Gray matter volume and corresponding covariance connectivity are biomarkers for major depressive disorder.

The major depressive disorder (MDD) is a common and severe mental disorder. To identify a reliable biomarker for MDD is important for early diagnosis and prevention. Given easy access and high reproducibility, the structural magnetic resonance imaging (sMRI) is an ideal method to identify the biomarker for depression. In this study, sMRI data of first episode, treatment-naïve 66 MDD patients and 54 sex-, age-, and education-matched healthy controls (HC) were used to identify the differences in gray matter volume (GMV), group-level, individual-level covariance connections. Finally, the abnormal GMV and individual covariance connections were applied to classify MDD from HC. MDD patients showed higher GMV in middle occipital gyrus (MOG) and precuneus (PCun), and higher structural covariance connections between MOG and PCun. In addition, the Allen Human Brain Atlas (AHBA) was applied and revealed the genetic basis for the changes of gray matter volume. Importantly, we reported that GMV in MOG, PCun and structural covariance connectivity between MOG and PCun are able to discriminate MDD from HC. Our results revealed structural underpinnings for MDD, which may contribute towards early discriminating for depression.

Molecular basis underlying default mode network functional abnormalities in postpartum depression with and without anxiety.

Although Postpartum depression (PPD) and PPD with anxiety (PPD-A) have been well characterized as functional disruptions within or between multiple brain systems, however, how to quantitatively delineate brain functional system irregularity and the molecular basis of functional abnormalities in PPD and PPD-A remains unclear. Here, brain sample entropy (SampEn), resting-state functional connectivity (RSFC), transcriptomic and neurotransmitter density data were used to investigate brain functional system irregularity, functional connectivity abnormalities and associated molecular basis for PPD and PPD-A. PPD-A exhibited higher SampEn in medial prefrontal cortex (MPFC) and posterior cingulate cortex (PPC) than healthy postnatal women (HPW) and PPD while PPD showed lower SampEn in PPC compared to HPW and PPD-A. The functional connectivity analysis with MPFC and PPC as seed areas revealed decreased functional couplings between PCC and paracentral lobule and between MPFC and angular gyrus in PPD compared to both PPD-A and HPW. Moreover, abnormal SampEn and functional connectivity were associated with estrogenic level and clinical symptoms load. Importantly, spatial association analyses between functional changes and transcriptome and neurotransmitter density maps revealed that these functional changes were primarily associated with synaptic signaling, neuron projection, neurotransmitter level regulation, amino acid metabolism, cyclic adenosine monophosphate (cAMP) signaling pathways, and neurotransmitters of 5-hydroxytryptamine (5-HT), norepinephrine, glutamate, dopamine and so on. These results reveal abnormal brain entropy and functional connectivities primarily in default mode network (DMN) and link these changes to transcriptome and neurotransmitters to establish the molecular basis for PPD and PPD-A for the first time. Our findings highlight the important role of DMN in neuropathology of PPD and PPD-A.

Risk factors and predictive model for prenatal depression: A large retrospective study in China.

BACKGROUND: Prenatal depression, associated with adverse effects on mothers and fetuses, has received little attention. We conducted a large-sample study to investigate the risk factors of, and develop a predictive model for, prenatal depression in the Chinese population. METHODS: This study enrolled 14,329 pregnant women who delivered at the West China Second University Hospital, Sichuan University from January 2017 to December 2020. Participants were divided into a training or validation cohort. Multiple variables were collected and selected using univariate logistic regression and least absolute shrinkage and selection operator penalty regression. After multivariate logistic analysis, a predictive model was developed and validated internally and externally. RESULTS: Nine variables (employment, planned pregnancy, pregnancy number, conception methods, gestational diabetes mellitus, twin pregnancy, placenta previa, umbilical cord encirclement, and educational attainment) were identified as independent risk factors for prenatal depression. Receiver operating characteristic curves in both the training and validation cohorts showed excellent discrimination of the predictive model (the area under the curve: 0.746 and 0.732, respectively). LIMITATIONS: The results of this retrospective study may be affected by confounding and information bias. Some important variables were excluded, such as family history of mental disorders. The study was conducted in China; its results may not be generalizable to other regions. CONCLUSION: Our study identified nine significant risk factors for prenatal depression and constructed an accurate predictive model. This model could be applied as a clinical decision aid for individualized risk estimates and prevention of prenatal depression.

