Post Partum Risk Linked With Altered Brain Connectivity

Women at risk of post partum psychosis showed altered brain connectivity in networks associated with goal-directed behavior compared with healthy women, according to a study published in Translational Psychiatry.

“Previously, it’s been difficult to spot women at risk of post partum psychosis or explain why some are more vulnerable than others, as we really haven’t known enough about the neurobiology of the illness,” said Paola Dazzan, MD, PhD, professor of neurobiology of psychosis at King’s College London in the United Kingdom. “Our study is the first step towards a better understanding of brain connectivity as a marker of vulnerability to postpartum psychosis.”

The study included 27 healthy women and 32 women at risk of post partum psychosis. Women were considered at risk if they had a diagnosis of bipolar disorder or schizoaffective disorder or if they had experienced a previous episode of post partum psychosis. By 4 weeks post partum, 15 of the women became unwell with post partum psychosis symptoms.

At 8 weeks post partum, all participants underwent functional magnetic resonance imaging (fMRI) at rest and during an emotional processing task so researchers could investigate within and between-networks connectivity in the brain. The emotional processing task involved looking at expressive faces and identifying emotions being conveyed. Researchers documented how long it took participants to identify the emotions, as well as the involvement of different brain networks during the task.

Women at risk of post partum psychosis, particularly those who were unwell, had more difficulty understanding and decoding negative expressions compared with the healthy women, according to the study. Reduced connectivity between certain brain networks and longer reaction times to negative faces reflected the difficulty.

The study also suggested that increased connectivity within the executive network could represent a marker of resilience to post partum psychosis relapse.

“We recently published another paper looking at the role of stress in post partum psychosis, which found that higher levels of cortisol in the third trimester of pregnancy predicted post partum psychosis relapse,” Dr. Dazzan said. “If subtle alterations in the brain’s executive network, and its interaction with other brain areas, were also detectable in pregnancy, these could offer vital clues to the development of post partum psychosis. Potentially, this could enable us to intervene earlier, allowing clinicians to provide the best possible support for new mothers, before the onset of symptoms.”

—Jolynn Tumolo

References

Sambataro F, Cattarinussi G, Lawrence A, et al. Altered dynamics of the prefrontal networks are associated with the risk for post partum psychosis: a functional magnetic resonance imaging study. Translational Psychiatry. 2021;11(1):238.

Brain scans could offer sign of post partum psychosis risk [press release]. London, United Kingdom: King’s College London; May 13, 2021.