be changed by their experiences. Exposure to severe stress may disrupt adaptive changes in the maternal brain and further impact the neural circuits of stress regulation and maternal motivation. Emerging literature of human mothers provides evidence that stressful experience, whether from the past or present environment, is associated with altered responses to infant cues in brain circuits that support maternal motivation, emotion regulation, and empathy. Interventions that reduce stress levels in mothers may reverse the negative impact of stress exposure on the maternal brain. Finally, outstanding questions regarding the timing, chronicity, types, and severity of stress exposure, as well as study design to identify the causal impact of stress, and the role of race/ethnicity are discussed.
Collapse
Affiliation(s)
- Pilyoung Kim
- Department of Psychology, University of Denver, Denver, CO, United States.
| |
Collapse
|
19
|
Abstract
At least one in seven pregnant or recently postpartum women will experience a mental illness such as an anxiety disorder, depressive disorder, or substance use disorder. These mental illnesses have detrimental effects on the health of the mother, child, and family, but little is known about the hypothalamic and other neural correlates of maternal mental health concerns. The transition to parenthood alone is a time of remarkable neural plasticity, so it is perhaps not surprising that current research is showing that maternal mental illness has unique neural profiles. Furthermore, the neural systems affected by peripartum mental illness overlap and interact with the systems involved in maternal caregiving behaviors, and mother-infant interactions are, therefore, highly susceptible to disruption. This review discusses what we know about the unique neural changes occurring during peripartum mental illness and the role of the hypothalamus in these illnesses. With an improved understanding of the neural correlates of maternal mental health and disease, we will be better equipped to predict risk, develop effective treatments, and ultimately prevent suffering for millions of parents during this critical time in life.
Collapse
Affiliation(s)
- Jodi L Pawluski
- Univ Rennes, Inserm, EHESP, Irset (Institut de Recherche en Santé, Environnement et Travail), UMR S 1085, Rennes, France.
| | - James E Swain
- Department of Psychiatry and Behavioral Health, Renaissance School of Medicine at Stony Brook University, Stony Brook, NY, United States
| | - Joseph S Lonstein
- Neuroscience Program & Department of Psychology, Michigan State University, East Lansing, MI, United States
| |
Collapse
|
20
|
Bjertrup AJ, Jensen MB, Schjødt MS, Parsons CE, Kjærbye-Thygesen A, Mikkelsen RL, Moszkowicz M, Frøkjær VG, Vinberg M, Kessing LV, Væver MS, Miskowiak KW. Cognitive processing of infant stimuli in pregnant women with and without affective disorders and the association to postpartum depression. Eur Neuropsychopharmacol 2021; 42:97-109. [PMID: 33158668 DOI: 10.1016/j.euroneuro.2020.10.006] [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: 01/30/2020] [Revised: 08/21/2020] [Accepted: 10/16/2020] [Indexed: 11/26/2022]
Abstract
Pregnancy and childbirth are among the strongest risk factors for depression but the neurocognitive mechanisms underlying this enhanced risk are unknown. This study investigated emotional and non-emotional cognition in 57 pregnant women with or without an affective disorder during their third trimester, and the association between cognitive biases and subsequent postpartum depression (PPD). Of the pregnant women, 22 had a diagnosis of unipolar disorder (UD) and seven of bipolar disorder (BD) in full or partial remission, while 28 had no history of affective disorder. We included a control group of 29 healthy non-pregnant women. First, participants were interviewed, completed non-emotional and emotional cognitive tests and lastly filled out questionnaires. The participants were assessed two times after birth: at a home visit shortly after birth, and with a telephone interview to assess PPD in the first six months after birth. Healthy pregnant women rated infant cries less negatively than non-pregnant women, possibly reflecting preparation for motherhood. Pregnant women with UD exhibited a negative bias in ratings of infant cries, whereas pregnant women with BD showed a positive bias in ratings of infant happy faces and recognition of adult facial expressions. Across all pregnant women, more negative ratings of infant cries were associated with enhanced risk of PPD. Negatively biased perception of infant cries during pregnancy may thus signal vulnerability toward PPD.
