Mapping Neural Response to Infant Distress in Depressed New Mothers

描述（由申请人提供）：本研究的长期目标是通过将母婴协同调节的早期缺陷与大脑/神经内分泌发育的特定模式联系起来，阐明围产期抑郁症（PD）的病因和影响的生物社会机制，这些模式在面对生活压力源（如怀孕和为人父母）时导致情绪失调的脆弱性。这些见解将用于强调有PD风险的女性，并为阻断抑郁风险传播的心理社会和/或药物治疗目标提供信息。本研究的直接目的是验证PD母亲在婴儿痛苦的背景下在几个相关的反应水平上的情绪调节受损的假设：神经，神经内分泌和行为。为了实现这一目标，我建议1)比较PD母亲和非PD母亲对自己婴儿的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，在进行功能性神经成像时，在围产期表现出高抑郁程度（PD组）或持续低抑郁程度（非PD组）的初产妇暴露于自己和不熟悉的婴儿的哭泣记录和哭泣脸图像。不同条件下BOLD活动的对比（例如，自己和不熟悉的婴儿哭声）将测试母亲/群体内的反应模式，以及PD母亲和非PD母亲之间的反应差异。母亲的唾液皮质醇水平（指示HPA活动）和行为敏感性评分（均来自单独的产后评估）也将作为神经反应的预测因子，用于测试PD患者的脑激素-行为关联。公共卫生相关性：这项研究对公共卫生很重要，因为围产期抑郁症（PD）的成本很高，不仅对母亲，而且对婴儿的未来发展和心理健康风险也很重要。然而，PD的神经生物学基础及其对母婴的影响尚不清楚。通过识别区分围产期抑郁症母亲的神经反应模式，以及它们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处于危险之中，以及为什么，允许开发更精确和有效的治疗目标，从而减少疾病的传播。

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.