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Spann MN, Alleyne K, Holland CM, Davids A, Pierre-Louis A, Bang C, Oyeneye V, Kiflom R, Shea E, Cheng B, Peterson BS, Monk C, Scheinost D. The effects of experience of discrimination and acculturation during pregnancy on the developing offspring brain. Neuropsychopharmacology 2024; 49:476-485. [PMID: 37968451 PMCID: PMC10724278 DOI: 10.1038/s41386-023-01765-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/20/2022] [Revised: 11/01/2023] [Accepted: 11/02/2023] [Indexed: 11/17/2023]
Abstract
The experience of ethnic, racial, and structural inequalities is increasingly recognized as detrimental to health, and early studies suggest that its experience in pregnant mothers may affect the developing fetus. We characterized discrimination and acculturation experiences in a predominantly Hispanic sample of pregnant adolescent women and assessed their association with functional connectivity in their neonate's brain. We collected self-report measures of acculturation, discrimination, maternal distress (i.e., perceived stress, childhood trauma, and depressive symptoms), and socioeconomic status in 165 women. Then, we performed a data-driven clustering of acculturation, discrimination, perceived stress, depressive symptoms, trauma, and socioeconomic status variables during pregnancy to determine whether discrimination or acculturation clustered into distinct factors. Discrimination and acculturation styles loaded onto different factors from perceived stress, depressive symptoms, trauma, and socioeconomic status, suggesting that they were distinct from other factors in our sample. We associated these data-driven maternal phenotypes (discrimination and acculturation styles) with measures of resting-state functional MRI connectivity of the infant amygdala (n = 38). Higher maternal report of assimilation was associated with weaker connectivity between their neonate's amygdala and bilateral fusiform gyrus. Maternal experience of discrimination was associated with weaker connectivity between the amygdala and prefrontal cortex and stronger connectivity between the amygdala and fusiform of their neonate. Cautiously, the results may suggest a similarity to self-contained studies with adults, noting that the experience of discrimination and acculturation may influence amygdala circuitry across generations. Further prospective studies are essential that consider a more diverse population of minoritized individuals and with a comprehensive assessment of ethnic, racial, and structural factors.
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Affiliation(s)
- Marisa N Spann
- Vagelos College of Physicians and Surgeons, Columbia University, New York, NY, USA.
- New York State Psychiatric Institute, New York, NY, USA.
| | - Kiarra Alleyne
- Columbia University Mailman School of Public Health, New York, NY, USA
| | - Cristin M Holland
- Vagelos College of Physicians and Surgeons, Columbia University, New York, NY, USA
| | - Antonette Davids
- Vagelos College of Physicians and Surgeons, Columbia University, New York, NY, USA
| | - Arline Pierre-Louis
- Vagelos College of Physicians and Surgeons, Columbia University, New York, NY, USA
| | - Claire Bang
- Columbia University Mailman School of Public Health, New York, NY, USA
| | | | | | - Eileen Shea
- New York State Psychiatric Institute, New York, NY, USA
| | - Bin Cheng
- Columbia University Mailman School of Public Health, New York, NY, USA
| | - Bradley S Peterson
- Institute for the Developing Mind, Children's Hospital Los Angeles, Los Angeles, CA, USA
- Department of Psychiatry, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Catherine Monk
- Vagelos College of Physicians and Surgeons, Columbia University, New York, NY, USA
- New York State Psychiatric Institute, New York, NY, USA
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2
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Hu Y, Chen H, Li X, Larsen RJ, Sutton BP, Gao W, McElwain NL. Associations between infant amygdala functional connectivity and social engagement following a stressor: A preliminary investigation. Dev Sci 2024; 27:e13418. [PMID: 37340633 PMCID: PMC10730773 DOI: 10.1111/desc.13418] [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: 10/06/2022] [Revised: 05/20/2023] [Accepted: 05/23/2023] [Indexed: 06/22/2023]
Abstract
