Opioids and Maternal Brain-Behavior Adaptation During the Early Postpartum

阿片类药物与产后早期母亲大脑行为适应

• 批准号: 10022116
• 负责人: James Edward Swain
• 金额: $ 70.68万
• 依托单位: STATE UNIVERSITY NEW YORK STONY BROOK
• 依托单位国家: 美国
• 财政年份: 2019
• 资助国家: 美国
• 起止时间: 2019-09-30 至 2024-07-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10022116
• 关键词: Adaptive Behaviors; Affect; Amygdaloid structure; Anxiety; Base of the Brain; Behavior; Behavioral; Biological Markers; Brain; Brain imaging; Brain scan; Buprenorphine; Caring; Child; Child Abuse and Neglect; Child Rearing; Code; Coupled; Data; Disinhibition; Dose; Drug usage; Emotional; Epidemic; Family; Foundations; Globus Pallidus; Gold; Grant; Hostility; Human; Hypothalamic structure; Image; Impairment; Infant; Infant Development; Insula of Reil; Interpersonal Relations; Intervention; Link; MRI Scans; Magnetic Resonance Imaging; Maternal Behavior; Measures; Medial; Mediating; Mental Depression; Mental Health; Methods; Modeling; Mood Disorders; Moods; Mothers; Neonatal Abstinence Syndrome; Neurobiology; Nucleus Accumbens; Opiate Addiction; Opioid; Outcome; Output; Parents; Participant; Perinatal; Physiology; Postpartum Period; Postpartum Women; Pre-Clinical Model; Pregnant Women; Preoptic Areas; Questionnaires; Research; Resolution; Rest; Risk; Severities; Societies; Structure; Thinking; Ursidae Family; Ventral Tegmental Area; Withdrawal; Withdrawal Symptom; Woman; Work; base; behavior influence; brain behavior; buprenorphine treatment; caregiving; child bearing; clinical decision-making; comorbid depression; comorbidity; comparison group; cost; design; dosage; dyadic interaction; flexibility; foster care; gray matter; high risk; illicit opioid; imaging study; improved; maternal caregiving; midbrain central gray substance; multimodality; neuroimaging; non-opioid analgesic; offspring; opioid epidemic; opioid use; opioid use disorder; pre-clinical; pre-clinical research; prevent; recruit; relating to nervous system; response; social

Project Summary R01 DA047336-01: Opioids and Maternal Brain-Behavior Adaptation During the Early Postpartum Opioid use disorder (OUD) is a fast-growing and devastating epidemic in the US, affecting a high proportion of child-bearing women, with many suffering comorbid mood disorders. Untreated opioid use and dependence may cause withdrawal symptoms, impair interpersonal interactions and may be associated with polysubstance use and neonatal abstinence syndrome (NAS). These problems are linked to higher risks of child maltreatment and costly utilization of foster care. Buprenorphine Treatment (BT) reduces withdrawal and other deleterious effects of illicit opioids for peripartum women. However, the effects of BT on maternal neurobiology and infant-oriented behaviors in the context of OUD are unknown. Preclinical maternal brain-behavior research and human brain magnetic resonance imaging (MRI) studies have provided a model of corticolimbic maternal caregiving neurocircuit (MCN) for parenting behaviors. The MCN includes two reciprocally inhibiting subsystems for (1) maternal care, mediated by the medial preoptic area in hypothalamus, ventral tegmental area, nucleus accumbens and ventral pallidum; and (2) maternal defense, mediated by periaqueductal grey. For humans, the MCN regulates flexible responses to the demands of their own infant – such as to the unique, ethologically salient own-baby cry – during the early postpartum period. We aim to examine the human MCN and maternal behaviors in a group of mothers undergoing BT for OUD (n=80) as compared to non-OUD depression Matched Controls (MC, n=80). All participant will have 2 MRI scans: T1 at 1-month postpartum and T2 at 4-month postpartum. We will measure maternal thoughts and behaviors – including measures of infant-oriented care and defense – and polysubstance use and moods in all participants. We will use multimodal neuroimaging methods to measure resting-state functional connectivity, neural responses to own-baby cry, and gray matter volumes of MCN. Based on our preliminary research and preclinical models we hypothesize that BT in OUD increases activity in both care and defense subsystems of MCN and diminishes normal reciprocal inhibition between these subsystems, resulting in potential disinhibition of maternal infant-oriented defensive thoughts and behaviors. Finally, we will explore the effects of cumulative buprenorphine exposure (daily dosage x days on BT) on MCN physiology and maternal behaviors within the group of BT mothers, controlling for polysubstance use and NAS. The proposed research will elucidate the effects of BT in the context of OUD on the neurobiology of parenting - with translational potential to optimize current approaches to treat mothers with OUD and suggest directions to best manage postpartum mental health issues.

项目总结