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首页> 外文期刊>Journal of psychiatric research >GABAergic neuroactive steroids and resting-state functional connectivity in postpartum depression: A preliminary study
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GABAergic neuroactive steroids and resting-state functional connectivity in postpartum depression: A preliminary study

机译：产后抑郁症中GABA能神经活性类固醇与静息状态的功能连接性的初步研究

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Postpartum depression (PPD) affects up to 1 in 8 women. The early postpartum period is characterized by a downward physiological shift from relatively elevated levels of sex steroids during pregnancy to diminished levels after parturition. Sex steroids influence functional brain connectivity in healthy non-puerperal subjects. This study tests the hypothesis that PPD is associated with attenuation of resting-state functional connectivity (rs-fc) within corticolimbic regions implicated in depression and alterations in neuroactive steroid concentrations as compared to healthy postpartum women. Subjects (. n = 32) were prospectively evaluated during pregnancy and in the postpartum with repeated plasma neuroactive steroid measurements and mood and psychosocial assessments. Healthy comparison subjects (HCS) and medication-free subjects with unipolar PPD (PPD) were examined using functional magnetic resonance imaging (fMRI) within 9 weeks of delivery. We performed rs-fc analysis with seeds placed in the anterior cingulate cortex (ACC), and bilateral amygdala (AMYG), hippocampi (HIPP) and dorsolateral prefrontal cortices (DLPFCs). Postpartum rs-fc and perinatal neuroactive steroid plasma concentrations, quantified by liquid chromatography/mass spectrometry, were compared between groups. PPD subjects showed attenuation of connectivity for each of the tested regions (i.e. ACC, AMYG, HIPP and DLPFC) and between corticocortical and corticolimbic regions vs. HCS. Perinatal concentrations of pregnanolone, allopregnanolone and pregnenolone were not different between groups. This is the first report of a disruption in the rs-fc patterns in medication-free subjects with PPD. This disruption may contribute to the development of PPD, at a time of falling neuroactive steroid concentrations.
机译：产后抑郁症（PPD）最多影响八分之一的女性。产后早期的特征是生理上的下降，从怀孕期间相对较高的性类固醇水平下降到分娩后的水平下降。性类固醇会影响健康的非产后受试者的功能性大脑连接。这项研究检验了以下假设：与健康的产后妇女相比，PPD与皮质下突区域内的静止状态功能连通性（rs-fc）减弱有关，这与抑郁症和神经活性类固醇浓度的改变有关。在妊娠期间和产后对受试者（n = 32）进行了前瞻性评估，并进行了血浆神经活性类固醇测定，并进行了情绪和社会心理评估。在分娩后9周内使用功能磁共振成像（fMRI）检查了健康比较受试者（HCS）和单极PPD（PPD）的非药物受试者。我们用放置在前扣带回皮层（ACC），双侧杏仁核（AMYG），海马（HIPP）和背外侧前额叶皮层（DLPFCs）中的种子进行rs-fc分析。比较两组之间的产后rs-fc和围产期神经活性类固醇血浆浓度（通过液相色谱/质谱法定量）。 PPD受试者显示每个测试区域（即ACC，AMYG，HIPP和DLPFC）以及皮质和皮质区域与HCS之间的连通性减弱。两组之间围产期孕烷醇酮，去甲孕烷醇酮和孕烯醇酮的浓度无差异。这是无药物治疗的PPD患者的rs-fc模式中断的首次报道。在神经活性类固醇浓度下降时，这种破坏可能有助于PPD的发展。

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