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Bergman NJ. New policies on skin-to-skin contact warrant an oxytocin-based perspective on perinatal health care. Front Psychol 2024; 15:1385320. [PMID: 39049943 PMCID: PMC11267429 DOI: 10.3389/fpsyg.2024.1385320] [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: 02/12/2024] [Accepted: 06/10/2024] [Indexed: 07/27/2024] Open
Abstract
Background In 2023, the World Health Organization (WHO) published a Global Position Paper on Kangaroo Mother Care (KMC), which is applicable to all countries worldwide: from the moment of birth, every "small and sick" newborn should remain with mother in immediate and continuous skin-to-skin contact (SSC), receiving all required clinical care in that place. This was prompted by the startling results of a randomized controlled trial published in 2021: in which 1,609 infants receiving immediate SSC were compared with 1,602 controls that were separated from their mothers but otherwise received identical conventional state-of-the-art care. The intervention infants showed a 25% reduction in mortality after 28 days. New perspectives The new WHO guidelines are a significant change from earlier guidance and common clinical practice. The author presents that separating mothers and babies is assumed to be "normal" (a paradigm) but actually puts newborns at increased risk for morbidity and mortality. The author presents arguments and ethical perspectives for a new perspective on what is "normal," keeping newborns with their mothers is the infant's physiological expectation and critical requirement for healthy development. The author reviews the scientific rationale for changing the paradigm, based on synchronous interactions of oxytocin on both mother and infant. This follows a critique of the new policies that highlights the role of immediate SSC. Actionable recommendations This critique strengthens the case for implementing the WHO guidelines on KMC for small and sick babies. System changes will be necessary in both obstetric and neonatal settings to ensure seamless perinatal care. Based on the role of oxytocin, the author identifies that many current routine care practices may actually contribute to stress and increased vulnerability to the newborn. WHO has actionable recommendations about family involvement and presence in newborn intensive care units. Discussion The concepts of resilience and vulnerability have specific definitions well known in perinatal care: the key outcome of care should be resilience rather than merely the absence of vulnerability. Newborns in all settings and contexts need us to re-evaluate our paradigms and adopt and implement the new WHO guidelines on KMC in perinatal care.
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Affiliation(s)
- Nils J. Bergman
- Department of Women’s and Children’s Health, Karolinska Institutet, Stockholm, Sweden
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Bortolini T, Laport MC, Latgé-Tovar S, Fischer R, Zahn R, de Oliveira-Souza R, Moll J. The extended neural architecture of human attachment: An fMRI coordinate-based meta-analysis of affiliative studies. Neurosci Biobehav Rev 2024; 159:105584. [PMID: 38367888 DOI: 10.1016/j.neubiorev.2024.105584] [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: 09/25/2023] [Revised: 01/30/2024] [Accepted: 02/12/2024] [Indexed: 02/19/2024]
Abstract
Functional imaging studies and clinical evidence indicate that cortical areas relevant to social cognition are closely integrated with evolutionarily conserved basal forebrain structures and neighboring regions, enabling human attachment and affiliative emotions. The neural circuitry of human affiliation is continually being unraveled as functional magnetic resonance imaging (fMRI) becomes increasingly prevalent, with studies examining human brain responses to various attachment figures. However, previous fMRI meta-analyses on affiliative stimuli have encountered challenges, such as low statistical power and the absence of robustness measures. To address these issues, we conducted an exhaustive coordinate-based meta-analysis of 79 fMRI studies, focusing on personalized affiliative stimuli, including one's infants, family, romantic partners, and friends. We employed complementary coordinate-based analyses (Activation Likelihood Estimation and Signed Differential Mapping) and conducted a robustness analysis of the results. Findings revealed cluster convergence in cortical and subcortical structures related to reward and motivation, salience detection, social bonding, and cognition. Our study thoroughly explores the neural correlates underpinning affiliative responses, effectively overcoming the limitations noted in previous meta-analyses. It provides an extensive view of the neural substrates associated with affiliative stimuli, illuminating the intricate interaction between cortical and subcortical regions. Our findings significantly contribute to understanding the neurobiology of human affiliation, expanding the known human attachment circuitry beyond the traditional basal forebrain regions observed in other mammals to include uniquely human isocortical structures.
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Affiliation(s)
- Tiago Bortolini
- Cognitive Neuroscience and Neuroinformatics Unit, The D'Or Institute for Research and Education (IDOR), Rio de Janeiro, Brazil; IDOR - Pioneer Science Initiative, São Paulo, Brazil.
| | - Maria Clara Laport
- Cognitive Neuroscience and Neuroinformatics Unit, The D'Or Institute for Research and Education (IDOR), Rio de Janeiro, Brazil
| | - Sofia Latgé-Tovar
- Institute of Psychiatry, Center for Alzheimer's Disease, Federal University of Rio de Janeiro (UFRJ), Rio de Janeiro, RJ, Brazil
| | - Ronald Fischer
- Cognitive Neuroscience and Neuroinformatics Unit, The D'Or Institute for Research and Education (IDOR), Rio de Janeiro, Brazil; IDOR - Pioneer Science Initiative, São Paulo, Brazil; School of Psychology, PO Box 600, Victoria University of Wellington, Wellington 6021, New Zealand
| | - Roland Zahn
- Centre for Affective Disorders, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London SE5 8AF, UK
| | - Ricardo de Oliveira-Souza
- Cognitive Neuroscience and Neuroinformatics Unit, The D'Or Institute for Research and Education (IDOR), Rio de Janeiro, Brazil; The Federal University of the State of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Jorge Moll
- Cognitive Neuroscience and Neuroinformatics Unit, The D'Or Institute for Research and Education (IDOR), Rio de Janeiro, Brazil; IDOR - Pioneer Science Initiative, São Paulo, Brazil
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Beck-Hiestermann FML, Hartung LK, Richert N, Miethe S, Wiegand-Grefe S. Are 6 more accurate than 4? The influence of different modes of delivery on postpartum depression and PTSD. BMC Pregnancy Childbirth 2024; 24:118. [PMID: 38331809 PMCID: PMC10851577 DOI: 10.1186/s12884-024-06267-8] [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: 10/20/2023] [Accepted: 01/11/2024] [Indexed: 02/10/2024] Open
Abstract
BACKGROUND Empirical evidence shows that 4.6-6.3% of all women develop a post-traumatic stress disorder (PTSD) and approximately 10-15% postpartum depression (PPD) following childbirth. This study explores the relationship between delivery mode and the occurrence of PTSD and PPD, specifically examining four distinct caesarean section (CS) modes: primary on maternal request (Grade 4), medically indicated primary (Grade 3), secondary CS from relative indication (Grade 2) and emergency secondary CS (Grade 1), compared to vaginal and assisted vaginal delivery (AVD). The research aims to understand how these six subcategories of delivery modes impact PPD and PTSD levels. Common predictors, including the need for psychological treatment before childbirth, fear of childbirth, planning of pregnancy, induction of labor, birth debriefing, and lack of social support after childbirth, will be analyzed to determine their association with postpartum mental health outcomes. METHODS The study was planned and carried out by a research team of the psychology department at the Medical School Hamburg, Germany. Within an online-study (cross-sectional design) N = 1223 German speaking women with a baby who did not die before, during or after birth were surveyed once between four weeks and twelve months postpartum via an anonymous online questionnaire on demographic and gynecological data, delivery mode, PTSD (PCL-5) and PPD (EPDS). RESULTS For both psychiatric disorders, ANOVA revealed significant differences between delivery mode and PPD and PTSD. With weak effects for PPD and medium to strong effects for PTSD. Post-hoc tests showed increased levels of PPD for two CS types (Grade 1, Grade 3) compared to vaginal delivery. For PTSD, secondary CS from relative indication (Grade 2), emergency secondary CS (Grade 1) and assisted vaginal delivery (AVD) were associated with elevated levels of PTSD. Regression analysis revealed delivery mode as a significant predictor of EPDS- (medium effect size) and PCL-5-Score (medium to high effect size). LIMITATION Delivery was considered as the potential traumatic event, and any previous traumas were not documented. Additionally, the categorization of delivery modes relied on subjective reports rather than medical confirmation. CONCLUSION The study highlights the influence of delivery mode on the mental health of postpartum mothers: different modes influence postpartum disorders in various ways. However, the definition of delivery mode was only stated subjectively and not medically confirmed. Further research should investigate which aspects of the different delivery modes affect maternal mental health and explore how the perception of childbirth may be influenced by specific delivery experiences.
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Affiliation(s)
- Franziska Marie Lea Beck-Hiestermann
- Department of Psychology, Medical School Hamburg, Hamburg, Germany.
- Department of Psychosomatic Medicine and Psychotherapy, Psychologische Hochschule Berlin, Berlin, Germany.
| | - Lisa Kathrin Hartung
- Department of Psychology, Medical School Hamburg, Hamburg, Germany
- Clinic of Psychiatry, Socialpsychiatry and Psychotherapy, Hannover Medical School, Hannover, Germany
| | - Nadine Richert
- Department of Psychology, Medical School Hamburg, Hamburg, Germany
| | - Sandra Miethe
- Department of Psychology, Medical School Hamburg, Hamburg, Germany
- Institute for Clinical Psychology and Psychotherapy, Medical School Hamburg, Hamburg, Germany
| | - Silke Wiegand-Grefe
- Department of Child and Adolescent Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
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Khajehei M. Endorphins, Sexuality, and Reproduction. ADVANCES IN NEUROBIOLOGY 2024; 35:397-433. [PMID: 38874734 DOI: 10.1007/978-3-031-45493-6_20] [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: 06/15/2024]
Abstract
Beta-endorphin is secreted from the hypothalamus and pituitary in both mother and newborn. The placenta produces numerous pituitary hormones from the third month of pregnancy, one of which is βE. It has been suggested that βE has a role in the appetitive and precopulatory phase of sexual behavior in animals. An increase in endorphin levels during sexual activity in humans may contribute to attachment and bonding between partners, but contradictory reports in the literature question the association between sexuality and βE levels. The level of βE also increases during pregnancy, rises in early labor, peaks in late labor, and drops in the postpartum period. This fluctuation provides natural analgesia, raises the pain threshold, decreases the sensation of pain, or suppresses pain, and decreases fear levels during labor and birth. Beta-endorphin also protects the fetus from hypoxia during labor and birth and potential neural damage by aiding blood flow to the brain under hypoxic conditions. It has been suggested that a variety of pharmacologic and nonpharmacologic complementary therapies, when used in pregnancy, labor, and birth, activate the opioid receptors in the CNS and alter the sensation of pain during labor and birth, affect the mother-child attachment and affect sexual function. These studies report contradictory results that will be discussed in this chapter.
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Watkyns AF, Gretschel PJ, Buchanan H. Is Birth Method Associated with Sensory Hyperreactivity in Children 3-4 Years in an Upper-Middle-Income Country? Occup Ther Int 2023; 2023:5598392. [PMID: 38046621 PMCID: PMC10693467 DOI: 10.1155/2023/5598392] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2023] [Revised: 10/02/2023] [Accepted: 10/12/2023] [Indexed: 12/05/2023] Open
Abstract
Background Research has shown that pressure in the vaginal birth process aids the infant's neurophysiological adaption to extrauterine life, including their ability to regulate their responses to diverse sensory stimuli. As pressure is absent in elective caesarean section births, we hypothesised that these children may be at higher risk for developing sensory hyperreactivity (SHR), a sensory modulation difficulty which negatively impacts on the child's engagement in their occupations. This paper reports on a study which investigated associations between birth method and SHR. Method In this cross-sectional study, 91 children aged three and four years from various language, cultural, and socioeconomic groups were recruited and categorised based on birth method (caesarean section or vaginal birth). Caregivers of each child completed the Short Sensory Profile-2 and a demographic questionnaire. The prevalence of SHR between the birth method groups was compared. Results The prevalence of SHR was greater in the vaginal birth group (29%) than the caesarean section group (9%). Mothers in the vaginal birth group were younger (p ≤ 0.001), of lower-income level (p = 0.003), and more likely to be single (p = 0.037). During data collection with the vaginal birth group, comprehensibility of certain items in the Short Sensory Profile-2 proved challenging for many caregivers. Conclusion The statistically significant higher prevalence of SHR in the vaginal birth group supported a null hypothesis. However, the results are questioned due to the challenges related to data collection. Given this, the study supports the need for further investigation of how sociocultural and socioeconomic factors influence the assessment of SHR in the South African context.
