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Khoury JE, Ahtam B, Ou Y, Jenkins E, Klengel T, Enlow MB, Grant E, Lyons-Ruth K. Linking maternal disrupted interaction and infant limbic volumes: The role of infant cortisol output. Psychoneuroendocrinology 2023; 158:106379. [PMID: 37683305 DOI: 10.1016/j.psyneuen.2023.106379] [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: 03/06/2023] [Revised: 08/22/2023] [Accepted: 08/29/2023] [Indexed: 09/10/2023]
Abstract
Despite a large animal literature documenting the role of low maternal nurturance and elevated glucocorticoid production on offspring limbic development, these pathways have not yet been assessed during human infancy. Informed by animal models, the present study examined whether 1) maternal disrupted interaction is related to infant cortisol levels, 2) infant cortisol levels are associated with infant limbic volumes, and 3) infant cortisol levels mediate associations between maternal disrupted interaction and infant limbic volumes. Participants included 57 mother-infant dyads. Infant saliva was measured at one time point before and two time points after the Still-Face Paradigm (SFP) at age 4 months. Five aspects of maternal disrupted interaction were coded during the SFP reunion episode. Between 4 and 25 months (M age = 11.74 months, SD = 6.12), under natural sleep, infants completed an MRI. Amygdala and hippocampal volumes were calculated via automated segmentation. Results indicated that 1) maternal disrupted interaction, and specifically disoriented interaction, with the infant was associated with higher infant salivary cortisol (AUCg) levels during the SFP, 2) higher infant AUCg was related to enlarged bilateral amygdala and hippocampal volumes, and 3) infant AUCg mediated the relation between maternal disrupted interaction and infant amygdala and hippocampal volumes. Findings are consistent with controlled animal studies and provide evidence of a link between increased cortisol levels and enlarged limbic volumes in human infants. Results further suggest that established interventions to decrease maternal disrupted interaction could impact both infant cortisol levels and infant limbic volumes.
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Affiliation(s)
| | - Banu Ahtam
- Fetal-Neonatal Neuroimaging & Developmental Science Center, Division of Newborn Medicine, Department of Pediatrics, Boston Children's Hospital, Harvard Medical School, United States
| | - Yangming Ou
- Fetal-Neonatal Neuroimaging & Developmental Science Center, Division of Newborn Medicine, Department of Pediatrics, Boston Children's Hospital, Harvard Medical School, United States; Department of Radiology, Boston Children's Hospital, Harvard Medical School, United States
| | | | - Torsten Klengel
- Department of Psychiatry, McLean Hospital, Harvard Medical School, United States
| | - Michelle Bosquet Enlow
- Department of Psychiatry and Behavioral Sciences, Boston Children's Hospital, Department of Psychiatry, Harvard Medical School, United States
| | - Ellen Grant
- Fetal-Neonatal Neuroimaging & Developmental Science Center, Division of Newborn Medicine, Department of Pediatrics, Boston Children's Hospital, Harvard Medical School, United States
| | - Karlen Lyons-Ruth
- Department of Psychiatry, Cambridge Hospital, Harvard Medical School, United States
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Tang E, Wiencke JK, Warrier G, Hansen H, McCoy L, Rice T, Bracci PM, Wrensch M, Taylor JW, Clarke JL, Koestler DC, Salas LA, Christensen BC, Kelsey KT, Molinaro AM. Evaluation of cross-platform compatibility of a DNA methylation-based glucocorticoid response biomarker. Clin Epigenetics 2022; 14:136. [PMID: 36307860 PMCID: PMC9617416 DOI: 10.1186/s13148-022-01352-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2022] [Accepted: 10/11/2022] [Indexed: 11/10/2022] Open
Abstract
Background Identifying blood-based DNA methylation patterns is a minimally invasive way to detect biomarkers in predicting age, characteristics of certain diseases and conditions, as well as responses to immunotherapies. As microarray platforms continue to evolve and increase the scope of CpGs measured, new discoveries based on the most recent platform version and how they compare to available data from the previous versions of the platform are unknown. The neutrophil dexamethasone methylation index (NDMI 850) is a blood-based DNA methylation biomarker built on the Illumina MethylationEPIC (850K) array that measures epigenetic responses to dexamethasone (DEX), a synthetic glucocorticoid often administered for inflammation. Here, we compare the NDMI 850 to one we built using data from the Illumina Methylation 450K (NDMI 450). Results The NDMI 450 consisted of 22 loci, 15 of which were present on the NDMI 850. In adult whole blood samples, the linear composite scores from NDMI 450 and NDMI 850 were highly correlated and had equivalent predictive accuracy for detecting DEX exposure among adult glioma patients and non-glioma adult controls. However, the NDMI 450 scores of newborn cord blood were significantly lower than NDMI 850 in samples measured with both assays. Conclusions We developed an algorithm that reproduces the DNA methylation glucocorticoid response score using 450K data, increasing the accessibility for researchers to assess this biomarker in archived or publicly available datasets that use the 450K version of the Illumina BeadChip array. However, the NDMI850 and NDMI450 do not give similar results in cord blood, and due to data availability limitations, results from sample types of newborn cord blood should be interpreted with care. Supplementary Information The online version contains supplementary material available at 10.1186/s13148-022-01352-1.
