2026 ECNP Congress

PS04-4114

Brain metabolites and their association with maternal–neonatal attachment and parenting stress in postpartum depression: a magnetic resonance spectroscopy pilot study

Nicholas Citerà — G. Delvecchio, L. Squarcina, S. Giomi, A. Clavarino, M. Cuomo, L. Sperti, C. Pini, C. Prunas, L. Lombardi, F.M. Triulzi, C. Moltrasio, S.M. Pozzoli, D. Mercadante, M. Fumagalli, P. Brambilla · Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Department of Neurosciences and Mental Health, Milan, Italy

2026 ECNP Congress

Introduction

Postpartum depression (PPD) is a mood disorder characterized by significant depressive symptoms that can appear during pregnancy and continue after childbirth [1]. Early recognition and treatment of PPD are crucial, as they improve both maternal and child health outcomes, reducing the risk of cognitive impairments and psychopathology in offspring. Neurobiologically, PPD is associated with structural and functional alterations in brain regions involved in emotion regulation and cognition [2]. Furthermore, magnetic resonance spectroscopy (¹H-MRS) has emerged as a valuable tool for investigating in vivo brain neurochemistry in depression, allowing the quantification of key metabolites that may reflect underlying neurobiological alterations in depressed patients compared to healthy controls (HC) [3].

Aims

The aim of this preliminary study was to investigate brain metabolite concentrations using 1H-MRS in women with postpartum depression compared to healthy controls, and their associations with depressive symptoms and maternal-neonatal emotional attachment.

Methods

Thirty-three post-partum women were recruited at IRCCS Ca’ Granda Ospedale Maggiore Policlinico: 21 HC (34.86 ± 3.54 years) and 12 PPD patients (34.08 ± 4.08 years). Single-voxel ¹H-MRS data were acquired in the dorso-lateral prefrontal cortex. Absolute metabolite concentrations were estimated using the unsuppressed water signal as an internal reference. Multiple linear regression analyses were performed to assess the relationship between ¹H-MRS (tNAA, mI, Glx, tCr, tCho concentrations) and scores on the Maternal Postnatal Attachment Scale (MPAS, subscales: Quality of Attachment (QA), Absence of Hostility (AH), Pleasure in Interaction (PI)) and the Parenting Stress Index (PSI, subscales: Parental Distress (PD), Parent-Child Dysfunctional Interaction (P-CDI), Difficult Child (DC), and Defensive Responding (DR)), including age, psychiatric treatment, and BMI as covariates. Analyses were conducted separately for the full sample and for the group of patients.

Results

Patients showed significantly lower MPAS-QA and higher PSI DR and PSI PD scores compared to HC (all p < 0.05), with no significant differences in age, BMI or metabolite concentrations between groups. In the full sample, significant models were found for MPAS-QA (p = 0.001), PSI DR (p = 0.008), and PSI PD (p = 0.009). Psychiatric treatment was the dominant predictor, being negatively associated with MPAS-QA (p < 0.001) and positively associated with PSI subscales (p < 0.05). Among metabolites, tCho was a negative predictor of PSI DR (p = 0.05). In patients, trends were observed for PSI DC (p = 0.096) and PSI P-CDI (p = 0.069), with mI (p = 0.033) and tCr (p = 0.020) emerging as potential predictors.

Discussion

The findings of our study reveal significant differences in terms of depressive symptoms and maternal-neonatal emotional attachment in PPD patients compared to HC. Moreover, interesting associations between selective brain metabolites and MPAS and PSI subscales were observed, highlighting the potential role of brain metabolism influencing depression and emotional attachment in PPD individuals. These associations suggest that specific metabolites may serve as biomarkers for identifying postpartum depression and understanding the emotional dynamics between mothers and their neonates, ultimately enhancing our understanding of the complex interplay between brain function and maternal mental health.

References

  1. American Psychiatric Association, 2013. Diagnostic and Statistical Manual of Mental Disorders, fifth ed. American Psychiatric Publishing, Arlington, VA.
  2. Tang, Y., Tang, Z., Zhou, Y., Luo, Y., Wen, X., Yang, Z., Jiang, T., Luo, N., 2025. A systematic review of resting-state functional-MRI studies in the diagnosis, comorbidity and treatment of postpartum depression. J. Affect. Disord. 383, 153–166. https://doi.org/10.1016/j.jad.2025.04.142
  3. Urrila, A.S., Hakkarainen, A., Castaneda, A., Paunio, T., Marttunen, M., Lundbom, N., 2017. Frontal cortex myo-inositol is associated with sleep and depression in adolescents: a proton magnetic resonance spectroscopy study. Neuropsychobiology 75 (1), 21–31. https://doi.org/10.1159/000478861