Structural insights into postpartum depression: Hippocampal volume as a predictor for symptom relief
Poster No:
477
Submission Type:
Abstract Submission
Authors:
Carina Koeppel*1, Josefin Mücke*2, Sofia Attolini1, Julia Wildschut1, Malek Bajbouj1, Simone Grimm3
Institutions:
1Charité Universitätsmedizin, Berlin, 2Universität Konstanz, Baden Württemberg, 3Medical School, Berlin
First Author:
Co-Author(s):
Introduction:
Postpartum depression (PPD) is one of the most prevalent postpartum complications with severe adverse effects for both the parent and the offspring. PPD impairs maternal quality of life, mother-infant bonding as well as the offspring's physical and emotional development (Slomian et al., 2019; Vogel et al., 2024). Hormonal transition periods such as pregnancy and postpartum are critical for the development of affective symptoms and closely linked to reductions in hippocampal volume observable up to two years postpartum (Pritschet et al., 2024). Having a unique function in mood regulation, memory encoding and adult neurogenesis, the observed alterations might reflect physiological neuroplasticity in the maternal brain, which is potentially dysregulated in postpartum depression (Cárdenas et al., 2020). However, studies in postpartum depressed mothers focusing on associations between structural markers and disease outcome remain scarce. Hence, in the present study, we aimed to investigate if hippocampal volume predicts treatment response in postpartum depression.
Methods:
To address this research question, clinical data was retrospectively collected from 18 mothers suffering from postpartum depression, admitted for in-patient treatment over 8-10 weeks to the psychiatric parent-child unit at Charité Berlin. Depression severity was weekly assessed via the Montgomery–Åsberg Depression Rating Scale (MADRS; Montgomery & Asberg, 1979) and every patient received a structural MRI at admission. Treatment response was defined as a reduction in total MADRS score from admission to discharge of fifty percent or more or a total MADRS score at discharge smaller or equal to ten (Hawley et al., 2002). The percentual change of the MADRS score from admission to discharge for each subject was calculated as a continuous measure of overall symptom reduction. Left and right hippocampus were defined as ROIs and segmented using the FSL pipeline fsl_anat, the volumes extracted using the fslstats command. Linear regression analyses were performed with percentual change in MADRS score as outcome variable and either left or right hippocampal volume as predictor, and TIV and depression severity as control variables. For all tests the alpha level was set to .05, statistical analysis was performed using R version 4.3.1.
Results:
Over the course of in-patient treatment, the mothers showed an average overall symptom reduction of 57.86% (SD = 20.35, range from 23.68 to 100%). The right hippocampus volume was significantly lower in the responders (M = 3650.02, SD = 269.32) than in the non-responders group (M = 4014.96, SD = 376.78), t(16)=2.40, p = .029. The model with left hippocampal volume as predictor for overall symptom reduction did not reach significance (F(1, 16) = 0.80, p = .386), while the model including the right hippocampal volume as predictor yielded statistical significance and explained 24.86% of the variance in overall symptom reduction in our sample (F(1, 16) = 5.29, p = .035, R² = .2486), Fig. 1.
Conclusions:
Our findings introduce first insights into structural markers for treatment response in postpartum depression with smaller hippocampal volume predicting better treatment outcomes. In line with neuroplastic changes observed over the course of the menstrual cycle, pregnancy and postpartum, our work further highlights the key role of the hippocampal structure in understanding the underlying mechanisms of affective disorders occurring in specific hormonal transition periods. Prospectively, structural markers may help provide more precise and personalized treatment strategies.
Disorders of the Nervous System:
Psychiatric (eg. Depression, Anxiety, Schizophrenia) 1
Novel Imaging Acquisition Methods:
Anatomical MRI 2
Keywords:
Affective Disorders
MRI
Psychiatric
Psychiatric Disorders
1|2Indicates the priority used for review
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Provide references using APA citation style.
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