Neural Dysfunction in Postpartum Depression:An fMRI Pilot Study
Abstract
INTRODUCTION: With approximately 4 million births each year in the United States, an estimated 760,000 women annually suffer from a clinically significant postpartum depressive illness. Yet even though the relationship between psychiatric disorders and the postpartum period has been documented since the time of Hippocrates, fewer than half of all these cases are recognized. OBJECTIVE: Because postpartum depression (PPD), the most common complication of childbearing, remains poorly characterized, and its etiology remains unclear, we attempted to address a critical gap in the mechanistic understanding of PPD by probing its systems-level neuropathophysiology, in the context of a specific neurobiological model of fronto-limbic-striatal function. METHODS: Using emotionally valenced word probes, with linguistic semantic specificity within an integrated functional magnetic resonance imaging (fMRI) protocol, we investigated emotional processing, behavioral regulation, and their interaction (functions of clinical relevance to PPD), in the context of fronto-limbic-striatal function. RESULTS: We observed attenuated activity in posterior orbitofrontal cortex for negative versus neutral stimuli with greater PPD symptomatology, increased amygdala activity in response to negative words in those without PPD symptomotology, and attenuated striatum activation to positive word conditions with greater PPD symptomotology. CONCLUSION: Identifying the functional neuroanatomical profile of brain systems involved in the regulation of emotion and behavior in the postpartum period will not only assist in determining whether the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition psychiatric diagnostic specifier of PPD has an associated, unique, functional neuroanatomical profile, but a neurobiological characterization in relation to asymptomatic (postpartum non-depressed) control subjects, will also increase our understanding of the affective disorder spectrum, shed additional light on the possible mechanism(s) responsible for PPD and provide a necessary foundation for the development of more targeted, biologically based diagnostic and therapeutic strategies for PPD.
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A small study of eight women revealed reduced activity in the posterior orbitofrontal cortex in response to negative words in women with postpartum depression compared to healthy postpartum women.
“A small study (n=8) revealed reduced activity in the posterior OFC in response to negative words in women with PPD compared to healthy postpartum women (Silverman et al., 2007).”
From The maternal brain and its plasticity in humans (2016) · cites this paper as Silverman et al., 2007
In mothers attending to non-infant negative emotional stimuli, postpartum depression versus healthy status and greater postpartum depression severity were associated with reduced activity in the amygdala to fearful and threatening faces or negatively valenced words.
“Two existing studies (Moses-Kolko et al., 2010; Silverman et al., 2007) of mothers attending to non-infant negative emotional stimuli found that PPD versus healthy status and greater PPD severity was associated with reduced activity in the amygdala to fearful and threatening faces or negatively valenced words.”
From The maternal brain and its plasticity in humans (2016) · cites this paper as Silverman et al., 2007
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- Authors
- Silverman, M. E., Loudon, H., Safier, M., Protopopescu, X., Leiter, G., Liu, X., & Goldstein, M.
- Affiliations
- Icahn School of Medicine at Mount Sinai (US)
- Venue
- CNS Spectrums
- Publisher
- Cambridge University Press (CUP)
- Published
- 2007-11
- Volume
- 12
- Issue
- 11
- Pages
- 853-862
- ISSN
- 1092-8529 (ISSN-L)
- 2165-6509
- OpenAlex
- W2143768387
- Cited by
- 91
- References
- 67
- Citations by year
- 2026: 4 · 2025: 5 · 2024: 4 · 2023: 6 · 2022: 7 · 2021: 9 · 2020: 10 · 2019: 3 · 2018: 7 · 2017: 5 · 2016: 4 · 2015: 7 · 2014: 5 · 2013: 2 · 2012: 2
- FWCI
- 2.07
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- CNS Spectrums (publishedVersion)
- PubMed (publishedVersion)
- Funders
- National Center for Research Resources (MO1RR00071, M01RR000071)
- Topics
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Maternal Mental Health During Pregnancy and Postpartum
- Life Sciences › Neuroscience › Cognitive Neuroscience › Neural and Behavioral Psychology Studies
- Health Sciences › Medicine › Psychiatry and Mental health › Neurological Complications and Syndromes
- Keywords
- postpartum depression, emotional processing, behavioral regulation, orbitofrontal cortex, amygdala, striatum, neuropathophysiology, maternal mental health
- MeSH terms
- Adult, Amygdala, Cerebral Cortex, Corpus Striatum, Female, Frontal Lobe, Humans, Magnetic Resonance Imaging, Pilot Projects, Pregnancy, Reaction Time, Depression, Postpartum
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