Association between traumatic events with suicidality among adolescents: A large-scale cross-sectional study of 260,423 participants.

Traumatic events have significant negative impacts throughout one's life. We aimed to comprehensively examine the early associations between traumatic events and suicidality among adolescents. In a cross-sectional sample of 260,423 adolescents in Deyang, China in September 2021, we assessed individual traumatic events, cumulative types, and patterns, alongside suicide risk scores and ideation, attempts, or plans. Linear and Poisson regression models adjusted for demographic confounders evaluated the association. Robust associations existed between interpersonal violence-related traumatic events and higher suicidality, with physical abuse demonstrating the strongest correlation. Moreover, suicide risk scores displayed a clear trend, indicating a progressively stronger association with suicidality as cumulative traumatic event types increased. Four distinct traumatic patterns emerged, including low traumas, high physical abuse, high death/serious injuries of a loved one, and multiple traumas, with the latter showing the strongest association with suicidality. Notably, the stratified analysis showed these associations were more pronounced in females, urban residents, only children, left-behind children, and those aged 13-15, while weaker in participants from families with intact parental relationships and middle socioeconomic status. Understanding the role of demographic factors and traumatic patterns in identifying at-risk youth can enable early detection and targeted interventions for suicide-related concerns.

Altered Functional Connectivity Strength in Distinct Brain Networks of Children With Early-Onset Schizophrenia.

BACKGROUND: Schizophrenia is regarded as a brain network or connectome disorder that is associated with neurodevelopment. Children with early-onset schizophrenia (EOS) provide an opportunity to evaluate the neuropathology of schizophrenia at a very early stage without potential confounding factors. But dysfunction in brain networks of schizophrenia is inconsistent. PURPOSE: To identify abnormal functional connectivity (FC) in EOS patients and relationships with clinical symptoms, we aimed to reveal neuroimaging phenotypes of EOS. STUDY TYPE: Prospective, cross-sectional. POPULATION: Twenty-six female/22 male patients (age:14.3 ± 3.45 years) with first-episode EOS, 27 female/22 male age- and gender-matched healthy controls (HC) (age:14.1 ± 4.32). FIELD STRENGTH/SEQUENCE: 3-T, resting-state (rs) gradient-echo echo-planar imaging and three-dimensional magnetization-prepared rapid gradient-echo imaging. ASSESSMENT: Intelligence quotient (IQ) was measured by the Wechsler Intelligence Scale-Fourth edition for Children (WISC-IV). The clinical symptoms were evaluated by the Positive and Negative Syndrome Scale (PANSS). FC strength (FCS) from rs functional MRI (rsfMRI) was used to investigate functional integrity of global brain regions. In addition, associations between regionally altered FCS and clinical symptoms in EOS patients were examined. STATISTICAL TESTS: Two-sample t-test controlling for sample size, diagnostic method, brain volume algorithm, and age of the subjects, Bonferroni correction, Pearson's correlation analysis. A P-value <0.05 with a minimum cluster size of 50 voxels was considered statistically significant. RESULTS: Compared with HC, EOS patients had significantly lower total IQ scores (IQ:91.5 ± 16.1), increased FCS in the bilateral precuneus, left dorsolateral prefrontal cortex, left thalamus, and left parahippocampus (paraHIP), and decreased FCS in the right cerebellum posterior lobe and right superior temporal gyrus. The PANSS total score of EOS patients (PANSS total score:74.30 ± 7.23) was found to be positively correlated to FCS in the left paraHIP (r = 0.45). DATA CONCLUSION: Our study revealed that disrupted FC of brain hubs illustrate multiple abnormalities in brain networks in EOS patients. EVIDENCE LEVEL: 1 TECHNICAL EFFICACY STAGE: 2.

