How the DMM- AAI pr e dic ts br ain and be havior al r e sponse s of mothe r s and the ir infants L ane Str athe ar n, MBBS, PhD Unive rsity of Iowa , USA la ne - stra the a rn@uiowa .e du
the inte rna tio na l a sso c ia tio n fo r the stud y o f a tta c hme nt
the inte rna tio na l a sso c ia tio n fo r the stud y o f a tta c hme nt
Ne ur obiology of mate r nal c ar e giving SENSORY MOTOR INPUT OUTPUT (e.g. child (e.g. caregiving face/cry cues) behavior) the inte rna tio na l a sso c ia tio n fo r the stud y o f a tta c hme nt
Ne ur obiology of mate r nal c ar e giving SENSORY MOTOR INPUT OUTPUT (e.g. child (e.g. caregiving face/cry cues) behavior) the inte rna tio na l a sso c ia tio n fo r the stud y o f a tta c hme nt
Ne ur obiology of mate r nal c ar e giving VENTROMEDIAL PREFRONTAL CORTEX SENSORY MOTOR INPUT OUTPUT VENTRAL STRIATUM (e.g. child (e.g. caregiving face/cry cues) behavior) + +/- VENTRAL HYPO- TEGMENTAL THALAMUS AREA ENDOGENOUS OXYTOCIN Mesocorticolimbic Dopamine Pathway: “Reward” the inte rna tio na l a sso c ia tio n fo r the stud y o f a tta c hme nt
Ne ur obiology of mate r nal c ar e giving VENTROMEDIAL DORSOLATERAL PREFRONTAL PREFRONTAL CORTEX CORTEX SENSORY MOTOR INPUT OUTPUT VENTRAL DORSAL STRIATUM STRIATUM (e.g. child (e.g. caregiving face/cry cues) behavior) + + +/- +/- VENTRAL HYPO- SUBSTANTIA + TEGMENTAL THALAMUS NIGRA AREA ENDOGENOUS OXYTOCIN Mesocorticolimbic Nigrostriatal Dopamine Pathway: Dopamine Pathway: “Reward” “Habit Formation” the inte rna tio na l a sso c ia tio n fo r the stud y o f a tta c hme nt
Ne ur obiology of mate r nal c ar e giving VENTROMEDIAL DORSOLATERAL PREFRONTAL PREFRONTAL CORTEX CORTEX AMYGDALA SENSORY MOTOR INPUT OUTPUT VENTRAL DORSAL STRIATUM STRIATUM (e.g. child (e.g. caregiving face/cry cues) behavior) + + +/- +/- VENTRAL HYPO- SUBSTANTIA + TEGMENTAL THALAMUS NIGRA AREA ENDOGENOUS OXYTOCIN Mesocorticolimbic Nigrostriatal Dopamine Pathway: Dopamine Pathway: “Reward” “Habit Formation” the inte rna tio na l a sso c ia tio n fo r the stud y o f a tta c hme nt
Own Happy F ac e s: T ype B vs. T ype A VENTRAL 5 STRIATUM (se=1.0, t=3.0, p=0.006) 4 Bila te ra l % Signal Change 3 Ve ntra l 2 Stria tum 1 0 -1 y=11 Secure Insecure/Dismissing MEDIAL 1.5 (se=0.4, t=3.1, p=0.005) PREFRONTAL mPFC CORTEX 1 % Signal Change 0.5 Rig ht 0 -0.5 Me dia l -1 PF C x=-6 -1.5 Secure Insecure/Dismissing Stra the a rn e t al. Ne uro psyc ho pharmac o lo g y (2009) the inte rna tio na l a sso c ia tio n fo r the stud y o f a tta c hme nt
Own Sad F ac e s: T ype B vs. T ype A VENTRAL 1.4 STRIATUM 1.2 (se=0.4, t=3.1, p=0.005) R Ve ntra l 1 % Signal Change 0.8 VS Stria tum 0.6 0.4 0.2 0 -0.2 -0.4 -0.6 y=11 y=11 Secure Insecure/Dismissing 1.2 Insula (se=1.0, t=3.0, p=0.006) 1 % Signal Change 0.8 0.6 0.4 0.2 R I nsula 0 -0.2 -0.4 x=-6 y=17 Secure Insecure/Dismissing Stra the a rn e t al. Ne uro psyc ho pharmac o lo g y (2009) the inte rna tio na l a sso c ia tio n fo r the stud y o f a tta c hme nt
Unr e solve d tr auma in mothe r s • I nc lude s o c c urre nc e s o f c hildho o d a b use , ne g le c t, o r de a th o f a pa re nt • Curre nt disc o urse fro m Adult Atta c hme nt I nte rvie w indic a te s tha t the tra uma ha s no t b e e n a de q ua te ly pro c e sse d, a nd c o ntinue s to inte rfe re with c urre nt func tio ning the inte rna tio na l a sso c ia tio n fo r the stud y o f a tta c hme nt
