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Adams GB, Steuart S, Lawler EC, Shone H, Abraham AJ. Increases in benzodiazepine prescribing for postpartum anxiety during COVID-19. Arch Womens Ment Health 2024:10.1007/s00737-024-01488-4. [PMID: 38940966 DOI: 10.1007/s00737-024-01488-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/12/2024] [Accepted: 06/18/2024] [Indexed: 06/29/2024]
Abstract
PURPOSE Postpartum mood disorders affect many women following childbirth. Prescribing medication for depression and anxiety is one strategy for the effective treatment of postpartum mood disorders. Left untreated, mothers experiencing these disorders and their infants face increased risks of adverse health outcomes. Little is known about how diagnosis and treatment of postpartum mood disorders changed during COVID-19. METHODS We used a retrospective pooled cross-sectional design in a sample of privately-insured postpartum women in U.S. claims data from January 1, 2016 to December 31, 2020. We measured changes in diagnoses of anxiety and depression and changes in prescription fills and days supplied of classes of medications used to treat these conditions (antidepressants, benzodiazepines, and z-drugs). We used ordinary least squares (OLS) regression for each outcome variable during the pre-pandemic period and forecast expected outcomes the observation period. Forecasted and actual values of the outcomes were then compared. RESULTS Following the onset of the COVID-19 pandemic in March 2020, diagnoses of depression and anxiety were not significantly higher among privately insured postpartum women in the United States. The proportion of privately-insured postpartum women filling a benzodiazepine prescription increased by 15.2%. CONCLUSIONS We find diagnosis of postpartum mood disorders did not increase after the onset of the COVID-19 pandemic, however, fills of benzodiazepines increased among privately-insured postpartum women. Given prior evidence of increased depressive and anxiety symptoms among postpartum women during COVID-19, this suggests increased barriers to appropriate diagnoses and treatment for depression during this period.
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Sanson A, Krieg P, Schramm MM, Kellner K, Maloumby R, Klampfl SM, Brunton PJ, Bosch OJ. CRF binding protein activity in the hypothalamic paraventricular nucleus is essential for stress adaptations and normal maternal behaviour in lactating rats. Neurobiol Stress 2024; 30:100631. [PMID: 38601362 PMCID: PMC11004997 DOI: 10.1016/j.ynstr.2024.100631] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2023] [Revised: 03/15/2024] [Accepted: 03/21/2024] [Indexed: 04/12/2024] Open
Abstract
To ensure the unrestricted expression of maternal behaviour peripartum, activity of the corticotropin-releasing factor (CRF) system needs to be minimised. CRF binding protein (CRF-BP) might be crucial for this adaptation, as its primary function is to sequester freely available CRF and urocortin1, thereby dampening CRF receptor (CRF-R) signalling. So far, the role of CRF-BP in the maternal brain has barely been studied, and a potential role in curtailing activation of the stress axis is unknown. We studied gene expression for CRF-BP and both CRF-R within the paraventricular nucleus (PVN) of the hypothalamus. In lactating rats, Crh-bp expression in the parvocellular PVN was significantly higher and Crh-r1 expression in the PVN significantly lower compared to virgin rats. Acute CRF-BP inhibition in the PVN with infusion of CRF(6-33) increased basal plasma corticosterone concentrations under unstressed conditions in dams. Furthermore, while acute intra-PVN infusion of CRF increased corticosterone secretion in virgin rats, it was ineffective in vehicle (VEH)-pre-treated lactating rats, probably due to a buffering effect of CRF-BP. Indeed, pre-treatment with CRF(6-33) reinstated a corticosterone response to CRF in lactating rats, highlighting the critical role of CRF-BP in maintaining attenuated stress reactivity in lactation. To our knowledge, this is the first study linking hypothalamic CRF-BP activity to hypothalamic-pituitary-adrenal axis regulation in lactation. In terms of behaviour, acute CRF-BP inhibition in the PVN under non-stress conditions reduced blanket nursing 60 min and licking/grooming 90 min after infusion compared to VEH-treated rats, while increasing maternal aggression towards an intruder. Lastly, chronic intra-PVN inhibition of CRF-BP strongly reduced maternal aggression, with modest effects on maternal motivation and care. Taken together, intact activity of the CRF-BP in the PVN during the postpartum period is essential for the dampened responsiveness of the stress axis, as well as for the full expression of appropriate maternal behaviour.
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Affiliation(s)
- Alice Sanson
- Department of Behavioural and Molecular Neurobiology, Regensburg Center of Neuroscience, University of Regensburg, Regensburg, Germany
| | - Paula Krieg
- Department of Behavioural and Molecular Neurobiology, Regensburg Center of Neuroscience, University of Regensburg, Regensburg, Germany
| | - Milena M. Schramm
- Department of Behavioural and Molecular Neurobiology, Regensburg Center of Neuroscience, University of Regensburg, Regensburg, Germany
| | - Kerstin Kellner
- Department of Behavioural and Molecular Neurobiology, Regensburg Center of Neuroscience, University of Regensburg, Regensburg, Germany
| | - Rodrigue Maloumby
- Department of Behavioural and Molecular Neurobiology, Regensburg Center of Neuroscience, University of Regensburg, Regensburg, Germany
| | - Stefanie M. Klampfl
- Department of Behavioural and Molecular Neurobiology, Regensburg Center of Neuroscience, University of Regensburg, Regensburg, Germany
| | - Paula J. Brunton
- Centre for Discovery Brain Sciences, University of Edinburgh, Edinburgh, UK
| | - Oliver J. Bosch
- Department of Behavioural and Molecular Neurobiology, Regensburg Center of Neuroscience, University of Regensburg, Regensburg, Germany
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Piper JA, Musumeci G, Castorina A. The Neuroanatomy of the Habenular Complex and Its Role in the Regulation of Affective Behaviors. J Funct Morphol Kinesiol 2024; 9:14. [PMID: 38249091 PMCID: PMC10801627 DOI: 10.3390/jfmk9010014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/09/2023] [Revised: 12/13/2023] [Accepted: 12/31/2023] [Indexed: 01/23/2024] Open
Abstract
The habenular complex is a diencephalic structure divided into the medial and lateral divisions that lie within the epithalamus of most vertebrates. This brain structure, whose activities are mainly regulated via inputs/outputs from and to the stria medullaris and the fasciculus retroflexus, plays a significant role in the modulation of anti-reward behaviors in both the rodent and human brain. Such anti-reward circuits are regulated by dopaminergic and serotonergic projections with several other subcortical and cortical regions; therefore, it is plausible that impairment to this key subcortical structure or its connections contributes to the pathogenesis of affective disorders. Current literature reveals the existence of structural changes in the habenula complex in individuals afflicted by such disorders; however, there is a need for more comprehensive investigations to elucidate the underlying neuroanatomical connections that underpin disease development. In this review article, we aim to provide a comprehensive view of the neuroanatomical differences between the rodent and human habenular complex, the main circuitries, and provide an update on the emerging roles of this understudied subcortical structure in the control of affective behaviors, with special emphasis to morbid conditions of the affective sphere.
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Affiliation(s)
- Jordan Allan Piper
- School of Health Sciences, College of Health and Medicine, University of Tasmania (Sydney), Sydney, NSW 2040, Australia;
- Laboratory of Cellular & Molecular Neuroscience (LCMN), School of Life Sciences, Faculty of Science, University of Technology Sydney, P.O. Box 123, Sydney, NSW 2007, Australia
| | - Giuseppe Musumeci
- Department of Biomedical & Biotechnological Sciences, Anatomy, Histology & Movement Sciences, University of Catania, 95123 Catania, Italy;
| | - Alessandro Castorina
- Laboratory of Cellular & Molecular Neuroscience (LCMN), School of Life Sciences, Faculty of Science, University of Technology Sydney, P.O. Box 123, Sydney, NSW 2007, Australia
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4
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Gorman-Sandler E, Wood G, Cloude N, Frambes N, Brennen H, Robertson B, Hollis F. Mitochondrial might: powering the peripartum for risk and resilience. Front Behav Neurosci 2023; 17:1286811. [PMID: 38187925 PMCID: PMC10767224 DOI: 10.3389/fnbeh.2023.1286811] [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: 09/01/2023] [Accepted: 11/01/2023] [Indexed: 01/09/2024] Open
Abstract
The peripartum period, characterized by dynamic hormonal shifts and physiological adaptations, has been recognized as a potentially vulnerable period for the development of mood disorders such as postpartum depression (PPD). Stress is a well-established risk factor for developing PPD and is known to modulate mitochondrial function. While primarily known for their role in energy production, mitochondria also influence processes such as stress regulation, steroid hormone synthesis, glucocorticoid response, GABA metabolism, and immune modulation - all of which are crucial for healthy pregnancy and relevant to PPD pathology. While mitochondrial function has been implicated in other psychiatric illnesses, its role in peripartum stress and mental health remains largely unexplored, especially in relation to the brain. In this review, we first provide an overview of mitochondrial involvement in processes implicated in peripartum mood disorders, underscoring their potential role in mediating pathology. We then discuss clinical and preclinical studies of mitochondria in the context of peripartum stress and mental health, emphasizing the need for better understanding of this relationship. Finally, we propose mitochondria as biological mediators of resilience to peripartum mood disorders.
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Affiliation(s)
- Erin Gorman-Sandler
- Department of Pharmacology, Physiology, and Neuroscience, University of South Carolina School of Medicine, Columbia, SC, United States
- Columbia VA Healthcare System, Columbia, SC, United States
| | - Gabrielle Wood
- Department of Pharmacology, Physiology, and Neuroscience, University of South Carolina School of Medicine, Columbia, SC, United States
| | - Nazharee Cloude
- Department of Pharmacology, Physiology, and Neuroscience, University of South Carolina School of Medicine, Columbia, SC, United States
| | - Noelle Frambes
- Department of Pharmacology, Physiology, and Neuroscience, University of South Carolina School of Medicine, Columbia, SC, United States
| | - Hannah Brennen
- Department of Pharmacology, Physiology, and Neuroscience, University of South Carolina School of Medicine, Columbia, SC, United States
| | - Breanna Robertson
- Department of Pharmacology, Physiology, and Neuroscience, University of South Carolina School of Medicine, Columbia, SC, United States
| | - Fiona Hollis
- Department of Pharmacology, Physiology, and Neuroscience, University of South Carolina School of Medicine, Columbia, SC, United States
- Columbia VA Healthcare System, Columbia, SC, United States
- USC Institute for Cardiovascular Disease Research, Columbia, SC, United States
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5
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O'Donnell MG, Stumpp L, Gallaher MJ, Powers RW. Pre-pregnancy stress induces maternal vascular dysfunction during pregnancy and postpartum. Reprod Sci 2023; 30:3197-3211. [PMID: 37219786 PMCID: PMC10204668 DOI: 10.1007/s43032-023-01248-2] [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: 05/23/2022] [Accepted: 04/21/2023] [Indexed: 05/24/2023]
Abstract
An estimated 20% of women suffer from a stress-related mood disorder including depression and anxiety during and after pregnancy, making these disorders among the most common complications of pregnancy. These stress-related disorders are associated with adverse pregnancy outcomes including gestational hypertension and preeclampsia, which are associated with poor cardiometabolic health postpartum. Despite these associations, the direct impact of stress and related disorders on maternal vascular health, and contributing mechanisms, remain understudied. The aim of this study was to investigate the effect of pre-pregnancy stress on maternal vascular outcomes in a BALB/c mouse model of chronic unpredictable stress. Maternal blood pressure and ex-vivo vascular function were investigated during pregnancy and postpartum. Offspring characteristics were assessed at the end of pregnancy and postpartum. Main findings show that pre-pregnancy stress exposure increased blood pressure during mid and late pregnancy and impaired ex vivo vascular function at the end of pregnancy. These effects persisted into the postpartum period, suggesting a long-term effect of stress on maternal vascular health, which appear to be partially attributable to disruptions in nitric oxide (NO) pathway signaling. These data suggest exposure to stress and related disorders, even prior to pregnancy, can contribute to vascular complications during pregnancy and postpartum.
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Affiliation(s)
- Mary Gemmel O'Donnell
- Magee-Womens Research Institute, Pittsburgh, PA, 15213, USA.
- Department of Obstetrics, Gynecology and Reproductive Sciences, University of Pittsburgh School of Medicine, Pittsburgh, PA, 15213, USA.