Clinical utilisation of multimodal quantitative magnetic resonance imaging in investigating muscular damage in Duchenne muscular dystrophy: a study on the association between gluteal muscle groups and motor function.

BACKGROUND: Duchenne muscular dystrophy (DMD) is a neuromuscular disease characterised by progressive muscular weakness and atrophy. Currently, studies on DMD muscle function mostly focus on individual muscles; little is known regarding the effect of gluteal muscle group damage on motor function. OBJECTIVE: To explore potential imaging biomarkers of hip and pelvic muscle groups for measuring muscular fat replacement and inflammatory oedema in DMD with multimodal quantitative magnetic resonance imaging (MRI). MATERIALS AND METHODS: One hundred fifty-nine DMD boys and 32 healthy male controls were prospectively included. All subjects underwent MRI examination of the hip and pelvic muscles with T1 mapping, T2 mapping and Dixon sequences. Quantitatively measured parameters included longitudinal relaxation time (T1), transverse relaxation time (T2) and fat fraction. Investigations were all based on hip and pelvic muscle groups covering flexors, extensors, adductors and abductors. The North Star Ambulatory Assessment and stair climbing tests were used to measure motor function in DMD. RESULTS: T1 of the extensors (r = 0.720, P < 0.01), flexors (r = 0.558, P < 0.01) and abductors (r = 0.697, P < 0.001) were positively correlated with the North Star Ambulatory Assessment score. In contrast, T2 of the adductors (r = -0.711, P < 0.01) and fat fraction of the extensors (r = -0.753, P < 0.01) were negatively correlated with the North Star Ambulatory Assessment score. Among them, T1 of the abductors (b = 0.013, t = 2.052, P = 0.042), T2 of the adductors (b = -0.234, t = -2.554, P = 0.012) and fat fraction of the extensors (b = -0.637, t = - 4.096, P < 0.001) significantly affected the North Star Ambulatory Assessment score. Moreover, T1 of the abductors was highly predictive for identifying motor dysfunction in DMD, with an area under the curve of 0.925. CONCLUSION: Magnetic resonance biomarkers of hip and pelvic muscle groups (particularly T1 values of the abductor muscles) have the potential to be used as independent risk factors for motor dysfunction in DMD.

A Meta-Analysis of Neural Correlates of Reward Anticipation in Individuals at Clinical Risk for Schizophrenia.

BACKGROUND: Aberrant striatal responses to reward anticipation have been observed in schizophrenia. However, it is unclear whether these dysfunctions predate the onset of psychosis and whether reward anticipation is impaired in individuals at clinical high risk for schizophrenia (CHR). METHODS: To examine the neural correlates of monetary anticipation in the prodromal phase of schizophrenia, we performed a whole-brain meta-analysis of 13 functional neuroimaging studies that compared reward anticipation signals between CHR individuals and healthy controls (HC). Three databases (PubMed, Web of Science, and ScienceDirect) were systematically searched from January 1, 2000, to May 1, 2022. RESULTS: Thirteen whole-brain functional magnetic resonance imaging studies including 318 CHR individuals and 426 HC were identified through comprehensive literature searches. Relative to HC, CHR individuals showed increased brain responses in the medial prefrontal cortex and anterior cingulate cortex and decreased activation in the mesolimbic circuit, including the putamen, parahippocampal gyrus, insula, cerebellum, and supramarginal gyrus, during reward anticipation. CONCLUSIONS: Our findings in the CHR group confirmed the existence of abnormal motivational-related activation during reward anticipation, thus demonstrating the pathophysiological characteristics of the risk populations. These results have the potential to lead to the early identification and more accurate prediction of subsequent psychosis as well as a deeper understanding of the neurobiology of high-risk state of psychotic disorder.

Connectomic disturbances in Duchenne muscular dystrophy with mild cognitive impairment.