Collapse
Affiliation(s)
- A J Bjertrup
- Department of Psychology, University of Copenhagen, Copenhagen, Denmark; Copenhagen Affective Disorders research Center (CADIC), Psychiatric Centre Copenhagen, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen University Hospital, Rigshospitalet, Edel Sauntes Allé 10, DK-2100 Copenhagen, Denmark
| | - M B Jensen
- Copenhagen Affective Disorders research Center (CADIC), Psychiatric Centre Copenhagen, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen University Hospital, Rigshospitalet, Edel Sauntes Allé 10, DK-2100 Copenhagen, Denmark
| | - M S Schjødt
- Copenhagen Affective Disorders research Center (CADIC), Psychiatric Centre Copenhagen, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen University Hospital, Rigshospitalet, Edel Sauntes Allé 10, DK-2100 Copenhagen, Denmark
| | - C E Parsons
- Interacting Minds Center, Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
| | - A Kjærbye-Thygesen
- Department of Obstetrics and Gynecology, Faculty of Health and Medical Sciences, University of Copenhagen, Hvidovre, Denmark
| | - R L Mikkelsen
- Copenhagen Affective Disorders research Center (CADIC), Psychiatric Centre Copenhagen, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen University Hospital, Rigshospitalet, Edel Sauntes Allé 10, DK-2100 Copenhagen, Denmark
| | - M Moszkowicz
- Child and Adolescent Psychiatric Center, Infant Psychiatric Unit, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen Denmark
| | - V G Frøkjær
- Neurobiology Research Unit, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen Denmark
| | - M Vinberg
- Copenhagen Affective Disorders research Center (CADIC), Psychiatric Centre Copenhagen, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen University Hospital, Rigshospitalet, Edel Sauntes Allé 10, DK-2100 Copenhagen, Denmark; Psychiatric Research Unit, Psychiatric Centre North Zealand, Faculty of Health and Medical Sciences, University of Copenhagen, Hillerød, Denmark
| | - L V Kessing
- Copenhagen Affective Disorders research Center (CADIC), Psychiatric Centre Copenhagen, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen University Hospital, Rigshospitalet, Edel Sauntes Allé 10, DK-2100 Copenhagen, Denmark
| | - M S Væver
- Department of Psychology, University of Copenhagen, Copenhagen, Denmark
| | - K W Miskowiak
- Department of Psychology, University of Copenhagen, Copenhagen, Denmark; Copenhagen Affective Disorders research Center (CADIC), Psychiatric Centre Copenhagen, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen University Hospital, Rigshospitalet, Edel Sauntes Allé 10, DK-2100 Copenhagen, Denmark.
| |
Collapse
|
21
|
Cárdenas EF, Kujawa A, Humphreys KL. Neurobiological changes during the peripartum period: implications for health and behavior. Soc Cogn Affect Neurosci 2020; 15:1097-1110. [PMID: 31820795 PMCID: PMC7657461 DOI: 10.1093/scan/nsz091] [Citation(s) in RCA: 28] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2019] [Revised: 10/01/2019] [Accepted: 10/14/2019] [Indexed: 01/22/2023] Open
Abstract
Pregnancy and the transition to parenthood is an important period marked by dramatic neurobiological and psychosocial changes that may have implications for the health of women and offspring. Although human and non-human animal research suggests that the brain undergoes alterations during the peripartum period, these changes are poorly understood. Here, we review existing research, particularly human neuroimaging and psychophysiological research, to examine changes in brain structure and function during the peripartum period and discuss potential implications for the health of women and offspring. First, we discuss the potential causes of these changes across pregnancy, including physiological and psychosocial factors. Next, we discuss the evidence for structural and functional changes in the brain during pregnancy and into the postpartum period, noting the need for research conducted prospectively across human pregnancy. Finally, we propose potential models of individual differences in peripartum neurobiological changes (i.e. hypo-response, typical response, hyper-response) and emphasize the need to consider trajectories of change in addition to pre-existing factors that may predict maternal adjustment to parenthood. We suggest that the consideration of individual differences in neurobiological trajectories across pregnancy may contribute to a better understanding of risk for negative health and behavior outcomes for women and offspring.
