Violence Across the Lifespan - Opioids Maternal Brain

项目摘要/摘要 暴力贯穿一生-阿片类药物母亲的大脑 围产期妇女受到阿片类药物使用障碍(OUD)快速增长和毁灭性流行的影响 美国构成了一个研究不足、代表性不足和报告不足(U3)的重要公众群体 健康的重要性。与一生中的暴力有关的OUD，体现了退缩 症状、人际交往障碍、抑郁、新生儿禁欲综合征和更高的风险 虐待儿童。我们计划在当前的NIDA R01 DA047336上利用此管理补充 《阿片类药物与产妇产后早期大脑行为适应》，正在研究中 大脑皮质边缘母亲行为神经回路(MBN)中调节父母行为的机制和 可能受到OUD的影响。MBN包含大脑回路，也被确定为影响儿童时期 精神创伤和人际暴力。对于母性行为，有两个相互抑制的子系统 (1)CARE，由下丘脑视前内侧区、腹侧被盖区、核团介导 伏隔核和腹侧苍白球；(2)中脑导水管周围灰质介导的防御/攻击。MBN 在产后早期对母亲自己的婴儿的需求做出灵活的反应--例如 至于独特的、在行为学上突出的自己婴儿的哭声和对自己婴儿形象的移情反应。在 在我们R01的范围内，本附录将检查参与研究的母亲的人类母亲的大脑行为 接受丁丙诺啡治疗的OUD(n=32)与非OUD抑郁症的对照研究 对照组(MC，n=32)。在同时进行的R01中，所有参与者在大约6个月后都已经接受了fMRI扫描 产后一个月测量静息状态的功能连接，对自己婴儿哭声的神经反应， 和MBN的灰质体积。该补充将允许我们增加一个“额外的”儿童脸镜任务 (CFMT)作为母亲同理心的神经测量。我们还将增加儿童和近期创伤的衡量标准， 人际暴力、社会不平等、剥夺、歧视和复原力。因此。有了这个 跨学科补充，回答NOT-OD-22-031《妇女健康研究》 对于研究不足、代表性不足和报告不足的(U3)人群，我们提出了具体目标，以探索 一种调解模式，将(1)检查儿童创伤和当前 人际暴力、OUD和MBN失调以及(2)检查大脑行为机制 母体社会认知和主体间性，这可能是母体和婴儿结局的关键。我们会 还探讨了缺乏知识和大脑行为机制对暴力的影响 妊娠妇女U3人群的寿命--有无脐带绕颈。翻译潜力包括 更好地了解患有先天性巨结肠的母亲的风险/复原力概况，这些母亲承担着代际负担 围产期吸毒，并可能暴露在暴力中。

Project Summary/ Abstract Violence Across the Lifespan – Opioids Maternal Brain Peripartum women affected by the fast-growing and devastating epidemic of Opioid use disorder (OUD) in the US constitute an understudied, underrepresented, and underreported (U3) population of significant public health importance. OUD, which is associated with violence across the lifespan, manifests withdrawal symptoms, impaired interpersonal interactions, depression, neonatal abstinence syndrome and higher risks of child maltreatment. We plan to piggy-back this administrative supplement on our current NIDA R01 DA047336 “Opioids and Maternal Brain-Behavior Adaptation During the Early Postpartum”, which is examining mechanisms in our corticolimbic maternal behavior neurocircuit (MBN) that regulate parenting behaviors and may be affected by OUD. The MBN contains brain circuits, that are also established to be affected childhood trauma and interpersonal violence. For maternal behavior, there are two reciprocally inhibiting subsystems for (1) care, mediated by the medial preoptic area in the hypothalamus, ventral tegmental area, nucleus accumbens and ventral pallidum; and (2) defense/aggression, mediated by periaqueductal grey. The MBN regulates flexible responses to the demands of mother's own infant during the early postpartum period – such as to the unique, ethologically salient own-baby cry and empathic responses to own infant images. Within the scope of our R01, this Supplement will examine human maternal brain-behavior in the participant mothers undergoing Buprenorphine Treatment (BT) for OUD (n=32) as compared to non-OUD depression Matched Controls (MC, n=32). In the concurrent R01, all participants are already undergoing fMRI scans at ~6 months month postpartum with measures of resting-state functional connectivity, neural responses to own-baby cry, and gray matter volumes of MBN. The supplement will allow us to add a “bonus” Child Face Mirror Task (CFMT) as a neural measure of maternal empathy. We will also add measures of child & recent trauma, interpersonal violence, social inequality, deprivation, discrimination, and resilience. Thus. with this interdisciplinary supplement, in answer to NOT-OD-22-031 “Research on the Health of Women of Understudied, Underrepresented and Underreported (U3) Populations”, we propose specific aims to explore a mediation model that will (1) examine associations between childhood trauma and current interpersonal violence, OUD, and MBN dysregulation and (2) examine brain-behavior mechanisms in maternal social cognition and intersubjectivity, that may be crucial for OUD and infant outcome. We will also explore the scant knowledge and brain behavior mechanisms on the impact of violence across the lifespan on the U3 population of pregnant women – with and without OUD. Translational potentials include better understandings of risk/resilience profiles for mothers with OUD that bear the transgenerational burden of peripartum drug use and may be exposed to violence.