Abnormal Dynamics of Resting-Sate Functional Activity and Couplings in Postpartum Depression With and Without Anxiety

Abstract

Postpartum depression (PPD) and PPD comorbid with anxiety (PPD-A) are very prevalent and become severe mental health problems in women after childbirth. PPD with and without anxiety shares many similar pathopsychological features leading to ongoing debates about their diagnostic and neurobiological uniqueness.\xa0The present work 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. PPD-A showed specifically increased dynamic amplitude of low-frequency fluctuation (dALFF) in subgenual anterior cingulate cortex (sgACC) and specifically increased dynamic functional connectivity (dFC) between sgACC and superior temporal sulcus (STS). PPD exhibited specifically increased static FC (sFC) between sgACC and ventral anterior insula. Moreover, the common changes of disrupted sFC between sgACC and middle temporal gyrus (MTG) were found in both PPD and PPD-A patients. Interestingly, the dynamic changes of dFC between sgACC and superior temporal gyrus could differentiate PPD, PPD-A and healthy postnatal women. Taken together, our study presents the initial evidence on specifically abnormal functional dynamics of limbic, emotion regulation, and social cognition systems in the patients with PDD and PPD-A, which provides new insight into the brain dynamic dysfunction of PPD and PPD-A and may facilitate understanding neurophysiological mechanisms, diagnosis and treatment for PPD and PPD-A. \n \nFunding: This study was supported by the Chinese National Natural Science Foundation (Grant No. 82027808); Shenzhen Key Basic Research Schemes (JCYJ20200109144801736, 2019SHIBS0003); the Sichuan Science and Technology Program (Grant No. 2021YJ0186, 2019YJ0080; 21YYJC2988); the National Key Technology RD Scientific research project of Sichuan health planning committee (Grant No.20PJ078); 1.3.5 Project for disciplines of excellence, West China Hospital of Sichuan University (Grant No. 2018HXFH035); and Project of Chengdu Science and Technology Bureau (Grant No. 2019-YF05-00341- SN); and National Clinical Research Center for Geriatrics, West China Hospital of Sichuan University (Grant No. Z2018A06). \n \nDeclaration of Interest: None to declare. \n \nEthical Approval: This study was approved by the local ethics committee of West China Second University Hospital of Sichuan University and was in accordance with the latest revision of the Declaration of Helsinki.