Study uses brain imaging to understand postpartum depression
Findings may help identify women who are at high risk

Physician-scientists at UMass Medical School are using a series of innovative imaging techniques to measure chemical levels in the brains of postpartum women in an effort to understand why certain women develop depression after giving birth. Researchers believe that clues gleaned from the brain’s chemistry may be used to understand what causes the disorder so that future research can help identify women who are at high risk of developing postpartum depression before it occurs.

A form of clinical depression, postpartum depression affects one in eight women following childbirth. While the causes of postpartum depression aren’t fully understood, symptoms can include sadness, loss of interest in activities, feelings of hopelessness, crying spells, loss of appetite, anxiety and changes in sleeping and eating patterns. These symptoms can last anywhere from a few months to a year and may impact the patient’s ability to function. In some cases, severe symptoms can impair a mother’s ability to bond with or care for her child.

“Using new methods of imaging and measuring the brain’s chemistry, we can look at specific neurotransmitters in the brain involved in depression and see if there are any differences between women who develop postpartum depression and those who don’t,” said Kristina Deligiannidis, MD, assistant professor of psychiatry and principal investigator on the study.

Using noninvasive magnetic resonance spectroscopy (MRS), physician-scientists are measuring several neurotransmitters, including levels of gamma-aminobutyric (GABA), a neurotransmitter believed to be associated with depression, in the brains of postpartum patients, both with and without depression, who have volunteered for the study.

“People have shown that GABA levels, in people who are depressed, tend to be low,” said Constance Moore, PhD, associate professor of psychiatry and associate director of translational imaging. “Using MRS, we are able to measure the levels of GABA in a couple of different brain regions and compare them to other chemical indicators of depression to see how it varies in women who suffer from postpartum depression.”

Dr. Deligiannidis and Dr. Moore hypothesize that low levels of GABA and other neurotransmitters, in combination with changes in brain hormone levels, may be an indicator for women who are more prone to postpartum depression. “By better understanding the interaction of brain hormones and neurotransmitters during and after pregnancy, we hope to develop a test that can identify which women are more prone to develop postpartum depression,” said Deligiannidis. “It would then be possible to intervene before the illness manifests.”

Study volunteers are evaluated throughout pregnancy and then scanned after giving birth to isolate neurotransmitter levels in the brain. “The expertise and technology to perform MRS scans of these brain chemicals are available at only a handful of academic medical centers in the country,” said Deligiannidis. “We’re fortunate to have the technology and skill available at UMass Medical School to develop these unique methods for evaluating the interaction of brain chemicals and hormones in patients that make this study possible.”

The two-year, $150,000 study is funded by the UMass Center for Clinical and Translational Science and the Pilot Project Program Award, which is part of a broader five-year, $20 million Clinical and Translational Science Award UMMS received in 2010 from the National Institutes of Health to accelerate the process of turning laboratory discoveries into treatments for patients, engage communities in clinical research and enhance the training of a new generation of researchers.

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