- Department of Biology, Thiel College, Greenville, PA, 16125, USA.
| | - Lauren Stumpp
- Magee-Womens Research Institute, Pittsburgh, PA, 15213, USA
| | | | - Robert W Powers
- Magee-Womens Research Institute, Pittsburgh, PA, 15213, USA
- Department of Obstetrics, Gynecology and Reproductive Sciences, University of Pittsburgh School of Medicine, Pittsburgh, PA, 15213, USA
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Evans MC, Anderson GM. The Role of RFRP Neurons in the Allostatic Control of Reproductive Function. Int J Mol Sci 2023; 24:15851. [PMID: 37958834 PMCID: PMC10648169 DOI: 10.3390/ijms242115851] [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: 10/02/2023] [Revised: 10/30/2023] [Accepted: 10/30/2023] [Indexed: 11/15/2023] Open
Abstract
Reproductive function is critical for species survival; however, it is energetically costly and physically demanding. Reproductive suppression is therefore a physiologically appropriate adaptation to certain ecological, environmental, and/or temporal conditions. This 'allostatic' suppression of fertility enables individuals to accommodate unfavorable reproductive circumstances and safeguard survival. The mechanisms underpinning this reproductive suppression are complex, yet culminate with the reduced secretion of gonadotropin-releasing hormone (GnRH) from the hypothalamus, which in turn suppresses gonadotropin release from the pituitary, thereby impairing gonadal function. The focus of this review will be on the role of RFamide-related peptide (RFRP) neurons in different examples of allostatic reproductive suppression. RFRP neurons release the RFRP-3 peptide, which negatively regulates GnRH neurons and thus appears to act as a 'brake' on the neuroendocrine reproductive axis. In a multitude of predictable (e.g., pre-puberty, reproductive senescence, and seasonal or lactational reproductive quiescence) and unpredictable (e.g., metabolic, immune and/or psychosocial stress) situations in which GnRH secretion is suppressed, the RFRP neurons have been suggested to act as modulators. This review examines evidence for and against these roles.
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Affiliation(s)
| | - Greg M. Anderson
- Centre for Neuroendocrinology and Department of Anatomy, School of Biomedical Sciences, University of Otago, Dunedin 9016, New Zealand;
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7
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Jaramillo I, Karl M, Bergunde L, Mack JT, Weise V, Weidner K, Gao W, Steudte-Schmiedgen S, Garthus-Niegel S. Maternal postpartum depressive symptoms: The predictive role of objective and subjective birth experience and hair glucocorticoids. J Affect Disord 2023; 339:974-983. [PMID: 37459971 DOI: 10.1016/j.jad.2023.07.034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/02/2023] [Revised: 06/13/2023] [Accepted: 07/08/2023] [Indexed: 08/04/2023]
Abstract
BACKGROUND Having a negative childbirth experience is a known risk-factor for developing postpartum depression (PPD). Alterations of the hypothalamus-pituitary-adrenal (HPA)-axis have been discussed as a potential underlying mechanism. However, research on the association between negative birth experiences and long-term integrated glucocorticoids (GCs) is lacking. This study aimed to examine whether objective and subjective birth experience predicted long-term GCs and PPD symptoms. METHODS Measures of objective and subjective birth experience, PPD symptoms, and hair strands for the assessment of hair cortisol concentrations (HairF), hair cortisone concentrations (HairE), and HairF/HairE ratio, were provided eight weeks after childbirth by 235 mothers participating in the study DREAMHAIR. RESULTS A negative objective birth experience predicted a higher HairF/HairE ratio but was not associated with HairF or HairE. The subjective birth experience did not explain additional variance in hair GCs but was a significant predictor for PPD symptoms. A higher HairF/HairE ratio predicted PPD symptoms when controlling for prepartum depressive symptoms and number of lifetime traumatic events. LIMITATIONS Analyses were based on a relatively homogeneous sample and women reported in general positive birth experiences and low levels of depressive symptoms. Therefore, results should be applied to the broader population with caution. CONCLUSIONS Our results suggest that negative objective birth experience is associated with an altered HairF/HairE ratio, which in turn, seems to be a promising biomarker to identify women at risk for developing PPD. A negative subjective birth experience may be less critical for alterations of the HPA-axis but remains an essential risk factor for PPD.
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Affiliation(s)
- Isabel Jaramillo
- Institute and Policlinic of Occupational and Social Medicine, Faculty of Medicine, Technische Universität Dresden, Fetscherstr. 74, 01307 Dresden, Germany; Department of Psychotherapy and Psychosomatic Medicine, Faculty of Medicine, Technische Universität Dresden, Fetscherstr. 74, 01307 Dresden, Germany.
| | - Marlene Karl
- Institute and Policlinic of Occupational and Social Medicine, Faculty of Medicine, Technische Universität Dresden, Fetscherstr. 74, 01307 Dresden, Germany; Department of Psychotherapy and Psychosomatic Medicine, Faculty of Medicine, Technische Universität Dresden, Fetscherstr. 74, 01307 Dresden, Germany.
| | - Luisa Bergunde
- Institute and Policlinic of Occupational and Social Medicine, Faculty of Medicine, Technische Universität Dresden, Fetscherstr. 74, 01307 Dresden, Germany; Department of Psychotherapy and Psychosomatic Medicine, Faculty of Medicine, Technische Universität Dresden, Fetscherstr. 74, 01307 Dresden, Germany.
| | - Judith T Mack
- Institute and Policlinic of Occupational and Social Medicine, Faculty of Medicine, Technische Universität Dresden, Fetscherstr. 74, 01307 Dresden, Germany.
| | - Victoria Weise
- Institute and Policlinic of Occupational and Social Medicine, Faculty of Medicine, Technische Universität Dresden, Fetscherstr. 74, 01307 Dresden, Germany.
| | - Kerstin Weidner
- Department of Psychotherapy and Psychosomatic Medicine, Faculty of Medicine, Technische Universität Dresden, Fetscherstr. 74, 01307 Dresden, Germany.
| | - Wei Gao
- Institute of Biological Psychology, Faculty of Psychology, Technische Universität Dresden, Zellerscher Weg, 01069 Dresden, Germany.
| | - Susann Steudte-Schmiedgen
- Department of Psychotherapy and Psychosomatic Medicine, Faculty of Medicine, Technische Universität Dresden, Fetscherstr. 74, 01307 Dresden, Germany.
| | - Susan Garthus-Niegel
- Institute and Policlinic of Occupational and Social Medicine, Faculty of Medicine, Technische Universität Dresden, Fetscherstr. 74, 01307 Dresden, Germany; Institute for Systems Medicine (ISM), Faculty of Medicine, MSH Medical School Hamburg, Am Kaiserkai 1, 20457 Hamburg, Germany; Department of Childhood and Families, Norwegian Institute of Public Health, N-0213 Oslo, Norway.
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8
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Roets M, Brand L, Steyn SF. Increased depressive-like behaviour of postpartum Flinders sensitive and resistant line rats is reversed by a predictable postpartum stressor. Behav Brain Res 2023; 442:114321. [PMID: 36720349 DOI: 10.1016/j.bbr.2023.114321] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2022] [Revised: 01/18/2023] [Accepted: 01/27/2023] [Indexed: 02/02/2023]
Abstract
During the peripartum period, women are at an increased risk to develop perinatal distress, presenting as symptoms of depression and/or anxiety. Yet, due to practical and ethical restrictions, our understanding of this condition remains limited. Animal studies that focus on the neuropsychiatric mechanisms associated with the postpartum period, often ignore the genetical predisposition factor. We therefore investigated whether pregnancy could alter the bio-behavioural profile of the Flinders sensitive and resistant line rats, and whether these effects are exacerbated by a postpartum stressor. Postpartum dams were compared to nulliparous controls in behavioural tests, analysing depressive- and anxiety-like behaviours. Next, postpartum dams were subjected to a maternal separation and early weaning (MSEW) regimen, with their behaviour and serotonergic and noradrenergic concentrations compared to rats not separated from their pups. Regardless of strain, pregnancy decreased time spent in the open arms of the elevated plus maze and hippocampal serotonin concentrations. Time spent immobile in the forced swim test was also increased, with a significant effect in the FRL and a strong trend in the FSL rats. MSEW reversed these behaviours in both strains and increased social interaction with a male counterpart in the FSL rats, without influencing hippocampal or cortical serotonin or norepinephrine. Taken together, these results suggest that pregnancy influences postpartum behaviour, in a strain-dependent manner. Contrary to what we expected, MSEW overall decreased depressive- and anxiety-like behaviours, with strain specific differences, indicating that a chronic, predictable stressor may not necessarily adversely affect postpartum behaviour.
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Affiliation(s)
- Mareli Roets
- Centre of Excellence for Pharmaceutical Sciences, Faculty of Health Sciences, North-West University, Potchefstroom, South Africa
| | - Linda Brand
- Centre of Excellence for Pharmaceutical Sciences, Faculty of Health Sciences, North-West University, Potchefstroom, South Africa
| | - Stephan F Steyn
- Centre of Excellence for Pharmaceutical Sciences, Faculty of Health Sciences, North-West University, Potchefstroom, South Africa.
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Lecca S, Congiu M, Royon L, Restivo L, Girard B, Mazaré N, Bellone C, Telley L, Mameli M. A neural substrate for negative affect dictates female parental behavior. Neuron 2023; 111:1094-1103.e8. [PMID: 36731469 DOI: 10.1016/j.neuron.2023.01.003] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2022] [Revised: 11/23/2022] [Accepted: 01/05/2023] [Indexed: 02/04/2023]
Abstract
Parental behaviors secure the well-being of newborns and concomitantly limit negative affective states in adults, which emerge when coping with neonatal distress becomes challenging. Whether negative-affect-related neuronal circuits orchestrate parental actions is unknown. Here, we identify parental signatures in lateral habenula neurons receiving bed nucleus of stria terminalis innervation (BNSTLHb). We find that LHb neurons of virgin female mice increase their activity following pup distress vocalization and are necessary for pup-call-driven aversive behaviors. LHb activity rises during pup retrieval, a behavior worsened by LHb inactivation. Intersectional cell identification and transcriptional profiling associate BNSTLHb cells to parenting and outline a gene expression in female virgins similar to that in mothers but different from that in non-parental virgin male mice. Finally, tracking and manipulating BNSTLHb cell activity demonstrates their specificity for encoding negative affect and pup retrieval. Thus, a negative affect neural circuit processes newborn distress signals and may limit them by guiding female parenting.
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Affiliation(s)
- Salvatore Lecca
- The Department of Fundamental Neuroscience, The University of Lausanne, 1005 Lausanne, Switzerland
| | - Mauro Congiu
- The Department of Fundamental Neuroscience, The University of Lausanne, 1005 Lausanne, Switzerland
| | - Léa Royon
- The Department of Fundamental Neuroscience, The University of Lausanne, 1005 Lausanne, Switzerland
| | - Leonardo Restivo
- The Department of Fundamental Neuroscience, The University of Lausanne, 1005 Lausanne, Switzerland
| | - Benoit Girard
- The Department of Basic Neuroscience, The University of Geneva, 1205 Geneva, Switzerland
| | - Noemie Mazaré
- The Department of Fundamental Neuroscience, The University of Lausanne, 1005 Lausanne, Switzerland
| | - Camilla Bellone
- The Department of Basic Neuroscience, The University of Geneva, 1205 Geneva, Switzerland
| | - Ludovic Telley
- The Department of Fundamental Neuroscience, The University of Lausanne, 1005 Lausanne, Switzerland
| | - Manuel Mameli
- The Department of Fundamental Neuroscience, The University of Lausanne, 1005 Lausanne, Switzerland; Inserm, UMR-S 839, 75005 Paris, France.
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Rincón-Cortés M, Grace AA. Dopamine downregulation in novel rodent models useful for the study of postpartum depression. Front Behav Neurosci 2022; 16:1065558. [PMID: 36620861 PMCID: PMC9812956 DOI: 10.3389/fnbeh.2022.1065558] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2022] [Accepted: 11/30/2022] [Indexed: 12/24/2022] Open
Abstract
Postpartum depression (PPD) is the most common psychiatric disorder following childbirth and is characterized by maternal mood disturbances, impaired maternal responses, and disrupted caregiving- all of which negatively impact offspring development. Since PPD has detrimental consequences for both mother and child, clinical and preclinical research has focused on identifying brain changes associated with this disorder. In humans, PPD is linked to dysregulated mesolimbic dopamine (DA) system function and altered neural responses (i.e., decreased reward-related activity) to infant-related cues, which are considered hallmark features of PPD. In accordance, rodent models employing translational risk factors useful for the study of PPD have demonstrated alterations in mesolimbic DA system structure and function, and these changes are reviewed here. We also present two novel rodent models based on postpartum adversity exposure (i.e., pup removal, scarcity-adversity) which result in PPD-relevant behavioral changes (e.g., disrupted mother-infant interactions, deficits in maternal behavior, depressive-like phenotypes) and attenuated ventral tegmental area (VTA) DA neuron activity consistent with a hypodopaminergic state. Furthermore, we highlight open questions and future directions for these rodent models. In sum, human and rodent studies converge in showing blunted mesolimbic DA function (i.e., DA downregulation) in PPD. We propose that reduced activity of VTA DA neurons, resulting in downregulation of the mesolimbic DA system, interferes with reward-related processes necessary for maternal motivation and responsiveness. Thus, the mesolimbic DA system may constitute a therapeutic target for ameliorating reward-related deficits in PPD.
