Opioids and Maternal Brain-Behavior Adaptation During the Early Postpartum

阿片类药物与产后早期母亲大脑行为适应

基本信息

批准号：
10399732
负责人：
James Edward Swain
金额：
$ 2.88万
依托单位：
STATE UNIVERSITY NEW YORK STONY BROOK
依托单位国家：
美国
项目类别：
财政年份：
2019
资助国家：
美国
起止时间：
2019-09-30 至 2024-07-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/10399732
关键词：
Adaptive Behaviors Affect Aggressive behavior Amygdaloid structure Anxiety Base of the Brain Behavior Behavioral Biological Markers Brain Brain imaging Brain scan Buprenorphine Caring Child Child Abuse and Neglect Child Rearing Childhood Code Coupled Data Disinhibition Dose Drug usage Emotional Epidemic Family Foundations Globus Pallidus Gold Grant Hostility Human Hypothalamic structure Image Impairment Infant Infant Development Insula of Reil Interpersonal Relations Intervention Link MRI Scans Magnetic Resonance Imaging Maternal Behavior Measures Medial Mediating Mental Depression Mental Health Methods Modeling Mood Disorders Moods Mothers Neonatal Abstinence Syndrome Neurobiology Nucleus Accumbens Opiate Addiction Opioid Outcome Output Parents Participant Perinatal Physiology Postpartum Period Postpartum Women Pre-Clinical Model Pregnant Women Preoptic Areas Questionnaires Research Resolution Rest Risk Severities Societies Structure System Thinking Time Ursidae Family Ventral Tegmental Area Withdrawal Withdrawal Symptom Woman Work base behavior influence brain behavior buprenorphine treatment caregiving child bearing clinical decision-making comorbid depression comorbidity comparison group cost design dyadic interaction flexibility foster care gray matter high risk illicit opioid imaging study improved maternal caregiving midbrain central gray substance multimodality neuroimaging non-opioid analgesic offspring opioid epidemic opioid use opioid use disorder polysubstance use pre-clinical pre-clinical research prevent recruit response social

项目摘要

Project Summary Opioids and Maternal Brain-Behavior Adaptation During the Early Postpartum Opioid use disorder is a fast-growing and devastating epidemic in the US, affecting a high proportion of child-bearing women, with many suffering comorbid mood disorders. Untreated opioid use and dependence may cause withdrawal symptoms, impair interpersonal interactions and may be associated with polysubstance use and neonatal abstinence syndrome. These problems are linked to higher risks of child maltreatment and costly utilization of foster care. Buprenorphine Treatment (BT) reduces withdrawal and other deleterious effects of illicit opioids for expectant mothers. However, the effects of BT on maternal neurobiology and infant-oriented behaviors are unknown. Preclinical maternal brain-behavior research and human brain magnetic resonance imaging (MRI) studies have provided a model of corticolimbic maternal caregiving neurocircuits (MCN) for parenting and offspring survival. The MCN includes two reciprocally modulating systems for (1) maternal caregiving, mediated by the hypothalamic medial preoptic area (mPOA), ventral tegmental area (VTA), nucleus accumbens (NAc) and ventral pallidum; and (2) maternal defensive/aggressive behaviors, mediated by periaqueductal grey (PAG). For humans, the MCN regulates flexible responses to the demands of their own infant during adaptation to the early postpartum period - such as to the unique, ethologically salient own-baby cry. We aim to examine the human MCN and maternal behaviors in a group of opioid-dependent mothers undergoing BT (n=80), as compared to non-opioid using Depression Matched Controls (MC, n=80). All participant will have 2 MRI scans: T1 at 1-month postpartum and T2 at 4-month postpartum. The drug use and moods in all participants will be assessed at these two time points. We will combine multimodal neuroimaging methods, including functional responses to own-baby cry, gray matter volumes and resting state activity with assessments of maternal caregiving thoughts and behaviors – including measures of sensitivity and hostility – at T1 and T2. Based on our preliminary research and preclinical models we hypothesize that BT increases caregiving MCN responses to own vs. other-baby cry and such effects are linked to maternal caregiving thoughts and behaviors. We predict that T1 to T2 plastic adaptation in the MCN will be affected by BT - such that BT may interfere with normally opposing caregiving and defense subsystems of the MCN. Our controls will include recruitment of depression matched participants and statistical control for maternal childhood aversity, polysubstance use and offspring neonatal abstinence syndrome. Finally, we will explore the effects of these factors on brain and maternal behaviors within the group of BT-treated mothers. The proposed research will elucidate the effects of BT on the neurobiology of parenting - with translational potential to optimize current approaches and suggest directions to best manage postpartum mental health issues and improve mother-child bonding and child outcomes - a brain based biomarker.

项目概要阿片类药物与产后早期母亲大脑行为适应阿片类药物使用障碍在美国是一种快速增长且具有破坏性的流行病，影响了很大一部分人育龄妇女，许多患有未经治疗的阿片类药物使用和依赖的共病情绪障碍。可能导致戒断症状，损害人际互动，并可能与多种物质有关这些问题与儿童虐待和新生儿戒断综合症的较高风险有关。昂贵的寄养治疗（BT）可减少戒断和其他有害物质。然而，非法阿片类药物对孕妇的影响。婴儿导向的行为尚不清楚。临床前母亲大脑行为研究和人类大脑。磁共振成像（MRI）研究提供了皮质边缘孕产妇护理模型用于养育和后代生存的神经回路（MCN） MCN 包括两个相互调节的神经回路。 (1) 产妇护理系统，由下丘脑内侧视前区 (mPOA)、腹侧被盖区 (VTA)、伏隔核 (NAc) 和腹侧苍白球；(2) 母性防御/攻击性；对于人类来说，MCN 调节对导水管周围灰质 (PAG) 的灵活反应。自己的婴儿在适应产后早期的过程中的需求 - 例如独特的、我们的目的是研究人类的 MCN 和母亲行为。接受 BT 治疗的阿片类药物依赖母亲 (n=80)，与使用抑郁匹配的非阿片类药物相比对照（MC，n=80）。所有参与者将接受 2 次 MRI 扫描：产后 1 个月时进行 T1 扫描，4 个月时进行 T2 扫描。我们将在这两个时间点评估所有参与者的药物使用情况和情绪。结合多模式神经影像方法，包括对自己婴儿哭声的功能反应、灰质容量和静息状态活动以及对母亲护理思想和行为的评估 - 包括敏感性和敌意的测量——T1 和 T2 基于我们的初步研究和临床前模型。我们面临着 BT 增加了护理 MCN 对自己婴儿和其他婴儿哭声等的反应我们预测 T1 到 T2 的影响与母亲的护理思想和行为有关。 MCN 的适应将受到 BT 的影响 - 以致 BT 可能会干扰通常对立的护理我们的控制措施将包括招募抑郁症匹配的参与者。对母亲童年厌恶、多物质使用和后代新生儿戒断的统计控制最后，我们将探讨这些因素对群体内大脑和母亲行为的影响。拟议的研究将阐明 BT 对养育子女的神经生物学的影响。 - 具有优化当前方法的转化潜力，并提出最佳产后管理方向建议心理健康问题并改善母子关系和儿童结局 - 一种基于大脑的生物标志物。