Functional architecture of the infant brain, especially functional connectivity (FC) within the amygdala network and between the amygdala and other networks (i.e., default-mode [DMN] and salience [SAL] networks), provides a neural basis for infant socioemotional functioning. Yet, little is known about the extent to which early within- and between-network amygdala FC are related to infant stress recovery across the first year of life. In this study, we examined associations between amygdala FC (i.e., within-network amygdala connectivity, and between-network amygdala connectivity with the DMN and SAL) at 3 months and infant recovery from a mild social stressor at 3, 6 and 9 months. At 3 months, thirty-five infants (13 girls) underwent resting-state functional magnetic resonance imaging during natural sleep. Infants and their mothers completed the still-face paradigm at 3, 6, and 9 months, and infant stress recovery was assessed at each time point as the proportion of infant social engagement during the reunion episode. Bivariate correlations indicated that greater positive within-network amygdala FC and greater positive amygdala-SAL FC, but not amygdala-DMN FC, at 3 months predicted lower levels of stress recovery at 3 and 6 months, but were nonsignificant at 9 months. These findings provide preliminary evidence that early functional synchronization within the amygdala network, as well as segregation between the amygdala and the SAL, may contribute to infant stress recovery in the context of infant-mother interaction.
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Affiliation(s)
- Yannan Hu
- Department of Human Development and Family Studies, University of Illinois at Urbana-Champaign, Urbana, Illinois, USA
| | - Haitao Chen
- Department of Biomedical Sciences and Imaging, Biomedical Imaging Research Institute, Cedars Sinai Medical Center, Los Angeles, California, USA
| | - Xiaomei Li
- Department of Human Development and Family Studies, University of Illinois at Urbana-Champaign, Urbana, Illinois, USA
| | - Ryan J. Larsen
- Department of Bioengineering, University of Illinois at Urbana-Champaign, Urbana, Illinois, USA
| | - Bradley P. Sutton
- Department of Bioengineering, University of Illinois at Urbana-Champaign, Urbana, Illinois, USA
- Beckman Institute for Advanced Science and Technology, University of Illinois at Urbana-Champaign, Urbana, Illinois, USA
| | - Wei Gao
- Department of Biomedical Sciences and Imaging, Biomedical Imaging Research Institute, Cedars Sinai Medical Center, Los Angeles, California, USA
| | - Nancy L. McElwain
- Department of Human Development and Family Studies, University of Illinois at Urbana-Champaign, Urbana, Illinois, USA
- Beckman Institute for Advanced Science and Technology, University of Illinois at Urbana-Champaign, Urbana, Illinois, USA
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3
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Banihashemi L, Schmithorst VJ, Bertocci MA, Samolyk A, Zhang Y, Lima Santos JP, Versace A, Taylor M, English G, Northrup JB, Lee VK, Stiffler R, Aslam H, Panigrahy A, Hipwell AE, Phillips ML. Neural Network Functional Interactions Mediate or Suppress WM-Emotional Behavior Relationships in Infants. Biol Psychiatry 2023:S0006-3223(23)01088-0. [PMID: 36918062 PMCID: PMC10365319 DOI: 10.1016/j.biopsych.2023.03.004] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/01/2022] [Revised: 02/28/2023] [Accepted: 03/02/2023] [Indexed: 03/16/2023]
Abstract
BACKGROUND Elucidating the neural basis of infant positive emotionality (PE) and negative emotionality (NE) can identify biomarkers of pathophysiological risk. Our goal was to determine how functional interactions among large-scale networks supporting emotional regulation influence WM microstructural-emotional behavior relationships in 3-month-old infants. We hypothesized that microstructural-emotional behavior relationships would be differentially mediated or suppressed by underlying resting-state functional connectivity (rsFC), particularly between Default Mode Network (DMN) and Central Executive Network (CEN) structures. METHODS The analytic sample comprised primary caregiver-infant dyads [52 infants (42% female, mean age at scan=15.10 weeks)], with infant neuroimaging and emotional behavior assessments at 3 months. Infant WM and rsFC were assessed by diffusion-weighted imaging/tractography and resting-state magnetic resonance imaging (MRI) during natural, non-sedated sleep. The Infant Behavior Questionnaire-R provided measures of infant PE and NE. RESULTS Following significant WM-emotional behavior relationships, multimodal analyses were performed using whole-brain voxelwise mediation. Results revealed that greater cingulum bundle volume was significantly associated with lower infant PE (ß = -0.263, p = 0.031); however, a pattern of lower rsFC between CEN and DMN structures suppressed this otherwise negative relationship. Greater uncinate fasciculus volume was significantly associated with lower infant NE (ß = -0.296, p = 0.022); however, lower orbitofrontal cortex (OFC)-amygdala rsFC, suppressed this otherwise negative relationship, while greater OFC-CEN rsFC mediated this relationship. CONCLUSIONS Functional interactions among neural networks have an important influence on WM microstructural-emotional behavior relationships in infancy. These relationships can elucidate neural mechanisms contributing to future behavioral and emotional problems in childhood.
