Data from: Emotion reactivity is increased 4-6 weeks postpartum in healthy women: a longitudinal fMRI study

Marked endocrine alterations occur after delivery. Most women cope well
with these changes, but the postpartum period is associated with an
increased risk of depressive episodes. Previous studies of emotion
processing have focused on maternal–infant bonding or postpartum
depression (PPD), and longitudinal studies of the neural correlates of
emotion processing throughout the postpartum period in healthy women are
lacking. In this study, 13 women, without signs of post partum depression,
underwent fMRI with an emotional face matching task and completed the
MADRS-S, STAI-S, and EPDS within 48 h (early postpartum) and 4–6 weeks
after delivery (late postpartum). Also, data from a previous study
including 15 naturally cycling controls assessed in the luteal and
follicular phase of the menstrual cycle was used. Women had lower
reactivity in insula, middle frontal gyrus (MFG), and inferior frontal
gyrus (IFG) in the early as compared to the late postpartum assessment.
Insular reactivity was positively correlated with anxiety in the early
postpartum period and with depressive symptoms late postpartum. Reactivity
in insula and IFG were greater in postpartum women than in non-pregnant
control subjects. Brain reactivity was not correlated with serum estradiol
or progesterone levels. Increased reactivity in the insula, IFG, and MFG
may reflect normal postpartum adaptation, but correlation with self-rated
symptoms of depression and anxiety in these otherwise healthy postpartum
women, may also suggest that these changes place susceptible women at
increased risk of PPD. These findings contribute to our understanding of
the neurobiological aspects of the postpartum period, which might shed
light on the mechanisms underlying affective puerperal disorders, such as
PPD.

分娩后会出现显著的内分泌改变。多数女性可较好地适应此类变化，但产后阶段仍会增加抑郁发作的风险。过往针对情绪加工的研究多聚焦于母婴联结或产后抑郁（Postpartum Depression, PPD），而针对健康女性整个产后周期内情绪加工的神经关联的纵向研究仍较为匮乏。本研究纳入13名无产后抑郁迹象的女性，分别在分娩后48小时内（产后早期）以及分娩后4~6周（产后晚期）完成情绪面孔匹配任务的功能磁共振成像（functional Magnetic Resonance Imaging, fMRI）扫描，并填写蒙哥马利-阿斯伯格抑郁量表简化版（MADRS-S）、状态特质焦虑量表-状态版（STAI-S）与爱丁堡产后抑郁量表（EPDS）。此外，本研究还使用了一项既往研究的数据：该研究纳入15名自然月经周期的健康对照者，分别在其月经周期的黄体期与卵泡期进行了评估。与产后晚期评估相比，产后早期评估时受试者的脑岛、额中回（MFG）与额下回（IFG）激活度更低。产后早期的脑岛激活度与焦虑水平呈正相关，而产后晚期的脑岛激活度则与抑郁症状呈正相关。产后女性的脑岛与额下回激活度均高于非妊娠对照者。脑激活度与血清雌二醇或孕酮水平无相关性。脑岛、额下回与额中回的激活度升高可能反映了产后的正常适应性变化，但在这类本应健康的产后女性中，该激活度与自评的抑郁、焦虑症状存在关联，这也提示此类变化可能使易感女性罹患产后抑郁的风险升高。本研究结果有助于我们理解产后阶段的神经生物学机制，或可为阐明产后情感障碍（如PPD）的发病机制提供新的视角。