Resident Physician MGH/McLean Hospital Boston, Massachusetts, United States
Abstract
Background: Childhood maltreatment is a pervasive public health problem with devastating and lasting consequences for psychological well-being and health across the lifespan. Although previously thought to be limited to a single individual, the negative effects of childhood maltreatment may be transmitted across generations, increasing the risk for behavioral and psychiatric disorders in the offspring. An increased understanding of the mechanisms underlying intergenerational effects is important for the development of preventive interventions. The present study, therefore, aims to examine the associations between maternal childhood maltreatment and offspring brain and biobehavioral outcomes.
Methods: Maternal childhood maltreatment history was assessed during pregnancy using the Childhood Trauma Questionnaire (CTQ) in 64 women. Shortly after birth (M=26.48 ± 11.43 days), their offspring underwent a resting state functional connectivity MRI scan during natural sleep. A whole-brain voxel-wise regression model was performed with the log of the total CTQ score predicting offspring amygdala functional connectivity. Neonatal amygdala connections that remained significantly associated with maternal childhood maltreatment after adjusting for potential confounds were considered as potential candidate neural phenotypes to examine in relation to infant attachment classification using the Strange Situation Procedure. A structural equation model was used to test for mediation by examining the indirect path from maternal childhood maltreatment history to infant biobehavioral outcomes via the selected newborn neural phenotype.
Results: Neonates of mothers with a history of childhood maltreatment showed altered amygdala functional connectivity to several brain regions including the pars opercularis, parahippocampus, temporal pole, dorsal anterior cingulate cortex (dACC), occipital cortex, fusiform, precentral gyrus, and cuneus. Follow up analyses focused on amygdala-dACC functional connectivity, due to its role in stress reactivity and regulation. Stronger amygdala-dACC functional connectivity related to increased likelihood of infants developing an insecure attachment at 12 months of age after adjusting for key potential confounds in the postnatal environment. Interestingly, stronger neonatal amygdala-dACC connectivity also mediated the association between maternal history of childhood maltreatment and increased risk of insecure attachment. Conclusion: The results of this study suggest a neural phenotype related to a maternal history of childhood maltreatment. The findings further suggest that the intrauterine period is important for the intergenerational transmission of the effects of maternal childhood maltreatment, even in a cohort with relatively low rates of reported childhood maltreatment. Given the role of the anterior cingulate cortex as a potential biomarker for both risk and resilience, and its sensitivity to environmental influences, it is imperative to explore how prenatal and preconceptional interventions can best support maternal and infant mental health.