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Affiliation(s)
- Layla Banihashemi
- University of Pittsburgh School of Medicine, Department of Psychiatry, Pittsburgh, PA.
| | - Vanessa J Schmithorst
- UPMC Children's Hospital of Pittsburgh, Department of Pediatric Radiology, Pittsburgh, PA
| | - Michele A Bertocci
- University of Pittsburgh School of Medicine, Department of Psychiatry, Pittsburgh, PA
| | - Alyssa Samolyk
- University of Pittsburgh School of Medicine, Department of Psychiatry, Pittsburgh, PA
| | - Yicheng Zhang
- University of Pittsburgh School of Medicine, Department of Psychiatry, Pittsburgh, PA
| | | | - Amelia Versace
- University of Pittsburgh School of Medicine, Department of Psychiatry, Pittsburgh, PA
| | - Megan Taylor
- University of Pittsburgh School of Medicine, Department of Psychiatry, Pittsburgh, PA
| | - Gabrielle English
- University of Pittsburgh School of Medicine, Department of Psychiatry, Pittsburgh, PA
| | - Jessie B Northrup
- University of Pittsburgh School of Medicine, Department of Psychiatry, Pittsburgh, PA
| | - Vincent K Lee
- UPMC Children's Hospital of Pittsburgh, Department of Pediatric Radiology, Pittsburgh, PA
| | - Richelle Stiffler
- University of Pittsburgh School of Medicine, Department of Psychiatry, Pittsburgh, PA
| | - Haris Aslam
- University of Pittsburgh School of Medicine, Department of Psychiatry, Pittsburgh, PA
| | - Ashok Panigrahy
- UPMC Children's Hospital of Pittsburgh, Department of Pediatric Radiology, Pittsburgh, PA
| | - Alison E Hipwell
- University of Pittsburgh School of Medicine, Department of Psychiatry, Pittsburgh, PA
| | - Mary L Phillips
- University of Pittsburgh School of Medicine, Department of Psychiatry, Pittsburgh, PA
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4
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Bezanson S, Nichols ES, Duerden EG. Postnatal maternal distress, infant subcortical brain macrostructure and emotional regulation. Psychiatry Res Neuroimaging 2023; 328:111577. [PMID: 36512951 DOI: 10.1016/j.pscychresns.2022.111577] [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: 07/18/2022] [Revised: 09/16/2022] [Accepted: 11/22/2022] [Indexed: 12/12/2022]
Abstract
BACKGROUND Maternal distress is associated with an increased risk for adverse emotional development in infants, including difficulties with emotion regulation. Prenatal maternal distress has been associated with alterations in infant brain development. However, less is known about these associations with postnatal maternal distress, despite this being an important modifiable risk factor that can promote healthy brain development and emotional outcomes in infants. METHODS & RESULTS Infants underwent magnetic resonance imaging (MRI) and mothers completed standardized questionnaires concerning their levels of perceived distress 2-5 months postpartum. Infant emotion regulation was assessed at 8-11 months via maternal report. When examining the associations between maternal distress and infant macrostructure, maternal anxiety was associated with infant right pallidum volumes. Increased display of negative emotions at 8-11 months of age was associated with smaller hippocampal volumes and this association was stronger in girls than boys. CONCLUSION Findings suggest that postnatal maternal distress may be associated with early infant brain development and emphasize the importance of maternal mental health, supporting previous work. Furthermore, macrostructural properties of infant subcortical structures may be further investigated as potential biomarkers to identify infants at risk of adverse emotional outcomes.
