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Maternal Depression and Antidepressant Effects on Fetal Brain Structure and Function (FABMOMS)
PROJECT ABSTRACT Major depressive disorder (MDD) is one of the most common diseases in childbearing women, with a prevalence of 12.7% in pregnancy and 21.9% the year after birth. Exposure to maternal stress and depressive symptoms alters fetal/infant neurodevelopment, functional brain connectivity, and networks implicated in stress processing. About 5% of pregnant women are prescribed a serotonin selective or serotonin norepinephrine reuptake inhibitor (collectively, SRI). Remission of maternal MDD is crucial to the health and functioning of the mother and family. In observational studies typical of this field, differentiating the effects of drug exposure on offspring from the sequelae of the underlying psychiatric disease, both physiological and psychosocial, is challenging. Substantial progress has been made using sophisticated study designs and analytic approaches with large pregnancy cohorts that reduce the risk of spurious associations. Increased rates of overall and cardiac defects, stillbirth, preterm birth, and fetal growth have been largely explained by confounding by factors associated with both MDD and these outcomes rather than SRI exposure. Assessing the neurobehavioral development of children exposed in utero to SRI is the current research priority in this field. Our team pioneered the development of novel and safe fetal and neonatal quantitative magnetic resonance imaging (qMRI) tools, which will be combined with an evaluation of maternal heart rate variability to explore associations between exposures to stress, psychiatric symptoms and SRI on fetal and neonatal brain structure and function. The overarching goal of this project is to evaluate the separate and interactive effects of exposure to antidepressants in utero and maternal MDD on fetal and infant brain structure and function, with a specific focus on the hippocampus. We will accomplish this by evaluating four groups of pregnant women who have: 1) MDD treated with SRI to remission), 2) MDD treated with SRI (non-remitted, with both depressive symptom and SRI exposure), 3) MDD untreated with antidepressants, and 4) no current MDD or SRI treatment. Maternal assessments will occur at intake and in the early third trimesters and in then newborn period (at the time of fetal/newborn MRI) after birth. Maternal and infant evaluations will continue at 6 and 12 months postpartum. Maternal psychosocial and psychiatric status will provide extensive data on the context in which mothers experience pregnancy and infant care and allow adjustment for factors that will inevitably differ across groups. Lastly, we will explore the effects of maternal choline on MDD and offspring brain development. As these exposures and neurodevelopmental studies are conducted, exploring primary preventive strategies is a public health imperative. We will explore a potential mediator, poor maternal choline intake, a modifiable risk factor for both maternal MDD and altered fetal hippocampal growth and infant neurobehavior.
Does subjective time interact with the heart rate?
Decades of research have investigated the relationship between perception of time and heart rate with often mixed results. In search of such a relationship, I will present my far journey between two projects: from time perception in the realistic VR experience of crowded subway trips in the order of minutes (project 1); to the perceived duration of sub-second white noise tones (project 2). Heart rate had multiple concurrent relationships with subjective temporal distortions for the sub-second tones, while the effects were lacking or weak for the supra-minute subway trips. What does the heart have to do with sub-second time perception? We addressed this question with a cardiac drift-diffusion model, demonstrating the sensory accumulation of temporal evidence as a function of heart rate.
Brain-body interactions that modulate fear
In most animals including in humans, emotions occur together with changes in the body, such as variations in breathing or heart rate, sweaty palms, or facial expressions. It has been suggested that this interoceptive information acts as a feedback signal to the brain, enabling adaptive modulation of emotions that is essential for survival. As such, fear, one of our basic emotions, must be kept in a functional balance to minimize risk-taking while allowing for the pursuit of essential needs. However, the neural mechanisms underlying this adaptive modulation of fear remain poorly understood. In this talk, I want to present and discuss the data from my PhD work where we uncover a crucial role for the interoceptive insular cortex in detecting changes in heart rate to maintain an equilibrium between the extinction and maintenance of fear memories in mice.
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Severity assessment in the unilateral and bilateral 6-OHDA rat Parkinson model: Telemetric monitoring of heart rate and activity
FENS Forum 2024
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