Mapping Neural Response to Infant Distress in Depressed New Mothers

描述(申请人提供)：这项研究的长期目标是通过将母婴共同调节早期缺陷与大脑/神经内分泌发育的特定模式联系起来，阐明围产期抑郁(PD)的病因和影响所涉及的生物社会机制，这些模式使人在面对生活压力(如怀孕和为人父母)时容易受到情绪调节失调的影响。这些见解将被用来强调有帕金森病风险的女性，并向阻止抑郁风险传播的心理社会和/或药物治疗目标提供信息。这项研究的直接目标是检验这一假设，即PD母亲在婴儿痛苦的背景下，以情绪调节受损为特征，在几个相互关联的反应水平上：神经、神经内分泌和行为。为了实现这一目标，我建议1)比较帕金森病和非帕金森病母亲对自己婴儿痛苦信号的神经反应模式，2)将这些模式与母亲的下丘脑-垂体-肾上腺(HPA)轴活动联系起来，3)将这些模式与母亲观察到的对婴儿的敏感性联系起来。在这项初步研究中，无论是在围产期表现出高度抑郁的初产母亲(PD组)还是持续低抑郁的母亲(非PD组)，在接受功能神经成像的同时，接触到她们自己和不熟悉的婴儿的哭声录音和哭脸图像。不同条件下大胆活动的对比(例如，自己和不熟悉的婴儿哭泣)将测试母亲/群体内的反应模式，以及帕金森病和非帕金森病母亲之间的反应差异。母亲的唾液皮质醇水平(指示HPA活性)和行为敏感性评分(两者都来自单独的出生后评估)也将作为神经反应的预测指标，以测试帕金森病患者的大脑-激素-行为关联。公共卫生相关性：这项研究对公共健康很重要，因为围产期抑郁症(PD)的高成本，不仅对母亲，而且对她的婴儿未来的发展和心理健康风险都是如此。然而，帕金森病的神经生物学基础及其对母婴二联体的影响尚不清楚。通过确定区分围产期抑郁母亲的神经反应模式及其与行为和神经内分泌失调方面的关系，我们将能够更好地确定谁有风险以及原因，从而开发出更精确和有效的治疗目标，减少疾病的传播。

DESCRIPTION (provided by applicant): The long-term objective of this research is to elucidate the biosocial mechanisms involved in the etiology and impact of perinatal depression (PD) by linking early deficits in mother-infant coregulation to specific patterns of brain/neuroendocrine development that confer vulnerability to emotional dysregulation in the face of life stressors such as pregnancy and parenthood. These insights will be used to highlight women at risk for PD and to inform psychosocial and/or pharmacological treatment targets that block the transmission of depression risk. The immediate goal of this study is to test the hypothesis that PD mothers are distinguished by impaired emotion regulation in the context of their infant's distress at several interrelated levels of response: neural, neuroendocrine, and behavioral. To achieve this goal, I propose to 1) compare PD and non-PD mothers' patterns of neural response to their own infants' distress signals, 2) relate these patterns to mothers' hypothalamic-pituitary-adrenal (HPA) axis activity, and 3) relate these patterns to mothers' observed sensitivity to their infant. For this preliminary study, primiparous mothers who either show elevated depression across the perinatal period (PD group) or consistently low depression (non-PD group) are exposed to cry recordings and cry face images from their own and unfamiliar infants while undergoing functional neuroimaging. Contrasts between BOLD activity in different conditions (e.g., own vs. unfamiliar infant cry) will test response patterns within mothers/groups, as well as differences in response between PD and non-PD mothers. Mothers' salivary cortisol levels (indexing HPA activity) and behavioral sensitivity scores (both from a separate postnatal assessment) will also be entered as predictors of neural response to test brain-hormone-behavior associations in PD. PUBLIC HEALTH RELEVANCE: This research is important for public health because of the high cost of perinatal depression (PD), not only for the mother, but also for her infant's future development and mental health risk. However, the neurobiological basis for PD and its effects on the mother-infant dyad are not well understood. By identifying the patterns of neural response that distinguish perinatally depressed mothers and their relationship to aspects of behavioral and neuroendocrine dysregulation shown to harm the infant, we will be able to better characterize who is at risk and why, allowing for the development of more precise and efficacious treatment targets that will reduce the propagation of disorder.