Duchenne muscular dystrophy (DMD) is frequently associated with mild cognitive deficits. However, the underlying disrupted brain connectome and the neural basis remain unclear. In our current study, 38 first-episode, treatment-naive patients with DMD and 22 matched healthy controls (HC) were enrolled and received resting-sate functional magnetic resonance imaging scans. Voxel-based degree centrality (DC), seed-based functional connectivity (FC), and clinical correlation were performed. Relative to HC, DMD patients had lower height, full Intellectual Quotients (IQ), and IQ-verbal comprehension. Significant increment of DC of DMD patients were found in the left dorsolateral prefrontal cortex (DLPFC.L) and right dorsomedial prefrontal cortex (DMPFC.R), while decreased DC were found in right cerebellum posterior lobe (CPL.R), right precentral/postcentral gyrus (Pre/Postcentral G.R). DMD patients had stronger FC in CPL.R-bilateral lingual gyrus, Pre/Postcentral G.R-Insular, and DMPFC.R-Precuneus.R, had attenuated FC in DLPFC.L-Insular. These abnormally functional couplings were closely associated with the extent of cognitive impairment, suggested an over-activation of default mode network and executive control network, and a suppression of primary sensorimotor cortex and cerebellum-visual circuit. The findings collectively suggest the distributed brain connectome disturbances maybe a neuroimaging biomarker in DMD patients with mild cognitive impairment.

Emotional intelligence mediates the protective role of the orbitofrontal cortex spontaneous activity measured by fALFF against depressive and anxious symptoms in late adolescence.

As a stable personality construct, trait emotional intelligence (TEI) refers to a battery of perceived emotion-related skills that make individuals behave effectively to adapt to the environment and maintain well-being. Abundant evidence has consistently shown that TEI is important for the outcomes of many mental health issues, particularly depression and anxiety. However, the neural substrates involved in TEI and the underlying neurobehavioral mechanism of how TEI reduces depression and anxiety symptoms remain largely unknown. Herein, resting-state functional magnetic resonance imaging and a group of behavioral measures were applied to examine these questions among a large sample comprising 231 general adolescent students aged 16-20 years (52% female). Whole-brain correlation analysis and prediction analysis demonstrated that TEI was negatively linked with spontaneous activity (measured with the fractional amplitude of low-frequency fluctuations) in the bilateral medial orbitofrontal cortex (OFC), a critical site implicated in emotion-related processes. Furthermore, structural equation modeling analysis found that TEI mediated the link of OFC spontaneous activity to depressive and anxious symptoms. Collectively, the current findings present new evidence for the neurofunctional bases of TEI and suggest a potential "brain-personality-symptom" pathway for alleviating depressive and anxious symptoms among students in late adolescence.

Altered MRI Diffusion Properties of the White Matter Tracts Connecting Frontal and Thalamic Brain Regions in First-Episode, Drug-Naïve Patients With Postpartum Depression.

BACKGROUND: Although progress has been made in exploring postpartum depression (PPD), the involvement of cerebral structure connectivity in PPD patients keeps unclear. PURPOSE: To explore structural connectivity alternations in mothers with PPD, diffusion tensor imaging (DTI) and automated fiber quantification (AFQ) were used to calculate brain white matter microstructure properties. STUDY TYPE: Cross-sectional. POPULATION: A total of 51 women with first-episode, treatment-näive PPD, and 49 matched healthy postpartum women (HPW) controls. FIELD STRENGTH: A 3.0 T; single-shot echo-planar imaging sequence. ASSESSMENT: DTI measurements of fractional anisotropy (FA), axial diffusivity (AD), radial diffusivity (RD) and mean diffusivity (MD) were obtained for 18 specific white matter tracts. The relationship between PDD symptoms, hormone levels, and postpartum days was also investigated. STATISTICAL TESTS: Two sample t test and Pearson's correlation analysis. The analysis was performed by using a permutation-based multiple-comparison correction approach, with the threshold of P < 0.05 (family wise error corrected [FWE-corrected]) separately across the four different outcome measures. RESULTS: Women with PPD showed significantly increased FA and AD in right anterior thalamic radiation (ATR) tract and significantly increased FA and significantly reduced RD in the cingulum tract, compared to women without PPD. The RD values of right cingulum were significantly positively correlated with postpartum days in HPW (r = 0.39). There were no significant relationships between brain measures and hormone levels in either patients or controls. DATA CONCLUSIONS: DTI measures have revealed altered integrity in the white matter of the cortical-thalamic circuits in women with PPD compared to HPW. Damage to these circuits may be a structural basis for the impaired emotional regulation and blunted mother-infant bonding in mothers with PPD and a potential target for the development of new treatments. EVIDENCE LEVEL: 2 TECHNICAL EFFICACY: Stage 3.

