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J Neuroendocrinol. 2019 Jul 9:e12770. doi: 10.1111/jne.12770. [Epub ahead of print]

Early postpartum resting-state functional connectivity for mothers receiving buprenorphine treatment for opioid use disorder: A Pilot Study.

Author information

1
Department of Psychiatry and Behavioral Health & Psychology, Stony Brook University Medical Center, Stony Brook, NY.
2
Department of Psychiatry, Psychology and Center of Human Growth and Development, University of Michigan, Ann Arbor, MI, United States.

Abstract

OBJECTIVE:

Between 1999 and 2014, the prevalence of opioid use disorder (OUD) among pregnant women quadrupled in the U.S. The standard treatment for peripartum women with OUD is buprenorphine. However, the Maternal Behavior Neurocircuit, that regulates maternal behavior and mother-infant bonding, has not been previously studied for human mothers receiving buprenorphine treatment for OUD (BT). Rodent research shows opioid effects on reciprocal inhibition between maternal care and defense maternal brain subsystems: hypothalamus and periaqueductal gray respectively. We conducted a longitudinal functional magnetic resonance imaging (fMRI) pilot study in humans to specifically examine resting-state functional connectivity (rs-FC) between periaqueductal gray and hypothalamus, and explore associations with maternal bonding for BT.

METHODS:

We studied 32 mothers who completed fMRI scans at 1-month (T1) and 4-months postpartum (T2), including 7 mothers receiving buprenorphine for OUD and 25 non-OUD mothers as a comparison group (CG). The participants underwent a 6-minute resting-state fMRI scan at each time point. We measured potential bonding impairments with the Postpartum Bonding Questionnaire to explore how rs-FC with periaqueductal gray is associated with bonding impairments.

RESULTS:

As compared to CG, BT mothers differed in periaqueductal gray-dependent rs-FC with the hypothalamus, amygdala, insular cortex, and other brain regions at T1 and many of these differences disappeared at T2, suggesting potential therapeutic effects of continuing buprenorphine treatment. Also, the "rejection and pathological anger" subscale of Postpartum Bonding Questionnaire at T1 and T2 were associated with the T1-to-T2 increases in periaqueductal gray-dependent rs-FC with the hypothalamus and amygdala.

CONCLUSION:

Preliminary evidence links maternal bonding problems for mothers with OUD early in the postpartum to connectivity between specific care and defense maternal brain circuits, which may be mitigated by buprenorphine treatment. This exploratory study supports a potential mechanism to study both therapeutic benefits and risks of opioids for maternal care and bonding with infants. This article is protected by copyright. All rights reserved.

KEYWORDS:

Opioid; bonding; buprenorphine; hypothalamus; maternal brain behavior neurocircuit; mothers; neuroimaging; periaqueductal gray; resting-state functional connectivity

PMID:
31287922
DOI:
10.1111/jne.12770

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