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Stoye DQ, Boardman JP, Osmond C, Sullivan G, Lamb G, Black GS, Homer NZM, Nelson N, Theodorsson E, Mörelius E, Reynolds RM. Saliva cortisol diurnal variation and stress responses in term and preterm infants. Arch Dis Child Fetal Neonatal Ed 2022; 107:558-564. [PMID: 35256524 PMCID: PMC9411886 DOI: 10.1136/archdischild-2021-321593] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/09/2021] [Accepted: 02/11/2022] [Indexed: 01/15/2023]
Abstract
OBJECTIVE To determine if preterm birth is associated with adaptation of the hypothalamic-pituitary-adrenal (HPA) axis and whether HPA axis programming relates to the degree of prematurity (defined as extremely preterm birth at <28 weeks or very preterm birth at 28-32 weeks gestation). DESIGN This study reports findings from a prospective birth cohort. Saliva cortisol concentrations were measured prevaccination and postvaccination, and in the morning and evening, at 4 months chronological age. SETTING Infants born at a single Scottish hospital. PARTICIPANTS 45 term-born, 42 very preterm and 16 extremely preterm infants. OUTCOMES Cortisol stress response to vaccination (postvaccination minus prevaccination cortisol concentrations), diurnal slope (log-transformed morning minus log-transformed evening cortisol values) and mean log-transformed daily cortisol. RESULTS Compared with infants born at term, infants born extremely preterm had a blunted cortisol response to vaccination (5.8 nmol/L vs 13.1 nmol/L, difference in means: -7.3 nmol/L, 95% CI -14.0 to -0.6) and a flattened diurnal slope (difference in geometric means: -72.9%, 95% CI -87.1 to -42.8). In contrast, the cortisol response to vaccination (difference in means -2.7 nmol/L, 95% CI -7.4 to 2.0) and diurnal slope at 4 months (difference in geometric means: -33.6%, 95% CI -62.0 to 16.0) did not differ significantly in infants born very preterm compared with infants born at term. CONCLUSIONS Infants born extremely preterm have blunted cortisol reactivity and a flattened diurnal slope. These patterns of HPA axis regulation are commonly seen after childhood adversity and could contribute to later metabolic and neurodevelopmental phenotypes observed in this population.
