Violence Across the Lifespan - Opioids Maternal Brain

项目摘要/摘要

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.