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Affiliation(s)
- Millie Rincón-Cortés
- Department of Neuroscience, School of Behavioral and Brain Sciences, University of Texas at Dallas, Richardson, TX, United States,*Correspondence: Millie Rincón-Cortés
| | - Anthony A. Grace
- Departments of Neuroscience, Psychiatry and Psychology, University of Pittsburgh, Pittsburgh, PA, United States
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11
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Animal models of postpartum depression revisited. Psychoneuroendocrinology 2022; 136:105590. [PMID: 34839082 DOI: 10.1016/j.psyneuen.2021.105590] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/19/2021] [Revised: 11/02/2021] [Accepted: 11/04/2021] [Indexed: 11/21/2022]
Abstract
Postpartum depression (PPD) is a heterogeneous mood disorder and the most frequent psychiatric complication of the postnatal period. Given its potential long-lasting repercussions on the well-being of the mother and the infants, it should be a priority in public health. In spite of efforts devoted to clinical investigation and preclinical studies, the underlying neurobiological mechanisms of this disorder remain unknown in detail. Much of the progress in the area has been made from animal models, especially rodent models. The aim of this mini-review is to update the current rodent models in PPD research and their main contributions to the field. Animal models are critical tools to advance understanding of the pathophysiological basis of this disorder and to help the development of new therapeutic strategies. Here, we group PPD models into 2 main categories (Models based on hormone manipulations, Models based on stress exposure), each of which includes different paradigms that reflect risk factors or physiological conditions associated with this disease. Finally, we provide an overview of emerging models that provide new perspectives on the study of possible pathophysiological factors related to PPD, to contribute to tackling potential therapeutic targets.
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Tharwat D, Trousselard M, Fromage D, Belrose C, Balès M, Sutter-Dallay AL, Ezto ML, Hurstel F, Harvey T, Martin S, Vigier C, Spitz E, Duffaud AM. Acceptance Mindfulness-Trait as a Protective Factor for Post-Natal Depression: A Preliminary Research. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:1545. [PMID: 35162565 PMCID: PMC8834924 DOI: 10.3390/ijerph19031545] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/30/2021] [Revised: 01/21/2022] [Accepted: 01/24/2022] [Indexed: 02/06/2023]
Abstract
(1) Background: the prevalence of postnatal depression (PND) reaches up to 20%. PND could be based on the interaction between a psychological vulnerability and chronic stress that pregnancy would activate. Vulnerability factors reflect a psychological profile mirroring mindfulness-trait (MT). A high level of MT is associated with an efficient regulation of both physiological and psychological stress, especially negative moods. Interestingly, mindfulness level can be improved by program based on mindfulness meditation. We hypothesize that MT is a protective factor for PND. We also postulate that negative moods increase during the pregnancy for women who develop a PND after delivery (2) Methods: we conducted a multicentric prospective longitudinal study including 85 women during their first trimester of their pregnancy and 72 from the childbirth to the baby's first birthday". At the inclusion, presence and acceptance of MT and various variables of personality and of psychological functioning were assessed. Mood evolution was monitored each month during the pregnancy and a delivery trauma risk was evaluated after delivery. PND detection was carried out at 48 h, 2, 6 and 12 months after the delivery with the Edinburgh Postnatal Depression Scale with a screening cut-off >11. (3) Results: high-acceptance MT is a protective factor for PND (OR: 0.79). Women without PND displayed less negative mood during pregnancy (p < 0.05 for Anxiety, Confusion and Anger). (4) Conclusions: these results suggest the value of deploying programs to enhance the level of mindfulness, especially in its acceptance dimension, before, during and after pregnancy, to reduce the risk of PND.
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Affiliation(s)
- Dahlia Tharwat
- Groupe Hospitalier Diaconesses Croix Saint Simon, 75012 Paris, France; (D.T.); (T.H.)
- Unit of Stress Neurophysiology, French Armed Forces Biomedical Research Institute, BP73, 91223 Brétigny-sur-Orge, France; (M.T.); (C.B.); (C.V.)
- APEMAC/EPSAM, Université de Lorraine, UR 4360, Ile du Saulcy, BP 30309, CEDEX 1, 57006 Metz, France;
| | - Marion Trousselard
- Unit of Stress Neurophysiology, French Armed Forces Biomedical Research Institute, BP73, 91223 Brétigny-sur-Orge, France; (M.T.); (C.B.); (C.V.)
- Réseau ABC des Psychotraumas, CEDEX 5, 34093 Montpellier, France
- French Military Health Service Academy, 1 Place Alphonse Laveran, CEDEX 05, 75230 Paris, France; (D.F.); (S.M.)
| | - Dominique Fromage
- French Military Health Service Academy, 1 Place Alphonse Laveran, CEDEX 05, 75230 Paris, France; (D.F.); (S.M.)
| | - Célia Belrose
- Unit of Stress Neurophysiology, French Armed Forces Biomedical Research Institute, BP73, 91223 Brétigny-sur-Orge, France; (M.T.); (C.B.); (C.V.)
- Réseau ABC des Psychotraumas, CEDEX 5, 34093 Montpellier, France
| | - Mélanie Balès
- Périnatal Psychiatry Network, University Department of Child Psychaitry, CH Charles Perrens, 33076 Bordeaux, France; (M.B.); (A.-L.S.-D.)
| | - Anne-Laure Sutter-Dallay
- Périnatal Psychiatry Network, University Department of Child Psychaitry, CH Charles Perrens, 33076 Bordeaux, France; (M.B.); (A.-L.S.-D.)
- BPHRC, Inserm 1219, Bordeaux University, 33000 Bordeaux, France
| | | | - Françoise Hurstel
- Protection Maternelle et Infantile du Department de la Moselle, 57000 Metz, France;
| | - Thierry Harvey
- Groupe Hospitalier Diaconesses Croix Saint Simon, 75012 Paris, France; (D.T.); (T.H.)
| | - Solenne Martin
- French Military Health Service Academy, 1 Place Alphonse Laveran, CEDEX 05, 75230 Paris, France; (D.F.); (S.M.)
| | - Cécile Vigier
- Unit of Stress Neurophysiology, French Armed Forces Biomedical Research Institute, BP73, 91223 Brétigny-sur-Orge, France; (M.T.); (C.B.); (C.V.)
| | - Elisabeth Spitz
- APEMAC/EPSAM, Université de Lorraine, UR 4360, Ile du Saulcy, BP 30309, CEDEX 1, 57006 Metz, France;
| | - Anaïs M. Duffaud
- Unit of Stress Neurophysiology, French Armed Forces Biomedical Research Institute, BP73, 91223 Brétigny-sur-Orge, France; (M.T.); (C.B.); (C.V.)
- Réseau ABC des Psychotraumas, CEDEX 5, 34093 Montpellier, France
- French Military Health Service Academy, 1 Place Alphonse Laveran, CEDEX 05, 75230 Paris, France; (D.F.); (S.M.)
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13
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Zoubovsky SP, Williams MT, Hoseus S, Tumukuntala S, Riesenberg A, Schulkin J, Vorhees CV, Campbell K, Lim HW, Muglia LJ. Neurobehavioral abnormalities following prenatal psychosocial stress are differentially modulated by maternal environment. Transl Psychiatry 2022; 12:22. [PMID: 35039487 PMCID: PMC8764031 DOI: 10.1038/s41398-022-01785-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/23/2020] [Revised: 12/20/2021] [Accepted: 01/06/2022] [Indexed: 02/06/2023] Open
Abstract
Prenatal stress (PS) is associated with increased vulnerability to affective disorders. Transplacental glucocorticoid passage and stress-induced maternal environment alterations are recognized as potential routes of transmission that can fundamentally alter neurodevelopment. However, molecular mechanisms underlying aberrant emotional outcomes or the individual contributions intrauterine stress versus maternal environment play in shaping these mechanisms remain unknown. Here, we report anxiogenic behaviors, anhedonia, and female hypothalamic-pituitary-adrenal axis hyperactivity as a consequence of psychosocial PS in mice. Evidence of fetal amygdala programming precedes these abnormalities. In adult offspring, we observe amygdalar transcriptional changes demonstrating sex-specific dysfunction in synaptic transmission and neurotransmitter systems. We find these abnormalities are primarily driven by in-utero stress exposure. Importantly, maternal care changes postnatally reverse anxiety-related behaviors and partially rescue gene alterations associated with neurotransmission. Our data demonstrate the influence maternal environment exerts in shaping offspring emotional development despite deleterious effects of intrauterine stress.
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Affiliation(s)
- Sandra P. Zoubovsky
- grid.24827.3b0000 0001 2179 9593Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH USA ,grid.239573.90000 0000 9025 8099Center for the Prevention of Preterm Birth, Perinatal Institute, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH USA ,grid.24827.3b0000 0001 2179 9593Molecular and Developmental Biology Graduate Program, University of Cincinnati College of Medicine, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH USA
| | - Michael T. Williams
- grid.24827.3b0000 0001 2179 9593Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH USA ,grid.24827.3b0000 0001 2179 9593Molecular and Developmental Biology Graduate Program, University of Cincinnati College of Medicine, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH USA ,grid.239573.90000 0000 9025 8099Division of Neurology, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH USA
| | - Sarah Hoseus
- grid.239573.90000 0000 9025 8099Center for the Prevention of Preterm Birth, Perinatal Institute, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH USA ,grid.239573.90000 0000 9025 8099Division of Human Genetics, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH USA
| | - Shivani Tumukuntala
- grid.239573.90000 0000 9025 8099Center for the Prevention of Preterm Birth, Perinatal Institute, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH USA ,grid.239573.90000 0000 9025 8099Division of Human Genetics, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH USA
| | - Amy Riesenberg
- grid.239573.90000 0000 9025 8099Division of Developmental Biology, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH USA
| | - Jay Schulkin
- grid.213910.80000 0001 1955 1644Department of Neuroscience, Georgetown University, Washington, DC USA ,grid.34477.330000000122986657Department of Obstetrics and Gynecology, University of Washington, Seattle, WA USA
| | - Charles V. Vorhees
- grid.24827.3b0000 0001 2179 9593Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH USA ,grid.24827.3b0000 0001 2179 9593Molecular and Developmental Biology Graduate Program, University of Cincinnati College of Medicine, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH USA ,grid.239573.90000 0000 9025 8099Division of Neurology, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH USA
| | - Kenneth Campbell
- grid.24827.3b0000 0001 2179 9593Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH USA ,grid.24827.3b0000 0001 2179 9593Molecular and Developmental Biology Graduate Program, University of Cincinnati College of Medicine, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH USA ,grid.239573.90000 0000 9025 8099Division of Developmental Biology, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH USA ,grid.239573.90000 0000 9025 8099Division of Neurosurgery, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH USA
| | - Hee-Woong Lim
- grid.24827.3b0000 0001 2179 9593Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH USA ,grid.24827.3b0000 0001 2179 9593Molecular and Developmental Biology Graduate Program, University of Cincinnati College of Medicine, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH USA ,grid.239573.90000 0000 9025 8099Division of Biomedical Informatics, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH USA
| | - Louis J. Muglia
- grid.24827.3b0000 0001 2179 9593Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH USA ,grid.239573.90000 0000 9025 8099Center for the Prevention of Preterm Birth, Perinatal Institute, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH USA ,grid.24827.3b0000 0001 2179 9593Molecular and Developmental Biology Graduate Program, University of Cincinnati College of Medicine, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH USA ,grid.239573.90000 0000 9025 8099Division of Human Genetics, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH USA ,grid.427464.70000 0000 8727 8697Office of the President, Burroughs Wellcome Fund, Research Triangle Park, NC USA
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14
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Duran S, Kaynak S. Investigation of the Relationship Between Postpartum-Specific Anxiety and Maternal Attachment and Affecting Factors in a Turkish Sample. EURASIAN JOURNAL OF FAMILY MEDICINE 2021. [DOI: 10.33880/ejfm.2021100408] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Aim: Postpartum-specific anxiety is associated with impaired mother-infant attachment, postpartum depression, reduced probability of breastfeeding, increased risk of infant abuse, and increased probability of anxiety in children and may lead to psychological, cognitive, and psycho-motor disorders in child development. This descriptive and cross-sectional study aims to determine the effect of anxiety level in the postpartum period in women on maternal attachment.
Methods: The participants were 384 postpartum women who have a 1-3-month old baby. Data were collected using a personal information form, Postpartum Specific Anxiety Scale, and Maternal Attachment Inventory.
Results: It was found that the Postpartum Specific Anxiety Scale in women was at a medium level, while maternal attachment was at a high level. While the Postpartum Specific Anxiety Scale was at higher levels in those who were younger, unemployed, and had no other children, the younger age of the partner increased the Postpartum Specific Anxiety Scale score. No statistically significant relationship was found between Postpartum Specific Anxiety Scale and maternal attachment.
Conclusion: It is seen that to evaluate women in terms of anxiety in the postpartum period and to provide the necessary psychosocial support is necessary. The fact that maternal attachment in women was high may have had a positive effect on her relationship with postpartum anxiety.
