Examining early structural and functional brain alterations in postpartum depression through multimodal neuroimaging
Background: Postpartum depression (PPD) affects approximately 1 in 10 women after childbirth. A thorough understanding of a preexisting vulnerability for PPD will likely aid the early detection and treatment of PPD and help minimize its debilitating effects.Methods: Using a within-sample association, the study aimed to determine whether the brain’s structural and functional alterations predict the onset of depression. To that end, 157 euthymic postpartum women were subjected to a multimodal MRI scan within the first 6 days of childbirth, and were subsequently followed up for 12 weeks. Based on a clinical interview 12 weeks postpartum, participants were classified as mentally healthy or having either PPD or adjustment disorder (AD). Voxel-based morphometry and resting-state functional connectivity comparisons were performed between the three groups. Results: 13.4% of women in our study developed PPD (n=21) and 12.1% (n=19) adjustment disorder (AD). The risk factors for PPD were a psychiatric history and the experience and severity of baby blues and the history of premenstrual syndrome. Despite the different risk profiles, no differences between the PPD, AD and control group were apparent based on the structural and functional neuroimaging data. At 12 weeks postpartum, a significant association was observed between Integrated Local Correlation (LCor) and the Edinburgh Postnatal Depression Score (EPDS). Conclusion: Our findings do not support the notion that the brain’s structural and resting-state functional alterations, if present, can be used as an early biomarker of PPD or AD. However, effects may become apparent if continuous measures of symptom severity are chosen.