title: Relationship of monoamine oxidase-A distribution volume to postpartum depression and postpartum crying.
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 [(11)C]-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.
authors: 1] CAMH Research Imaging Centre, Campbell Family Mental Health Research Institute, CAMH, Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada [2] Mood and Anxiety Disorders Division, Centre for Addiction and Mental Health and Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada [3] Clinic of Cognitive Neurology, University of Leipzig and Department of Neurology, Max-Planck-Institute for Human Cognitive and Brain Sciences, Leipzig, Germany.
authors: Julia
authors: J
authors: Sacher
authors: 1] CAMH Research Imaging Centre, Campbell Family Mental Health Research Institute, CAMH, Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada [2] Mood and Anxiety Disorders Division, Centre for Addiction and Mental Health and Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada.
authors: P Vivien
authors: PV
authors: Rekkas
authors: CAMH Research Imaging Centre, Campbell Family Mental Health Research Institute, CAMH, Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada.
authors: Alan A
authors: AA
authors: Wilson
authors: CAMH Research Imaging Centre, Campbell Family Mental Health Research Institute, CAMH, Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada.
authors: Sylvain
authors: S
authors: Houle
authors: 1] CAMH Research Imaging Centre, Campbell Family Mental Health Research Institute, CAMH, Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada [2] Mood and Anxiety Disorders Division, Centre for Addiction and Mental Health and Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada.
authors: Leslie
authors: L
authors: Romano
authors: Mood and Anxiety Disorders Division, Centre for Addiction and Mental Health and Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada.
authors: Jinous
authors: J
authors: Hamidi
authors: CAMH Research Imaging Centre, Campbell Family Mental Health Research Institute, CAMH, Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada.
authors: Pablo
authors: P
authors: Rusjan
authors: 1] CAMH Research Imaging Centre, Campbell Family Mental Health Research Institute, CAMH, Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada [2] Mood and Anxiety Disorders Division, Centre for Addiction and Mental Health and Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada.
authors: Ian
authors: I
authors: Fan
authors: Women's Health Program and the Toronto General Research Institute, University Health Network, University of Toronto, Toronto, Ontario, Canada.
authors: Donna E
authors: DE
authors: Stewart
authors: 1] CAMH Research Imaging Centre, Campbell Family Mental Health Research Institute, CAMH, Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada [2] Mood and Anxiety Disorders Division, Centre for Addiction and Mental Health and Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada.
authors: Jeffrey H
authors: JH
authors: Meyer
mesh_terms: D000328:Adult; D015415:Biomarkers / Q000378:metabolism; D002250:Carbon Radioisotopes; D003448:Crying / Q000502:physiology*; D019052:Depression, Postpartum / Q000000981:diagnostic imaging / Q000201:enzymology*; D005260:Female; D006179:Gyrus Cinguli / Q000000981:diagnostic imaging / Q000201:enzymology*; D006247:Harmine; D006801:Humans; D008995:Monoamine Oxidase / Q000378:metabolism*; D008996:Monoamine Oxidase Inhibitors; D015999:Multivariate Analysis; D049268:Positron-Emission Tomography; D017397:Prefrontal Cortex / Q000000981:diagnostic imaging / Q000201:enzymology*; D019275:Radiopharmaceuticals; D012815:Signal Processing, Computer-Assisted
chemical_list: D015415:Biomarkers; D002250:Carbon Radioisotopes; D008996:Monoamine Oxidase Inhibitors; D019275:Radiopharmaceuticals; D006247:Harmine; D008995:Monoamine Oxidase