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Affiliation(s)
- David Q Stoye
- MRC Centre for Reproductive Health, The University of Edinburgh, Edinburgh, UK
| | - James P Boardman
- MRC Centre for Reproductive Health, The University of Edinburgh, Edinburgh, UK
- Centre for Clinical Brain Sciences, The University of Edinburgh, Edinburgh, UK
| | - Clive Osmond
- MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, UK
| | - Gemma Sullivan
- MRC Centre for Reproductive Health, The University of Edinburgh, Edinburgh, UK
| | - Gillian Lamb
- MRC Centre for Reproductive Health, The University of Edinburgh, Edinburgh, UK
| | - Gill S Black
- MRC Centre for Reproductive Health, The University of Edinburgh, Edinburgh, UK
| | - Natalie Z M Homer
- Centre for Cardiovascular Science, The University of Edinburgh, Edinburgh, UK
| | - Nina Nelson
- Department of Clinical and Experimental Medicine, Linköping University, Linkoping, Sweden
- Department of Neurobiology, Care Sciences and Society, Karolinska Institute, Stockholm, Sweden
| | - Elvar Theodorsson
- Division of Clinical Chemistry, Department of Biomedical and Clinical Sciences, Faculty of Medicine and Health Sciences, Linköping University, Linkoping, Sweden
| | - Evalotte Mörelius
- School of Nursing and Midwifery, Edith Cowan University, Joondalup, Western Australia, Australia
| | - Rebecca M Reynolds
- MRC Centre for Reproductive Health, The University of Edinburgh, Edinburgh, UK
- Centre for Cardiovascular Science, The University of Edinburgh, Edinburgh, UK
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Ginnell L, O'Carroll S, Ledsham V, Jiménez Sánchez L, Stoye DQ, Sullivan G, Hall J, Homer NZM, Boardman JP, Fletcher-Watson S, Reynolds RM. Emotion regulation and cortisol response to the still-face procedure in preterm and full-term infants. Psychoneuroendocrinology 2022; 141:105760. [PMID: 35447496 DOI: 10.1016/j.psyneuen.2022.105760] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/13/2021] [Revised: 04/02/2022] [Accepted: 04/03/2022] [Indexed: 11/25/2022]
Abstract
In infancy, stress responses and emotion regulation are often coupled. Both are impacted by prematurity, though their relationship to one another in the case of infants born preterm is not fully understood. We investigated emotion regulation behaviours, cortisol reactivity and recovery and coupling between emotion regulation and cortisol reactivity to and recovery from a stressor in preterm infants. 53 preterm and 67 full-term infants with mean (range) gestational age at birth 29+3 (24+0-31+6) and 39+3 (36+2-42+0) weeks respectively were exposed to a socio-emotional stressor, the still-face (SF) paradigm, at 9 months of age (corrected for prematurity). The duration of negative affect and self-comforting behaviours exhibited in response to the SF, coded from a 10-minute video-taped interaction, were compared between groups. Saliva was collected from a subset (20 preterm, 24 term infants) at three timepoints: pre-SF and 20- and 30-minutes post SF. Cortisol concentrations at each timepoint were compared between groups. Associations between behavioural measures and cortisol concentrations were explored. There was no significant difference in duration of self-comforting behaviour between preterm and term infants. Preterm infants spent a significantly smaller proportion of time in a negative affective state compared to term infants (0.18 vs 0.25 s, p = 0.03). Salivary cortisol concentration was significantly higher in the preterm compared to the term group 30 min post SF (2.85 vs 1.77 nmol/L, p = 0.009), though findings were no longer significant after adjusting for time of day of sampling and socioeconomic deprivation. After controlling for time of day, greater negative affect was correlated with higher cortisol concentration 30 min post SF in the full-term (r = 0.58, p = 0.004) but not the preterm group (r = -0.01, p > 0.05). Our findings suggest altered response to an acute stressor in preterm infants, manifesting as a muted emotional response, and a lack of coupling between endocrine and behavioural stress response. Replication studies in larger samples would help to further understand biological stress repose in preterm infants and its relationship to behaviour, time of day and deprivation.
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Affiliation(s)
- Lorna Ginnell
- The University of Edinburgh, Salvesen Mindroom Research Centre. Kennedy Tower, Morningside Terrace, Edinburgh EH10 5HF, UK.
| | - Sinéad O'Carroll
- The University of Edinburgh, Salvesen Mindroom Research Centre. Kennedy Tower, Morningside Terrace, Edinburgh EH10 5HF, UK.
| | - Victoria Ledsham
- The University of Edinburgh, MRC Centre for Reproductive Health. The Queen's Medical Research Institute, Edinburgh BioQuarter, 47 Little France Crescent, Edinburgh EH16 4TJ, UK.
| | - Lorena Jiménez Sánchez
- Translational Neuroscience PhD programme, Salvesen Mindroom Research Centre. Kennedy Tower, Morningside Terrace, Edinburgh EH10 5HF, UK.