Keywords: postpartum, anxiety, children, bonding
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Affiliation(s)
- Songul Duran
- Izmir Demokrasi University Health Services Vocational College, Care of Elderly Program
| | - Serap Kaynak
- Balikesir University Faculty of Health, Department of Child Health Nursing
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15
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Kuipers YJ, Beeck EV, Cijsouw A, van Gils Y. The impact of motherhood on the course of women's psychological wellbeing. JOURNAL OF AFFECTIVE DISORDERS REPORTS 2021. [DOI: 10.1016/j.jadr.2021.100216] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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16
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Pallarés ME, Monteleone MC, Pastor V, Grillo Balboa J, Alzamendi A, Brocco MA, Antonelli MC. Early-Life Stress Reprograms Stress-Coping Abilities in Male and Female Juvenile Rats. Mol Neurobiol 2021; 58:5837-5856. [PMID: 34409559 DOI: 10.1007/s12035-021-02527-2] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2021] [Accepted: 08/06/2021] [Indexed: 01/06/2023]
Abstract
Prenatal stress (PS) is a major risk factor for the development of emotional disorders in adulthood that may be mediated by an altered hypothalamic-pituitary-adrenal axis response to stress. Although the early onset of stress-related disorders is recognized as a major public health problem, to date, there are relatively few studies that have examined the incidence of early-life stressors in younger individuals. In this study, we assessed PS impact on the stress-coping response of juvenile offspring in behavioral tests and in the induced molecular changes in the hippocampus. Furthermore, we assessed if pregnancy stress could be driving changes in patterns of maternal behavior during early lactation. We found that PS modified stress-coping abilities of both sex offspring. In the hippocampus, PS increased the expression of bdnf-IV and crfr1 and induced sex difference changes on glucocorticoids and BDNF mRNA receptor levels. PS changed the hippocampal epigenetic landscape mainly in male offspring. Stress during pregnancy enhanced pup-directed behavior of stressed dams. Our study indicates that exposure to PS, in addition to enhanced maternal behavior, induces dynamic neurobehavioral variations at juvenile ages of the offspring that should be considered adaptive or maladaptive, depending on the characteristics of the confronting environment. Our present results highlight the importance to further explore risk factors that appear early in life that will be important to allow timely prevention strategies to later vulnerability to stress-related disorders.
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MESH Headings
- Animals
- Female
- Male
- Pregnancy
- Rats
- Adaptation, Psychological
- Anxiety/etiology
- Anxiety/genetics
- Anxiety/physiopathology
- Brain-Derived Neurotrophic Factor/biosynthesis
- Brain-Derived Neurotrophic Factor/genetics
- Corticosterone/blood
- Corticotropin-Releasing Hormone/biosynthesis
- Corticotropin-Releasing Hormone/genetics
- Elevated Plus Maze Test
- Gene Expression Regulation
- Glucocorticoids/biosynthesis
- Glucocorticoids/genetics
- Hippocampus/embryology
- Hippocampus/physiology
- Hypothalamo-Hypophyseal System/embryology
- Hypothalamo-Hypophyseal System/physiopathology
- Lactation/physiology
- Lactation/psychology
- Maternal Behavior
- Pituitary-Adrenal System/embryology
- Pituitary-Adrenal System/physiopathology
- Pregnancy Complications/physiopathology
- Pregnancy Complications/psychology
- Prenatal Exposure Delayed Effects
- Rats, Wistar
- Receptor, trkB/biosynthesis
- Receptor, trkB/genetics
- Receptors, Corticotropin-Releasing Hormone/biosynthesis
- Receptors, Corticotropin-Releasing Hormone/genetics
- Receptors, Glucocorticoid/biosynthesis
- Receptors, Glucocorticoid/genetics
- Restraint, Physical/adverse effects
- Sex Characteristics
- Stress, Physiological/physiology
- Stress, Psychological/physiopathology
- Swimming
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Affiliation(s)
- María Eugenia Pallarés
- Laboratorio de Neuroprogramación Perinatal del Neurodesarrollo, Instituto de Biología Celular Y Neurociencias "Prof. Eduardo De Robertis" (IBCN)- Facultad de Medicina, Universidad de Buenos Aires, 2155 Paraguay St. CABA, C1121ABG, Buenos Aires, Argentina.
| | - Melisa Carolina Monteleone
- Instituto de Investigaciones Biotecnológicas (IIB), Universidad Nacional de San Martín, Buenos Aires, Argentina
| | - Verónica Pastor
- Laboratorio de Neuroprogramación Perinatal del Neurodesarrollo, Instituto de Biología Celular Y Neurociencias "Prof. Eduardo De Robertis" (IBCN)- Facultad de Medicina, Universidad de Buenos Aires, 2155 Paraguay St. CABA, C1121ABG, Buenos Aires, Argentina
| | - Jazmín Grillo Balboa
- Laboratorio de Neuroprogramación Perinatal del Neurodesarrollo, Instituto de Biología Celular Y Neurociencias "Prof. Eduardo De Robertis" (IBCN)- Facultad de Medicina, Universidad de Buenos Aires, 2155 Paraguay St. CABA, C1121ABG, Buenos Aires, Argentina
| | - Ana Alzamendi
- Instituto Multidisciplinario de Biología Celular, Universidad Nacional de La Plata, Buenos Aires, Argentina
| | - Marcela Adriana Brocco
- Instituto de Investigaciones Biotecnológicas (IIB), Universidad Nacional de San Martín, Buenos Aires, Argentina
| | - Marta Cristina Antonelli
- Laboratorio de Neuroprogramación Perinatal del Neurodesarrollo, Instituto de Biología Celular Y Neurociencias "Prof. Eduardo De Robertis" (IBCN)- Facultad de Medicina, Universidad de Buenos Aires, 2155 Paraguay St. CABA, C1121ABG, Buenos Aires, Argentina
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17
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Demarchi L, Pawluski JL, Bosch OJ. The brain oxytocin and corticotropin-releasing factor systems in grieving mothers: What we know and what we need to learn. Peptides 2021; 143:170593. [PMID: 34091013 DOI: 10.1016/j.peptides.2021.170593] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/25/2021] [Revised: 05/17/2021] [Accepted: 05/31/2021] [Indexed: 12/15/2022]
Abstract
The bond between a mother and her child is the strongest bond in nature. Consequently, the loss of a child is one of the most stressful and traumatic life events that causes Prolonged Grief Disorder in up to 94 % of bereaved parents. While both parents are affected, mothers are of higher risk to develop mental health complications; yet, very little research has been done to understand the impact of the loss of a child, stillbirth and pregnancy loss on key neurobiological systems. The emotional impact of losing a child, e.g., Prolonged Grief Disorder, is likely accompanied by dysregulations in neural systems important for mental health. Among those are the neuropeptides contributing to attachment and stress processing. In this review, we present evidence for the involvement of the brain oxytocin (OXT) and corticotropin-releasing factor (CRF) systems, which both play a role in maternal behavior and the stress response, in the neurobiology of grief in mothers from a behavioral and molecular point of view. We will draw conclusions from reviewing relevant animal and human studies. However, the paucity of research on the tragic end to an integral bond in a female's life calls for the need and responsibility to conduct further studies on mothers experiencing the loss of a child both in the clinic and in appropriate animal models.
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Affiliation(s)
- Luisa Demarchi
- Department of Behavioural and Molecular Neurobiology, Regensburg Center of Neuroscience, University of Regensburg, 93053 Regensburg, Germany.
| | - Jodi L Pawluski
- Univ Rennes, Inserm, EHESP, Irset (Institut de Recherche en Santé, Environnement et Travail), UMR_S, 1085 Rennes, France.
| | - Oliver J Bosch
- Department of Behavioural and Molecular Neurobiology, Regensburg Center of Neuroscience, University of Regensburg, 93053 Regensburg, Germany.
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18
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Rudolph S, Guo C, Pashkovski SL, Osorno T, Gillis WF, Krauss JM, Nyitrai H, Flaquer I, El-Rifai M, Datta SR, Regehr WG. Cerebellum-Specific Deletion of the GABA A Receptor δ Subunit Leads to Sex-Specific Disruption of Behavior. Cell Rep 2021; 33:108338. [PMID: 33147470 PMCID: PMC7700496 DOI: 10.1016/j.celrep.2020.108338] [Citation(s) in RCA: 30] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2019] [Revised: 08/04/2020] [Accepted: 10/08/2020] [Indexed: 12/19/2022] Open
Abstract
Granule cells (GCs) of the cerebellar input layer express high-affinity δ GABAA subunit-containing GABAA receptors (δGABAARs) that respond to ambient GABA levels and context-dependent neuromodulators like steroids. We find that GC-specific deletion of δGABAA (cerebellar [cb] δ knockout [KO]) decreases tonic inhibition, makes GCs hyperexcitable, and in turn, leads to differential activation of cb output regions as well as many cortical and subcortical brain areas involved in cognition, anxiety-like behaviors, and the stress response. Cb δ KO mice display deficits in many behaviors, but motor function is normal. Strikingly, δGABAA deletion alters maternal behavior as well as spontaneous, stress-related, and social behaviors specifically in females. Our findings establish that δGABAARs enable the cerebellum to control diverse behaviors not previously associated with the cerebellum in a sex-dependent manner. These insights may contribute to a better understanding of the mechanisms that underlie behavioral abnormalities in psychiatric and neurodevelopmental disorders that display a gender bias. Rudolph et al. show that deletion of the neuromodulator and hormone-sensitive δGABAA receptor subunit from cerebellar granule cells results in anxiety-like behaviors and female-specific deficits in social behavior and maternal care. δGABAA deletion is associated with hyperexcitability of the cerebellar input layer and altered activation of many stress-related brain regions.
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Affiliation(s)
- Stephanie Rudolph
- Department of Neurobiology, Harvard Medical School, Boston, MA 02115, USA
| | - Chong Guo
- Department of Neurobiology, Harvard Medical School, Boston, MA 02115, USA
| | - Stan L Pashkovski
- Department of Neurobiology, Harvard Medical School, Boston, MA 02115, USA
| | - Tomas Osorno
- Department of Neurobiology, Harvard Medical School, Boston, MA 02115, USA
| | - Winthrop F Gillis
- Department of Neurobiology, Harvard Medical School, Boston, MA 02115, USA
| | - Jeremy M Krauss
- Department of Neurobiology, Harvard Medical School, Boston, MA 02115, USA
| | - Hajnalka Nyitrai
- Department of Neurobiology, Harvard Medical School, Boston, MA 02115, USA
| | - Isabella Flaquer
- Department of Neurobiology, Harvard Medical School, Boston, MA 02115, USA
| | - Mahmoud El-Rifai
- Department of Neurobiology, Harvard Medical School, Boston, MA 02115, USA
| | | | - Wade G Regehr
- Department of Neurobiology, Harvard Medical School, Boston, MA 02115, USA.
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19
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Ojukwu EN, De Oliveira GC, Cianelli R, Villegas-Rodriguez N, Toledo C. Social determinants of peripartum depressive symptoms among Black peripartum women living with HIV. Arch Psychiatr Nurs 2021; 35:102-110. [PMID: 33593501 DOI: 10.1016/j.apnu.2020.05.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/03/2019] [Accepted: 05/21/2020] [Indexed: 11/16/2022]
Abstract
HIV infection during pregnancy, may present risk of developing depression during pregnancy and postpartum. This psychiatric mood disorder, and many others such as anxiety and HIV-related post-traumatic stress disorder (PTSD) have been reported prevalent among pregnant and non-pregnant women living with HIV (WLWH). Multiple studies have found associations between social determinants of health and depressive symptoms in this population. However, despite deleterious effects on mother and child which may include suicidal ideations and infant death, only very few studies have examined this phenomenon for peripartum women, particularly Black women- a population prone to living in poor social and economic environments. Therefore, guided by the socio-ecologic model, this study examined predictors of peripartum depressive symptoms among Black peripartum WLWH. The study was a secondary data analysis of 143 Black women seen at special prenatal and women's health clinics in Miami, South Florida, USA. More than half of the women who experienced peripartum depressive symptoms (PDS) (n = 81, 57%) were of low socio-economic status. Low income was associated with increased odds of experiencing PDS. Women who endorsed intimate partner violence/abuse (IPV/A) were 6.5 times more likely to experience PDS; and compared to women with 1 or no childcare burden, women with 2 children-care burden were 4.6 times more likely to experience PDS. These findings demonstrate the negative impact of social factors on the psychological health of Black peripartum WLWH. Burdensome interpersonal relationships may have deleterious effects and trigger PDS among these women. Implications for nursing practice, education and research are also discussed.
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Affiliation(s)
- Emmanuela Nneamaka Ojukwu
- Faculty of Applied Sciences, School of Nursing The University of British Columbia, Vancouver Campus, Musqueam Traditional Territory, T201-2211 Wesbrook Mall, Vancouver, BC V6T 2B5, Canada.
| | - Giovanna Cecilia De Oliveira
- University of Miami School of Nursing and Health Studies, 5030 Brunson Drive, Coral Gables, Miami 33143, United States of America.
| | - Rosina Cianelli
- University of Miami School of Nursing and Health Studies, 5030 Brunson Drive, Coral Gables, Miami 33143, United States of America.
| | - Natalia Villegas-Rodriguez
- University of Miami School of Nursing and Health Studies, 5030 Brunson Drive, Coral Gables, Miami 33143, United States of America.
| | - Christine Toledo
- University of Miami School of Nursing and Health Studies, 5030 Brunson Drive, Coral Gables, Miami 33143, United States of America.