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Affiliation(s)
| | - Pamela Joy Gretschel
- Division of Occupational Therapy, Department of Health and Rehabilitation Sciences, University of Cape Town, Cape Town, South Africa
| | - Helen Buchanan
- Division of Occupational Therapy, Department of Health and Rehabilitation Sciences, University of Cape Town, Cape Town, South Africa
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6
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Hiraoka D, Makita K, Sakakibara N, Morioka S, Orisaka M, Yoshida Y, Tomoda A. Longitudinal changes in attention bias to infant crying in primiparous mothers. Front Behav Neurosci 2023; 17:1192275. [PMID: 37809040 PMCID: PMC10556249 DOI: 10.3389/fnbeh.2023.1192275] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2023] [Accepted: 09/08/2023] [Indexed: 10/10/2023] Open
Abstract
Introduction Infant stimuli attract caregiver attention and motivate parenting behavior. Studies have confirmed the existence of attentional bias toward infant face stimuli; however, relatively little is known about whether attentional bias exists for infant cry stimuli, which are as important as faces in child-rearing situations. Furthermore, scarce longitudinal evidence exists on how attentional bias toward infant crying changes through the postpartum period. Methods In the present study, we conducted an experiment to assess bias toward infant crying at two postpartum time points: at Time 1 (Mean = 75.24 days), 45 first-time mothers participated and at Time 2 (Mean = 274.33 days), 30 mothers participated. At both time points, the mothers participated in a Stroop task with infant crying and white noise as the stimuli. They were instructed to answer the color out loud as quickly and accurately as possible, while ignoring the sound. Four types of audio stimuli were used in this task (the cry of the mother's own infant, the cry of an unfamiliar infant, white noise matched to the cry of the mother's own infant, and white noise matched to the cry of an unfamiliar infant), one of which was presented randomly before each trial. Response time and the correct response rate for each condition were the dependent variables. Results For response time, the main effect of familiarity was significant, with longer response times when the participant's infant's cry was presented. In addition, response times were lower at Time 2 than at Time 1 in some conditions in which crying was presented. Discussion The results suggest that mothers may be less disturbed by infant crying as they gain more experience. Elucidating the characteristics of postpartum mothers' changes in cognitive performance related to infants' cries would be useful in fundamental and applied research to understand the process of parents' adaptation to parenting.
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Affiliation(s)
- Daiki Hiraoka
- Research Center for Child Mental Development, University of Fukui, Fukui, Japan
- The Japan Society for the Promotion of Science, Tokyo, Japan
| | - Kai Makita
- Research Center for Child Mental Development, University of Fukui, Fukui, Japan
| | - Nobuko Sakakibara
- Research Center for Child Mental Development, University of Fukui, Fukui, Japan
| | - Shigemi Morioka
- Department of Pediatrics, Fukui Aiiku Hospital, Fukui, Japan
- Department of Pediatrics, Japanese Red Cross Kyoto Daini Hospital, Kyoto, Japan
| | - Makoto Orisaka
- Faculty of Medical Sciences, Department of Obstetrics and Gynecology, University of Fukui, Fukui, Japan
| | - Yoshio Yoshida
- Faculty of Medical Sciences, Department of Obstetrics and Gynecology, University of Fukui, Fukui, Japan
| | - Akemi Tomoda
- Research Center for Child Mental Development, University of Fukui, Fukui, Japan
- Department of Child and Adolescent Psychological Medicine, University of Fukui Hospital, Matsuoka-Shimoaizuki, Fukui, Japan
- Division of Developmental Higher Brain Functions, United Graduate School of Child Development, Osaka University, Kanazawa University, Hamamatsu University School of Medicine, Chiba University, and University of Fukui, Osaka, Japan
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7
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Orchard ER, Voigt K, Chopra S, Thapa T, Ward PGD, Egan GF, Jamadar SD. The maternal brain is more flexible and responsive at rest: effective connectivity of the parental caregiving network in postpartum mothers. Sci Rep 2023; 13:4719. [PMID: 36959247 PMCID: PMC10036465 DOI: 10.1038/s41598-023-31696-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2022] [Accepted: 03/15/2023] [Indexed: 03/25/2023] Open
Abstract
The field of neuroscience has largely overlooked the impact of motherhood on brain function outside the context of responses to infant stimuli. Here, we apply spectral dynamic causal modelling (spDCM) to resting-state fMRI data to investigate differences in brain function between a group of 40 first-time mothers at 1-year postpartum and 39 age- and education-matched women who have never been pregnant. Using spDCM, we investigate the directionality (top-down vs. bottom-up) and valence (inhibition vs excitation) of functional connections between six key left hemisphere brain regions implicated in motherhood: the dorsomedial prefrontal cortex, ventromedial prefrontal cortex, posterior cingulate cortex, parahippocampal gyrus, amygdala, and nucleus accumbens. We show a selective modulation of inhibitory pathways related to differences between (1) mothers and non-mothers, (2) the interactions between group and cognitive performance and (3) group and social cognition, and (4) differences related to maternal caregiving behaviour. Across analyses, we show consistent disinhibition between cognitive and affective regions suggesting more efficient, flexible, and responsive behaviour, subserving cognitive performance, social cognition, and maternal caregiving. Together our results support the interpretation of these key regions as constituting a parental caregiving network. The nucleus accumbens and the parahippocampal gyrus emerging as 'hub' regions of this network, highlighting the global importance of the affective limbic network for maternal caregiving, social cognition, and cognitive performance in the postpartum period.
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Affiliation(s)
- Edwina R Orchard
- Turner Institute for Brain and Mental Health, Monash University, Melbourne, VIC, 3800, Australia
- Monash Biomedical Imaging, Monash University, Melbourne, VIC, 3800, Australia
- Australian Research Council Centre of Excellence for Integrative Brain Function, Melbourne, Australia
- Department of Psychology, Yale University, New Haven, CT, USA
- Yale Child Study Center, Yale University, New Haven, CT, USA
| | - Katharina Voigt
- Turner Institute for Brain and Mental Health, Monash University, Melbourne, VIC, 3800, Australia
- Monash Biomedical Imaging, Monash University, Melbourne, VIC, 3800, Australia
| | - Sidhant Chopra
- Turner Institute for Brain and Mental Health, Monash University, Melbourne, VIC, 3800, Australia
- Monash Biomedical Imaging, Monash University, Melbourne, VIC, 3800, Australia
- Department of Psychology, Yale University, New Haven, CT, USA
| | - Tribikram Thapa
- Turner Institute for Brain and Mental Health, Monash University, Melbourne, VIC, 3800, Australia
- Monash Biomedical Imaging, Monash University, Melbourne, VIC, 3800, Australia
| | - Phillip G D Ward
- Turner Institute for Brain and Mental Health, Monash University, Melbourne, VIC, 3800, Australia
- Monash Biomedical Imaging, Monash University, Melbourne, VIC, 3800, Australia
- Australian Research Council Centre of Excellence for Integrative Brain Function, Melbourne, Australia
| | - Gary F Egan
- Turner Institute for Brain and Mental Health, Monash University, Melbourne, VIC, 3800, Australia
- Monash Biomedical Imaging, Monash University, Melbourne, VIC, 3800, Australia
- Australian Research Council Centre of Excellence for Integrative Brain Function, Melbourne, Australia
| | - Sharna D Jamadar
- Turner Institute for Brain and Mental Health, Monash University, Melbourne, VIC, 3800, Australia.
- Monash Biomedical Imaging, Monash University, Melbourne, VIC, 3800, Australia.
- Australian Research Council Centre of Excellence for Integrative Brain Function, Melbourne, Australia.
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8
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Cabeen RP, Toga AW, Allman JM. Mapping frontoinsular cortex from diffusion microstructure. Cereb Cortex 2023; 33:2715-2733. [PMID: 35753692 PMCID: PMC10016069 DOI: 10.1093/cercor/bhac237] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2022] [Revised: 05/20/2022] [Accepted: 05/21/2022] [Indexed: 11/13/2022] Open
Abstract
We developed a novel method for mapping the location, surface area, thickness, and volume of frontoinsular cortex (FI) using structural and diffusion magnetic resonance imaging. FI lies in the ventral part of anterior insular cortex and is characterized by its distinctive population von Economo neurons (VENs). Functional neuroimaging studies have revealed its involvement in affective processing, and histopathology has implicated VEN loss in behavioral-variant frontotemporal dementia and chronic alcoholism; however, structural neuroimaging of FI has been relatively limited. We delineated FI by jointly modeling cortical surface geometry and its coincident diffusion microstructure parameters. We found that neurite orientation dispersion in cortical gray matter can be used to map FI in specific individuals, and the derived measures reflect a range of behavioral factors in young adults from the Human Connectome Project (N=1052). FI volume was larger in the left hemisphere than the right (31%), and the percentage volume of FI was larger in women than men (15.3%). FI volume was associated with measures of decision-making (delay discounting, substance abuse), emotion (negative intrusive thinking and perception of hostility), and social behavior (theory of mind and working memory for faces). The common denominator is that larger FI size is related to greater self-control and social awareness.
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Affiliation(s)
- Ryan P Cabeen
- Laboratory of Neuro Imaging, USC Stevens Institute for Neuroimaging and Informatics, Keck School of Medicine of USC, University of Southern California, Los Angeles, CA 90033, United States
| | - Arthur W Toga
- Laboratory of Neuro Imaging, USC Stevens Institute for Neuroimaging and Informatics, Keck School of Medicine of USC, University of Southern California, Los Angeles, CA 90033, United States
| | - John M Allman
- Division of Biology and Biological Engineering, California Institute of Technology, Pasadena, CA 91125, United States
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9
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Yang W, Jiang Y, Ma L, Xiao M, Liu M, Ren Z, Hu L, Zhang Y. Cortical and subcortical morphological alterations in postpartum depression. Behav Brain Res 2023; 447:114414. [PMID: 37001820 DOI: 10.1016/j.bbr.2023.114414] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2022] [Revised: 03/16/2023] [Accepted: 03/27/2023] [Indexed: 03/31/2023]
Abstract
Postpartum depression (PPD) is the most common postpartum psychiatric disorder, which can negatively affect both mothers and their offspring. Although the functional changes of PPD have been extensively studied, little is known about its structural abnormalities. This study aimed to examine the cortical and subcortical morphological abnormalities in PPD. High resolution T1 structural MRI data of 29 PPD women and 23 matched healthy postpartum women (HPW) were included in this study. Using surface-based morphometry, we examined the differences between the PPD and HPW group in the cortical thickness, local gyrification index and shape changes of deep gray matter nuclei. Compared with the HPW group, women with PPD showed significantly increased cortical thickness in the left superior frontal gyrus, cuneus and right lingual gyrus and fusiform gyrus, which correlated marginally with the EPDS scores of these subjects. In addition, women with PPD showed significant regional inflation in the right pallidum compared with the HPW group. These findings provided further evidence for the structural brain abnormalities in PPD.
