Neural emotion regulation during pregnancy - a fMRI study investigating a transdiagnostic mental health factor in healthy first-time pregnant women

Franziska Weinmar, Lydia Kogler, Elisa Rehbein, Carmen Morawetz, Inger Sundstroem-Poromaa, Alkistis Skalkidou, Birgit Derntl
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Abstract

Pregnancy is a psycho-neuro-endocrinological transition phase in which a plethora of hormone levels rise substantially, modulating socioemotional functions, brain structures, and networks and thus presenting a window of vulnerability for mental health. A transdiagnostic factor for psychopathology is emotion regulation, which is influenced by sex hormones, such as estradiol (E2), across the menstrual cycle on the behavioral and neural level. Whether this is also the case in the antepartum period remains unknown. For the first time, behavioral and neural emotion regulation were investigated in healthy primiparous pregnant females with extremely high E2 levels during the second trimester (N = 15) using a functional magnetic resonance imaging (fMRI) paradigm. Results were compared with naturally-cycling females with high E2 levels (after E2-administration, N = 16) and low E2 levels (early follicular phase, N = 16). Although pregnant females reported the lowest trait use of cognitive reappraisal, all females successfully regulated their emotions by applying cognitive reappraisal in the scanner. On the neural level, all females had increased activity in the left middle frontal gyrus during downregulation of negative emotions. Pregnant females showed no significant differences in functional connectivity (psychophysiological interaction, resting-state) related to emotion regulation compared to the nonpregnant group. However, group differences emerged for amygdala activation. In pregnant females, increased amygdala activity predicted reduced regulation success and was positively associated with depression scores. This first fMRI study during pregnancy indicates that depression scores are reflected in heightened amygdala activity already observable in the antepartum period. Thus, through its association with reduced regulation success, increased amygdala activity suggests a neural risk marker for peripartum mental health. Future research needs to investigate emotion regulation in pregnant and postpartum women to further understand pregnancy-related changes and associations of mood, emotional and neural functions. Eventually, this will allow enhanced identification, prevention, and treatment of peri- and postpartum mental ill-health.
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怀孕期间的神经情绪调节--fMRI 研究调查健康初产孕妇的跨诊断心理健康因素
怀孕是一个心理-神经-内分泌的过渡阶段,在这一阶段,大量激素水平大幅上升,调节社会情感功能、大脑结构和网络,从而为心理健康提供了一个脆弱的窗口。情绪调节是精神病理学的一个跨诊断因素,它在整个月经周期的行为和神经水平上受到雌二醇(E2)等性激素的影响。产前是否也受此影响尚不清楚。研究人员首次使用功能磁共振成像(fMRI)范式,对雌二醇(E2)水平极高的健康初产孕妇(15 人)的行为和神经情绪调节进行了研究。研究结果与高 E2 水平(E2-给药后,16 人)和低 E2 水平(卵泡早期,16 人)的自然周期女性进行了比较。虽然妊娠期女性使用认知再评价的特质最少,但所有女性都在扫描仪中通过认知再评价成功地调节了自己的情绪。在神经层面上,所有女性在下调负面情绪时,左侧额叶中回的活动都有所增加。与非怀孕组相比,怀孕女性在与情绪调节有关的功能连接(心理生理交互作用、静息状态)方面没有明显差异。但是,杏仁核激活出现了组间差异。在怀孕女性中,杏仁核活动的增加预示着调节成功率的降低,并与抑郁评分呈正相关。这项首次孕期 fMRI 研究表明,抑郁评分反映在杏仁核活动的增强上,这在产前就已经可以观察到。因此,杏仁核活动的增加与调节成功率的降低有关,是围产期心理健康的神经风险标志。未来的研究需要对孕妇和产后妇女的情绪调节进行调查,以进一步了解与妊娠有关的变化以及情绪、情感和神经功能的关联。最终,这将有助于更好地识别、预防和治疗围产期和产后精神疾病。
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