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20
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Kim P. How stress can influence brain adaptations to motherhood. Front Neuroendocrinol 2021; 60:100875. [PMID: 33038383 PMCID: PMC7539902 DOI: 10.1016/j.yfrne.2020.100875] [Citation(s) in RCA: 34] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/18/2020] [Revised: 10/02/2020] [Accepted: 10/04/2020] [Indexed: 12/15/2022]
Abstract
Research shows that a woman's brain and body undergo drastic changes to support her transition to parenthood during the perinatal period. The presence of this plasticity suggests that mothers' brains may be changed by their experiences. Exposure to severe stress may disrupt adaptive changes in the maternal brain and further impact the neural circuits of stress regulation and maternal motivation. Emerging literature of human mothers provides evidence that stressful experience, whether from the past or present environment, is associated with altered responses to infant cues in brain circuits that support maternal motivation, emotion regulation, and empathy. Interventions that reduce stress levels in mothers may reverse the negative impact of stress exposure on the maternal brain. Finally, outstanding questions regarding the timing, chronicity, types, and severity of stress exposure, as well as study design to identify the causal impact of stress, and the role of race/ethnicity are discussed.
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Affiliation(s)
- Pilyoung Kim
- Department of Psychology, University of Denver, Denver, CO, United States.
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21
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Hutchison SM, Mâsse LC, Pawluski JL, Oberlander TF. Perinatal selective serotonin reuptake inhibitor (SSRI) and other antidepressant exposure effects on anxiety and depressive behaviors in offspring: A review of findings in humans and rodent models. Reprod Toxicol 2021; 99:80-95. [DOI: 10.1016/j.reprotox.2020.11.013] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2020] [Revised: 11/04/2020] [Accepted: 11/16/2020] [Indexed: 12/13/2022]
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22
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Kim P, Tribble R, Olsavsky AK, Dufford AJ, Erhart A, Hansen M, Grande L, Gonzalez DM. Associations between stress exposure and new mothers' brain responses to infant cry sounds. Neuroimage 2020; 223:117360. [PMID: 32927083 PMCID: PMC8291268 DOI: 10.1016/j.neuroimage.2020.117360] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2020] [Revised: 07/24/2020] [Accepted: 09/03/2020] [Indexed: 01/16/2023] Open
Abstract
Exposure to severe stress has been linked to negative postpartum outcomes among new mothers including mood disorders and harsh parenting. Non-human animal studies show that stress exposure disrupts the normative adaptation of the maternal brain, thus identifying a neurobiological mechanism by which stress can lead to negative maternal outcomes. However, little is known about the impact of stress exposure on the maternal brain response to infant cues in human mothers. We examined the association of stress exposure with brain response to infant cries and maternal behaviors, in a socioeconomically diverse (low- and middle-income) sample of first-time mothers (N=53). Exposure to stress across socioeconomic, environmental, and psychosocial domains was associated with reduced brain response to infant cry sounds in several regions, including the right insula/inferior frontal gyrus and superior temporal gyrus. Reduced activation in these regions was further associated with lower maternal sensitivity observed during a mother-infant interaction. The findings demonstrate that higher levels of stress exposure may be associated with reduced brain response to an infant’s cry in regions that are important for emotional and social information processing, and that reduced brain responses may further be associated with increased difficulties in developing positive mother-infant relationships.
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Affiliation(s)
- Pilyoung Kim
- Department of Psychology, University of Denver, Denver, 2155 South Race Street, Denver, CO 80208-3500, United States.
| | - Rebekah Tribble
- Department of Psychology, University of Denver, Denver, 2155 South Race Street, Denver, CO 80208-3500, United States
| | - Aviva K Olsavsky
- Department of Psychology, University of Denver, Denver, 2155 South Race Street, Denver, CO 80208-3500, United States; University of Colorado Anschutz School of Medicine/Children's Hospital Colorado, 13123 E. 16th Avenue, CO 80045, United States
| | - Alexander J Dufford
- Department of Psychology, University of Denver, Denver, 2155 South Race Street, Denver, CO 80208-3500, United States
| | - Andrew Erhart
- Department of Psychology, University of Denver, Denver, 2155 South Race Street, Denver, CO 80208-3500, United States
| | - Melissa Hansen
- Department of Psychology, University of Denver, Denver, 2155 South Race Street, Denver, CO 80208-3500, United States
| | - Leah Grande
- Department of Psychology, University of Denver, Denver, 2155 South Race Street, Denver, CO 80208-3500, United States
| | - Daniel M Gonzalez
- Department of Psychology, University of Denver, Denver, 2155 South Race Street, Denver, CO 80208-3500, United States; Harvard Medical School, Boston, 25 Shattuck St, Boston, MA 02115, United States
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23
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Olsavsky AK, Stoddard J, Erhart A, Tribble R, Kim P. Neural processing of infant and adult face emotion and maternal exposure to childhood maltreatment. Soc Cogn Affect Neurosci 2020; 14:997-1008. [PMID: 31680141 PMCID: PMC7058929 DOI: 10.1093/scan/nsz069] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2019] [Revised: 08/07/2019] [Accepted: 08/19/2019] [Indexed: 01/26/2023] Open
Abstract
Face processing in mothers is linked to mother–infant social communication, which is critical for parenting and in turn for child development. Neuroimaging studies of child maltreatment-exposed (CME) mothers are sparse compared to studies of mothers with postpartum depression, which have suggested blunted amygdala reactivity to infant stimuli. We expected to see a similar pattern in CME mothers. Based on broader studies in trauma-exposed populations, we anticipated increased amygdala reactivity to negative adult face stimuli in a comparison task in CME mothers given heightened evaluation of potential threat. We examined Neuroimaging studies of mothers with childhood maltreatment exposure (CME) (18–37 years old), who performed infant (N = 45) and/or adult (N = 46) face processing tasks. CME mothers exhibited blunted bilateral amygdala reactivity to infant faces. There was no between-group difference in amygdala reactivity to adult faces. In infant and adult face processing tasks regardless of CME, superior temporal gyrus activation was increased for negative-valence stimuli. Our preliminary findings suggest that childhood maltreatment alters maternal processing of infant social cues, a critical skill impacting infant socioemotional development.
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Affiliation(s)
- Aviva K Olsavsky
- Department of Psychiatry, School of Medicine, University of Colorado Anschutz Medical Campus.,Pediatric Mental Health Institute, Children's Hospital Colorado
| | - Joel Stoddard
- Department of Psychiatry, School of Medicine, University of Colorado Anschutz Medical Campus.,Pediatric Mental Health Institute, Children's Hospital Colorado
| | | | | | - Pilyoung Kim
- Department of Psychiatry, School of Medicine, University of Colorado Anschutz Medical Campus.,Department of Psychology, University of Denver
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24
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Rincón-Cortés M, Grace AA. Adaptations in reward-related behaviors and mesolimbic dopamine function during motherhood and the postpartum period. Front Neuroendocrinol 2020; 57:100839. [PMID: 32305528 PMCID: PMC7531575 DOI: 10.1016/j.yfrne.2020.100839] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/16/2020] [Revised: 03/15/2020] [Accepted: 04/10/2020] [Indexed: 02/07/2023]
Abstract
Initiation and maintenance of maternal behavior is driven by a complex interaction between the physiology of parturition and offspring stimulation, causing functional changes in maternal brain and behavior. Maternal behaviors are among the most robust and rewarding motivated behaviors. Mesolimbic dopamine (DA) system alterations during pregnancy and the postpartum enable enhanced reward-related responses to offspring stimuli. Here, we review behavioral evidence demonstrating postpartum rodents exhibit a bias towards pups and pup-related stimuli in reward-related tasks. Next, we provide an overview of normative adaptations in the mesolimbic DA system induced by parturition and the postpartum, which likely mediate shifts in offspring valence. We also discuss a causal link between dopaminergic dysfunction and disrupted maternal behaviors, which are recapitulated in postpartum depression (PPD) and relevant rodent models. In sum, mesolimbic DA system activation drives infant-seeking behavior and strengthens the mother-infant bond, potentially representing a therapeutic target for reward-related deficits in PPD.
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Affiliation(s)
- Millie Rincón-Cortés
- Departments of Neuroscience, Psychiatry and Psychology, University of Pittsburgh, Pittsburgh, PA 15217, United States.
| | - Anthony A Grace
- Departments of Neuroscience, Psychiatry and Psychology, University of Pittsburgh, Pittsburgh, PA 15217, United States
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25
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Zoubovsky SP, Hoseus S, Tumukuntala S, Schulkin JO, Williams MT, Vorhees CV, Muglia LJ. Chronic psychosocial stress during pregnancy affects maternal behavior and neuroendocrine function and modulates hypothalamic CRH and nuclear steroid receptor expression. Transl Psychiatry 2020; 10:6. [PMID: 32066677 PMCID: PMC7026416 DOI: 10.1038/s41398-020-0704-2] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/18/2019] [Revised: 12/09/2019] [Accepted: 12/20/2019] [Indexed: 02/06/2023] Open
Abstract
Postpartum depression (PPD) affects up to 20% of mothers and has negative consequences for both mother and child. Although exposure to psychosocial stress during pregnancy and abnormalities in the hypothalamic pituitary adrenal (HPA) axis have been linked to PPD, molecular changes in the brain that contribute to this disease remain unknown. This study utilized a novel chronic psychosocial stress paradigm during pregnancy (CGS) to investigate the effects of psychosocial stress on maternal behavior, neuroendocrine function, and gene expression changes in molecular regulators of the HPA axis in the early postpartum period. Postpartum female mice exposed to CGS display abnormalities in maternal behavior, including fragmented and erratic maternal care patterns, and the emergence of depression and anxiety-like phenotypes. Dysregulation in postpartum HPA axis function, evidenced by blunted circadian peak and elevation of stress-induced corticosterone levels, was accompanied by increased CRH mRNA expression and a reduction in CRH receptor 1 in the paraventricular nucleus of the hypothalamus (PVN). We further observed decreased PVN expression of nuclear steroid hormone receptors associated with CRH transcription, suggesting these molecular changes could underlie abnormalities in postpartum HPA axis and behavior observed. Overall, our study demonstrates that psychosocial stress during pregnancy induces changes in neuroendocrine function and maternal behavior in the early postpartum period and introduces our CGS paradigm as a viable model that can be used to further dissect the molecular defects that lead to PPD.
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Affiliation(s)
- Sandra P Zoubovsky
- Center for the Prevention of Preterm Birth, Perinatal Institute, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
- Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH, USA
- Molecular and Developmental Biology Graduate Program, University of Cincinnati College of Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
| | - Sarah Hoseus
- Center for the Prevention of Preterm Birth, Perinatal Institute, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
- Division of Human Genetics, Cincinnati Children's Hospital Medical Center, Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH, USA
| | - Shivani Tumukuntala
- Center for the Prevention of Preterm Birth, Perinatal Institute, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
- Division of Human Genetics, Cincinnati Children's Hospital Medical Center, Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH, USA
| | - Jay O Schulkin
- Department of Neuroscience, Georgetown University, Washington, DC, USA
- Department of Obstetrics and Gynecology, University of Washington, Seattle, WA, USA
| | - Michael T Williams
- Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH, USA
- Division of Neurology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
| | - Charles V Vorhees
- Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH, USA
- Division of Neurology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
| | - Louis J Muglia
- Center for the Prevention of Preterm Birth, Perinatal Institute, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA.
- Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH, USA.
- Molecular and Developmental Biology Graduate Program, University of Cincinnati College of Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA.
- Division of Human Genetics, Cincinnati Children's Hospital Medical Center, Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH, USA.
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26
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Hillerer KM, Slattery DA, Pletzer B. Neurobiological mechanisms underlying sex-related differences in stress-related disorders: Effects of neuroactive steroids on the hippocampus. Front Neuroendocrinol 2019; 55:100796. [PMID: 31580837 PMCID: PMC7115954 DOI: 10.1016/j.yfrne.2019.100796] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/08/2018] [Revised: 09/26/2019] [Accepted: 09/27/2019] [Indexed: 12/19/2022]
Abstract
Men and women differ in their vulnerability to a variety of stress-related illnesses, but the underlying neurobiological mechanisms are not well understood. This is likely due to a comparative dearth of neurobiological studies that assess male and female rodents at the same time, while human neuroimaging studies often don't model sex as a variable of interest. These sex differences are often attributed to the actions of sex hormones, i.e. estrogens, progestogens and androgens. In this review, we summarize the results on sex hormone actions in the hippocampus and seek to bridge the gap between animal models and findings in humans. However, while effects of sex hormones on the hippocampus are largely consistent in animals and humans, methodological differences challenge the comparability of animal and human studies on stress effects. We summarise our current understanding of the neurobiological mechanisms that underlie sex-related differences in behavior and discuss implications for stress-related illnesses.