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10
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Cerebellar engagement in the attachment behavioral system. Sci Rep 2022; 12:13571. [PMID: 35945247 PMCID: PMC9363408 DOI: 10.1038/s41598-022-17722-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2021] [Accepted: 07/29/2022] [Indexed: 11/08/2022] Open
Abstract
Brain structural bases of individual differences in attachment are not yet fully clarified. Given the evidence of relevant cerebellar contribution to cognitive, affective, and social functions, the present research was aimed at investigating potential associations between attachment dimensions (through the Attachment Style Questionnaire, ASQ) and cerebellar macro- and micro-structural measures (Volumetric and Diffusion Tensor Imaging data). In a sample of 79 healthy subjects, cerebellar and neocortical volumetric data were correlated with ASQ scores at the voxel level within specific Regions Of Interest. Also, correlations between ASQ scores and age, years of education, anxiety and depression levels were performed to control for the effects of sociodemographic and psychological variables on neuroimaging results. Positive associations between scores of the Preoccupation with Relationships (ASQ subscale associated to insecure/anxious attachment) and cortical volume were found in the cerebellum (right lobule VI and left Crus 2) and neocortex (right medial OrbitoFrontal Cortex, OFC) regions. Cerebellar contribution to the attachment behavioral system reflects the more general cerebellar engagement in the regulation of emotional and social behaviors. Cerebellar properties of timing, prediction, and learning well integrate with OFC processing, supporting the regulation of attachment experiences. Cerebellar areas might be rightfully included in the attachment behavioral system.
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11
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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.
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Affiliation(s)
| | | | | | | | | | - Qiang Xu
- Humboldt Universität zu Berlin, Germany; Ningbo University, China
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12
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Capistrano CG, Grande LA, McRae K, Phan KL, Kim P. Maternal socioeconomic disadvantage, neural function during volitional emotion regulation, and parenting. Soc Neurosci 2022; 17:276-292. [PMID: 35620995 PMCID: PMC10829500 DOI: 10.1080/17470919.2022.2082521] [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: 11/15/2018] [Revised: 03/27/2022] [Indexed: 10/18/2022]
Abstract
The transition to becoming a mother involves numerous emotional challenges, and the ability to effectively keep negative emotions in check is critical for parenting. Evidence suggests that experiencing socioeconomic disadvantage interferes with parenting adaptations and alters neural processes related to emotion regulation. The present study examined whether socioeconomic disadvantage is associated with diminished neural activation while mothers engaged in volitional (i.e., purposeful) emotion regulation. 59 mothers, at an average of 4 months postpartum, underwent fMRI scanning and completed the Emotion Regulation Task (ERT). When asked to regulate emotions using reappraisal (i.e., Reappraise condition; reframing stimuli in order to decrease negative emotion), mothers with lower income-to-needs ratio exhibited dampened neural activation in the dorsolateral and ventrolateral PFC, middle frontal and middle temporal gyrus, and caudate. Without explicit instructions to down-regulate (i.e., Maintain condition), mothers experiencing lower income also exhibited dampened response in regulatory areas, including the middle frontal and middle temporal gyrus and caudate. Blunted middle frontal gyrus activation across both Reappraise and Maintain conditions was associated with reduced maternal sensitivity during a mother-child interaction task. Results of the present study demonstrate the influence of socioeconomic disadvantage on prefrontal engagement during emotion regulation, which may have downstream consequences for maternal behaviors.
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Affiliation(s)
| | - Leah A Grande
- Department of Psychology, University of Denver, Denver, CO, USA
| | - Kateri McRae
- Department of Psychology, University of Denver, Denver, CO, USA
| | - K Luan Phan
- Department of Psychiatry and Behavioral Health, The Ohio State University, Columbus, OH, USA
| | - Pilyoung Kim
- Department of Psychology, University of Denver, Denver, CO, USA
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13
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Sanson A, Bosch OJ. Dysfunctions of brain oxytocin signaling: Implications for poor mothering. Neuropharmacology 2022; 211:109049. [PMID: 35390436 DOI: 10.1016/j.neuropharm.2022.109049] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2021] [Revised: 03/03/2022] [Accepted: 03/29/2022] [Indexed: 10/18/2022]
Abstract
Good mothering has profound impact on both the mother's and the young's well-being. Consequently, experiencing inadequate maternal care - or even neglect - in the first stages of life is a major risk factor for the development of psychiatric disorders, and even for poor parenting towards the future offspring. Thus, understanding the neurobiological basis of maternal neglect becomes crucial. Along with other neurotransmitters and neuropeptides, oxytocin (OXT) has long been known as one of the main modulators of maternal behavior. In rodents, disruptions of central OXT transmission have been associated with poor maternal responses, like impaired onset of nursing behaviors, and reduced care and defense of the pups. Importantly, such behavioral and molecular deficits can be transmitted through generations, creating a vicious circle of low-quality maternal behavior. Similarly, evidence from human studies shows that OXT signaling is defective in conditions of inadequate mothering and child neglect. On those premises, this review aims at providing a comprehensive overview of animal and human studies linking perturbed OXT transmission to poor maternal behavior. Considering the important fallouts of inadequate maternal responses, we believe that unraveling the alterations in OXT transmission might provide useful insights for a better understanding of maternal neglect and, ultimately, for future intervention approaches.
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Affiliation(s)
- Alice Sanson
- Department of Behavioural and Molecular Neurobiology, Regensburg Center of Neuroscience, University of Regensburg, Regensburg, Germany.
| | - Oliver J Bosch
- Department of Behavioural and Molecular Neurobiology, Regensburg Center of Neuroscience, University of Regensburg, Regensburg, Germany.
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14
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Cabré S, Ratsika A, Rea K, Stanton C, Cryan JF. Animal Models for Assessing Impact of C-Section Delivery on Biological Systems. Neurosci Biobehav Rev 2022; 135:104555. [PMID: 35122781 DOI: 10.1016/j.neubiorev.2022.104555] [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: 06/29/2021] [Revised: 01/28/2022] [Accepted: 01/30/2022] [Indexed: 12/02/2022]
Abstract
There has been a significant increase in Caesarean section (C-section) births worldwide over the past two decades and although it is can be a life-saving procedure, the enduring effects on host physiology are now undergoing further scrutiny. Indeed, epidemiological data have linked C-section birth with multiple immune, metabolic and neuropsychiatric diseases. Birth by C-section is known to alter the colonisation of the neonatal gut microbiota (with C-section delivered infants lacking vaginal microbiota associated with passing along the birth canal), which in turn can impact the development and maintenance of many important biological systems. Appropriate animal models are key to disentangling the role of missing microbes in brain health and disease in C-section births. In this review of preclinical studies, we interrogate the effects of C-section birth on the development (and maintenance) of several biological systems and we discuss the involvement of the gut microbiome on C-section-related alterations.
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Affiliation(s)
- Sílvia Cabré
- APC Microbiome Ireland, Biosciences Institute, University College Cork, Cork T12 YT20, Ireland; Department of Anatomy and Neuroscience, University College Cork, Cork T12 YT20, Ireland
| | - Anna Ratsika
- APC Microbiome Ireland, Biosciences Institute, University College Cork, Cork T12 YT20, Ireland; Department of Anatomy and Neuroscience, University College Cork, Cork T12 YT20, Ireland
| | - Kieran Rea
- APC Microbiome Ireland, Biosciences Institute, University College Cork, Cork T12 YT20, Ireland
| | - Catherine Stanton
- APC Microbiome Ireland, Biosciences Institute, University College Cork, Cork T12 YT20, Ireland; Department of Psychiatry and Neurobehavioural Science, University College Cork, Cork T12 YT20, Ireland; Teagasc Food Research Centre, Moorepark, Fermoy P61 C996, Ireland
| | - John F Cryan
- APC Microbiome Ireland, Biosciences Institute, University College Cork, Cork T12 YT20, Ireland; Department of Anatomy and Neuroscience, University College Cork, Cork T12 YT20, Ireland.
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15
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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.
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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
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16
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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.
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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
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17
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Takács L, Putnam SP, Bartoš F, Čepický P, Monk C. Parity moderates the effect of delivery mode on maternal ratings of infant temperament. PLoS One 2021; 16:e0255367. [PMID: 34383795 PMCID: PMC8360581 DOI: 10.1371/journal.pone.0255367] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2021] [Accepted: 07/14/2021] [Indexed: 12/02/2022] Open
Abstract
Objective Cesarean section (CS) rates are rising rapidly around the world but no conclusive evidence has been obtained about the possible short- and long-term effects of CS on child behavior. We evaluated prospectively the association between CS and infant temperament across the first 9 postpartum months, controlling for indications for CS and investigating parity and infant sex as moderators. Methods The sample consisted of mothers and their healthy infants. Infant temperament was measured using the Infant Characteristics Questionnaire completed by the mothers at 6 weeks (n = 452) and 9 months (n = 258) postpartum. Mode of birth was classified into spontaneous vaginal birth (n = 347 for 6 weeks sample; 197 for 9 months sample), CS planned for medical reasons (n = 55; 28) and emergency CS (n = 50; 33). Results Multiple regression analysis revealed no main effects of birth mode, but showed a significant interaction between birth mode and parity indicating that emergency CS in firstborn infants was associated with more difficult temperament at 6 weeks. There were no significant associations between indications for CS and infant temperament, although breech presentation predicted difficult temperament at 9 months. Conclusion We largely failed to support the association between CS and infant temperament. Although our results suggest that emergency CS may be associated with temperament in firstborns, further research is needed to replicate this finding, preferably using observational measures to assess child temperament.
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Affiliation(s)
- Lea Takács
- Department of Psychology, Faculty of Arts, Charles University, Prague, Czech Republic
- * E-mail:
| | - Samuel P. Putnam
- Department of Psychology, Bowdoin College, Brunswick, Maine, United States of America
| | - František Bartoš
- Department of Psychology, Faculty of Arts, Charles University, Prague, Czech Republic
| | - Pavel Čepický
- Department of Psychology, Faculty of Arts, Charles University, Prague, Czech Republic
| | - Catherine Monk
- Department of Obstetrics & Gynecology, and Psychiatry, Columbia University Irving Medical Center, New York, New York, United States of America
- New York State Psychiatric Institute, New York, New York, United States of America
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18
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Sakakibara N, Makita K, Hiraoka D, Kasaba R, Kuboshita R, Shimada K, Fujisawa TX, Tomoda A. Increased resting-state activity in the cerebellum with mothers having less adaptive sensory processing and trait anxiety. Hum Brain Mapp 2021; 42:4985-4995. [PMID: 34270152 PMCID: PMC8449103 DOI: 10.1002/hbm.25594] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2021] [Revised: 07/04/2021] [Accepted: 07/06/2021] [Indexed: 12/13/2022] Open
Abstract
Child‐rearing mothers with high levels of trait anxiety have a tendency for less adaptive sensory processing, which causes parenting stress. However, the neural mechanisms underlying this sensory processing and trait anxiety remain unclear. We aimed to determine the whole‐brain spontaneous neural activity and sensory processing characteristics in mothers with varying parenting stress levels. Using resting‐state functional magnetic resonance imaging, we assessed mothers caring for more than one preschool aged (2–5 years) child and presenting with varying levels of sensory processing, trait anxiety, and parenting stress. Spontaneous neural activities in select brain regions were evaluated by whole‐brain correlation analyses based on the fractional amplitude of low‐frequency fluctuations (fALFF). We found significant positive correlations between levels of sensory processing with trait anxiety and parenting stress. Mothers having less adaptive sensory processing had significantly increased resting‐state network activities in the left lobule VI of the cerebellum. Increased fALFF values in the left lobule VI confirmed the mediation effect on the relationship between trait anxiety and sensory processing. A tendency for less adaptive sensory processing involving increased brain activity in lobule VI could be an indicator of maternal trait anxiety and the risk of parenting stress.