Electroconvulsive therapy for obsessive-compulsive disorder: A retrospective study.

Background: Chronic mental diseases such as obsessive-compulsive disorder (OCD) are associated with a high disability rate. Some patients still do not improve their symptoms even with adequate cognitive-behavioral therapy and drug treatment. In the treatment of OCD, electroconvulsive therapy (ECT) is not considered a neuromodulation modality with sufficient evidence. Objective: This retrospective study aimed to determine the efficacy and associated risk factors of ECT in OCD patients. Materials and methods: The study included 21 OCD patients who underwent ECT at a high-volume center in China between January 2009 and December 2020. The demographics and clinical characteristics of the patients were assessed using descriptive statistics. Based on Clinical Global Impressions-Improvement scale, patients were categorized into response and non-response groups. Clinical and demographic characteristics of two groups of patients were compared. Results: An analysis of 21 patients was conducted. In total, 12 patients (57.1%) responded to ECT, 11 patients (52.4%) reported side effects, and an average of 7 ECT sessions were administered. In terms of demographic, there was no statistically significant difference between the two groups. It is noteworthy that the non-response group reported more depression and schizophrenia related disorders comorbidities than the response group (χ2 = 6.252, P = 0.041). Conclusion: The effectiveness of ECT in treating OCD is limited, especially in patients with refractory symptoms. Comorbidity with other mental disorders may affect the efficacy of ECT.

Cases report: MRI findings of asymptomatically familial subependymal heterotopia with filamin A gene abnormality.

Subependymal heterotopia (SEH) is a rare neuronal migration disorder consisting of gray matter nodules along the lateral ventricular walls and is often associated with other brain malformations. Despite most SEH cases showing epilepsy during their lifetimes, very few patients with asymptomatically familial SEH tend to cause misdiagnosis or missed diagnosis. We present four familial SEH cases without any positive symptoms and medical history, including two fetuses, who were diagnosed by MRI and confirmed by genetic testing with mutation of filamin A. This report emphasizes the role of MRI in the recognition of SEH at an early age of gestation and in asymptomatically familial SEH. MRI provides a fast, repeatable, reliable, and cheap choice for detecting and screening familial SEH.

Prediction of childhood maltreatment and subtypes with personalized functional connectome of large-scale brain networks.

Childhood maltreatment (CM) has a long impact on physical and mental health of children. However, the neural underpinnings of CM are still unclear. In this study, we aimed to establish the associations between functional connectome of large-scale brain networks and influences of CM evaluated through Childhood Trauma Questionnaire (CTQ) at the individual level based on resting-state functional magnetic resonance imaging data of 215 adults. A novel individual functional mapping approach was employed to identify subject-specific functional networks and functional network connectivities (FNCs). A connectome-based predictive modeling (CPM) was used to estimate CM total and subscale scores using individual FNCs. The CPM established with FNCs can well predict CM total scores and subscale scores including emotion abuse, emotion neglect, physical abuse, physical neglect, and sexual abuse. These FNCs primarily involve default mode network, fronto-parietal network, visual network, limbic network, motor network, dorsal and ventral attention networks, and different networks have distinct contributions to predicting CM and subtypes. Moreover, we found that CM showed age and sex effects on individual functional connections. Taken together, the present findings revealed that different types of CM are associated with different atypical neural networks which provide new clues to understand the neurobiological consequences of childhood adversity.