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Affiliation(s)
- Katharina M Hillerer
- Department of Obstetrics and Gynaecology, Salzburger Landeskrankenhaus (SALK), Paracelsus Medical University (PMU), Clinical Research Center Salzburg (CRCS), Salzburg, Austria.
| | - David A Slattery
- Department of Psychiatry, Psychosomatic Medicine and Psychotherapy, University Hospital, Goethe University, Frankfurt, Germany
| | - Belinda Pletzer
- Department of Psychology, University of Salzburg, Salzburg, Austria; Centre for Cognitive Neuroscience, University of Salzburg, Salzburg, Austria
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27
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Schwarz JM. Frank Beach Award Winner - The future of mental health research: Examining the interactions of the immune, endocrine and nervous systems between mother and infant and how they affect mental health. Horm Behav 2019; 114:104521. [PMID: 30981689 PMCID: PMC7367439 DOI: 10.1016/j.yhbeh.2019.04.008] [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: 02/01/2019] [Revised: 03/28/2019] [Accepted: 04/10/2019] [Indexed: 10/27/2022]
Abstract
Pregnancy and the postpartum period are periods of significant change in the immune and endocrine systems. This period of life is also associated with an increased risk of mental health disorders in the mother, and an increased risk of developmental and neuropsychiatric disorders in her infant. The collective data described here supports the idea that peripartum mood disorders in mother and developmental disorders in her infant likely reflects multiple pathogeneses, stemming from various interactions between the immune, endocrine and nervous systems, thereby resulting in various symptom constellations. In this case, testing the mechanisms underlying specific symptoms of these disorders (e.g. deficits in specific types of learning or anhedonia) may provide a better understanding of the various physiological interactions and multiple etiologies that most likely underlie the risk of mental health disorders during this unique time in life. The goal here is to summarize the current understanding of how immune and endocrine factors contribute to maternal mental health, while simultaneously understanding the impact these unique interactions have on the developing brain of her infant.
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Affiliation(s)
- Jaclyn M Schwarz
- University of Delaware, Department of Psychological and Brain Sciences, 108 Wolf Hall, Newark, DE 19716, USA.
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28
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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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29
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Pawluski JL, Li M, Lonstein JS. Serotonin and motherhood: From molecules to mood. Front Neuroendocrinol 2019; 53:100742. [PMID: 30878665 PMCID: PMC6541513 DOI: 10.1016/j.yfrne.2019.03.001] [Citation(s) in RCA: 29] [Impact Index Per Article: 5.8] [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: 02/27/2019] [Accepted: 03/12/2019] [Indexed: 12/20/2022]
Abstract
Emerging research points to a valuable role of the monoamine neurotransmitter, serotonin, in the display of maternal behaviors and reproduction-associated plasticity in the maternal brain. Serotonin is also implicated in the pathophysiology of numerous affective disorders and likely plays an important role in the pathophysiology of maternal mental illness. Therefore, the main goals of this review are to detail: (1) how the serotonin system of the female brain changes across pregnancy and postpartum; (2) the role of the central serotonergic system in maternal caregiving and maternal aggression; and (3) how the serotonin system and selective serotonin reuptake inhibitor medications (SSRIs) are involved in the treatment of maternal mental illness. Although there is much work to be done, studying the central serotonin system's multifaceted role in the maternal brain is vital to our understanding of the processes governing matrescence and the maintenance of motherhood.
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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, F-35000 Rennes, France.
| | - Ming Li
- Department of Psychology, University of Nebraska-Lincoln, Lincoln, NE 68588-0308, USA.
| | - Joseph S Lonstein
- Neuroscience Program & Department of Psychology, Michigan State University, East Lansing, MI 48824, USA.
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30
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Dickens MJ, Pawluski JL. The HPA Axis During the Perinatal Period: Implications for Perinatal Depression. Endocrinology 2018; 159:3737-3746. [PMID: 30256957 DOI: 10.1210/en.2018-00677] [Citation(s) in RCA: 56] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/25/2018] [Accepted: 09/19/2018] [Indexed: 12/19/2022]
Abstract
The transition to motherhood is characterized by some of the most pronounced endocrine changes a woman will experience in her lifetime. Unfortunately, matrescence is also a time in a woman's life when she is most susceptible to mental illness such as perinatal depression. A growing body of research has aimed to determine how key endocrine systems, such as the hypothalamic-pituitary-adrenal (HPA) axis, are involved in the dysregulation of perinatal mental health. However, very little research has consistently linked perinatal changes in the HPA axis with maternal mental illness. Therefore, the aims of this mini review are to: (i) clearly summarize the normative changes in the HPA axis that occur during pregnancy and the postpartum period; (ii) summarize what we know about the HPA axis in perinatal depression, and (iii) propose key areas for future research. Understanding physiological biomarkers that can predict which women are at risk for perinatal mood disorders will lead to better tools for treating, and ultimately preventing, these debilitating disorders, improving the health of mother, child, and family.
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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
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31
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Gemmel M, Bögi E, Ragan C, Hazlett M, Dubovicky M, van den Hove DL, Oberlander TF, Charlier TD, Pawluski JL. Perinatal selective serotonin reuptake inhibitor medication (SSRI) effects on social behaviors, neurodevelopment and the epigenome. Neurosci Biobehav Rev 2018; 85:102-116. [DOI: 10.1016/j.neubiorev.2017.04.023] [Citation(s) in RCA: 37] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2017] [Revised: 04/10/2017] [Accepted: 04/21/2017] [Indexed: 12/15/2022]
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32
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Gemmel M, Harmeyer D, Bögi E, Fillet M, Hill LA, Hammond GL, Charlier TD, Pawluski JL. Perinatal fluoxetine increases hippocampal neurogenesis and reverses the lasting effects of pre-gestational stress on serum corticosterone, but not on maternal behavior, in the rat dam. Behav Brain Res 2018; 339:222-231. [DOI: 10.1016/j.bbr.2017.11.038] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2017] [Revised: 11/16/2017] [Accepted: 11/29/2017] [Indexed: 10/18/2022]
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33
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Gemmel M, Kokras N, Dalla C, Pawluski JL. Perinatal fluoxetine prevents the effect of pre-gestational maternal stress on 5-HT in the PFC, but maternal stress has enduring effects on mPFC synaptic structure in offspring. Neuropharmacology 2018; 128:168-180. [DOI: 10.1016/j.neuropharm.2017.10.009] [Citation(s) in RCA: 30] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2017] [Revised: 10/04/2017] [Accepted: 10/07/2017] [Indexed: 01/29/2023]
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34
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Abdulai-Saiku S, Hegde A, Vyas A, Mitra R. Effects of stress or infection on rat behavior show robust reversals due to environmental disturbance. F1000Res 2017; 6:2097. [PMID: 29416851 PMCID: PMC5782406 DOI: 10.12688/f1000research.13171.2] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 12/28/2017] [Indexed: 12/16/2022] Open
Abstract
Background: The behavior of animals is intricately linked to the environment; a relationship that is often studied in laboratory conditions by using environmental perturbations to study biological mechanisms underlying the behavioral change. Methods: This study pertains to two such well-studied and well-replicated perturbations, i.e., stress-induced anxiogenesis and Toxoplasmagondii -induced loss of innate fear. Here, we demonstrate that behavioral outcomes of these experimental manipulations are contingent upon the ambient quality of the wider environment where animal facilities are situated. Results: During late 2014 and early 2015, a building construction project started adjacent to our animal facility. During this phase, we observed that maternal separation stress caused anxiolysis, rather than historically observed anxiogenesis, in laboratory rats. We also found that Toxoplasma gondii infection caused an increase, rather than historically observed decrease, in innate aversion to predator odors in rats. Conclusion: These observations suggest that effects of stress and Toxoplasma gondii are dependent on variables in the environment that often go unreported in the published literature.
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Affiliation(s)
- Samira Abdulai-Saiku
- School of Biological Sciences, Nanyang Technological University, Singapore, 637551, Singapore
| | - Akshaya Hegde
- School of Biological Sciences, Nanyang Technological University, Singapore, 637551, Singapore
| | - Ajai Vyas
- School of Biological Sciences, Nanyang Technological University, Singapore, 637551, Singapore
| | - Rupshi Mitra
- School of Biological Sciences, Nanyang Technological University, Singapore, 637551, Singapore
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35
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Abdulai-Saiku S, Hegde A, Vyas A, Mitra R. Effects of stress or infection on rat behavior show robust reversals due to environmental disturbance. F1000Res 2017; 6:2097. [PMID: 29416851 PMCID: PMC5782406 DOI: 10.12688/f1000research.13171.1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 11/30/2017] [Indexed: 12/13/2022] Open
Abstract
Background: The behavior of animals is intricately linked to the environment; a relationship that is often studied in laboratory conditions by using environmental perturbations to study biological mechanisms underlying the behavioral change. Methods: This study pertains to two such well-studied and well-replicated perturbations, i.e., stress-induced anxiogenesis and Toxoplasma-induced loss of innate fear. Here, we demonstrate that behavioral outcomes of these experimental manipulations are contingent upon the ambient quality of the wider environment where animal facilities are situated. Results: During late 2014 and early 2015, a building construction project started adjacent to our animal facility. During this phase, we observed that maternal separation stress caused anxiolysis, rather than historically observed anxiogenesis, in laboratory rats. We also found that Toxoplasma infection caused an increase, rather than historically observed decrease, in innate aversion to predator odors in rats. Conclusion: These observations suggest that effects of stress and Toxoplasma are dependent on variables in the environment that often go unreported in the published literature.
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Affiliation(s)
- Samira Abdulai-Saiku
- School of Biological Sciences, Nanyang Technological University, Singapore, 637551, Singapore
| | - Akshaya Hegde
- School of Biological Sciences, Nanyang Technological University, Singapore, 637551, Singapore
| | - Ajai Vyas
- School of Biological Sciences, Nanyang Technological University, Singapore, 637551, Singapore
| | - Rupshi Mitra
- School of Biological Sciences, Nanyang Technological University, Singapore, 637551, Singapore
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36
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Chen HH, Lai JCY, Hwang SJ, Huang N, Chou YJ, Chien LY. Understanding the relationship between cesarean birth and stress, anxiety, and depression after childbirth: A nationwide cohort study. Birth 2017; 44:369-376. [PMID: 28594092 DOI: 10.1111/birt.12295] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/19/2016] [Revised: 04/26/2017] [Accepted: 04/26/2017] [Indexed: 11/28/2022]
Abstract
BACKGROUND Women who undergo cesarean birth might have an increased risk for poor mental health after childbirth, possibly because of maternal and neonatal physical problems, low parental confidence, and decreased levels of oxytocin. However, this relationship remains controversial and requires further examination. The study aimed to examine the effect of cesarean birth on postpartum stress, anxiety, and depression. METHODS This nationwide population-based cohort study was conducted using the Taiwan National Health Insurance Database. A total of 12 619 women who underwent cesarean birth and 12 619 control women who underwent vaginal birth were matched by propensity score based on age, socioeconomic status, residential urbanicity, antepartum comorbidity, and index year of delivery. We compared the incidence of stress, anxiety, and depression during the first postpartum year between cesarean and comparison groups by calculating incidence rate ratios (IRRs). RESULTS The cesarean group showed a significantly higher risk for stress symptoms (IRR 1.4 [95% confidence interval {CI} 1.02-1.92]), but not anxiety (IRR 1.14 [95% CI 0.95-1.38]) or depression (IRR 1.32 [95% CI 0.94-1.87]), although the IRRs were also greater than one. The cesarean group had a significantly higher risk of any of the above-listed three disorders than the comparison group (incidence 27.6 vs 23.4 per 1000 person-years; IRR 1.18 [95% CI 1.01-1.38]). CONCLUSIONS Cesarean birth was associated with an increased risk of postpartum stress symptoms. Health professionals should avoid unnecessary cesarean birth, pay attention to women who deliver by cesarean, and intervene appropriately in an attempt to improve mental health among postpartum women.