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Affiliation(s)
- Nobuko Sakakibara
- Research Center for Child Mental Development, University of Fukui, Fukui, Japan.,Division of Developmental Higher Brain Functions, United Graduate School of Child Development, University of Fukui, Fukui, Japan
| | - Kai Makita
- Research Center for Child Mental Development, University of Fukui, Fukui, Japan
| | - Daiki Hiraoka
- Research Center for Child Mental Development, University of Fukui, Fukui, Japan.,Japan Society for the Promotion of Science, Tokyo, Japan
| | - Ryoko Kasaba
- Research Center for Child Mental Development, University of Fukui, Fukui, Japan
| | - Ryo Kuboshita
- Department of Rehabilitation, Faculty of Health Science, Fukui Health Science University, Fukui, Japan
| | - Koji Shimada
- Research Center for Child Mental Development, University of Fukui, Fukui, Japan.,Division of Developmental Higher Brain Functions, United Graduate School of Child Development, University of Fukui, Fukui, Japan.,Japan Biomedical Imaging Research Center, University of Fukui, Fukui, Japan
| | - Takashi X Fujisawa
- Research Center for Child Mental Development, University of Fukui, Fukui, Japan.,Division of Developmental Higher Brain Functions, United Graduate School of Child Development, University of Fukui, Fukui, Japan
| | - Akemi Tomoda
- Research Center for Child Mental Development, University of Fukui, Fukui, Japan.,Division of Developmental Higher Brain Functions, United Graduate School of Child Development, University of Fukui, Fukui, Japan.,Department of Child and Adolescent Psychological Medicine, University of Fukui Hospital, Fukui, Japan
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19
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Koop S, Oster H. Eat, sleep, repeat - endocrine regulation of behavioural circadian rhythms. FEBS J 2021; 289:6543-6558. [PMID: 34228879 DOI: 10.1111/febs.16109] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2021] [Revised: 06/23/2021] [Accepted: 07/05/2021] [Indexed: 02/07/2023]
Abstract
The adaptation of organisms to a rhythmic environment is mediated by an internal timing system termed the circadian clock. In mammals, molecular clocks are found in all tissues and organs. This circadian clock network regulates the release of many hormones, which in turn influence some of the most vital behavioural functions. Sleep-wake cycles are under strict circadian control with strong influence of rhythmic hormones such as melatonin, cortisol and others. Food intake, in contrast, receives circadian modulation through hormones such as leptin, ghrelin, insulin and orexin. A third behavioural output covered in this review is mating and bonding behaviours, regulated through circadian rhythms in steroid hormones and oxytocin. Together, these data emphasize the pervasive influence of the circadian clock system on behavioural outputs and its mediation through endocrine networks.
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Affiliation(s)
- Sarah Koop
- Centre of Brain, Behavior and Metabolism, Institute of Neurobiology, University of Lübeck, Germany
| | - Henrik Oster
- Centre of Brain, Behavior and Metabolism, Institute of Neurobiology, University of Lübeck, Germany
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20
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Rutherford HJV, Potenza MN, Mayes LC, Scheinost D. The Application of Connectome-Based Predictive Modeling to the Maternal Brain: Implications for Mother-Infant Bonding. Cereb Cortex 2021; 30:1538-1547. [PMID: 31690936 DOI: 10.1093/cercor/bhz185] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2019] [Revised: 07/15/2019] [Accepted: 07/16/2019] [Indexed: 12/16/2022] Open
Abstract
Maternal bonding early postpartum lays an important foundation for child development. Changing brain structure and function during pregnancy and postpartum may underscore maternal bonding. We employed connectome-based predictive modeling (CPM) to measure brain functional connectivity and predict self-reported maternal bonding in mothers at 2 and 8 months postpartum. At 2 months, CPM predicted maternal anxiety in the bonding relationship: Greater integration between cerebellar and motor-sensory-auditory networks and between frontoparietal and motor-sensory-auditory networks were associated with more maternal anxiety toward their infant. Furthermore, greater segregation between the cerebellar and frontoparietal, and within the motor-sensory-auditory networks, was associated with more maternal anxiety regarding their infant. We did not observe CPM prediction of maternal bonding impairments or rejection/anger toward the infant. Finally, considering 2 and 8 months of data, changes in network connectivity were associated with changes in maternal anxiety in the bonding relationship. Our results suggest that changing connectivity among maternal brain networks may provide insight into the mother-infant bond, specifically in the context of anxiety and the representation of the infant in the mother's mind. These findings provide an opportunity to mechanistically investigate approaches to enhance the connectivity of these networks to optimize the representational and behavioral quality of the caregiving relationship.
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Affiliation(s)
| | - Marc N Potenza
- Child Study Center, Yale School of Medicine, New Haven, CT 06520, USA.,Department of Psychiatry, Yale School of Medicine, New Haven, CT 06510, USA.,Department of Neuroscience, Yale School of Medicine, New Haven, CT 06510, USA.,The Connecticut Mental Health Center, New Haven, CT 06519, USA.,The Connecticut Council on Problem Gambling, Wethersfield, CT 06109, USA
| | - Linda C Mayes
- Child Study Center, Yale School of Medicine, New Haven, CT 06520, USA
| | - Dustin Scheinost
- Child Study Center, Yale School of Medicine, New Haven, CT 06520, USA.,Radiology and Bioimaging Sciences, Yale School of Medicine, New Haven, CT, 06510, USA.,Statistics and Data Science, Yale University, New Haven, CT 06510, USA
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21
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Bak Y, Nah Y, Han S, Lee SK, Kim J, Shin NY. Neural correlates of empathy for babies in postpartum women: A longitudinal study. Hum Brain Mapp 2021; 42:3295-3304. [PMID: 33939212 PMCID: PMC8193525 DOI: 10.1002/hbm.25435] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2020] [Revised: 03/24/2021] [Accepted: 03/25/2021] [Indexed: 12/30/2022] Open
Abstract
This study investigated the empathic response of postpartum women to babies in pain and the underlying neural mechanism. Postpartum women responded with more empathy and speed to babies over other stimuli compared to controls. Brain scans taken 3 months after birth showed more elevated activation in the Middle cingulate cortex/middle frontal gyrus (MCC/MFG) than the controls regardless of the task condition. When compared to the adult and neutral conditions, the posterior cingulate cortex (PCC) region was consistently more activated when postpartum women saw babies than controls. In addition, higher activation levels in the PCC region for the baby condition significantly correlated with faster and more empathic responses to babies. Considering that PCC is a core region for the theory of mind or mentalizing which requires cognitive reasoning to understand others, these results suggest that PCC might be a pivotal neural locus facilitating cognitive efforts to empathize with babies during the postpartum period. In a follow‐up experiment at 12 months after birth, we were still able to observe higher activity in the MCC/MFG of postpartum women. However, previously observed PCC activation patterns disappeared 12 months after birth, despite the women's response patterns to babies still being maintained. These results suggest that the mentalizing process activated to empathize with babies in the early postpartum period becomes less cognitively demanding over time.
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Affiliation(s)
- Yunjin Bak
- Department of Radiology, College of Medicine, The Catholic University of Korea, Seoul, South Korea
| | - Yoonjin Nah
- Department of Psychology, Yonsei University, Seoul, South Korea
| | - Sanghoon Han
- Department of Psychology, Yonsei University, Seoul, South Korea
| | - Seung-Koo Lee
- Department of Radiology, Yonsei University College of Medicine, Seoul, South Korea
| | - Jiwoong Kim
- Department of Computational Mathematics Science and Engineering, Michigan State University, East Lansing, Michigan, USA
| | - Na-Young Shin
- Department of Radiology, College of Medicine, The Catholic University of Korea, Seoul, South Korea
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22
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Chrzan-Dętkoś M, Walczak-Kozłowska TZ. How do new mothers perceive screening for perinatal depression? HEALTH PSYCHOLOGY REPORT 2021; 9:207-216. [PMID: 38084232 PMCID: PMC10501423 DOI: 10.5114/hpr.2021.102823] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2020] [Revised: 11/26/2020] [Accepted: 12/15/2020] [Indexed: 06/23/2024] Open
Abstract
BACKGROUND Countries recognize the risk of mental health difficulties during the perinatal period and the potential benefits of screening and early detection of depressive symptom-atology. This study aimed to analyse mothers' views on screening for postpartum depression (PPD) in Poland, where a new standard of perinatal care imposed (from January 2019) the obligation to monitor women' postpartum mental state. PARTICIPANTS AND PROCEDURE 150 women participated in the study. In the first stage, PPD symptoms were assessed with the Edinburgh Post-natal Depression Scale (EPDS) among postpartum women during midwives' home visits. The second stage consisted of a telephone survey with the EPDS and questions exploring mothers' perception of midwife competencies in screening for PPD. RESULTS Most women identified as relatively high midwives' competencies in communicating information about PPD, interpretation of the EPDS score and their ability to create comfortable conditions of the assessment and further discussion about postpartum mental health changes. Women with an elevated level of PPD symptoms assessed as significantly lower midwives' competence in this last aspect and those who had a caesarean section tend to assess as lower the usefulness of provided information on care of a newborn. CONCLUSIONS Midwives should be aware and prepared for a possible critical attitude of patients, which may be a sign of a depression. Otherwise, medical staff may not be willing to interact with a mother and offer her help and support. The ability to create a friendly condition in spite of adversity can contribute to the desire of women to undergo screening, discussion about the result and further treatment.
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Affiliation(s)
| | - Tamara Z. Walczak-Kozłowska
- Institute of Psychology, University of Gdansk, Gdansk, Poland
- Department of Psychology, Gdansk, University of Physical Education and Sport, Gdansk, Poland
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23
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García-Cabrerizo R, Carbia C, O Riordan KJ, Schellekens H, Cryan JF. Microbiota-gut-brain axis as a regulator of reward processes. J Neurochem 2021; 157:1495-1524. [PMID: 33368280 DOI: 10.1111/jnc.15284] [Citation(s) in RCA: 62] [Impact Index Per Article: 20.7] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2020] [Revised: 12/08/2020] [Accepted: 12/21/2020] [Indexed: 12/14/2022]
Abstract
Our gut harbours trillions of microorganisms essential for the maintenance of homeostasis and host physiology in health and disease. In the last decade, there has been a growing interest in understanding the bidirectional pathway of communication between our microbiota and the central nervous system. With regard to reward processes there is accumulating evidence from both animal and human studies that this axis may be a key factor in gating reward valence. Focusing on the mesocorticolimbic pathway, we will discuss how the intestinal microbiota is involved in regulating brain reward functions, both in natural (i.e. eating, social or sexual behaviours) and non-natural reinforcers (drug addiction behaviours including those relevant to alcohol, psychostimulants, opioids and cannabinoids). We will integrate preclinical and clinical evidence suggesting that the microbiota-gut-brain axis could be implicated in the development of disorders associated with alterations in the reward system and how it may be targeted as a promising therapeutic strategy. Cover Image for this issue: https://doi.org/10.1111/jnc.15065.
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Affiliation(s)
| | - Carina Carbia
- APC Microbiome Ireland, University College Cork, Cork, Ireland
| | | | - Harriet Schellekens
- APC Microbiome Ireland, University College Cork, Cork, Ireland.,Department of Anatomy and Neuroscience, University College Cork, Cork, Ireland
| | - John F Cryan
- APC Microbiome Ireland, University College Cork, Cork, Ireland.,Department of Anatomy and Neuroscience, University College Cork, Cork, Ireland
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24
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Shahsavan F, Akbari N, Gharraee B, Abolghasemi J, Khedmat L. The effect of internet-based guided self-help cognitive-behavioral therapies on Iranian women's psychological symptoms and preferred method of childbirth. Perspect Psychiatr Care 2021; 57:138-147. [PMID: 32567051 DOI: 10.1111/ppc.12535] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/18/2020] [Revised: 04/16/2020] [Accepted: 05/11/2020] [Indexed: 12/22/2022] Open
Abstract
PURPOSE The effectiveness of an Internet-based guided self-help cognitive-behavioral therapy (I-GSH-CBT) was assessed in alleviating childbirth fear (CBF), depression, anxiety, and stress of pregnant women during the first delivery. DESIGN AND METHODS In a quasi-experimental study, pregnant women in the intervention group used the I-GSH-CBT program during pregnancy. The Wijma Delivery Expectancy/Experience Questionnaire, and the Depression, Anxiety, and Stress Scale 42-item (DASS-42) questionnaires were used to collect the psychometric data. FINDINGS Implementing the I-GSH-CBT significantly reduced CBF, DASS-42 scores, and cesarean section preference. PRACTICE IMPLICATIONS The I-GSH-CBT program effectively decreases the adverse mood symptoms in nulliparous pregnant women.