Collapse
Affiliation(s)
- Emilia F Cárdenas
- Department of Psychology and Human Development, Vanderbilt University, 37203, Nashville, USA
| | - Autumn Kujawa
- Department of Psychology and Human Development, Vanderbilt University, 37203, Nashville, USA
| | - Kathryn L Humphreys
- Department of Psychology and Human Development, Vanderbilt University, 37203, Nashville, USA
| |
Collapse
|
22
|
Anke TMS, Slinning K, Moe V, Brunborg C, Siqveland TS, Skjelstad DV. Bipolar offspring and mothers: interactional challenges at infant age 3 and 12 months-a developmental pathway to enhanced risk? Int J Bipolar Disord 2020; 8:27. [PMID: 32869152 PMCID: PMC7459000 DOI: 10.1186/s40345-020-00192-3] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/03/2020] [Accepted: 06/04/2020] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND Bipolar offspring are considered a high-risk group for developing mental disorders. Developmental outcomes result from additive and interactive effects of biological vulnerability and environmental influences. Mother-infant interactions represent important early environmental influences that may modify infants' risk of mental disorders. The aim of the current prospective study was to investigate the patterns and development of mother-infant interactions in the first year of life in dyads in which the mothers have bipolar disorder (BD). METHODS Twenty-six dyads in which the mothers had BD and 28 dyads in which the mothers had no mental disorder were video-taped in a free play interaction. The Parent-Child Early Relational Assessment (PCERA) was used to assess the quality of the interactions on three domains (maternal behaviour, infant behaviour and dyadic coordination) at 3 and 12 months of infant age. First, we compared the mother-infant interaction patterns between the two groups at 12 months. Second, we investigated how the patterns developed within and between the groups from infant ages 3 to 12 months. RESULTS BD dyads demonstrated significantly more challenges in all three interaction domains at infant age 12 months compared to the healthy dyads. This observation was in line with the findings at infant age 3 months. Subdued expression of positive affect and mutual underinvolvement represented core challenges in maternal and infant behaviours in the BD dyads. Continuous difficulties with dyadic coordination and reciprocity were the most concerning interaction behaviours at 3 and 12 months. On the positive side, there was little expression of negative affect or tension in maternal, infant and dyadic behaviour, and some positive changes in infant behaviour from 3 to 12 months. CONCLUSIONS The current results suggest that challenges in mother-infant interaction patterns in the first year of life may enhance the developmental risk for bipolar offspring. Clinical interventions should address both the BD mothers' needs in relation to postpartum mood deviations and mother-infant interactions. We suggest interaction interventions to promote dyadic coordination and reciprocity, such as helping mothers being more sensitive to their infant's cues and to provide attuned contingent responses.
Collapse
Affiliation(s)
- Teija M S Anke
- Division of Mental Health and Addiction, Vestre Viken Hospital Trust, 3004, Drammen, Norway.
