Abstract
Postpartum depression (PPD) has a prevalence rate of 13% and a similarly high proportion of women report a subclinical state of one or more major depressive episode symptoms. The aim was to investigate whether monoamine oxidase-A (MAO-A) VT, an index of MAO-A density, is increased in the prefrontal and anterior cingulate cortex (PFC and ACC), during PPD or when a PPD spectrum symptom, greater predisposition to crying, is present. MAO-A is an enzyme that increases in density after estrogen decline, and has several functions including creating oxidative stress, influencing apoptosis and monoamine metabolism. Fifty-seven women were recruited including 15 first-onset, antidepressant naive, PPD subjects, 12 postpartum healthy who cry due to sad mood, 15 asymptomatic postpartum healthy women, and 15 healthy women not recently pregnant. Each underwent [11C]-harmine positron emission tomography scanning to measure MAO-A VT. Both PPD and greater predisposition to crying were associated with greater MAO-A VT in the PFC and ACC (multivariate analysis of variance (MANOVA), group effect, F21,135=1.856; p=0.019; mean combined region elevation 21% and 14% in PPD and crying groups, respectively, relative to postpartum asymptomatic). Greater MAO-A VT in the PFC and ACC represents a new biomarker in PPD, and the PPD symptom of predisposition to crying. Novel strategies for preventing PPD (and some PPD symptoms) may be possible by avoiding environmental conditions that elevate MAO-A level and enhancing conditions that normalize MAO-A level. These findings also argue for clinical trials in PPD with the newer, well-tolerated MAO-A inhibitor antidepressants.
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Acknowledgements
We thank Dr Alexandra Soliman, research co-ordinators Laura Miler and Cynthia Xu, administrative assistant Natasha Bennett, technicians Alvina Ng and Laura Nguyen, chemistry staff Jun Parkes, Armando Garcia, Winston Stableford and Min Wong, and engineers Terry Bell and Ted Harris-Brandts for their assistance with this project. This research received project support from the Canadian Institutes of Health Research (CIHR), the National Alliance for Research on Schizophrenia and Depression (NARSAD), salary support from Canadian Institutes of Health Research (CIHR), the Funds for the Advancement of Scientific Research Austria (FWF), the Society in Science (SiS) Branco Weiss Fellowship, Alexander von Humboldt Foundation, and infrastructure support from the Canadian Foundation for Innovation (CFI), and the Ontario Ministry for Research and Innovation. This research was presented in part at the 2011 Society of Biological Psychiatry and the American College of Neuropsychopharmacology meetings. Drs Meyer, Wilson, and Houle have received operating grant funding for other studies from Eli-Lilly, GlaxoSmithKline, Bristol Myers Squibb, Lundbeck, and SK Life Sciences in the past 5 years and Dr Meyer has consulted to several of these companies, as well as Sepracor, Mylan, and Teva. None of these companies participated in the funding, design or execution of this study, or writing the manuscript.
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Sacher, J., Rekkas, P., Wilson, A. et al. Relationship of Monoamine Oxidase-A Distribution Volume to Postpartum Depression and Postpartum Crying. Neuropsychopharmacol 40, 429–435 (2015). https://doi.org/10.1038/npp.2014.190
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DOI: https://doi.org/10.1038/npp.2014.190
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