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Affiliation(s)
- Fatemeh Shahsavan
- Department of Midwifery and Reproductive Health, Faculty of Nursing and Midwifery, Iran University of Medical Sciences, Tehran, Iran
| | - Nahid Akbari
- Department of Midwifery and Reproductive Health, Faculty of Nursing and Midwifery, Iran University of Medical Sciences, Tehran, Iran
| | - Banafsheh Gharraee
- Department of Clinical Psychology, School of Behavioral Sciences and Mental Health (Tehran Institute of Psychiatry), Iran University of Medical Sciences, Tehran, Iran
| | - Jamileh Abolghasemi
- Department of Biostatistics, School of Public Health, Iran University of Medical Sciences, Tehran, Iran
| | - Leila Khedmat
- Health Management Research Center, Baqiyatallah University of Medical Sciences, Tehran, Iran
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25
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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.
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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
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26
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Sacher J, Chechko N, Dannlowski U, Walter M, Derntl B. The peripartum human brain: Current understanding and future perspectives. Front Neuroendocrinol 2020; 59:100859. [PMID: 32771399 DOI: 10.1016/j.yfrne.2020.100859] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/14/2020] [Revised: 07/30/2020] [Accepted: 07/31/2020] [Indexed: 12/12/2022]
Abstract
The peripartum period offers a unique opportunity to improve our understanding of how dramatic fluctuations in endogenous ovarian hormones affect the human brain and behavior. This notwithstanding, peripartum depression remains an underdiagnosed and undertreated disorder. Here, we review recent neuroimaging findings with respect to the neuroplastic changes in the maternal brain during pregnancy and the postpartum period. We seek to provide an overview of multimodal neuroimaging designs of current peripartum depression models of hormone withdrawal, changes in monoaminergic signaling, and maladaptive neuroplasticity, which likely lead to the development of a condition that puts the lives of mother and infant at risk. We discuss the need to effectively integrate the available information on psychosocial and neurobiological risk factors contributing to individual vulnerability. Finally, we propose a systematic approach to neuroimaging the peripartum brain that acknowledges important co-morbidities and variation in disease onset.
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Affiliation(s)
- Julia Sacher
- Department of Neurology, Max-Planck-Institute for Human Cognitive and Brain Sciences, Stephanstr. 1A, 04103 Leipzig, Germany; Emotion Neuroimaging Lab, Max Planck Institute for Human Cognitive and Brain Sciences, Stephanstr. 1A, 04103 Leipzig, Germany; Clinic of Cognitive Neurology, University of Leipzig, Liebigstr. 16, 04103 Leipzig, Germany.
| | - Natalia Chechko
- Klinik für Psychiatrie, Psychotherapie und Psychosomatik, Pauwelsstr. 30, 52074 Aachen, Germany; Institute of Neuroscience and Medicine (INM-7: Brain and Behaviour), Forschungszentrum Jülich, Wilhelm-Johnen-Str., 52428 Jülich, Germany
| | - Udo Dannlowski
- Department of Psychiatry and Psychotherapy, University of Muenster, Albert Schweitzer-Campus 1, G 9A, 48149 Muenster, Germany
| | - Martin Walter
- Department of Psychiatry and Psychotherapy, Jena University Hospital, Philosophenweg 3, 07743 Jena, Germany
| | - Birgit Derntl
- Department of Psychiatry and Psychotherapy, Medical School, University of Tübingen, Osianderstr. 24, 72076 Tübingen, Germany; LEAD Graduate Training & Research Network, University of Tübingen, Walter-Simon-Str. 12, 72072 Tübingen, Germany
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Tipo de parto y sensibilidad materna: Efectos en el desarrollo socioemocional de niños y niñas al año de edad. ACTA COLOMBIANA DE PSICOLOGIA 2020. [DOI: 10.14718/acp.2020.23.2.10] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
Abstract
La infancia temprana es un periodo de gran relevancia en el desarrollo socioemocional infantil; de hecho, es donde se sientan las bases del desarrollo futuro. En este sentido, las adquisiciones durante el primer año de vida son predictores importantes de las habilidades sociales y emocionales futuras, de modo que la sensibilidad materna, según evidencia respecto a sus efectos en el desarrollo socioemocional del niño, ha demostrado ser un aspecto fundamental durante este periodo. Teniendo esto en cuenta, y considerando la relevancia de dicha competencia, así como el alza mundial y nacional en las tasas de cesárea y los posibles riesgos asociados al tipo de parto vivenciado, el presente estudio tuvo como objetivo analizar la influencia dela sensibilidad materna y del tipo de parto en el desarrollo socioemocional infantil al año de edad. Para ello, se estudió una muestra no probabilística intencionada de 91 madres con sus respectivos hijos o hijas de distinto nivel socioeconómico que asistían a salas cuna públicas o privadas en la ciudad de Santiago, Chile, por medio de dos instrumentos: la escala de sensibilidad del adulto (ESA) y la functional emotional assessment scale (FEAS). En general, los resultados no mostraron diferencias en el desarrollo socioemocional de los niños según el tipo de parto, aunque sí se pudo apreciar una relación entre una mayor sensibilidad materna y un mayor desarrollo socioemocional de los niños al año de edad. Al final se discuten las implicaciones de promover la sensibilidad materna con el fin de apoyar un óptimo desarrollo socioemocional en los infantes.
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The unique social sense of puerperium: Increased empathy and Schadenfreude in parents of newborns. Sci Rep 2020; 10:5760. [PMID: 32238840 PMCID: PMC7113282 DOI: 10.1038/s41598-020-62622-7] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2019] [Accepted: 03/05/2020] [Indexed: 11/29/2022] Open
Abstract
Pregnancy and puerperium are typified by marked biobehavioral changes. These changes, which are traceable in both mothers and fathers, play an important role in parenthood and may modulate social cognition abilities. However, the latter effects remain notably unexplored in parents of newborns (PNs). To bridge this gap, we assessed empathy and social emotions (envy and Schadenfreude) in 55 PNs and 60 controls (childless healthy participants without a romantic relationship or sexual intercourse in the previous 48 hours). We used facial electromyography to detect physiological signatures of social emotion processing. Results revealed higher levels of affective empathy and Schadenfreude in PNs, the latter pattern being accompanied by increased activity of the corrugator suppercilii region. These effects were not explained by potential confounding variables (educational level, executive functioning, depression, stress levels, hours of sleep). Our novel findings suggest that PNs might show social cognition changes crucial for parental bonding and newborn care.
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Rutherford HJV, Yip SW, Worhunsky PD, Kim S, Strathearn L, Potenza MN, Mayes LC. Differential responses to infant faces in relation to maternal substance use: An exploratory study. Drug Alcohol Depend 2020; 207:107805. [PMID: 31874448 PMCID: PMC7060928 DOI: 10.1016/j.drugalcdep.2019.107805] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/28/2019] [Revised: 12/04/2019] [Accepted: 12/05/2019] [Indexed: 01/27/2023]
Abstract
BACKGROUND Maternal substance use and addiction has been associated with negative consequences for parenting and may increase addiction vulnerability in the developing child. Neuroimaging research suggests that substance use may decrease the reward of caring for infants and heighten stress reactivity to affective infant cues. METHODS Thirty-two substance-using mothers and twenty-two non-substance-using mothers were presented with emotional face and cry stimuli generated from their own and a demographically matched unknown infant during fMRI scanning. Between-group differences in neural activity during task performance were assessed using whole-brain, mixed-effects models corrected for multiple comparisons (voxel-level p < 0.001, pFWE<0.05). RESULTS Relative to non-substance-using mothers, substance-using mothers exhibited greater activation when viewing their own infant's face as compared to an unknown infant's face across multiple brain regions, including superior medial frontal, inferior parietal, and middle temporal regions. Substance-using mothers also had a decreased response to sad infant faces in the ventral striatum relative to the non-substance-using mothers. Neural responses to own vs. unknown infant cries did not significantly differ between substance-using and non-substance-using mothers. CONCLUSIONS Findings suggest overlapping cortical and subcortical brain regions implicated in responding to infant faces, with activation differences related to infant familiarity, emotional expression, and maternal substance use. While prior work has focused on attenuated neural responses to infant cues, greater attention is needed toward understanding the increased reactivity to affective infant cues observed in substance-using mothers.
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Affiliation(s)
- Helena J V Rutherford
- Child Study Center, Yale University School of Medicine, New Haven, CT, 06520, United States.
| | - Sarah W Yip
- Child Study Center, Yale University School of Medicine, New Haven, CT, 06520, United States; Department of Psychiatry, Yale University School of Medicine, New Haven, CT, 06510, United States
| | - Patrick D Worhunsky
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, 06510, United States
| | - Sohye Kim
- Departments of Psychiatry, Pediatrics, and Obstetrics and Gynecology, University of Massachusetts Medical School, United States; Eunice Kennedy Shriver Center, University of Massachusetts Medical School, United States; Department of Obstetrics and Gynecology, Baylor College of Medicine, United States
| | - Lane Strathearn
- Stead Family Department of Pediatrics, University of Iowa Carver College of Medicine, United States; Center for Disabilities and Development, University of Iowa Stead Family Children's Hospital, Iowa City, IA, 52242, United States
| | - Marc N Potenza
- Child Study Center, Yale University School of Medicine, New Haven, CT, 06520, United States; Department of Psychiatry, Yale University School of Medicine, New Haven, CT, 06510, United States; Department of Neuroscience, Yale University School of Medicine, New Haven, CT, 06510, United States; The Connecticut Council on Problem Gambling, Wethersfield, CT, 06109, United States; The Connecticut Mental Health Center, New Haven, CT, 06519, United States
| | - Linda C Mayes
- Child Study Center, Yale University School of Medicine, New Haven, CT, 06520, United States
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Seghete KLM, Graham AM, Shank TM, Alsup SL, Fisher PA, Wilson AC, Ewing SWF. Advancing preventive interventions for pregnant women who are opioid using via the integration of addiction and mental health research. CURRENT ADDICTION REPORTS 2020; 7:61-67. [PMID: 32201680 DOI: 10.1007/s40429-020-00296-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Purpose of Review This review examines how research focused on treatment for opioid use in perinatal populations and preventive interventions for postpartum psychopathology have remained separate, despite significant overlap. Recent Findings Guidelines for best practice in caring for pregnant women with opioid use disorder suggest the use of medication-assisted treatment with additional comprehensive care, including behavioral and mental health interventions. However, intervention research often mutually excludes these two populations, with studies of behavioral interventions for opioid use excluding women with psychopathology and research on preventive interventions for postpartum psychopathology excluding women who are substance using. Summary There is a limited evidence-base to inform the selection of appropriate preventive interventions for pregnant women with opioid use disorder that can address opioid use and/or treatment adherence and concurrent mental health risks. We argue it is critical to integrate research on pregnant women who are opioid using and preventive perinatal mental health interventions to catalyze pivotal change in how we address the opioid epidemic within this growing population.
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Affiliation(s)
| | - Alice M Graham
- Department of Psychiatry, Oregon Health & Science University, Portland, OR
| | - Taylor M Shank
- School of Graduate Psychology, Pacific University, Hillsboro, OR
| | - Shelby L Alsup
- School of Graduate Psychology, Pacific University, Hillsboro, OR
| | | | - Anna C Wilson
- Department of Pediatrics, Oregon Health & Science University, Portland, OR
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van ‘t Veer AE, Thijssen S, Witteman J, van IJzendoorn MH, Bakermans-Kranenburg MJ. Exploring the neural basis for paternal protection: an investigation of the neural response to infants in danger. Soc Cogn Affect Neurosci 2020; 14:447-457. [PMID: 30847472 PMCID: PMC6523437 DOI: 10.1093/scan/nsz018] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2018] [Revised: 02/26/2019] [Accepted: 03/05/2019] [Indexed: 01/06/2023] Open
Abstract
Perceiving potential threat to an infant and responding to it is crucial for offspring survival and parent–child bonding. Using a combination of functional magnetic resonance imaging and multi-informant reports, this longitudinal study explores the neural basis for paternal responses to threat to infants pre-natally (N = 21) and early post-natally (n = 17). Participants viewed videos showing an infant in danger and matched control videos, while instructed to imagine that the infant was their own or someone else’s. Effects were found for infant-threatening vs neutral situations in the amygdala (region-of-interest analyses) and in clusters spanning cortical and subcortical areas (whole-brain analyses). An interaction effect revealed increased activation for own (vs unknown) infants in threatening (vs neutral) situations in bilateral motor areas, possibly indicating preparation for action. Post-natal activation patterns were similar; however, in part of the superior frontal gyrus the distinction between threat to own and unknown infant faded. Fathers showing more protective behavior in daily life recruited part of the frontal pole more when confronted with threat to their own vs an unknown infant. This exploratory study is the first to describe neural mechanisms involved in paternal protection and provides a basis for future work on fathers’ protective parenting.