Exploring lived experiences of informal caregivers for pregnant women seeking scheduled antenatal care during the COVID-19 lockdown in China: A phenomenological study.

OBJECTIVE: We aimed to explore the lived experiences of informal caregivers for pregnant women seeking scheduled antenatal care during the early stage of China's COVID-19 lockdown and potential measures to address the challenges. DESIGN: This is a phenomenological qualitative study. SETTING: The study was carried out in a leading teaching hospital in Southwest China. PARTICIPANTS: We recruited 15 informal caregivers for healthy pregnant women on routine antenatal visits about six months after China launched the city-wide lockdown and other control measures for COVID-19, including 10 males and 5 females with diverse demographic backgrounds. MEASURES AND FINDINGS: The research team developed a demographic form and an interview outline with key questions, conducted semi-structured interviews with the informal caregivers, and analyzed the data using the Colazzie's method. Five themes of lived experiences were revealed, i.e., increased caregiving burdens, disruption of routines in family life, lack of accurate information and knowledge, active role adjustment, and positive attitudes and coping in a difficult time. Some caregivers reacted positively to the lockdown experience and saw it as an opportunity to rethink their lives and improve family relations. KEY CONCLUSIONS: The informal caregivers experienced increased physical and psychological burdens. Strategies such as adoption of a less frequent prenatal visit schedule, use of tele-medicine technologies, and provision of accurate information and knowledge may help to ease the increased informal caregiving burdens. Psychological counseling, community services and disaster response policies specially targeting pregnant women and their informal caregivers may also be valuable resources. IMPLICATIONS FOR PRACTICE: Attention should be drawn to the group of informal caregivers for pregnant women during a COVID-19 lockdown, including professional assistance delivered by nursing and other related professionals. Measures are called for to minimize exposure opportunities such as adoption of a new prenatal care schedule and tele-medicine technologies. Patient education with reliable information should be provided, preferably by nursing staff and physicians. Social support efforts including professional mental counseling may added and work with other resources such as community services and policy makers.

Abnormal dynamics of resting-state functional activity and couplings in postpartum depression with and without anxiety.

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.

Social support mediates the influence of cerebellum functional connectivity strength on postpartum depression and postpartum depression with anxiety.

Post-Partum Depression (PPD) is the most common health issue impacting emotional well being in women and is often comorbid with anxiety (PPD-A). Previous studies have shown that adequate social support can protect against PPD and PPD-A. However, how the brain connectome is disrupted in PPD and PPD-A and the neural basis underlying the role of social support in PPD and PPD-A remains unclear. The present study aims to explore these issues in patients with PPD and PPD-A. Well-established questionnaires and resting-state functional Magnetic Resonance Imaging (rsfMRI) were performed in 45 PPD, 31 PDD-A patients and 62 Healthy Postnatal Women (HPW). Brain functional integration was measured by analysis of Functional Connectivity Strength (FCS). Association and mediation analyses were performed to investigate relationships between FCS, PPD and PPD-A symptoms and social support. PPD patients showed specifically higher FCS in right parahippocampus, whereas PPD-A patients showed specifically higher FCS in left ventrolateral prefrontal cortex. In all postpartum women, depression symptoms positively correlated with FCS in left paracentral lobule; depression and anxiety symptoms were negatively correlated with FCS in right cerebellem posterior lobe (CPL), a brain region implicated in supporting social cognition and regulation of emotion. Subsequent mediation analysis revealed that perceived social support mediated the association between right CPL FCS and PPD and PPD-A symptoms. Measurement of FCS in disorder-specific neural circuits offers a potential biomarker to study and measure the efficacy of social support for PPD and PPD-A.

Prolactin mediates the relationship between regional gray matter volume and postpartum depression symptoms.

