Anterior Cingulate Cortex Abnormalities in Postpartum Psychosis. A structural MRI study.

Presentation First Author: 
montserrat Fuste

Introduction: Postpartum Psychosis (PP) is the most severe psychiatric disorder associated with childbirth. The risk is very high in women with bipolar disorder. Unfortunately, the neurobiological basis of PP remains poorly understood and no previous study has evaluated brain structure in women at risk of, or with, PP. The aims of the study were: 1) Examine brain structural differences in women that develop PP episode compared to the ones that dont develop PP and healthy controls. 2) Study differences in the amygdala and the anterior cingulate cortex, areas known to be involved in the affective psychosis spectrum. Methods: This is a Cross-sectional study of 21 healthy postpartum women and 24 women at risk of postpartum psychosis. Within this group, 12 developed postpartum psychosis and 12 did not develop postpartum psychosis. We applied a Voxel Based Morphometry (VBM) first in a whole brain analysis and then a Region of interest analysis of Anterior Cingulate Cortex (ACC) and Amygdala to evaluate the differences in brain structure among the 3 groups. Results: The subgroup that developed PP showed a reduction in the Anterior Cingulate Cortex (ACC) volume compared to those who did not develop PP , the results were statistically significant peak value in coordinates (x, y, z) (4,9,29) t=3.36, pFWE -SVC= 0.002 and k= 129, whereas we did not find significant differences in the at risk group when comparing with control group. Conclusions: These findings suggest that postpartum psychosis show specific volumetric abnormalities in areas relevant to the pathophysiology of affective psychosis.

Conference Name: 
Presentation Date: 
January, 2015
Additional Authors: 
Astrid Pauls - Simone Reinders - Mitul Mehta - Andy Simmons - Steven CR Williams - Carmine Pariante - Paola Dazzan
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