Mothers' neural response to valenced infant interactions predicts postpartum depression and anxiety

A systematic review of resting-state functional-MRI studies in the diagnosis, comorbidity and treatment of postpartum depression

BACKGROUND

Postpartum depression (PPD) is a common and serious mental health problem that affects many new mothers and their families worldwide. In recent years, there has been an increasing number of studies using magnetic resonance techniques (MRI), particularly functional MRI (fMRI), to explore the neuroimaging biomarker of this disease.

METHODS

PubMed database was used to search for English literature focusing on resting-state fMRI and PPD published up to June 2024.

RESULTS

After screening, 17 studies were finally identified, among which all 17 studies reported abnormal regions or connectivity compared to health controls (HC), 4 studies reported results considering the differences between PPD and PPD with anxiety (PPD-A), and 2 studies reported biomarkers for the treatment of PPD. The existing studies indicate that PPD is characterized by functional impairments in multiple brain regions, especially the medial prefrontal cortex (MPFC), precentral gyrus and cerebellum. Abnormal functional connectivity has been widely reported in the dorsomedial prefrontal cortex (dmPFC), anterior cingulate cortex (ACC) and the orbitofrontal cortex (OFC). However, none of the four comorbidity studies identified overlapping discriminative biomarkers between PPD and PPD-A. Additionally, the two treatment-related studies consistently reported functional improvements in the amygdala after effective treatment.

CONCLUSION

The affected brain regions were highly overlapped with major depressive disorder (MDD), suggesting that PPD may be categorized as a potential subtype of MDD. Considering the negative effects of medication on PPD, future efforts should focus on developing non-pharmacological therapies, such as transcranial magnetic stimulation (TMS) and acupuncture, to support women with PPD in overcoming this unique and important phase.

Shared and disorder-specific large-scale intrinsic and effective functional network connectivities in postpartum depression with and without anxiety

Postpartum depression and postpartum depression with anxiety, which are highly prevalent and debilitating disorders, become a growing public concern. The high overlap on the symptomatic and neurobiological levels led to ongoing debates about their diagnostic and neurobiological uniqueness. Delineating the shared and disorder-specific intrinsic functional connectivities and their causal interactions is fundamental to precision diagnosis and treatment. In this study, we recruited 138 participants including 45 postpartum depression, 31 postpartum depression comorbid with anxiety patients, and 62 healthy postnatal women with age ranging from 23 to 40 years. We combined independent component analysis, resting-state functional connectivity, and Granger causality analysis to reveal the abnormal intrinsic functional couplings and their causal interactions in postpartum depression and postpartum depression comorbid with anxiety from a large-scale brain network perspective. We found that they exhibited widespread abnormalities in intrinsic and effective functional network connectivities. Importantly, the intrinsic and effective functional network connectivities within or between the fronto-parietal network, default model network, ventral and dorsal attention network, sensorimotor network, and visual network, especially the functional imbalances between primary and association cortices could serve as effective neural markers to differentiate postpartum depression, postpartum depression comorbid with anxiety, and healthy controls. Our findings provide the initial evidence for shared and disorder-specific intrinsic and effective functional network connectivities for postpartum depression and postpartum depression comorbid with anxiety, which provide an underlying neuropathological basis for postpartum depression or postpartum depression comorbid with anxiety to facilitate precision diagnosis and therapy in future studies.

A common neural response to perceiving but not implicitly regulating infant and adult affect in postpartum mothers

The transition to parenthood requires parents develop caregiving behaviors, such as the ability to identify their infant's emotions and regulate their own emotional response. Research has identified patterns of neural activation in parenting contexts that are interpreted as socioemotional processing. However, no prior research has directly tested whether mothers' neural responses to their infant's affect are the same as those involved in emotion perception/experience and regulation in other contexts. We employed conjunction analyses to clarify which components of mothers' neural response to viewing their infant's affect are shared with passively viewing and labeling adult affective faces (emotion perception/experience and implicit emotion regulation, respectively) in 24 mothers three months postpartum. Our results support a common neural response to viewing infant and adult affect in regions associated with emotion perception/experience (bilateral hippocampi, amygdalae, thalami, orbitofrontal cortex, and ventrolateral prefrontal cortex), but no areas of common response to viewing negative infant affect and implicitly regulating negative adult affect outside of the occipital lobe and cerebellum. This study provides corroborating evidence for shared neural patterns being involved in perceiving/experiencing infant and adult affect but not implicit regulation of infant and adult negative affect.

The extended neural architecture of human attachment: An fMRI coordinate-based meta-analysis of affiliative studies

Functional imaging studies and clinical evidence indicate that cortical areas relevant to social cognition are closely integrated with evolutionarily conserved basal forebrain structures and neighboring regions, enabling human attachment and affiliative emotions. The neural circuitry of human affiliation is continually being unraveled as functional magnetic resonance imaging (fMRI) becomes increasingly prevalent, with studies examining human brain responses to various attachment figures. However, previous fMRI meta-analyses on affiliative stimuli have encountered challenges, such as low statistical power and the absence of robustness measures. To address these issues, we conducted an exhaustive coordinate-based meta-analysis of 79 fMRI studies, focusing on personalized affiliative stimuli, including one's infants, family, romantic partners, and friends. We employed complementary coordinate-based analyses (Activation Likelihood Estimation and Signed Differential Mapping) and conducted a robustness analysis of the results. Findings revealed cluster convergence in cortical and subcortical structures related to reward and motivation, salience detection, social bonding, and cognition. Our study thoroughly explores the neural correlates underpinning affiliative responses, effectively overcoming the limitations noted in previous meta-analyses. It provides an extensive view of the neural substrates associated with affiliative stimuli, illuminating the intricate interaction between cortical and subcortical regions. Our findings significantly contribute to understanding the neurobiology of human affiliation, expanding the known human attachment circuitry beyond the traditional basal forebrain regions observed in other mammals to include uniquely human isocortical structures.

Neural activation to infant cry among Latina and non-Latina White mothers

Cultural neuroscience is an emerging framework positing that culture (for example, values, beliefs, practices, and modes of emotional expression) critically informs socialization goals and desired behaviors, which are perhaps accompanied by differential patterns of brain activation. Using fMRI, the current study examines brain activation to infant cry stimuli and matched white noise among 50 first-time biological mothers identifying as Latina or White in the United States. Results showed that brain activation to infant cries in the right posterior insula, left cerebellum, and left auditory were higher for White mothers compared to Latina mothers, p's < .05. White mothers showed greater activation to cry sounds compared to white noise in the right dorsolateral prefrontal cortex, left somatosensory, right and left premotor cortices, p's < .05, whereas Latina mothers did not. These brain regions are involved in motor planning, movement, sensory processing, and social information processing. It is important to note that mothers in the two groups did not show differences in stress and behavioral parenting measures. Therefore, Latina and White mothers differentially recruiting brain regions related to infant parenting behaviors indicates the potential role of cultural context in shaping patterns of neural activation. Our exploratory analysis suggests that this difference might be due to greater pre-parenting exposure among Latina mothers to children compared to White mothers. Taken together, although our data did not completely explain the differences in brain activation between groups, findings suggest potential culture-related influences in brain activation occurring in the postpartum period.