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Affiliation(s)
- Samantha Bezanson
- Neuroscience Program, Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada
| | - Emily S Nichols
- Applied Psychology, Faculty of Education, Western University, London, Ontario, Canada; Western Institute for Neuroscience, Western University, London, Ontario, Canada
| | - Emma G Duerden
- Neuroscience Program, Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada; Applied Psychology, Faculty of Education, Western University, London, Ontario, Canada; Western Institute for Neuroscience, Western University, London, Ontario, Canada; Department of Psychiatry, Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada; Children's Health Research Institute, Western University, London, Ontario, Canada.
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5
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Phillips ML. COVID-19 and the Infant Brain: Critical Links Among Prenatal Maternal Distress, Social Support, and Neurodevelopment. Biol Psychiatry 2022; 92:687-689. [PMID: 36202542 PMCID: PMC9527395 DOI: 10.1016/j.biopsych.2022.07.024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/29/2022] [Accepted: 07/29/2022] [Indexed: 11/04/2022]
Affiliation(s)
- Mary L Phillips
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, Pennsylvania.
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6
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Kaiser RH, Chase HW, Phillips ML, Deckersbach T, Parsey RV, Fava M, McGrath PJ, Weissman M, Oquendo MA, McInnis MG, Carmody T, Cooper CM, Trivedi MH, Pizzagalli DA. Dynamic Resting-State Network Biomarkers of Antidepressant Treatment Response. Biol Psychiatry 2022; 92:533-542. [PMID: 35680431 PMCID: PMC10640874 DOI: 10.1016/j.biopsych.2022.03.020] [Citation(s) in RCA: 10] [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: 11/15/2021] [Revised: 03/02/2022] [Accepted: 03/23/2022] [Indexed: 12/26/2022]
Abstract
BACKGROUND Delivery of effective antidepressant treatment has been hampered by a lack of objective tools for predicting or monitoring treatment response. This study aimed to address this gap by testing novel dynamic resting-state functional network markers of antidepressant response. METHODS The Establishing Moderators and Biosignatures of Antidepressant Response in Clinical Care (EMBARC) study randomized adults with major depressive disorder to 8 weeks of either sertraline or placebo, and depression severity was evaluated longitudinally. Participants completed resting-state neuroimaging pretreatment and again after 1 week of treatment (n = 259 eligible for analyses). Coactivation pattern analyses identified recurrent whole-brain states of spatial coactivation, and computed time spent in each state for each participant was the main dynamic measure. Multilevel modeling estimated the associations between pretreatment network dynamics and sertraline response and between early (pretreatment to 1 week) changes in network dynamics and sertraline response. RESULTS Dynamic network markers of early sertraline response included increased time in network states consistent with canonical default and salience networks, together with decreased time in network states characterized by coactivation of cingulate and ventral limbic or temporal regions. The effect of sertraline on depression recovery was mediated by these dynamic network changes. In contrast, early changes in dynamic functioning of corticolimbic and frontoinsular-default networks were related to patterns of symptom recovery common across treatment groups. CONCLUSIONS Dynamic resting-state markers of early antidepressant response or general recovery may assist development of clinical tools for monitoring and predicting effective intervention.
