Triple Network Neuroplasticity and Perinatal Mood Symptoms from Preconception to Postpartum: A Pilot Study

Background: Perinatal brain network alterations, including changes in resting-state functional connectivity (rsFC), may increase vulnerability for perinatal mood and anxiety disorders (PMAD). The Fronto-Parietal Network (FPN), the Default-Mode Network (DMN), and the Salience Network (SN) are interconnected networks implicated in mood disorders. However, these networks' role in perinatal neuroplasticity and PMAD remains unclear. Methods: This pilot study prospectively followed twenty-two women from preconception to postpartum. Participants completed anxiety and depression questionnaires and underwent fMRI scans at preconception and postpartum. The FPN, DMN, and SN were defined and average connectivity of each network was determined. Differences in connectivity from preconception to postpartum within each network and to each network at the whole-brain level were computed. Results: While connectivity within the FPN, DMN, and SN did not show significant changes from preconception to postpartum, we found increased rsFC from the left anterior prefrontal cortex to the DMN, and decreased rsFC from the right ventral posterior cingulate cortex to the FPN, from preconception to postpartum. Bilateral supplementary motor areas (SMAs) showed increased connectivity to the FPN from preconception to postpartum, and this change in connectivity was negatively correlated with anxiety scores during pregnancy. Right SMA connectivity to the FPN at preconception showed positive association with postpartum depression scores (p < 0.05 for all comparisons). Conclusions: RsFC perinatal-related changes were demonstrated in cognitive and motor regions connected to the DMN and FPN. Among women with perinatal depressive and anxiety symptoms, changes in SMA rsFC to the FPN from preconception to postpartum were observed, indicating possible roles in PMAD.