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Affiliation(s)
- Anna E van ‘t Veer
- Methodology and Statistics Unit, Institute of Psychology, Leiden University, Leiden, the Netherlands
- Leiden Institute for Brain and Cognition, Leiden University, Leiden, the Netherlands
- Correspondence should be addressed to Anna van ‘t Veer, Methodology and Statistics Unit, Institute of Psychology, Leiden University, Wassenaarseweg 52, Box 9555, 2300 RB, Leiden, the Netherlands. E-mail:
| | - Sandra Thijssen
- Department of Psychology, Education, and Child Studies, Erasmus University Rotterdam, Rotterdam, the Netherlands
| | - Jurriaan Witteman
- Leiden Institute for Brain and Cognition, Leiden University, Leiden, the Netherlands
- Leiden University Centre for Linguistics, Leiden University, Leiden, the Netherlands
| | - Marinus H van IJzendoorn
- Department of Psychology, Education, and Child Studies, Erasmus University Rotterdam, Rotterdam, the Netherlands
- School of Clinical Medicine, University of Cambridge, Cambridge, UK
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Ho SS, Muzik M, Rosenblum KL, Morelen D, Nakamura Y, Swain JE. Potential Neural Mediators of Mom Power Parenting Intervention Effects on Maternal Intersubjectivity and Stress Resilience. Front Psychiatry 2020; 11:568824. [PMID: 33363481 PMCID: PMC7752922 DOI: 10.3389/fpsyt.2020.568824] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/02/2020] [Accepted: 11/11/2020] [Indexed: 12/11/2022] Open
Abstract
Stress resilience in parenting depends on the parent's capacity to understand subjective experiences in self and child, namely intersubjectivity, which is intimately related to mimicking other's affective expressions (i. e., mirroring). Stress can worsen parenting by potentiating problems that can impair intersubjectivity, e.g., problems of "over-mentalizing" (misattribution of the child's behaviors) and "under-coupling" (inadequate child-oriented mirroring). Previously we have developed Mom Power (MP) parenting intervention to promote maternal intersubjectivity and reduce parenting stress. This study aimed to elucidate neural mechanisms underlying the effects of MP with a novel Child Face Mirroring Task (CFMT) in functional magnetic-resonance-imaging settings. In CFMT, the participants responded to own and other's child's facial pictures in three task conditions: (1) empathic mirroring (Join), (2) non-mirroring observing (Observe), and (3) voluntary responding (React). In each condition, each child's neutral, ambiguous, distressed, and joyful expressions were repeatedly displayed. We examined the CFMT-related neural responses in a sample of healthy mothers (n = 45) in Study 1, and MP effects on CFMT with a pre-intervention (T1) and post-intervention (T2) design in two groups, MP (n = 19) and Control (n = 17), in Study 2. We found that, from T1 to T2, MP (vs. Control) decreased parenting stress, decreased dorsomedial prefrontal cortex (dmPFC) during own-child-specific voluntary responding (React to Own vs. Other's Child), and increased activity in the frontoparietal cortices, midbrain, nucleus accumbens, and amygdala during own-child-specific empathic mirroring (Join vs. Observe of Own vs. Other's Child). We identified that MP effects on parenting stress were potentially mediated by T1-to-T2 changes in: (1) the left superior-temporal-gyrus differential responses in the contrast of Join vs. Observe of own (vs. other's) child, (2) the dmPFC-PAG (periaqueductal gray) differential functional connectivity in the same contrast, and (3) the left amygdala differential responses in the contrast of Join vs. Observe of own (vs. other's) child's joyful vs. distressed expressions. We discussed these results in support of the notion that MP reduces parenting stress via changing neural activities related to the problems of "over-mentalizing" and "under-coupling." Additionally, we discussed theoretical relationships between parenting stress and intersubjectivity in a novel dyadic active inference framework in a two-agent system to guide future research.
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Affiliation(s)
- S Shaun Ho
- Department of Psychiatry and Behavioral Health, Renaissance School of Medicine at Stony Brook University, Stony Brook, NY, United States
| | - Maria Muzik
- Departments of Psychiatry, Obstetrics & Gynecology, University of Michigan, Ann Arbor, MI, United States
| | - Katherine L Rosenblum
- Departments of Psychiatry, Obstetrics & Gynecology, University of Michigan, Ann Arbor, MI, United States
| | - Diana Morelen
- Department of Psychology, East Tennessee State University, Johnson City, TN, United States
| | - Yoshio Nakamura
- Department of Anesthesiology, Pain Research Center, University of Utah School of Medicine, Salt Lake City, UT, United States
| | - James E Swain
- Department of Psychiatry and Behavioral Health, Renaissance School of Medicine at Stony Brook University, Stony Brook, NY, United States
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Dekel S, Ein-Dor T, Berman Z, Barsoumian I, Agarwal S, Pitman RK. Delivery mode is associated with maternal mental health following childbirth. Arch Womens Ment Health 2019; 22:817-824. [PMID: 31041603 PMCID: PMC6821585 DOI: 10.1007/s00737-019-00968-2] [Citation(s) in RCA: 76] [Impact Index Per Article: 15.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/25/2019] [Accepted: 04/16/2019] [Indexed: 10/26/2022]
Abstract
Childbirth is a life-transforming event often followed by a time of heightened psychological vulnerability in the mother. There is a growing recognition of the importance of obstetrics aspects in maternal well-being with the way of labor potentially influencing psychological adjustment following parturition or failure thereof. Empirical scrutiny on the association between mode of delivery and postpartum well-being remains limited. We studied 685 women who were on average 3 months following childbirth and collected information concerning mode of delivery and pre- and postpartum mental health. Analysis of variance revealed that women who had cesarean section or vaginal instrumental delivery had higher somatization, obsessive compulsive, depression, and anxiety symptom levels than those who had natural or vaginal delivery as well as overall general distress, controlling for premorbid mental health, maternal age, education, primiparity, and medical complication in newborn. Women who underwent unplanned cesarean also had higher levels of childbirth-related PTSD symptoms excluding those with vaginal instrumental. The risk for endorsing psychiatric symptoms reflecting clinically relevant cases increased by twofold following unplanned cesarean and was threefold for probable childbirth-related PTSD. Maternal well-being following childbirth is associated with the experienced mode of delivery. Increasing awareness in routine care of the implications of operative delivery and obstetric interventions in delivery on a woman's mental health is needed. Screening at-risk women could improve the quality of care and prevent enduring symptoms. Research is warranted on the psychological and biological factors implicated in the mode of delivery and their role in postpartum adjustment.
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Affiliation(s)
- Sharon Dekel
- Department of Psychiatry, Massachusetts General Hospital, Building 120- 2nd Avenue, Charlestown, MA, 02129, USA. .,Harvard Medical School, Harvard University, 25 Shattuck St, Boston, MA, 02115, USA.
| | - Tsachi Ein-Dor
- Interdisciplinary Center, Kanfei Nesharim, Herzliya, 4610101, Israel
| | - Zohar Berman
- Department of Psychiatry, Massachusetts General Hospital, Building 120- 2nd Avenue, Charlestown, MA 02129, United States,Harvard Medical School, Harvard University, 25 Shattuck St, Boston, MA 02115, United States
| | - Ida Barsoumian
- Department of Psychiatry, Massachusetts General Hospital, Building 120- 2nd Avenue, Charlestown, MA 02129, United States
| | - Sonika Agarwal
- Department of Psychiatry, Massachusetts General Hospital, Building 120- 2nd Avenue, Charlestown, MA 02129, United States
| | - Roger K. Pitman
- Department of Psychiatry, Massachusetts General Hospital, Building 120- 2nd Avenue, Charlestown, MA 02129, United States,Harvard Medical School, Harvard University, 25 Shattuck St, Boston, MA 02115, United States
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Dufford AJ, Erhart A, Kim P. Maternal brain resting-state connectivity in the postpartum period. J Neuroendocrinol 2019; 31:e12737. [PMID: 31106452 PMCID: PMC6874214 DOI: 10.1111/jne.12737] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/31/2018] [Revised: 05/15/2019] [Accepted: 05/15/2019] [Indexed: 02/06/2023]
Abstract
In the postpartum period, the maternal brain experiences both structural and functional plasticity. Although we have a growing understanding of the responses of the human maternal brain to infant stimuli, little is known about the intrinsic connectivity among those regions during the postpartum months. Resting-state functional connectivity (rsFC) provides a measure of the functional architecture of the brain based upon intrinsic functional connectivity (ie, the temporal correlation in blood oxygenation level dependent signal when the brain is not engaged in a specific task). In the present study, we used resting-state functional magnetic resonance imaging to examine how later postpartum months are associated with rsFC and maternal behaviours. We recruited a sample of 47 socioeconomically diverse first-time mothers with singleton pregnancies. Because the amygdala has been shown to play a critical role in maternal behaviours in the postpartum period, this was chosen as the seed for a seed-based correlation analysis. For the left amygdala, later postpartum months were associated with greater connectivity with the anterior cingulate gyrus, left nucleus accumbens, right caudate and left cerebellum (P < 0.05, false discovery rate corrected). Furthermore, in an exploratory analysis, we observed indications that rsFC between the left amygdala and left nucleus accumbens was positively associated with maternal structuring during a mother child-interaction. In addition, later postpartum months were associated with greater connectivity between the right amygdala and the bilateral caudate and right putamen. Overall, we provide evidence of relationships between postpartum months and rsFC in the regions involved in salience detection and regions involved in maternal motivation. Greater connectivity between the amygdala and nucleus accumbens may play a role in positive maternal behaviours.
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Affiliation(s)
| | - Andrew Erhart
- Department of Psychology, University of Denver, Denver, CO, USA 80208
| | - Pilyoung Kim
- Department of Psychology, University of Denver, Denver, CO, USA 80208
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Swain JE, Ho SS. Early postpartum resting-state functional connectivity for mothers receiving buprenorphine treatment for opioid use disorder: A pilot study. J Neuroendocrinol 2019; 31:e12770. [PMID: 31287922 PMCID: PMC7195812 DOI: 10.1111/jne.12770] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/17/2018] [Revised: 07/03/2019] [Accepted: 07/03/2019] [Indexed: 12/14/2022]
Abstract
Between 1999 and 2014, the prevalence of opioid use disorder (OUD) among pregnant women quadrupled in the USA. The standard treatment for peripartum women with OUD is buprenorphine. However, the maternal behavior neurocircuit that regulates maternal behavior and mother-infant bonding has not been previously studied for human mothers receiving buprenorphine treatment for OUD (BT). Rodent research shows opioid effects on reciprocal inhibition between maternal care and defence maternal brain subsystems: the hypothalamus and periaqueductal gray, respectively. We conducted a longitudinal functional magnetic resonance imaging (fMRI) pilot study in humans to specifically examine resting-state functional connectivity (rs-FC) between the periaqueductal gray and hypothalamus, as well as to explore associations with maternal bonding for BT. We studied 32 mothers who completed fMRI scans at 1 month (T1) and 4 months postpartum (T2), including seven mothers receiving buprenorphine for OUD and 25 non-OUD mothers as a comparison group (CG). The participants underwent a 6-minute resting-state fMRI scan at each time point. We measured potential bonding impairments using the Postpartum Bonding Questionnaire to explore how rs-FC with periaqueductal gray is associated with bonding impairments. Compared to CG, BT mothers differed in periaqueductal gray-dependent rs-FC with the hypothalamus, amygdala, insular cortex and other brain regions at T1, with many of these differences disappearing at T2, suggesting potential therapeutic effects of continuing buprenorphine treatment. In contrast, the "rejection and pathological anger" subscale of the Postpartum Bonding Questionnaire at T1 and T2 was associated with the T1-to-T2 increases in periaqueductal gray-dependent rs-FC with the hypothalamus and amygdala. Preliminary evidence links maternal bonding problems for mothers with OUD early in the postpartum to connectivity between specific care and defence maternal brain circuits, which may be mitigated by buprenorphine treatment. This exploratory study supports a potential mechanism for investigating both the therapeutic benefits and risks of opioids for maternal care and bonding with infants.