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Affiliation(s)
- Roselinde H Kaiser
- Department of Psychology and Neuroscience, University of Colorado Boulder, Boulder, Colorado; Institute of Cognitive Science, University of Colorado Boulder, Boulder, Colorado; Renée Crown Wellness Institute, University of Colorado Boulder, Boulder, Colorado.
| | - Henry W Chase
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Mary L Phillips
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Thilo Deckersbach
- Department of Psychiatry, Harvard Medical School and Massachusetts General Hospital, Boston, Massachusetts
| | - Ramin V Parsey
- Department of Psychiatry, Stony Brook University, Stony Brook, New York
| | - Maurizio Fava
- Department of Psychiatry, Harvard Medical School and Massachusetts General Hospital, Boston, Massachusetts
| | - Patrick J McGrath
- Department of Psychiatry, New York State Psychiatric Institute and Columbia University Vagelos College of Physicians and Surgeons, New York, New York
| | - Myrna Weissman
- Department of Psychiatry, New York State Psychiatric Institute and Columbia University Vagelos College of Physicians and Surgeons, New York, New York
| | - Maria A Oquendo
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Melvin G McInnis
- Department of Psychiatry, University of Michigan, Ann Arbor, Michigan
| | - Thomas Carmody
- Department of Psychiatry, University of Texas, Southwestern Medical Center, Dallas, Texas
| | - Crystal M Cooper
- Department of Psychiatry, University of Texas, Southwestern Medical Center, Dallas, Texas
| | - Madhukar H Trivedi
- Department of Psychiatry, University of Texas, Southwestern Medical Center, Dallas, Texas
| | - Diego A Pizzagalli
- Department of Psychiatry, Harvard Medical School and McLean Hospital, Boston, Massachusetts
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7
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Scheinost D, Chang J, Lacadie C, Brennan-Wydra E, Foster R, Boxberger A, Macari S, Vernetti A, Constable RT, Ment LR, Chawarska K. Hypoconnectivity between anterior insula and amygdala associates with future vulnerabilities in social development in a neurodiverse sample of neonates. Sci Rep 2022; 12:16230. [PMID: 36171268 PMCID: PMC9517994 DOI: 10.1038/s41598-022-20617-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2022] [Accepted: 09/15/2022] [Indexed: 11/25/2022] Open
Abstract
Altered resting state functional connectivity (FC) involving the anterior insula (aINS), a key node in the salience network, has been reported consistently in autism. Here we examined, for the first time, FC between the aINS and the whole brain in a sample of full-term, postmenstrual age (PMA) matched neonates (mean 44.0 weeks, SD = 1.5) who due to family history have high likelihood (HL) for developing autism (n = 12) and in controls (n = 41) without family history of autism (low likelihood, LL). Behaviors associated with autism were evaluated between 12 and 18 months (M = 17.3 months, SD = 2.5) in a subsample (25/53) of participants using the First Year Inventory (FYI). Compared to LL controls, HL neonates showed hypoconnectivity between left aINS and left amygdala. Lower connectivity between the two nodes was associated with higher FYI risk scores in the social domain (r(25) = -0.561, p = .003) and this association remained robust when maternal mental health factors were considered. Considering that a subsample of LL participants (n = 14/41) underwent brain imaging during the fetal period at PMA 31 and 34 weeks, in an exploratory analysis, we evaluated prospectively development of the LaINS-Lamy connectivity and found that the two areas strongly coactivate throughout the third trimester of pregnancy. The study identifies left lateralized anterior insula-amygdala connectivity as a potential target of further investigation into neural circuitry that enhances likelihood of future onset of social behaviors associated with autism during neonatal and potentially prenatal periods.
