In search of neural endophenotypes of postpartum psychopathology and disrupted maternal caregiving.
In search of neural endophenotypes of postpartum psychopathology and disrupted maternal caregiving.
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DOI：
10.1111/jne.12183
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发表时间：
2014-10
影响因子：
3.2
通讯作者：
Swain JE
中科院分区：
文献类型：
--
作者：
Moses-Kolko EL;Horner MS;Phillips ML;Hipwell AE;Swain JE
这是一个选择性的审查，提供了围产期情感障碍机制的研究背景，并概述了未来的研究方向。我们整合了现有的文献沿着感兴趣的情感障碍和母亲的神经网络：（i）显着性/恐惧网络;（ii）执行网络;（iii）奖励/社会依恋网络;和（iv）默认模式网络。现有的显着性/恐惧网络的研究揭示了不同的反应和皮质边缘耦合各种刺激的基础上，主要是抑郁与焦虑（创伤后应激障碍）的临床表型。执行网络和默认模式连接异常已被描述在产后抑郁症（PPD），虽然在这些领域的研究非常有限。奖励/社会依恋的研究证实了一个强大的腹侧纹状体反应婴儿的刺激，包括哭和快乐的婴儿的脸，这是减少抑郁，不安全的重视和物质使用的母亲。收到的不良育儿经验和依恋不安全感的当前母亲的因素，与婴儿刺激相关的神经活动减少类似的PPD，并提出需要更多的研究，整合情绪和依恋的概念，在更大的研究样本。几项研究在静息状态和情绪激活功能磁共振成像范式的功能连接已经揭示了衰减的皮质边缘连接，这仍然是一个重要的结果，需要解剖越来越精确，以更好地定义神经治疗目标。预计在未来几年中，在改进感兴趣的临床表型和实验范式以及扩大样本以便于检查多个构建体方面，将取得方法学进展。功能性成像有望确定母体精神病理学和受损发育的神经机制，以便更早和更精确地检测异常。最终，这些机制的发现将促进对母亲的情感障碍，养育行为和养育弹性的增强治疗方法的完善。
This is a selective review that provides the context for the study of perinatal affective disorder mechanisms and outlines directions for future research. We integrate existing literature along neural networks of interest for affective disorders and maternal caregiving: (i) the salience/fear network; (ii) the executive network; (iii) the reward/social attachment network; and (iv) the default mode network. Extant salience/fear network research reveals disparate responses and corticolimbic coupling to various stimuli based upon a predominantly depressive versus anxious (post-traumatic stress disorder) clinical phenotype. Executive network and default mode connectivity abnormalities have been described in postpartum depression (PPD), although studies are very limited in these domains. Reward/social attachment studies confirm a robust ventral striatal response to infant stimuli, including cry and happy infant faces, which is diminished in depressed, insecurely attached and substance-using mothers. The adverse parenting experiences received and the attachment insecurity of current mothers are factors that are associated with a diminution in infant stimulus-related neural activity similar to that in PPD, and raise the need for additional studies that integrate mood and attachment concepts in larger study samples. Several studies examining functional connectivity in resting state and emotional activation functional magnetic resonance imaging paradigms have revealed attenuated corticolimbic connectivity, which remains an important outcome that requires dissection with increasing precision to better define neural treatment targets. Methodological progress is expected in the coming years in terms of refining clinical phenotypes of interest and experimental paradigms, as well as enlarging samples to facilitate the examination of multiple constructs. Functional imaging promises to determine neural mechanisms underlying maternal psychopathology and impaired caregiving, such that earlier and more precise detection of abnormalities will be possible. Ultimately, the discovery of such mechanisms will promote the refinement of treatment approaches toward maternal affective disturbance, parenting behaviours and the augmentation of parenting resiliency.
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影响因子：
5.8
作者：
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通讯作者：
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DOI：
10.1176/appi.neuropsych.19.3.274
发表时间：
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