| | - David Q Stoye
- The University of Edinburgh, MRC Centre for Reproductive Health. The Queen's Medical Research Institute, Edinburgh BioQuarter, 47 Little France Crescent, Edinburgh EH16 4TJ, UK.
| | - Gemma Sullivan
- The University of Edinburgh, MRC Centre for Reproductive Health. The Queen's Medical Research Institute, Edinburgh BioQuarter, 47 Little France Crescent, Edinburgh EH16 4TJ, UK.
| | - Jill Hall
- The University of Edinburgh, MRC Centre for Reproductive Health. The Queen's Medical Research Institute, Edinburgh BioQuarter, 47 Little France Crescent, Edinburgh EH16 4TJ, UK.
| | - Natalie Z M Homer
- Mass Spectrometry Core, Edinburgh Clinical Research Facility, University/BHF Centre for Cardiovascular, The Queen's Medical Research Institute, Edinburgh BioQuarter, 47 Little France Crescent, Edinburgh EH16 4TJ, UK; The University of Edinburgh, BHF/Centre for Cardiovascular Science. The Queen's Medical Research Institute, Edinburgh BioQuarter, 47 Little France Crescent, Edinburgh EH16 4TJ, UK.
| | - James P Boardman
- The University of Edinburgh, MRC Centre for Reproductive Health. The Queen's Medical Research Institute, Edinburgh BioQuarter, 47 Little France Crescent, Edinburgh EH16 4TJ, UK.
| | - Sue Fletcher-Watson
- The University of Edinburgh, Salvesen Mindroom Research Centre. Kennedy Tower, Morningside Terrace, Edinburgh EH10 5HF, UK.
| | - Rebecca M Reynolds
- The University of Edinburgh, BHF/Centre for Cardiovascular Science. The Queen's Medical Research Institute, Edinburgh BioQuarter, 47 Little France Crescent, Edinburgh EH16 4TJ, UK.
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Erickson SJ, Vaccaro S, Kubinec N, Moss N, Avila-Rieger R, Lowe JR, Tofighi D. Preliminary longitudinal evidence for stability of maternal behavior and infant stress regulation among infants born preterm at 4 and 9 months during the Still Face paradigm. Infant Behav Dev 2022; 68:101745. [PMID: 35760033 DOI: 10.1016/j.infbeh.2022.101745] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2022] [Revised: 06/16/2022] [Accepted: 06/16/2022] [Indexed: 11/17/2022]
Abstract
Stress regulation begins to develop in the first year of life through interactions with caregivers, particularly in the presence of stressors. High quality caregiving, characterized by maternal sensitivity and responsiveness to the infant's emotional cues, is particularly important in the development of infant stress regulation. The purpose of this study was to assess the longitudinal stability of, and associations between, maternal interactive behavior and infant stress regulation (indexed by positive infant affect and cortisol reactivity) in response to the Still Face paradigm (SF) in a cohort of infants born preterm (< 32 weeks gestation, N = 22) at four months and nine months (adjusted age). The percent of time mothers spent using specific interaction styles (contingent maternal interaction (CMI), attention seeking, and watching) during Play/baseline, Reunion#1, and Reunion#2 SF episodes was calculated To assess infant stress regulation, two indices were obtained at both 4 and 9 months during the SF paradigm: the percent of positive affect displayed over each SF episode (0-100%) and a neuroendocrine stress response score based on salivary cortisol reactivity. We found three non-significant but medium-large effect size differences between 4 and 9 month variables, with more positive findings at 9 months. Regarding stability within the 4 month and 9 month episodes, maternal behavior and positive infant affect were non-significantly but moderately stable, with maternal watching behavior being particularly stable. Positive infant affect stability between Reunion#1 and Reunion#2 at 4 months was significantly greater than positive infant affect stability across these two episodes at 9 months. Regarding stability across 4 and 9 month (same) episodes, CMI and positive infant affect showed modest but non-significant stability across (same) 4 and 9 month episodes. Finally, with positive infant affect at Reunion#2 as the "outcome" of the Still Face, CMI at both 4 month Play and Reunion#1 episodes were significantly correlated with this "outcome." Further, positive infant affect at Reunion#2 was more strongly correlated with CMI at both Play and Reunion#1 for 4 month old compared with 9 month old infants. Thus, sensitive care appears particularly important for younger infants born preterm, and mothers' behavior early in a repeated stress exposure paradigm may be particularly important in maintaining positive infant affect and in the development of infants' stress regulation more generally. Identifying the longer-term effects of early stress on infant stress regulation, and its relationship with maternal interaction, has important implications for understanding trajectories of regulatory patterns and deficits. A greater understanding of these relationships is particularly important given that greater emotion and neuroendocrine stress regulation in infancy have been directly associated with numerous positive outcomes throughout childhood.