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Affiliation(s)
- Hung-Hui Chen
- Institute of Public Health, National Yang-Ming University, Taipei, Taiwan
| | - Jerry Cheng-Yen Lai
- Department of Medical Research, Taitung Mackay Memorial Hospital, Taitung, Taiwan
| | - Shyh-Jou Hwang
- Institute of Public Health, National Yang-Ming University, Taipei, Taiwan.,Taipei Veterans General Hospital, Hsinchu Branch, Hsinchu, Taiwan
| | - Nicole Huang
- Institute of Hospital and Health Care Administration, National Yang-Ming University, Taipei, Taiwan
| | - Yiing-Jenq Chou
- Institute of Public Health, National Yang-Ming University, Taipei, Taiwan
| | - Li-Yin Chien
- Institute of Community Health Care, National Yang-Ming University, Taipei, Taiwan
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37
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Buss C, Entringer S, Moog NK, Toepfer P, Fair DA, Simhan HN, Heim CM, Wadhwa PD. Intergenerational Transmission of Maternal Childhood Maltreatment Exposure: Implications for Fetal Brain Development. J Am Acad Child Adolesc Psychiatry 2017; 56:373-382. [PMID: 28433086 PMCID: PMC5402756 DOI: 10.1016/j.jaac.2017.03.001] [Citation(s) in RCA: 150] [Impact Index Per Article: 21.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/05/2016] [Revised: 03/01/2017] [Accepted: 03/02/2017] [Indexed: 12/21/2022]
Abstract
OBJECTIVE Growing evidence suggests the deleterious consequences of exposure to childhood maltreatment (CM) not only might endure over the exposed individual's lifespan but also might be transmitted across generations. The time windows, mechanisms, and targets of such intergenerational transmission are poorly understood. The prevailing paradigm posits that mother-to-child transmission of the effects of maternal CM likely occurs after her child's birth. The authors seek to extend this paradigm and advance a transdisciplinary framework that integrates the concepts of biological embedding of life experiences and fetal origins of health and disease risk. METHOD The authors posit that the period of embryonic and fetal life represents a particularly sensitive time for intergenerational transmission; that the developing brain represents a target of particular interest; and that stress-sensitive maternal-placental-fetal biological (endocrine, immune) pathways represent leading candidate mechanisms of interest. RESULTS The plausibility of this model is supported by theoretical considerations and empirical findings in humans and animals. The authors synthesize several research areas and identify important knowledge gaps that might warrant further study. CONCLUSION The scientific and public health relevance of this effort relates to achieving a better understanding of the "when," "what," and "how" of intergenerational transmission of CM, with implications for early identification of risk, prevention, and intervention.
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Affiliation(s)
- Claudia Buss
- Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health (BIH); the University of California-Irvine; and the University of California-Irvine Development, Health and Disease Research Program, Orange, CA.
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Slattery DA, Cryan JF. Modelling depression in animals: at the interface of reward and stress pathways. Psychopharmacology (Berl) 2017; 234:1451-1465. [PMID: 28224183 DOI: 10.1007/s00213-017-4552-6] [Citation(s) in RCA: 76] [Impact Index Per Article: 10.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/11/2016] [Accepted: 01/27/2017] [Indexed: 12/13/2022]
Abstract
RATIONALE Despite substantial research efforts the aetiology of major depressive disorder (MDD) remains poorly understood, which is due in part to the heterogeneity of the disorder and the complexity of designing appropriate animal models. However, in the last few decades, a focus on the development of novel stress-based paradigms and a focus on using hedonic/anhedonic behaviour have led to renewed optimism in the use of animal models to assess aspects of MDD. OBJECTIVES Therefore, in this review article, dedicated to Athina Markou, we summarise the use of stress-based animal models for studying MDD in rodents and how reward-related readouts can be used to validate/assess the model and/or treatment. RESULTS We reveal the use and limitations of chronic stress paradigms, which we split into non-social (i.e. chronic mild stress), social (i.e. chronic social defeat) and drug-withdrawal paradigms for studying MDD and detail numerous reward-related readouts that are employed in preclinical research. Finally, we finish with a section regarding important factors to consider when using animal models. CONCLUSIONS One of the most consistent findings following chronic stress exposure in rodents is a disruption of the brain reward system, which can be easily assessed using sucrose, social interaction, food, drug of abuse or intracranial self-stimulation as a readout. Probing the underlying causes of such alterations is providing a greater understanding of the potential systems and processes that are disrupted in MDD.
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Affiliation(s)
- D A Slattery
- Laboratory of Translational Psychiatry, Department of Psychiatry, Psychosomatic Medicine and Psychotherapy, University Hospital Frankfurt, Heinrich-Hoffmann-Str. 10, 60528, Frankfurt, Germany.
| | - J F Cryan
- APC Microbiome Institute, Department of Anatomy and Neuroscience, University College Cork, Cork, Ireland
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Li M, Chou SY. Modeling postpartum depression in rats: theoretic and methodological issues. DONG WU XUE YAN JIU = ZOOLOGICAL RESEARCH 2017; 37:229-36. [PMID: 27469254 DOI: 10.13918/j.issn.2095-8137.2016.4.229] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
The postpartum period is when a host of changes occur at molecular, cellular, physiological and behavioral levels to prepare female humans for the challenge of maternity. Alteration or prevention of these normal adaptions is thought to contribute to disruptions of emotion regulation, motivation and cognitive abilities that underlie postpartum mental disorders, such as postpartum depression. Despite the high incidence of this disorder, and the detrimental consequences for both mother and child, its etiology and related neurobiological mechanisms remain poorly understood, partially due to the lack of appropriate animal models. In recent decades, there have been a number of attempts to model postpartum depression disorder in rats. In the present review, we first describe clinical symptoms of postpartum depression and discuss known risk factors, including both genetic and environmental factors. Thereafter, we discuss various rat models that have been developed to capture various aspects of this disorder and knowledge gained from such attempts. In doing so, we focus on the theories behind each attempt and the methods used to achieve their goals. Finally, we point out several understudied areas in this field and make suggestions for future directions.
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Affiliation(s)
- Ming Li
- Department of Psychology, University of Nebraska-Lincoln, Lincoln, Nebraska, 68588-0308 USA.
| | - Shinn-Yi Chou
- Department of Psychology, University of Nebraska-Lincoln, Lincoln, Nebraska, 68588-0308 USA
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Baka J, Csakvari E, Huzian O, Dobos N, Siklos L, Leranth C, MacLusky NJ, Duman RS, Hajszan T. Stress induces equivalent remodeling of hippocampal spine synapses in a simulated postpartum environment and in a female rat model of major depression. Neuroscience 2017; 343:384-397. [PMID: 28012870 PMCID: PMC5421158 DOI: 10.1016/j.neuroscience.2016.12.021] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2016] [Revised: 12/11/2016] [Accepted: 12/13/2016] [Indexed: 12/24/2022]
Abstract
Stress and withdrawal of female reproductive hormones are known risk factors of postpartum depression. Although both of these factors are capable of powerfully modulating neuronal plasticity, there is no direct electron microscopic evidence of hippocampal spine synapse remodeling in postpartum depression. To address this issue, hormonal conditions of pregnancy and postpartum period were simulated in ovariectomized adult female Sprague-Dawley rats (n=76). The number of hippocampal spine synapses and the depressive behavior of rats in an active escape task were investigated in untreated control, hormone-withdrawn 'postpartum', simulated proestrus, and hormone-treated 'postpartum' animals. After 'postpartum' withdrawal of gonadal steroids, inescapable stress caused a loss of hippocampal spine synapses, which was related to poor escape performance in hormone-withdrawn 'postpartum' females. These responses were equivalent with the changes observed in untreated controls that is an established animal model of major depression. Maintaining proestrus levels of ovarian hormones during 'postpartum' stress exposure did not affect synaptic and behavioral responses to inescapable stress in simulated proestrus animals. By contrast, maintaining pregnancy levels of estradiol and progesterone during 'postpartum' stress exposure completely prevented the stress-induced loss of hippocampal spine synapses, which was associated with improved escape performance in hormone-treated 'postpartum' females. This protective effect appears to be mediated by a muted stress response as measured by serum corticosterone concentrations. In line with our emerging 'synaptogenic hypothesis' of depression, the loss of hippocampal spine synapses may be a novel perspective both in the pathomechanism and in the clinical management of postpartum affective illness.
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Affiliation(s)
- Judith Baka
- Institute of Biophysics, Biological Research Center, Hungarian Academy of Sciences, Temesvari Krt 62, 6726 Szeged, Hungary
| | - Eszter Csakvari
- Institute of Biophysics, Biological Research Center, Hungarian Academy of Sciences, Temesvari Krt 62, 6726 Szeged, Hungary
| | - Orsolya Huzian
- Institute of Biophysics, Biological Research Center, Hungarian Academy of Sciences, Temesvari Krt 62, 6726 Szeged, Hungary
| | - Nikoletta Dobos
- Institute of Biophysics, Biological Research Center, Hungarian Academy of Sciences, Temesvari Krt 62, 6726 Szeged, Hungary
| | - Laszlo Siklos
- Institute of Biophysics, Biological Research Center, Hungarian Academy of Sciences, Temesvari Krt 62, 6726 Szeged, Hungary
| | - Csaba Leranth
- Department of Obstetrics, Gynecology, and Reproductive Sciences, Yale University School of Medicine, 333 Cedar Street, New Haven, CT 06510, United States; Department of Neuroscience, Yale University School of Medicine, 333 Cedar Street, New Haven, CT 06510, United States
| | - Neil J MacLusky
- Department of Biomedical Sciences, Ontario Veterinary College, University of Guelph, 50 Stone Road E, Guelph, Ontario N1G 2W1, Canada
| | - Ronald S Duman
- Department of Neuroscience, Yale University School of Medicine, 333 Cedar Street, New Haven, CT 06510, United States; Department of Psychiatry, Yale University School of Medicine, 34 Park Street, New Haven, CT 06508, United States
| | - Tibor Hajszan
- Institute of Biophysics, Biological Research Center, Hungarian Academy of Sciences, Temesvari Krt 62, 6726 Szeged, Hungary; Department of Obstetrics, Gynecology, and Reproductive Sciences, Yale University School of Medicine, 333 Cedar Street, New Haven, CT 06510, United States.
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Abstract
Successfully rearing young places multiple demands on the mammalian female. These are met by a wide array of alterations in maternal physiology and behavior that are coordinated with the needs of the developing young, and include adaptations in neuroendocrine systems not directly involved in maternal behavior or lactation. In this article, attenuations in the behavioral and neuroendocrine responses to stressors, the alterations in metabolic pathways facilitating both increased food intake and conservation of energy, and the changes in fertility that occur postpartum are described. The mechanisms underlying these processes as well as the factors that contribute to them and the relative contributions of these stimuli at different times postpartum are also reviewed. The induction and maintenance of the adaptations observed in the postpartum maternal brain are dependent on mother-young interaction and, in most cases, on suckling stimulation and its consequences for the hormonal profile of the mother. The peptide hormone prolactin acting on receptors within the brain makes a major contribution to changes in metabolic pathways, suppression of fertility and the attenuation of the neuroendocrine response to stress during lactation. Oxytocin is also released, both into the circulation and in some hypothalamic nuclei, in response to suckling stimulation and this hormone has been implicated in the decrease in anxiety behavior seen in the early postpartum period. The relative importance of these hormones changes across lactation and it is becoming increasingly clear that many of the adaptations to motherhood reviewed here reflect the outcome of multiple influences. © 2016 American Physiological Society. Compr Physiol 6:1493-1518, 2016.
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Affiliation(s)
- Barbara Woodside
- Center for Studies in Behavioral Neurobiology, Department of Psychology, Concordia University, Montreal, Quebec, Canada
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Slattery DA, Hillerer KM. The maternal brain under stress: Consequences for adaptive peripartum plasticity and its potential functional implications. Front Neuroendocrinol 2016; 41:114-28. [PMID: 26828151 DOI: 10.1016/j.yfrne.2016.01.004] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/17/2015] [Revised: 01/22/2016] [Accepted: 01/27/2016] [Indexed: 12/25/2022]
Abstract
The peripartum period represents a time during which all mammalian species undergo substantial physiological and behavioural changes, which prepare the female for the demands of motherhood. In addition to behavioural and physiological alterations, numerous brain regions, such as the medial prefrontal cortex, olfactory bulb, medial amygdala and hippocampus are subject to substantial peripartum-associated neuronal, dendritic and synaptic plasticity. These changes, which are temporally- and spatially-distinct, are strongly influenced by gonadal and adrenal hormones, such as estrogen and cortisol/corticosterone, which undergo dramatic fluctuations across this period. In this review, we describe our current knowledge regarding these plasticity changes and describe how stress affects such normal adaptations. Finally, we discuss the mechanisms potentially underlying these neuronal, dendritic and synaptic changes and their functional relevance for the mother and her offspring.
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Affiliation(s)
- David A Slattery
- Department of Behavioural and Molecular Neurobiology, University of Regensburg, Regensburg, Germany
| | - Katharina M Hillerer
- Department of Obstetrics and Gynaecology, Salzburger Landeskrankenhaus (SALK), Paracelsus Medical University, Salzburg, Austria
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Neonatal handling alters maternal emotional response to stress. Dev Psychobiol 2016; 58:614-22. [DOI: 10.1002/dev.21405] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2015] [Accepted: 02/21/2016] [Indexed: 11/07/2022]
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Abstract
This article is part of a Special Issue "Parental Care". The postpartum period involves some truly transformational changes in females' socioemotional behaviors. For most female laboratory rodents and women, these changes include an improvement in their affective state, which has positive consequences for their ability to sensitively care for their offspring. There is heterogeneity among females in the likelihood of this positive affective change, though, and some women experience elevated anxiety or depression (or in rodents anxiety- or depression-related behaviors) after giving birth. We aim to contribute to the understanding of this heterogeneity in maternal affectivity by reviewing selected components of the scientific literatures on laboratory rodents and humans examining how mothers' physical contact with her infants, genetics, history of anxiety and depression and early-life and recent-life experiences contribute to individual differences in postpartum affective states. These studies together indicate that multiple biological and environmental factors beyond female maternal state shape affective responses during the postpartum period, and probably do so in an interactive manner. Furthermore, the similar capacity of some of these factors to modulate anxiety and depression in human and rodent mothers suggests cross-species conservation of mechanisms regulating postpartum affectivity.
