Cheng Bochao, Wang Xiuli, Roberts Neil, Zhou Yushan, Wang Song, Deng Pengcheng, Meng Yajing, Deng Wei, Wang Jiaojian
Department of Radiology, West China Second University Hospital of Sichuan University, Chengdu 610041, China.
Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, Chengdu 610041, China.
Cereb Cortex. 2022 Dec 8;32(24):5597-5608. doi: 10.1093/cercor/bhac038.
Postpartum depression (PPD) and PPD comorbid with anxiety (PPD-A) are highly prevalent and severe mental health problems in postnatal women. PPD and PPD-A share similar pathopsychological features, leading to ongoing debates regarding the diagnostic and neurobiological uniqueness. This paper aims to delineate common and disorder-specific neural underpinnings and potential treatment targets for PPD and PPD-A by characterizing functional dynamics with resting-state functional magnetic resonance imaging in 138 participants (45 first-episode, treatment-naïve PPD; 31 PDD-A patients; and 62 healthy postnatal women [HPW]). PPD-A group showed specifically increased dynamic amplitude of low-frequency fluctuation in the subgenual anterior cingulate cortex (sgACC) and increased dynamic functional connectivity (dFC) between the sgACC and superior temporal sulcus. PPD group exhibited specifically increased static FC (sFC) between the sgACC and ventral anterior insula. Common disrupted sFC between the sgACC and middle temporal gyrus was found in both PPD and PPD-A patients. Interestingly, dynamic changes in dFC between the sgACC and superior temporal gyrus could differentiate PPD, PPD-A, and HPW. Our study presents initial evidence on specifically abnormal functional dynamics of limbic, emotion regulation, and social cognition systems in patients with PDD and PPD-A, which may facilitate understanding neurophysiological mechanisms, diagnosis, and treatment for PPD and PPD-A.
产后抑郁症（PPD）以及合并焦虑的产后抑郁症（PPD-A）是产后女性中高度流行且严重的心理健康问题。PPD和PPD-A具有相似的病理心理特征，这导致了关于诊断和神经生物学独特性的持续争论。本文旨在通过对138名参与者（45名首次发作、未接受过治疗的PPD患者；31名PPD-A患者；以及62名健康产后女性[HPW]）进行静息态功能磁共振成像来表征功能动力学，从而描绘出PPD和PPD-A共同的以及特定障碍的神经基础和潜在治疗靶点。PPD-A组在膝下前扣带回皮质（sgACC）表现出低频波动的动态幅度特别增加，并且sgACC与颞上沟之间的动态功能连接（dFC）增加。PPD组在sgACC与腹侧前岛叶之间表现出特定的静态功能连接（sFC）增加。在PPD和PPD-A患者中均发现sgACC与颞中回之间存在共同的功能连接中断。有趣的是，sgACC与颞上回之间dFC的动态变化可以区分PPD、PPD-A和HPW。我们的研究提供了初步证据，证明PPD和PPD-A患者的边缘系统、情绪调节系统和社会认知系统存在特定的异常功能动力学，这可能有助于理解PPD和PPD-A的神经生理机制、诊断和治疗。