BACKGROUND: Pospartum Depression (PPD) causes significant adverse effects on mothers and their offspring. The condition is considered to have multiple pathogenic factors. However, the underlying neural basis of these factors keeps unclear. METHODS: A group of 86 patients with PPD and 74 Healthy Postnatal Women (HPW) were enrolled in this structural Magnetic Resonance Imaging (MRI) study. Between-groups differences in regional gray matter volume (rGMV) were measured and association and mediation analyses were performed to investigate the relationship between rGMV, PPD severity and a range of demographic/clinical factors which could contribute to PPD. RESULTS: Relative to HPW, PPD patients had higher scores indicating adverse effects on most questionnaires and higher prolactin levels, as well as increased rGMV in left dorsolateral prefrontal cortex (DLPFC) and right anterior insular (anI). In PPD patients, rGMV in right anI was positively correlated with prolactin level, PPD severity, and the number of children raised, whereas rGMV in left DLPFC was negatively correlated with education and age. Besides, prolactin level was found to mediate the association between rGMV in anI and PPD symptoms. LIMITATIONS: Potentially factors such as fertility or delivery pattern were not studied. CONCLUSION: Our results provide information on the risk and protective factors, and rGMV abnormalities, associated with PPD. The finding that prolactin level mediated the impact of rGMV in right anI on PPD symptoms is a potential mechanism for explaining the association between brain structure and PPD symptoms. Increased understanding of the neuro-pathophysiology of PPD is important for early diagnosis and treatment.

Altered functional connectivity density and couplings in postpartum depression with and without anxiety.

Postpartum depression (PPD) is the most common psychological health issue among women, which often comorbids with anxiety (PPD-A). PPD and PPD-A showed highly overlapping clinical symptoms. Identifying disorder-specific neurophysiological markers of PDD and PPD-A is important for better clinical diagnosis and treatments. Here, we performed functional connectivity density (FCD) and resting-state functional connectivity (rsFC) analyses in 138 participants (45 unmedicated patients with first-episode PPD, 31 PDD-A patients and 62 healthy postnatal women, respectively). FCD mapping revealed specifically weaker long-range FCD in right lingual gyrus (LG.R) for PPD patients and significantly stronger long-range FCD in left ventral striatum (VS.L) for PPD-A patients. The follow-up rsFC analyses further revealed reduced functional connectivity between dorsomedial prefrontal cortex (dmPFC) and VS.L in both PPD and PPD-A. PPD showed specific changes of rsFC between LG.R and dmPFC, right angular gyrus and left precentral gyrus, while PPD-A represented specifically abnormal rsFC between VS.L and left ventrolateral prefrontal cortex. Moreover, the altered FCD and rsFC were closely associated with depression and anxiety symptoms load. Taken together, our study is the first to identify common and disorder-specific neural circuit disruptions in PPD and PPD-A, which may facilitate more effective diagnosis and treatments.

Postpartum depression and major depressive disorder: the same or not? Evidence from resting-state functional MRI.

Background: Although postpartum depression (PPD) and non-peripartum major depressive disorder (MDD) occurring within and outside the postpartum period share many clinical characteristics, whether PPD and MDD are the same or not remains controversial. Methods: The current study was devoted to identify the shared and different neural circuits between PPD and MDD by resting-state functional magnetic resonance imaging data from 77 participants (22 first-episodic drug-naïve MDD, 26 drug-naïve PPD, and 29 healthy controls (HC)). Results: Both the PPD and MDD groups exhibited higher fractional amplitude of low-frequency fluctuation (fALFF) in left temporal pole relative to the HC group; the MDD group showed specifically increased degree centrality in the right cerebellum while PPD showed specifically decreased fALFF in the left supplementary motor area and posterior middle temporal gyrus (pMTG_L), and specifically decreased functional connectivities between pMTG and precuneus and between left subgeneual anterior cingulate cortex (sgACC_L) and right sgACC. Moreover, sgACC and left thalamus showed abnormal regional homogeneity of functional activities between any pair of HC, MDD, and PPD. Conclusions: These results provide initial evidence that PPD and MDD have common and distinct neural circuits, which may facilitate understanding the neurophysiological basis and precision treatment for PPD.