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Affiliation(s)
- James E. Swain
- Department of Psychiatry and Behavioral Health & Psychology, Stony Brook University Medical Center, Stony Brook, NY, USA
- Department of Psychiatry, Psychology and Center for Human Growth and Development, University of Michigan, Ann Arbor, MI, USA
| | - S. Shaun Ho
- Department of Psychiatry and Behavioral Health & Psychology, Stony Brook University Medical Center, Stony Brook, NY, USA
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Swain JE, Ho SS, Fox H, Garry D, Brummelte S. Effects of opioids on the parental brain in health and disease. Front Neuroendocrinol 2019; 54:100766. [PMID: 31128130 PMCID: PMC8318357 DOI: 10.1016/j.yfrne.2019.100766] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/17/2018] [Revised: 05/20/2019] [Accepted: 05/21/2019] [Indexed: 12/20/2022]
Abstract
The epidemic of opioid use disorder (OUD) directly affects millions of women of child-bearing age. Unfortunately, parenting behaviors - among the most important processes for human survival - are vulnerable to the effects of OUD. The standard of care for pregnant women with OUD is opioid maintenance therapy (OMT), of which the primary objective is to mitigate addiction-related stress. The aim of this review is to synthesize current information specific to pregnancy and parenting that may be affected by OUD. We first summarize a model of the parental brain supported by animal research and human neuroimaging. We then review animal models of exogenous opioid effects on parental brain and behavior. We also present preliminary data for a unifying hypothesis that may link different effects of exogenous opioids on parenting across species and in the context of OMT. Finally, we discuss future directions that may inform research and clinical decision making for peripartum women with OUD.
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Affiliation(s)
- James E Swain
- Department of Psychiatry and Behavioral Health, and Psychology, Stony Brook University, Stony Brook, NY, United States; Department of Psychiatry, Psychology, and Center for Human Growth & Development, University of Michigan, Ann Arbor, MI, United States.
| | - S Shaun Ho
- Department of Psychiatry and Behavioral Health, and Psychology, Stony Brook University, Stony Brook, NY, United States
| | - Helen Fox
- Department of Psychiatry and Behavioral Health, and Psychology, Stony Brook University, Stony Brook, NY, United States
| | - David Garry
- Department of Obstetrics and Gynecology, Stony Brook University, Stony Brook, NY, United States
| | - Susanne Brummelte
- Department of Psychology, Wayne State University, Detroit, MI, United States.
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Bergman NJ. Birth practices: Maternal-neonate separation as a source of toxic stress. Birth Defects Res 2019; 111:1087-1109. [PMID: 31157520 DOI: 10.1002/bdr2.1530] [Citation(s) in RCA: 59] [Impact Index Per Article: 11.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2019] [Accepted: 05/15/2019] [Indexed: 12/26/2022]
Abstract
Maternal-neonate separation for human newborns has been the standard of care since the last century; low birth weight and preterm infants are still routinely separated from their mothers. With advanced technology, survival is good, but long-term developmental outcomes are very poor for these especially vulnerable newborns. The poor outcomes are similar to those described for adversity in childhood, ascribed to toxic stress. Toxic stress is defined as the absence of the buffering protection of adult support. Parental absence has been strictly enforced in neonatal care units for many reasons and could lead to toxic stress. The understanding of toxic stress comes from discoveries about our genome and epigenetics, the microbiome, developmental neuroscience and the brain connectome, and life history theory. The common factor is the early environment that gives (a) signals to epigenes, (b) sensory inputs to neural circuits, and (c) experiences for reproductive fitness. For human newborns that environment is direct skin-to-skin contact from birth. Highly conserved neuroendocrine behaviors determined by environment are described in this review. The scientific rationale underlying skin-to-skin contact is presented: autonomic development and regulation of the physiology leads to emotional connection and achieving resilience. Maternal-neonate separation prevents these critical neural processes from taking place, but also channel development into an alternative developmental strategy. This enables better coping in a stressful environment in the short term, but with permanently elevated stress systems that negatively impact mental and physical health in the long term. This may explain the increasing incidence of developmental problems in childhood, and also Developmental Origins of Health and Disease. Arguments are presented that maternal-neonate separation is indeed a source of toxic stress, and some suggestions are offered toward a "zero separation" paradigm.
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Affiliation(s)
- Nils J Bergman
- Department of Neonatology, Karolinska Institute, Stockholm, Sweden
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38
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Post C, Leuner B. The maternal reward system in postpartum depression. Arch Womens Ment Health 2019; 22:417-429. [PMID: 30554286 PMCID: PMC6784840 DOI: 10.1007/s00737-018-0926-y] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/08/2018] [Accepted: 11/07/2018] [Indexed: 12/12/2022]
Abstract
The experience of motherhood is most often emotionally positive and rewarding, but for many new mothers suffering from postpartum depression (PPD), this is not the case. Preclinical and clinical research has sought to uncover brain changes underlying PPD in order to gain a better understanding of how this disorder develops. This review focuses on the mesolimbic dopamine system, particularly the ventral tegmental area-nucleus accumbens pathway which has been implicated in the regulation of critical functions disrupted in PPD including mood, motivation, and mothering. Specifically, we discuss normative changes in the mesolimbic system during motherhood in both rodents and humans and how these are impacted in PPD. We also consider modulation of mesolimbic dopamine by the hypothalamic neuropeptide oxytocin and how oxytocin-dopamine interactions regulate mood and mothering during the postpartum period. In addition to providing an overview of reward mechanisms in PPD, our goal is to highlight open questions which warrant further research.
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Affiliation(s)
- Caitlin Post
- Department of Psychology, The Ohio State University, 1835 Neil Avenue, Columbus, OH, USA
| | - Benedetta Leuner
- Department of Psychology, The Ohio State University, 1835 Neil Avenue, Columbus, OH, USA.
- Department of Neuroscience, The Ohio State University Wexner Medical Center, Columbus, OH, USA.
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39
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Severity of anxiety moderates the association between neural circuits and maternal behaviors in the postpartum period. COGNITIVE AFFECTIVE & BEHAVIORAL NEUROSCIENCE 2019; 18:426-436. [PMID: 29619759 PMCID: PMC6546103 DOI: 10.3758/s13415-017-0516-x] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
Neuroimaging research has suggested that activity in the amygdala, center of the socioemotional network, and functional connectivity between the amygdala and cortical regions are associated with caregiving behaviors in postpartum mothers. Anxiety is common in the early postpartum period, with severity ranging from healthy maternal preoccupation to clinical disorder. However, little is known about the influence of anxiety on the neural correlates of early caregiving. We examined these relationships in a community cohort of 75 postpartum women (ages 18-22; predominantly low-SES, minority race) who listened to infant cry sounds while undergoing an fMRI assessment. Maternal self-reported symptoms of anxiety were mostly within the subclinical range. Positive and negative caregiving behaviors during filmed face-to-face mother-infant interactions were coded by independent observers. The results from whole-brain analyses showed that anxiety severity moderated the brain-maternal behavior relationships. Specifically, our results showed that the higher a mother's anxiety, the stronger the association between positive caregiving (i.e., maternal warmth and involvement) and amygdala-right posterior superior temporal sulcus (amygdala-RpSTS) functional connectivity. These results remained significant when we controlled for symptoms of depression and contextual variables. These findings suggest that functional connectivity between the amygdala and a social perception region (RpSTS) plays a particularly important role for anxious mothers in facilitating their positive parenting. These findings extend our understanding of the specific neural circuits that support positive maternal caregiving in the context of maternal anxiety, and they may help inform the future design of personalized and effective interventions.
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40
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Birth experience in newborn infants is associated with changes in nociceptive sensitivity. Sci Rep 2019; 9:4117. [PMID: 30858561 PMCID: PMC6412011 DOI: 10.1038/s41598-019-40650-2] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2018] [Accepted: 02/12/2019] [Indexed: 01/25/2023] Open
Abstract
Vaginal birth prepares the fetus for postnatal life. It confers respiratory, cardiovascular and homeostatic advantages to the newborn infant compared with elective cesarean section, and is reported to provide neonatal analgesia. We hypothesize that infants born by vaginal delivery will show lower noxious-evoked brain activity a few hours after birth compared to those born by elective cesarean section. In the first few hours of neonatal life, we record electrophysiological measures of noxious-evoked brain activity following the application of a mildly noxious experimental stimulus in 41 infants born by either vaginal delivery or by elective cesarean section. We demonstrate that noxious-evoked brain activity is related to the mode of delivery and significantly lower in infants born by vaginal delivery compared with those born by elective cesarean section. Furthermore, we found that the magnitude of noxious-evoked brain activity is inversely correlated with fetal copeptin production, a surrogate marker of vasopressin, and dependent on the experience of birth-related distress. This suggests that nociceptive sensitivity in the first few hours of postnatal life is influenced by birth experience and endogenous hormonal production.
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41
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Chen H, Tan D. Cesarean Section or Natural Childbirth? Cesarean Birth May Damage Your Health. Front Psychol 2019; 10:351. [PMID: 30846956 PMCID: PMC6394138 DOI: 10.3389/fpsyg.2019.00351] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2018] [Accepted: 02/04/2019] [Indexed: 01/13/2023] Open
Abstract
The increasing popularity of Cesarean birth has become a social concern in many countries. This paper reviews the literature on the effects of Cesarean section on children's psychological health. The results show that Cesarean birth may have adverse effects on children's sensory perception, sensory integration ability, neuropsychiatric development, and the infant-mother relationship. However, there remain deficiencies in extant research methods, research content, subject groupings, and interpretation of research results. Future research should improve research methods, broaden the research content, and refine the grouping of children born by Cesarean section. The exploration of neural mechanisms is also needed, as well as research directed toward suggesting effective interventions to reduce unnecessary Cesarean sections.
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Affiliation(s)
- Hongyan Chen
- School of Psychology, Nanjing Normal University, Nanjing, China
- School of Psychology, Xinxiang Medical University, Xinxiang, China
| | - Dingliang Tan
- School of Education Science, Nanjing Normal University, Nanjing, China
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42
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Jégh-Czinege N, Faragó T, Pongrácz P. A bark of its own kind – the acoustics of ‘annoying’ dog barks suggests a specific attention-evoking effect for humans. BIOACOUSTICS 2019. [DOI: 10.1080/09524622.2019.1576147] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Affiliation(s)
| | - Tamás Faragó
- Department of Ethology, Eötvös Loránd University, Budapest, Hungary
| | - Péter Pongrácz
- Department of Ethology, Eötvös Loránd University, Budapest, Hungary
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43
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Valtcheva S, Froemke RC. Neuromodulation of maternal circuits by oxytocin. Cell Tissue Res 2019; 375:57-68. [PMID: 30062614 PMCID: PMC6336509 DOI: 10.1007/s00441-018-2883-1] [Citation(s) in RCA: 32] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2018] [Accepted: 07/03/2018] [Indexed: 12/31/2022]
Abstract
Motherhood in mammals involves tremendous changes throughout the body and central nervous system, which support attention and nurturing of infants. Maternal care consists of complex behaviors, such as nursing and protection of the offspring, requiring new mothers to become highly sensitive to infant needs. Long-lasting neural plasticity in various regions of the cerebral cortex may enable the perception and recognition of infant cues, important for appropriate caregiving responses. Recent findings have demonstrated that the neuropeptide oxytocin is involved in a number of physiological processes, including parturition and lactation and dynamically shaping neuronal responses to infant stimuli as well. Here, we review experience-dependent changes within the cortex occurring throughout motherhood, focusing on plasticity of the somatosensory and auditory cortex. We outline the role of oxytocin in gating cortical plasticity and discuss potential mechanisms regulating oxytocin release in response to different sensory stimuli.