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Affiliation(s)
- Dustin Scheinost
- Department of Radiology and Biomedical Imaging, Yale School of Medicine, New Haven, CT, 06510, USA
- Department of Biomedical Engineering, Yale University, New Haven, CT, 06520, USA
- Department of Statistics and Data Science, Yale University, New Haven, CT, 06520, USA
- Child Study Center, Yale School of Medicine, New Haven, CT, 06510, USA
| | - Joseph Chang
- Department of Statistics and Data Science, Yale University, New Haven, CT, 06520, USA
| | - Cheryl Lacadie
- Department of Radiology and Biomedical Imaging, Yale School of Medicine, New Haven, CT, 06510, USA
| | | | - Rachel Foster
- Child Study Center, Yale School of Medicine, New Haven, CT, 06510, USA
| | | | - Suzanne Macari
- Child Study Center, Yale School of Medicine, New Haven, CT, 06510, USA
| | - Angelina Vernetti
- Child Study Center, Yale School of Medicine, New Haven, CT, 06510, USA
| | - R Todd Constable
- Department of Radiology and Biomedical Imaging, Yale School of Medicine, New Haven, CT, 06510, USA
- Department of Biomedical Engineering, Yale University, New Haven, CT, 06520, USA
- Department of Neurosurgery, Yale School of Medicine, New Haven, CT, 06510, USA
| | - Laura R Ment
- Department of Pediatrics, Yale School of Medicine, New Haven, CT, 06510, USA
- Department of Neurology, Yale School of Medicine, New Haven, CT, 06510, USA
| | - Katarzyna Chawarska
- Department of Statistics and Data Science, Yale University, New Haven, CT, 06520, USA.
- Department of Pediatrics, Yale School of Medicine, New Haven, CT, 06510, USA.
- Yale Child Study Center, Yale School of Medicine, 300 George Street, Suite 900, New Haven, CT, 06510, USA.
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8
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Prabhakar J, Nielson DM, Stringaris A. Origins of Anhedonia in Childhood and Adolescence. Curr Top Behav Neurosci 2022; 58:43-60. [PMID: 35585464 PMCID: PMC11156432 DOI: 10.1007/7854_2022_356] [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] [Indexed: 06/15/2023]
Abstract
Anhedonia reflects a reduced ability to engage in previously pleasurable activities and has been reported in children as young as 3 years of age. It manifests early and is a strong predictor of psychiatric disease onset and progression over the course of development and into adulthood. However, little is known about its mechanistic origins, particularly in childhood and adolescence. In this chapter, we provide a socio-cognitive model of the development of anhedonia. This model is substantiated by past literature presented in this chapter to account for how the individual trajectories of emotion knowledge, autobiographical memory, and self-concept representations contribute to the onset, persistence, and progression of anhedonia from early childhood through adolescence.
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Affiliation(s)
- Janani Prabhakar
- Section on Clinical and Computational Psychiatry, National Institute of Mental Health, Bethesda, MD, USA.
| | - Dylan M Nielson
- Section on Clinical and Computational Psychiatry, National Institute of Mental Health, Bethesda, MD, USA
- Machine Learning Team, National Institute of Mental Health, Bethesda, MD, USA
| | - Argyris Stringaris
- Division of Psychiatry and Division of Psychology and Language Sciences, University College London, London, UK
- National and Kapodistrian University Athens, Athens, Greece
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9
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Zhang Y, Mu Y, Li X, Sun C, Ma X, Li S, Li L, Zhang Z, Qi S. Improved Interhemispheric Functional Connectivity in Postpartum Depression Disorder: Associations With Individual Target-Transcranial Magnetic Stimulation Treatment Effects. Front Psychiatry 2022; 13:859453. [PMID: 35370853 PMCID: PMC8964485 DOI: 10.3389/fpsyt.2022.859453] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/21/2022] [Accepted: 02/14/2022] [Indexed: 11/19/2022] Open
Abstract
