A longitudinal multimodal investigation of postpartum neuroplasticity and the attendant risk and modulatory factors

首次申请者Susanne Stickel的修订提案涉及一项产后母亲大脑发育的多模式纵向研究。目的是建立一个跨学科和相关的产后神经可塑性模型，描述神经可塑性对婴儿依恋、母亲认知和情绪的影响及其风险和调节因素。在一项初步研究中，我们已经能够描述分娩后大脑结构变化的初步结果。然而，由于某些限制，其他先前的研究以及我们的初步研究留下了一些重要的问题没有得到解答。因此，在本研究中，我们希望研究结构和功能神经可塑性在产后是如何发展的，神经可塑性是否对产妇的行为和认知有影响，哪些调节因素对神经可塑性有影响，以及这对产妇健康有什么风险。为了回答这些问题，我们建议对健康怀孕的产后初产妇进行纵向和多模态MRI研究。参与者将在分娩后（产后1-4天）以及产后2、4、6、12周和6个月进行MRI检查。分娩后大脑结构（灰质和白质）、功能和连接的适应过程的特定时间里程碑将被检查。为了回答其他问题，将检查母婴依恋、认知、血液参数（雌二醇、黄体酮）、累积毛发皮质醇、身体活动和情绪等。为了与怀孕前的大脑进行比较，将对从未怀孕过的健康女性对照组进行研究。我们相信，通过这个跨学科的项目（精神病学和妇科），我们将能够展示一个临床、心理和神经生物学参数相互关联的母亲大脑模型。第一位申请人Susanne Stickel也将能够通过这个项目扩展她自己的研究领域并发展她的科学专业知识。

This revised proposal by first-time applicant Susanne Stickel involves a multimodal longitudinal study of maternal brain development in the postpartum period. The aim is to create an interdisciplinary and correlative model of postpartum neuroplasticity describing risk and modulating factors as well as the effects of neuroplasticity on infant attachment, maternal cognition and mood. In a pilot study, we have already been able to describe initial results on changes in brain structures after childbirth. However, other previous studies as well as our pilot study leave important questions unanswered due to certain limitations. In the proposed study, we therefore want to investigate how structural and functional neuroplasticity develops in the postpartum period, whether neuroplasticity contributes to maternal behavior and cognition, which modulating factors contribute to neuroplasticity, and what risk this poses to maternal health. To answer these questions, we are proposing a longitudinal and multimodal MRI study of postpartum primiparous women with healthy pregnancies. Participants will undergo MRI examinations immediately after delivery (1-4 days postpartum) and at 2, 4, 6, and 12 weeks and 6 months postpartum. Specific temporal milestones of the adaptive processes of brain structure (gray and white matter), function and connectivity after childbirth will be examined. To answer the other questions, maternal-infant attachment, cognition, blood parameters (estradiol, progesterone), cumulative hair cortisol, physical activity, and mood, among others, will be examined. To obtain a comparison with the brain before pregnancy, a healthy female control group that has never been pregnant will be studied. We believe that with this interdisciplinary project (psychiatry and gynecology) we will be able to present a model of the maternal brain in which clinical, psychological and neurobiological parameters will be correlated. The first applicant Susanne Stickel will also be able to expand her own field of research and develop her scientific expertise with this project.