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Affiliation(s)
- Daniella Agrati
- Department of Physiology and Nutrition, Facultad de Ciencias, Universidad de la Republica, Montevideo, Uruguay.
| | - Joseph S Lonstein
- Neuroscience Program & Department of Psychology, Michigan State University, East Lansing, MI 48824, USA
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Brummelte S, Galea LAM. Postpartum depression: Etiology, treatment and consequences for maternal care. Horm Behav 2016; 77:153-66. [PMID: 26319224 DOI: 10.1016/j.yhbeh.2015.08.008] [Citation(s) in RCA: 276] [Impact Index Per Article: 34.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/14/2015] [Revised: 08/18/2015] [Accepted: 08/21/2015] [Indexed: 01/20/2023]
Abstract
This article is part of a Special Issue "Parental Care". Pregnancy and postpartum are associated with dramatic alterations in steroid and peptide hormones which alter the mothers' hypothalamic pituitary adrenal (HPA) and hypothalamic pituitary gonadal (HPG) axes. Dysregulations in these endocrine axes are related to mood disorders and as such it should not come as a major surprise that pregnancy and the postpartum period can have profound effects on maternal mood. Indeed, pregnancy and postpartum are associated with an increased risk for developing depressive symptoms in women. Postpartum depression affects approximately 10-15% of women and impairs mother-infant interactions that in turn are important for child development. Maternal attachment, sensitivity and parenting style are essential for a healthy maturation of an infant's social, cognitive and behavioral skills and depressed mothers often display less attachment, sensitivity and more harsh or disrupted parenting behaviors, which may contribute to reports of adverse child outcomes in children of depressed mothers. Here we review, in honor of the "father of motherhood", Jay Rosenblatt, the literature on postnatal depression in the mother and its effect on mother-infant interactions. We will cover clinical and pre-clinical findings highlighting putative neurobiological mechanisms underlying postpartum depression and how they relate to maternal behaviors and infant outcome. We also review animal models that investigate the neurobiology of maternal mood and disrupted maternal care. In particular, we discuss the implications of endogenous and exogenous manipulations of glucocorticoids on maternal care and mood. Lastly we discuss interventions during gestation and postpartum that may improve maternal symptoms and behavior and thus may alter developmental outcome of the offspring.
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Affiliation(s)
| | - Liisa A M Galea
- Dept. of Psychology, Graduate Program in Neuroscience, Centre for Brain Health, University of British Columbia, Vancouver, BC, Canada
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Tian X, Hou X, Wang K, Wei D, Qiu J. Neuroanatomical correlates of individual differences in social anxiety in a non-clinical population. Soc Neurosci 2015; 11:424-37. [PMID: 26442578 DOI: 10.1080/17470919.2015.1091037] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
Socially anxious individuals are characterized as those with distorted negative self-beliefs (NSBs), which are thought to enhance reactions of social distress (emotional reactivity) and social avoidance (social functioning). However, it remains unclear whether individual differences in social distress and social avoidance are represented by differences in brain morphometry. To probe into these neural correlates, we analyzed magnetic resonance images of a sample of 130 healthy subjects and used the Connectome Computation System (CCS) to evaluate these factors. The results showed that social distress was correlated with the cortical volume of the right orbitofrontal cortex (OFC) and the subcortical volume of the left amygdala, while social avoidance was correlated with the cortical volume of the right dorsolateral prefrontal cortex (DLPFC). Additionally, loneliness might mediate the relationship between the amygdala volume and the social distress score. Our results demonstrated that social distress and social avoidance were represented by segregated cortical regions in the healthy individuals. These findings might provide a valuable basis for understanding the stable brain structures underlying individual differences in social anxiety.
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Affiliation(s)
- Xue Tian
- a Key Laboratory of Cognition and Personality (SWU) , Ministry of Education , Chongqing , China.,b Department of Psychology , Southwest University , Chongqing , China
| | - Xin Hou
- a Key Laboratory of Cognition and Personality (SWU) , Ministry of Education , Chongqing , China.,b Department of Psychology , Southwest University , Chongqing , China
| | - Kangcheng Wang
- a Key Laboratory of Cognition and Personality (SWU) , Ministry of Education , Chongqing , China.,b Department of Psychology , Southwest University , Chongqing , China
| | - Dongtao Wei
- a Key Laboratory of Cognition and Personality (SWU) , Ministry of Education , Chongqing , China.,b Department of Psychology , Southwest University , Chongqing , China
| | - Jiang Qiu
- a Key Laboratory of Cognition and Personality (SWU) , Ministry of Education , Chongqing , China.,b Department of Psychology , Southwest University , Chongqing , China
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Yang Y, Qin J, Chen W, Sui N, Chen H, Li M. Behavioral and pharmacological investigation of anxiety and maternal responsiveness of postpartum female rats in a pup elevated plus maze. Behav Brain Res 2015; 292:414-27. [PMID: 26159828 DOI: 10.1016/j.bbr.2015.07.010] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2015] [Revised: 06/28/2015] [Accepted: 07/02/2015] [Indexed: 01/26/2023]
Abstract
The present study investigated the validity of a novel pup-based repeated elevated plus maze task to detect reduced anxiety and increased maternal responsiveness in postpartum female rats and explored the roles of dopamine D2, serotonin transporter and GABA/benzodiazepine receptors in the mediation of these processes. Sprague-Dawley postpartum or nulliparous female rats were tested 4 times every other day on postpartum days 4, 6 and 8 in an elevated plus maze with 4 pups or 4 pup-size erasers placed on each end of the two open arms. When tested with erasers, untreated postpartum mother rats entered the open arms proportionally more than nulliparous rats. They also tended to spend more time in the open arms, indicating reduced anxiety. When tested with pups, postpartum rats retrieved pups into the closed arms, entered the open arms and closed arms more and had a higher moving speed than nulliparous rats, indicating increased maternal responsiveness. Both haloperidol (0.1 or 0.2 mg/kg, sc) and fluoxetine (5 or 10 mg/kg, ip) dose- and time-dependently decreased the percentage of time spent in the open arms and speed, but did not affect the percentage of open arm entries. Diazepam (1.0 or 2.0 mg/kg, ip) did not affect pup retrieval, open arm time/entry in lactating rats. Thus, the percentage of open arm entries appears to be the most sensitive measure of anxiety in postpartum female rats, while speed could be used to index maternal responsiveness to pups, which are likely mediated by the dopamine D2 and serotonin transporter systems.
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Affiliation(s)
- Yu Yang
- Key Laboratory of Cognition and Personality (Southwest University), Ministry of Education, China; Faculty of Psychology, Southwest University, Chongqing, China
| | - Jingxue Qin
- Key Laboratory of Cognition and Personality (Southwest University), Ministry of Education, China; Faculty of Psychology, Southwest University, Chongqing, China
| | - Weihai Chen
- Key Laboratory of Cognition and Personality (Southwest University), Ministry of Education, China; Faculty of Psychology, Southwest University, Chongqing, China
| | - Nan Sui
- Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing, China
| | - Hong Chen
- Key Laboratory of Cognition and Personality (Southwest University), Ministry of Education, China; Faculty of Psychology, Southwest University, Chongqing, China.
| | - Ming Li
- Department of Psychology, University of Nebraska-Lincoln, Lincoln, NE 68588-0308, USA.
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Abstract
The wide spectrum of disruptions that characterizes major depressive disorder (MDD) and bipolar disorder (BD) highlights the difficulties researchers are posed with as they try to mimic these disorders in the laboratory. Nonetheless, numerous attempts have been made to create rodent models of mood disorders or at least models of the symptoms of MDD and BD. Present antidepressants are all descendants of the serendipitous findings in the 1950s that the monoamine oxidase inhibitor iproniazid and the tricyclic antidepressant imipramine were effective antidepressants. Thus, the need for improved animal models to provide insights into the neuropathology underlying the disease is critical. Such information is in turn crucial for identifying new antidepressants and mood stabilisers. Currently, there is a shift away from traditional animal models to more focused research dealing with an endophenotype-style approach, genetic models, and incorporation of new findings from human neuroimaging and genetic studies. Such approaches are opening up more tractable avenues for understanding the neurobiological and genetic bases of these disorders. Further, such models promise to yield better translational animal models and hence more fruitful therapeutic targets. This overview focuses on such animal models and tests and how they can be used to assess MDD and BD in rodents.
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Tomihara K, Zoshiki T, Kukita SY, Nakamura K, Isogawa A, Ishibashi S, Tanaka A, Kuraoka AS, Matsumoto S. Effects of diethylstilbestrol exposure during gestation on both maternal and offspring behavior. Front Neurosci 2015; 9:79. [PMID: 25852458 PMCID: PMC4360566 DOI: 10.3389/fnins.2015.00079] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2014] [Accepted: 02/23/2015] [Indexed: 12/18/2022] Open
Abstract
Endocrine disruption during gestation impairs the physical and behavioral development of offspring. However, it is unclear whether endocrine disruption also impairs maternal behavior and in turn further contributes to the developmental and behavioral dysfunction of offspring. We orally administered the synthetic non-steroidal estrogen diethylstilbestrol (DES) to pregnant female C57BL/6J mice from gestation day 11-17 and then investigated the maternal behavior of mothers. In addition, we examined the direct effects of in utero DES exposure and the indirect effects of aberrant maternal behavior on offspring using the cross-fostering method. In mothers, endocrine disruption during gestation decreased maternal behavior. In addition, endocrine disruption of foster mother influenced anxiety-related behavior and passive avoidance learning of pups regardless of their exposure in utero. The influence of DES exposure in utero, irrespective of exposure to the foster mother, was also shown in female offspring. These results demonstrate the risks of endocrine disruptors on both mother as well as offspring and suggest that developmental deficits may stem from both in utero toxicity and aberrant maternal care.
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Affiliation(s)
- Kazuya Tomihara
- Department of Psychology, Faculty of Law, Economics, and Humanities, Kagoshima University Kagoshima, Japan
| | - Takahiro Zoshiki
- Department of Psychology, Faculty of Law, Economics, and Humanities, Kagoshima University Kagoshima, Japan
| | - Sayaka Y Kukita
- Department of Psychology, Faculty of Law, Economics, and Humanities, Kagoshima University Kagoshima, Japan
| | - Kanako Nakamura
- Department of Psychology, Faculty of Law, Economics, and Humanities, Kagoshima University Kagoshima, Japan
| | - Ayuko Isogawa
- Department of Psychology, Faculty of Law, Economics, and Humanities, Kagoshima University Kagoshima, Japan
| | - Sawako Ishibashi
- Department of Psychology, Faculty of Law, Economics, and Humanities, Kagoshima University Kagoshima, Japan
| | - Ayumi Tanaka
- Department of Psychology, Faculty of Law, Economics, and Humanities, Kagoshima University Kagoshima, Japan
| | - Ayaka S Kuraoka
- Department of Psychology, Faculty of Law, Economics, and Humanities, Kagoshima University Kagoshima, Japan
| | - Saki Matsumoto
- Department of Psychology, Faculty of Law, Economics, and Humanities, Kagoshima University Kagoshima, Japan
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Haim A, Sherer M, Leuner B. Gestational stress induces persistent depressive-like behavior and structural modifications within the postpartum nucleus accumbens. Eur J Neurosci 2014; 40:3766-73. [PMID: 25359225 DOI: 10.1111/ejn.12752] [Citation(s) in RCA: 59] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2014] [Revised: 09/10/2014] [Accepted: 09/11/2014] [Indexed: 12/22/2022]
Abstract
Postpartum depression (PPD) is a common complication following childbirth experienced by one in every five new mothers. Pregnancy stress enhances vulnerability to PPD and has also been shown to increase depressive-like behavior in postpartum rats. Thus, gestational stress may be an important translational risk factor that can be used to investigate the neurobiological mechanisms underlying PPD. Here we examined the effects of gestational stress on depressive-like behavior during the early/mid and late postpartum periods and evaluated whether this was accompanied by altered structural plasticity in the nucleus accumbens (NAc), a brain region that has been linked to PPD. We show that early/mid (postpartum day 8) postpartum female rats exhibited more depressive-like behavior in the forced swim test as compared with late postpartum females (postpartum day 22). However, 2 weeks of restraint stress during pregnancy increased depressive-like behavior regardless of postpartum timepoint. In addition, dendritic length, branching and spine density on medium spiny neurons in the NAc shell were diminished in postpartum rats that experienced gestational stress although stress-induced reductions in spine density were evident only in early/mid postpartum females. In the NAc core, structural plasticity was not affected by gestational stress but late postpartum females exhibited lower spine density and reduced dendritic length. Overall, these data not only demonstrate structural changes in the NAc across the postpartum period, they also show that postpartum depressive-like behavior following exposure to gestational stress is associated with compromised structural plasticity in the NAc and thus may provide insight into the neural changes that could contribute to PPD.
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Affiliation(s)
- Achikam Haim
- Department of Neuroscience, The Ohio State University Wexner Medical Center, Columbus, OH, USA
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