Postpartum depression (PPD) is a depressive condition that is associated with a high risk of stressful life events, poor marital relationships, and even suicide. Neuroimaging techniques have enriched our understanding of cerebral mechanisms underlying PPD; namely, abnormalities in the amygdala-insula-frontal circuit might contribute to the pathogenesis of PPD. Stanford Accelerated Intelligent Neuromodulation Therapy (SAINT) is a recently validated neuroscience-informed accelerated intermittent theta-burst stimulation repetitive transcranial magnetic stimulation (rTMS) protocol. It has been shown to be effective, safe, tolerable, and rapid acting for treating treatment-resistant depression, and may be a valuable tool in the treatment of PPD. The purpose of the current study was to detect inter-hemispheric connectivity changes and their relationship with the clinical treatment effects of rTMS. Resting-state fMRI data from 32 patients with PPD treated with SAINT were collected and compared with findings from 32 age matched healthy controls. Voxel-mirrored homotopic connectivity (VMHC) was used to analyze the patterns of interhemispheric intrinsic functional connectivity in patients with PPD. Scores on the 17-item Hamilton Depression Rating Scale, Edinburgh Postnatal Depression Scale (EPDS) scores, and the relationships between these clinical characteristics and VMHC were the primary outcomes. Patients with PPD at baseline showed reduced VMHC in the amygdala, insula, and medial frontal gyrus compared with the HCs. These properties showed a renormalization after individualized rTMS treatment. Furthermore, increased connectivity between the left and right insula after SAINT was significantly correlated with the improvement of EPDS scores. Our results reveal the disruptions in the intrinsic functional architecture of interhemispheric communication in patients with PPD, and provide evidence for the pathophysiological mechanisms and the effects of rTMS.
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Affiliation(s)
- Yao Zhang
- Xijing Hospital, The Air Force Military Medical University, Xi'an, China
| | - Yunfeng Mu
- Department of Gynecological Oncology, Shaanxi Provincial Cancer Hospital, Xi'an, China
| | - Xiang Li
- Research Center for Brain-Inspired Intelligence, Xi'an Jiaotong University, Xi'an, China.,The Key Laboratory of Biomedical Information Engineering of Ministry of Education, Institute of Health and Rehabilitation Science, School of Life Science and Technology, Xi'an Jiaotong University, Xi'an, China.,The Key Laboratory of Neuro-informatics & Rehabilitation Engineering of Ministry of Civil Affairs, Xi'an, China.,Xi'an Solide Brain Control Medical Technology Company, Xi'an, China
| | - Chuanzhu Sun
- The Key Laboratory of Biomedical Information Engineering of Ministry of Education, Institute of Health and Rehabilitation Science, School of Life Science and Technology, Xi'an Jiaotong University, Xi'an, China.,The Key Laboratory of Neuro-informatics & Rehabilitation Engineering of Ministry of Civil Affairs, Xi'an, China
| | - Xiaowei Ma
- Department of Nuclear Medicine, The Second Xiangya Hospital, Central South University, Changsha, China
| | - Sanzhong Li
- Department of Neurosurgery, Xijing Hospital, The Air Force Military Medical University, Xi'an, China
| | - Li Li
- Center of Treatment and Rehabilitation of Severe Neurological Disorders, Xi'an International Medical Center Hospital, Xi'an, China
| | - Zhaohui Zhang
- Henan Key Laboratory of Neurorestoratology, The First Affiliated Hospital of Xinxiang Medical University, Weihui, China.,Henan Engineering Research Center of Physical Diagnostics and Treatment Technology for the Mental and Neurological Diseases, The Second Affiliated Hospital of Xinxiang Medical University, Xinxiang, China
| | - Shun Qi
- Research Center for Brain-Inspired Intelligence, Xi'an Jiaotong University, Xi'an, China.,Shaanxi Brain Modulation and Scientific Research Center, Xi'an, China
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10
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Lean RE. Links Between Caregiver Postpartum Internalizing Symptoms and Infant Brain and Behavior Raise New Questions. Biol Psychiatry 2021; 90:e27-e29. [PMID: 34384529 PMCID: PMC9437862 DOI: 10.1016/j.biopsych.2021.07.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/09/2021] [Revised: 07/05/2021] [Accepted: 07/06/2021] [Indexed: 11/18/2022]
Affiliation(s)
- Rachel E Lean
- Department of Psychiatry, Division of Child and Adolescent Psychiatry, Washington University School of Medicine, St. Louis, Missouri.
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