| | - Kari Slinning
- The Center for Child and Adolescent Mental Health, Eastern and Southern Norway, Oslo, Norway
| | - Vibeke Moe
- Department of Psychology, University of Oslo, Oslo, Norway
| | - Cathrine Brunborg
- Oslo Centre for Biostatistics and Epidemiology, Research Support Services, Oslo University Hospital, Ullevål, Oslo, Norway
| | | | - Dag Vegard Skjelstad
- Division of Mental Health and Addiction, Vestre Viken Hospital Trust, 3004, Drammen, Norway
- Department of Psychology, University of Oslo, Oslo, Norway
| |
Collapse
|
23
|
Rincón-Cortés M, Grace AA. Adaptations in reward-related behaviors and mesolimbic dopamine function during motherhood and the postpartum period. Front Neuroendocrinol 2020; 57:100839. [PMID: 32305528 PMCID: PMC7531575 DOI: 10.1016/j.yfrne.2020.100839] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/16/2020] [Revised: 03/15/2020] [Accepted: 04/10/2020] [Indexed: 02/07/2023]
Abstract
Initiation and maintenance of maternal behavior is driven by a complex interaction between the physiology of parturition and offspring stimulation, causing functional changes in maternal brain and behavior. Maternal behaviors are among the most robust and rewarding motivated behaviors. Mesolimbic dopamine (DA) system alterations during pregnancy and the postpartum enable enhanced reward-related responses to offspring stimuli. Here, we review behavioral evidence demonstrating postpartum rodents exhibit a bias towards pups and pup-related stimuli in reward-related tasks. Next, we provide an overview of normative adaptations in the mesolimbic DA system induced by parturition and the postpartum, which likely mediate shifts in offspring valence. We also discuss a causal link between dopaminergic dysfunction and disrupted maternal behaviors, which are recapitulated in postpartum depression (PPD) and relevant rodent models. In sum, mesolimbic DA system activation drives infant-seeking behavior and strengthens the mother-infant bond, potentially representing a therapeutic target for reward-related deficits in PPD.
Collapse
Affiliation(s)
- Millie Rincón-Cortés
- Departments of Neuroscience, Psychiatry and Psychology, University of Pittsburgh, Pittsburgh, PA 15217, United States.
| | - Anthony A Grace
- Departments of Neuroscience, Psychiatry and Psychology, University of Pittsburgh, Pittsburgh, PA 15217, United States
| |
Collapse
|
24
|
Maguire J, McCormack C, Mitchell A, Monk C. Neurobiology of maternal mental illness. HANDBOOK OF CLINICAL NEUROLOGY 2020; 171:97-116. [PMID: 32736761 DOI: 10.1016/b978-0-444-64239-4.00005-9] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
This chapter provides an overview of current research discoveries beginning to uncover the neurobiology of maternal mental illness. Results are described according to standard diagnostic categories (specifically, perinatal depression, perinatal anxiety and OCD, postpartum psychosis and bipolar disorder, and trauma and posttraumatic stress disorder), yet we aim to put this approach in context with the introduction of a classification model for psychiatric research, the research domain criteria, gaining traction in basic and clinical translational fields. We first review a new area of study, the neuroplasticity of the pregnant and postpartum brain, as work here has relevance for understanding the pathophysiology of mental disorders and may provide clues to changes in brain functioning that are related to compromised parenting in the context of postpartum depression. We next provide background information on neuroendocrine and immune changes during pregnancy and, to a lesser extent, the postpartum period, as alterations in these systems are significantly implicated in underlying neurobiology of mental illness for peripartum women. Our discussion of the major mental illnesses for pregnant and postpartum women includes neuroendocrine changes, neuroinflammation, and neurotransmitter alterations, as well as circuit dysfunction. Overall, remarkable progress has been made in identifying variations in neurobiology (and related systems) involved in maternal mental illness; yet, it is clear that, as classified with standard diagnostic systems, these are heterogeneous disorders and there is individual variability in the alterations in neurobiology for the same illness.
Collapse
Affiliation(s)
- Jamie Maguire
- Department of Neuroscience, Tufts University School of Medicine, Boston, MA, United States
| | - Clare McCormack
- Center for Science and Society, Columbia University, New York, NY, United States
| | - Anika Mitchell
- Department of Obstetrics and Gynecology, Columbia University Irving Medical Center, New York, NY, United States
| | - Catherine Monk
- Department of Obstetrics and Gynecology, Columbia University Irving Medical Center, New York, NY, United States; Department of Psychiatry, Columbia University Irving Medical Center, New York, NY, United States; New York State Psychiatric Institute, New York, NY, United States.
| |
Collapse
|