Psychopharmacology

, 186:425

Preliminary evidence of reduced occipital GABA concentrations in puerperal women: a 1H-MRS study

  • C. Neill Epperson
  • Ralitza Gueorguieva
  • Kathryn A. Czarkowski
  • Stephanie Stiklus
  • Edward Sellers
  • John H. Krystal
  • Douglas L. Rothman
  • Graeme F. Mason
Original Investigation

DOI: 10.1007/s00213-006-0313-7

Cite this article as:
Epperson, C.N., Gueorguieva, R., Czarkowski, K.A. et al. Psychopharmacology (2006) 186: 425. doi:10.1007/s00213-006-0313-7

Abstract

Rationale

Childbirth is associated with rapid neuroendocrine fluctuations, which are thought to contribute to the phatogenesis of postpartum major depression (PPD).

Objectives

The aim of this proton magnetic resonance spectroscopy (1H-MRS) study was two-fold; 1) to examine whether puerperium is associated with alterations in occipital cortex gamma-aminobutyric acid (GABA) concentrations and 2) to determine whether such alterations may be more prominent in women with PPD.

Materials and methods

Nine women with PPD, 14 postpartum healthy controls, and ten healthy follicular phase females underwent 1H-MRS at 2.1 Tesla to measure occipital cortex GABA concentrations. Postpartum women were scanned within 6 months of delivery and prior to resumption of menstruation. Healthy non-puerperal controls, drawn from a historical sample, were scanned during the early to mid-follicular phase when ovarian hormone levels would be similar to those found in the puerperium. GABA data were analyzed using analysis of covariance, and regression models were used to explore the relationship between cortical GABA concentrations and blood levels of estradiol, progesterone, and neurosteroids.

Results

Cortical GABA and plasma allopregnanolone (ALLO) concentrations were reduced in both groups of postpartum women, regardless of PPD diagnosis, compared to healthy follicular phase women. There was no correlation between cortical GABA concentrations and estradiol, progesterone, ALLO, or pregnenolone (PREG).

Conclusions

This study is the first to describe reductions in occipital cortex GABA levels in the postpartum period, a time of increased vulnerability to mood disturbances in women. The concomitant reduction in peripheral ALLO levels provides further evidence of alterations in the balance between cortical excitation and inhibition during the puerperium. Women with PPD may represent a subgroup of women who fail to adequately adapt to this alteration in the neuroendocrine milieu.

Keywords

Postpartum depression Puerperium GABA Neurosteroids MRS Pregnancy Allopregnanolone 

Copyright information

© Springer-Verlag 2006

Authors and Affiliations

  • C. Neill Epperson
    • 1
    • 2
    • 3
  • Ralitza Gueorguieva
    • 1
    • 3
    • 4
  • Kathryn A. Czarkowski
    • 1
    • 3
  • Stephanie Stiklus
    • 1
    • 3
  • Edward Sellers
    • 5
  • John H. Krystal
    • 1
    • 3
  • Douglas L. Rothman
    • 6
    • 7
  • Graeme F. Mason
    • 1
    • 6
  1. 1.Department of PsychiatryYale University School of MedicineNew HavenUSA
  2. 2.Department of Obstetrics, Gynecology and Reproductive SciencesYale University School of MedicineNew HavenUSA
  3. 3.Abraham Ribicoff Research FacilitiesConnecticut Mental Health CenterNew HavenUSA
  4. 4.Department of Epidemiology and Public HealthYale University School of MedicineNew HavenUSA
  5. 5.Departments of Pharmacology, Medicine and PsychiatryUniversity of Toronto and Ventana Clinical Research CorporationTorontoCanada
  6. 6.Department of Diagnostic RadiologyYale University School of MedicineNew HavenUSA
  7. 7.Department of Biomedical EngineeringYale University School of MedicineNew HavenUSA

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