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Affiliation(s)
- Sarah J Erickson
- Department of Psychology, Logan Hall 1 University of New Mexico, MSC03 2220, Albuquerque, NM 87131, USA.
| | - Suzanne Vaccaro
- Department of Psychology, Logan Hall 1 University of New Mexico, MSC03 2220, Albuquerque, NM 87131, USA
| | | | | | | | - Jean R Lowe
- Department of Pediatrics, University of New Mexico, Albuquerque, NM 87131, USA
| | - Davood Tofighi
- Department of Psychology, Logan Hall 1 University of New Mexico, MSC03 2220, Albuquerque, NM 87131, USA
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Erickson SJ, Kubinec N, Vaccaro S, Moss N, Avila-Rieger R, Rowland A, Lowe JR. The role of maternal interactive behavior and gestational age in predicting infant affect during the Still-Face Paradigm. Early Hum Dev 2021; 163:105485. [PMID: 34649191 DOI: 10.1016/j.earlhumdev.2021.105485] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/03/2021] [Revised: 08/13/2021] [Accepted: 10/04/2021] [Indexed: 11/30/2022]
Abstract
BACKGROUND Emotion regulation develops through bidirectional affective communication. AIM To investigate the role of maternal interactive behavior in predicting infant affect among preterm versus full-term infants. STUDY DESIGN The association between maternal interactive behavior (contingent, attention seeking, watching) and infant affect during a modified Still Face (SF) paradigm in a sample of 22 preterm and 28 full term infants (3 ½ - 4 ½ months old) was investigated. METHODS Maternal behavior and infant affect were coded in one second intervals. RESULTS Maternal contingent interaction was positively correlated with positive infant affect (p < 0.001 for Play; p < 0.001 for Reunion#1; p < 0.01 for Reunion#2, respectively), with a stronger association during the second reunion for preterm infants (p < 0.001). In the preterm sample but not in the full-term sample, attention seeking maternal interaction at Play (baseline), Reunion#1, and Reunion#2 were all positively correlated with negative infant affect at Still Face#2. Maternal watching was negatively associated with positive infant affect for the full sample for both Reunion episodes (p < 0.05). Full term infants' negative affect increased from baseline to the first SF episode and then plateaued, whereas preterm infants demonstrated greater negative affect and less recovery throughout. Mothers of full-term infants showed increased contingent responding after the first SF stressor, while mothers of preterm infants did not (p < 0.05). CONCLUSIONS Preterm infants may be more susceptible to both positive and negative maternal behaviors and mothers of full-term infants may be more responsive to infants' increased distress. Relationship-focused interventions addressing maternal behaviors may enhance positive emotionality and improve self-regulation in medically at-risk infants.
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Affiliation(s)
- Sarah J Erickson
- Department of Psychology, University of New Mexico, Logan Hall, MSC03 2220, Albuquerque, NM 87131, United States.
| | - Nicole Kubinec
- Department of Psychology, University of New Mexico, Logan Hall, MSC03 2220, Albuquerque, NM 87131, United States
| | - Suzanne Vaccaro
- Department of Psychology, University of New Mexico, Logan Hall, MSC03 2220, Albuquerque, NM 87131, United States
| | - Natalia Moss
- Department of Psychology, University of New Mexico, Logan Hall, MSC03 2220, Albuquerque, NM 87131, United States
| | - Rebecca Avila-Rieger
- Department of Psychology, University of New Mexico, Logan Hall, MSC03 2220, Albuquerque, NM 87131, United States
| | - Andrew Rowland
- UNM College of Population Health, University of New Mexico, Albuquerque, NM 87131, United States
| | - Jean R Lowe
- Department of Pediatrics, University of New Mexico, Albuquerque, NM 87131, United States
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