Amygdala ac tivation to infant distr e ss in mothe r s with unr e solve d tr auma B. Unresolved A. No trauma trauma 1.1 R Amygdala BOLD Signal Change 1.1 (Estimated Marginal Means) 1.0 1.0 0.9 0.9 ** 0.8 0.8 Infant Identity 0.7 0.7 Own Unknown 0.6 0.6 0.5 0.5 y = -5 Happy Sad Happy Sad Amygdala AMYGDALA Infant Affect K im e t al. So c ial Ne uro sc ie nc e (2014) the inte rna tio na l a sso c ia tio n fo r the stud y o f a tta c hme nt
Unr e solve d tr auma in addic te d mothe r s • 98% o f study mo the rs with a ddic tio n pro b le ms a lso ha d unre so lve d tra uma (vs. 67% o f c o ntro l g ro up; p<0.001) the inte rna tio na l a sso c ia tio n fo r the stud y o f a tta c hme nt
Own-Happy Unknown-Happy Normative Mothers Addicted Mothers (n=36) (n=39) > 0.3 0.3 0.2 0.2 0.1 VENTRO- 0.1 MEDIAL 0 0 PFC -0.1 -0.1 -0.2 -0.2 -2 0 2 4 6 8 -2 0 2 4 6 8 Time (sec) Time (sec) 0.2 0.2 0 0 VENTRAL STRIATUM -0.2 -0.2 -0.4 -0.4 K im, S., Iye ng a r, U., Ma ye s, L . C., -2 0 2 4 6 8 -2 0 2 4 6 8 Po te nza , M. N., Ruthe rfo rd, H. J. V., & Stra the a rn, L . (2017). Human Time (sec) Time (sec) Brain Mapping , 38 (11), 5421-5439. the inte rna tio na l a sso c ia tio n fo r the stud y o f a tta c hme nt
Own-Happy Unknown-Happy Normative Mothers Addicted Mothers (n=36) (n=39) > x = -7 x = -16 VENTRO- MEDIAL PFC 0.3 0.3 0.2 0.2 0.1 0.1 0 0 -0.1 -0.1 -0.2 -0.2 -2 0 2 4 6 8 -2 0 2 4 6 8 Time (sec) Time (sec) y = 7 y = 7 VENTRAL STRIATUM 0.2 0.2 K im, S., Iye ng a r, U., Ma ye s, L . C., 0 0 Po te nza , M. N., Ruthe rfo rd, H. J. V., -0.2 -0.2 & Stra the a rn, L . (2017). Human -0.4 -0.4 -2 0 2 4 6 8 -2 0 2 4 6 8 Brain Mapping , 38 (11), 5421-5439. Time (sec) Time (sec) the inte rna tio na l a sso c ia tio n fo r the stud y o f a tta c hme nt
Whe r e to fr om he r e ? • Ra ndo mize d c o ntro lle d tria ls o f intra na sa l o xyto c in • Mo the rs with a ddic tio n • Po st-na ta l de pre ssio n • Mo the rs with inse c ure a tta c hme nt the inte rna tio na l a sso c ia tio n fo r the stud y o f a tta c hme nt
VENTROMEDIAL DORSOLATERAL PREFRONTAL PREFRONTAL CORTEX CORTEX AMYGDALA SENSORY MOTOR INPUT OUTPUT VENTRAL DORSAL STRIATUM STRIATUM (e.g. child (e.g. caregiving face/cry cues) behavior) + + +/- +/- VENTRAL HYPO- SUBSTANTIA + TEGMENTAL THALAMUS NIGRA AREA ENDOGENOUS OXYTOCIN Mesocorticolimbic Nigrostriatal Dopamine Pathway: Dopamine Pathway: “Reward” “Habit Formation” the inte rna tio na l a sso c ia tio n fo r the stud y o f a tta c hme nt
INTRANASAL OXYTOCIN VENTROMEDIAL DORSOLATERAL PREFRONTAL PREFRONTAL CORTEX CORTEX + AMYGDALA SENSORY MOTOR INPUT OUTPUT VENTRAL DORSAL STRIATUM STRIATUM (e.g. child (e.g. caregiving face/cry cues) behavior) + + +/- +/- VENTRAL HYPO- SUBSTANTIA + TEGMENTAL THALAMUS NIGRA AREA ENDOGENOUS OXYTOCIN Mesocorticolimbic Nigrostriatal Dopamine Pathway: Dopamine Pathway: “Reward” “Habit Formation” the inte rna tio na l a sso c ia tio n fo r the stud y o f a tta c hme nt
Oxytoc in inc re a se s re wa rd a nd a myg da la re sponse to infa nt fa c e s Own-Happy Unknown-Happy Normative Oxytocin Placebo Mothers (n=10) > VENTRAL/ DORSAL STRIATUM AMYGDALA VENTRAL TEGMENTAL AREA (VTA) the inte rna tio na l a sso c ia tio n fo r the stud y o f a tta c hme nt
Be rtino ro , 2008 Camb ridg e , 2010 T o download pr ogr am mate r ials, c lic k he r e https:/ / www.ia sa - dmm.org / ia sa - c onfe re nc e / F rankfurt, 2012 Miami, 2015
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