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Affiliation(s)
- Silvana Valtcheva
- Skirball Institute for Biomolecular Medicine, New York University School of Medicine, 540 First Avenue, New York, NY, 10016, USA
- Neuroscience Institute, New York University School of Medicine, 540 First Avenue, New York, NY, 10016, USA
- Department of Otolaryngology, New York University School of Medicine, 540 First Avenue, New York, NY, 10016, USA
- Department of Neuroscience and Physiology, New York University School of Medicine, 540 First Avenue, New York, NY, 10016, USA
| | - Robert C Froemke
- Skirball Institute for Biomolecular Medicine, New York University School of Medicine, 540 First Avenue, New York, NY, 10016, USA.
- Neuroscience Institute, New York University School of Medicine, 540 First Avenue, New York, NY, 10016, USA.
- Department of Otolaryngology, New York University School of Medicine, 540 First Avenue, New York, NY, 10016, USA.
- Department of Neuroscience and Physiology, New York University School of Medicine, 540 First Avenue, New York, NY, 10016, USA.
- Howard Hughes Medical Institute Faculty Scholar, New York University School of Medicine, 540 First Avenue, New York, NY, 10016, USA.
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44
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Barba-Müller E, Craddock S, Carmona S, Hoekzema E. Brain plasticity in pregnancy and the postpartum period: links to maternal caregiving and mental health. Arch Womens Ment Health 2019; 22:289-299. [PMID: 30008085 PMCID: PMC6440938 DOI: 10.1007/s00737-018-0889-z] [Citation(s) in RCA: 99] [Impact Index Per Article: 19.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/26/2018] [Accepted: 07/02/2018] [Indexed: 12/16/2022]
Abstract
Pregnancy and the postpartum period involve numerous physiological adaptations that enable the development and survival of the offspring. A distinct neural plasticity characterizes the female brain during this period, and dynamic structural and functional changes take place that accompany fundamental behavioral adaptations, stimulating the female to progress from an individual with self-directed needs to being responsible for the care of another life. While many animal studies detail these modifications, an emerging body of research reveals the existence of reproduction-related brain plasticity in human mothers too. Additionally, associations with aspects of maternal caregiving point to adaptive changes that benefit a woman's transition to motherhood. However, the dynamic changes that affect a woman's brain are not merely adaptive, and they likely confer a vulnerability for the development of mental disorders. Here, we review the changes in brain structure and function that a woman undergoes during the peripartum period, outlining associations between these neural alterations and different aspects of maternal care. We additionally discuss peripartum mood disorders and postpartum psychosis, and review the neuroimaging studies that investigate the neural bases of these conditions.
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Affiliation(s)
- Erika Barba-Müller
- Brain and Development Research Center, Leiden University, Leiden, the Netherlands ,Leiden Institute for Brain and Cognition, Leiden, the Netherlands ,University Institute of Mental Health Vidal i Barraquer, Ramon Llull University, Barcelona, Spain
| | - Sinéad Craddock
- Brain and Development Research Center, Leiden University, Leiden, the Netherlands ,Leiden Institute for Brain and Cognition, Leiden, the Netherlands
| | - Susanna Carmona
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain ,Unidad de Medicina y Cirugía Experimental, Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain ,Faculty of Health Sciences, Universitat Oberta de Catalunya, Barcelona, Spain
| | - Elseline Hoekzema
- Brain and Development Research Center, Leiden University, Leiden, the Netherlands. .,Leiden Institute for Brain and Cognition, Leiden, the Netherlands.
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45
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Elmadih A, Abumadini M. Epigenetic Transmission of Maternal Behavior: Impact on the Neurobiological System of Healthy Mothers. SAUDI JOURNAL OF MEDICINE & MEDICAL SCIENCES 2018; 7:3-8. [PMID: 30787850 PMCID: PMC6381851 DOI: 10.4103/sjmms.sjmms_163_17] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Quality of maternal caregiving not only impacts children's development but can also result in heritable changes in gene expression (i.e., in an epigenetic manner). Consequently, when women become mothers, they adopt parenting behavior similar to that they received at family of origin. This transgenerational transmission of maternal behavior may also be associated with changes in the neurobiological system of future mothers. This review aims to highlight the effect quality of perceived parenting has on maternal behavior and the neurobiological system of mothers, specifically the oxytocin system, brain morphology and brain function. This would likely help in finding biomarkers that profile the impact of perceived parenting on mothers, and thus allow identification of mothers who experience poor-quality parenting for intervention.
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Affiliation(s)
- Alya Elmadih
- Department of Psychiatry, College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia.,Department of Psychiatry, King Fahd Hospital of the University, Al Khobar, Saudi Arabia.,Centre for Women's Mental Health, University of Manchester, Manchester, UK
| | - Mahdi Abumadini
- Department of Psychiatry, College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia.,Department of Psychiatry, King Fahd Hospital of the University, Al Khobar, Saudi Arabia
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46
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Senese VP, Miranda MC, De Falco S, Venuti P, Bornstein MH. How becoming a mother shapes implicit and explicit responses to infant cues. Dev Psychobiol 2018; 60:950-962. [DOI: 10.1002/dev.21772] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2017] [Revised: 07/04/2018] [Accepted: 07/18/2018] [Indexed: 11/11/2022]
Affiliation(s)
- Vincenzo P. Senese
- Psychometric Laboratory, Department of Psychology; University of Campania “Luigi Vanvitelli”; Caserta Italy
| | - Maria C. Miranda
- Psychometric Laboratory, Department of Psychology; University of Campania “Luigi Vanvitelli”; Caserta Italy
| | - Simona De Falco
- Department of Psychology and Cognitive Science; University of Trento; Trento Italy
| | - Paola Venuti
- Department of Psychology and Cognitive Science; University of Trento; Trento Italy
| | - Marc H. Bornstein
- Eunice Kennedy Shriver National Institute of Child Health and Human Development; National Institutes of Health, U.S. Department of Health and Human Services; Bethesda Maryland
- Institute for Fiscal Studies; London UK
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Abstract
Recent expansion of the legal definition of parenthood in New York State raises the question of whether the presence of a genetic relationship between a parent and child trumps environmental and interpersonal factors in the formation of a strong, secure attachment bond. The purpose of this paper is to emphasize that attachment between a child and secure attachment figure is inherently biological, and that such biological attachment supersedes the existence of a genetic parent-child relationship. First, the paper provides an overview of attachment and its biological basis. It then discusses the impact on attachment of environmental and interpersonal influences, which current research suggests have the power to alter brain biology. There is no clear evidence that a genetic relationship confers a significant advantage in terms of attachment. This paper proposes that the term "biological parent" be redefined to include anyone with whom a child shares a strong attachment bond.
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48
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Kim P, Dufford AJ, Tribble RC. Cortical thickness variation of the maternal brain in the first 6 months postpartum: associations with parental self-efficacy. Brain Struct Funct 2018; 223:3267-3277. [PMID: 29855765 PMCID: PMC6358213 DOI: 10.1007/s00429-018-1688-z] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2017] [Accepted: 02/24/2018] [Indexed: 12/17/2022]
Abstract
The postpartum period is associated with structural and functional plasticity in brain regions involved in parenting. While one study identified an increase in gray matter volume during the first 4 months among new mothers, little is known regarding the relationship between cortical thickness across postpartum months and perceived adjustment to parenthood. In this study of 39 socioeconomically diverse first-time new mothers, we examined the relations among postpartum months, cortical thickness, and parental self-efficacy. We identified a positive association between postpartum months and cortical thickness in the prefrontal cortex including the superior frontal gyrus extending into the medial frontal and orbitofrontal gyri, in the lateral occipital gyrus extending into the inferior parietal and fusiform gyri, as well as in the caudal middle frontal and precentral gyri. The relationship between cortical thickness and parental self-efficacy was specific to the prefrontal regions. These findings contribute to our understanding of the maternal brain in the first 6 months postpartum and provide evidence of a relationship between brain structure and perceived adjustment to parenthood.
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Affiliation(s)
- Pilyoung Kim
- Department of Psychology, University of Denver, 2155 South Race Street, Denver, CO, 80208-3500, USA.
| | - Alexander J Dufford
- Department of Psychology, University of Denver, 2155 South Race Street, Denver, CO, 80208-3500, USA
| | - Rebekah C Tribble
- Department of Psychology, University of Denver, 2155 South Race Street, Denver, CO, 80208-3500, USA
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49
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Putting salient vocalizations in context: Adults' physiological arousal to emotive cues in domestic and external environments. Physiol Behav 2018; 196:25-32. [PMID: 30149085 DOI: 10.1016/j.physbeh.2018.08.010] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2018] [Revised: 07/24/2018] [Accepted: 08/22/2018] [Indexed: 01/08/2023]
Abstract
Salient vocalizations are automatically processed and distinguished from emotionally irrelevant information. However, little is known of how contextual, gender and attentional variables interact to modulate physiological responses to salient emotive vocalizations. In this study, electrocardiogram (ECG) was utilized to investigate differences in peripheral nervous activity of men and women to infant cry (IC), infant laughter (IL) and adult cry (AC) in two different situational contexts: the domestic environment (DE) and the outside environment (OE). As the mental state of listeners can affect their response to vocalizations, a between-subject design was applied: one group was instructed to imagine being inside the scenes (Task 1: explicit task), and the other group was told to look at the scenes (Task 2: implicit task). Results revealed that females exhibited lower inter-beat interval (IBI) index in the OE condition, as compared to both males in OE and females in DE conditions, suggesting greater physiological arousal amongst females in response to vocalizations in an outside environment. Additionally, Task 1 revealed that males demonstrated higher Low Frequency/High Frequency (LFHF) index towards AC than IL. Task 2 showed the same association between these two sounds in females. The implicit task also elicited lower LFHF index in response to both IL and IC than control sound (CS), only amongst females. Findings highlight the important roles that contextual information and cognitive demand play in regulating physiological responses to salient emotive vocalizations. Integrated perspectives of physiological responses to emotive vocalizations that consider the influence of internal (adult mental states) and external (environment) contextual information will provide a better understanding of mechanisms underlying emotional processing of salient social cues.
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50
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Glynn LM, Howland MA, Fox M. Maternal programming: Application of a developmental psychopathology perspective. Dev Psychopathol 2018; 30:905-919. [PMID: 30068423 PMCID: PMC6274636 DOI: 10.1017/s0954579418000524] [Citation(s) in RCA: 40] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
The fetal phase of life has long been recognized as a sensitive period of development. Here we posit that pregnancy represents a simultaneous sensitive period for the adult female with broad and persisting consequences for her health and development, including risk for psychopathology. In this review, we examine the transition to motherhood through the lens of developmental psychopathology. Specifically, we summarize the typical and atypical changes in brain and behavior that characterize the perinatal period. We highlight how the exceptional neuroplasticity exhibited by women during this life phase may account for increased vulnerability for psychopathology. Further, we discuss several modes of signaling that are available to the fetus to affect maternal phenotypes (hormones, motor activity, and gene transfer) and also illustrate how evolutionary perspectives can help explain how and why fetal functions may contribute to maternal psychopathology. The developmental psychopathology perspective has spurred advances in understanding risk and resilience for mental health in many domains. As such, it is surprising that this major epoch in the female life span has yet to benefit fully from similar applications.
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Affiliation(s)
| | | | - Molly Fox
- University of California,Los Angeles
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