The relationship between mirror-touch synaesthesia and empathy: new evidence and a new screening tool

People with mirror-touch synaesthesia (MTS) report experiencing tactile sensations on their own body when seeing another person being touched. Although this has been associated with heightened empathy and emotion perception, this finding has recently been disputed. Here, we conduct two experiments to explore this relationship further. In Study 1, we develop a new screening measure for MTS. We show that MTS is related to vicarious experiences more generally (including to itch and pain), but is not a simple exaggerated version of normality. For example, people with MTS report videos of scratching as ‘touch’ rather than ‘itchiness’ and have localized sensations when watching others in pain. In Study 2, we show that MTS is related to increased emotional empathy to others and better ability to read facial expressions of emotion, but other measures of empathy are normal-to-low. In terms of theoretical models, we propose that this is more consistent with a qualitative difference in the ability to selectively inhibit the other and attending to the self, which leads to heightened activity in shared self-other representations (including a mirror system for touch, but also includes other kinds of vicarious experience)

Restless Legs Syndrome During Pregnancy and 12 Weeks Postpartum and Its Links to Cardiovascular Diseases, Stressful Life Events, and Psychiatric History

Restless legs syndrome (RLS) is highly prevalent among pregnant women. In the present study, a neurological–obstetrical sample of 561 postpartum women was retrospectively screened for RLS symptoms during pregnancy and in the first 12 weeks postpartum. The first screening took place within 1 to 6 days of delivery (T0) and the second 12 weeks after childbirth (T1). The pregnancy-related RLS prevalence rate was found to be 21% (n = 119), with the women suffering from RLS being more often affected by psychiatric history and having been more exposed to stressful life events. They were also found to have experienced baby blues more frequently shortly after childbirth. However, RLS in pregnancy did not appear to have any effect on the development of postpartum depression. Additionally, a positive trend was observed toward an association between pregnancy-related RLS and gestational diabetes and hypertension. Of the 119 women, 23 (19.3%) remained affected by RLS 12 weeks postpartum. Body mass index (BMI), weight gain, parity, childbearing history, or chronic stress exposure in pregnancy as measured by hair cortisol were not found to be linked to RLS. In summary, a comprehensive understanding of the interaction of clinical, environmental, and anamnestic factors can help shed valuable light on this pregnancy-related condition

Diminishing effects after recurrent use of self-guided internet-based interventions in depression: Randomized controlled trial

Background: Self-guided internet-based interventions have several advantages over guided interventions and are generally effective in treating psychiatric symptoms. Objective: We aimed to investigate whether the use of a new self-guided internet-based intervention (MOOD) would lead to a significant reduction in depressive symptoms compared with a care-as-usual (CAU) control group in a sample of individuals with depressive symptoms, most of whom had already used a different self-guided internet-based intervention in a previous trial. Methods: A total of 125 individuals were randomized to the intervention condition (MOOD) and received access to the intervention for a period of six weeks or a CAU group. After six weeks, all participants were invited to take part in the post assessment. The Beck Depression Inventory-II served as the primary outcome. Results: Both intention-to-treat as well as per-protocol analyses indicated that the depressive symptomatology decreased in both conditions but showed no advantage for those who had used MOOD. Subsequent moderation analyses suggested that those individuals who had less experience with psychotherapy benefitted to a greater extent compared with those with more experience. Conclusions: Self-guided internet-based interventions are deemed a suitable first-step approach to the treatment of depression. However, our results indicate that they are more efficacious in those with less psychotherapy experience

Results of RIPOD (risk of postpartum depression) study: postpartum follow-ups, risk factors and prediction for clinical cases, and multimodal neuroimaging data

As part of the RiPoD study, a large cohort (n = 700) of new mothers were recruited 1-6 days postpartum at the university hospital in Aachen and were observed for a period of 12 weeks. While 9% of them were found to develop postpartum depression (PPD), 13% developed postpartum adjustment disorder (AD). The PPD and AD cases were accurately identified by means of a combination of clinical and remote assessment tools (Hahn et al. 2021). In the exploration cohort, a balanced accuracy of 87% was achieved in week 3 postpartum using a combination of baseline and follow-up depression EPDS scores and mood scores (online mood assessment) for the differentiation between PPD and ND. The results were confirmed in the independent replication cohort. Within the first 6 weeks postpartum, the clinical manifestation of AD and PPD resembled each other based on personal and family history of depression, stressful life events, depressive symptoms, and attachment to the child. A comparison between cumulative hair cortisol and cortisone levels in the third trimester of pregnancy and the first 12 weeks postpartum revealed that only ND and AD (and not PPD) had pregnancy-related physiological adaptation in cortisol/cortisone levels, which reverted to the pre-pregnancy baseline following delivery (Stickel et al. 2021). Approximately 2 days after delivery, we also found that women who developed either AD or PPD within 12 weeks did not differ from ND immediately after delivery on the basis of structural and functional neuroimaging data (Schnakenberg et al. 2021). In the very early postpartum period, the mothers showed a significant reduction in gray matter volume in brain areas related to socio-cognitive and emotional processes compared to their nulliparous counterparts, indicating an effect of pregnancy on brain structure (Chechko et al. 2021)

Phenotypical predictors of pregnancy-related restless legs syndrome and their association with basal ganglia and the limbic circuits

Restless legs syndrome (RLS) in pregnancy is a common disorder with a multifactorial etiology. A neurological and obstetrical cohort of 308 postpartum women was screened for RLS within 1 to 6 days of childbirth and 12 weeks postpartum. Of the 308 young mothers, 57 (prevalence rate 19%) were identified as having been affected by RLS symptoms in the recently completed pregnancy. Structural and functional MRI was obtained from 25 of these 57 participants. A multivariate two-window algorithm was employed to systematically chart the relationship between brain structures and phenotypical predictors of RLS. A decreased volume of the parietal, orbitofrontal and frontal areas shortly after delivery was found to be linked to persistent RLS symptoms up to 12 weeks postpartum, the symptoms' severity and intensity in the most recent pregnancy, and a history of RLS in previous pregnancies. The same negative relationship was observed between brain volume and not being married, not receiving any iron supplement and higher numbers of stressful life events. High cortisol levels, being married and receiving iron supplements, on the other hand, were found to be associated with increased volumes in the bilateral striatum. Investigating RLS symptoms in pregnancy within a brain-phenotype framework may help shed light on the heterogeneity of the condition

Examining early structural and functional brain alterations in postpartum depression through multimodal neuroimaging

Background: Postpartum depression (PPD) affects approximately 1 in 10 women after childbirth. A thorough understanding of a preexisting vulnerability for PPD will likely aid the early detection and treatment of PPD and help minimize its debilitating effects. Methods: Using a within-sample association, the study aimed to determine whether the brain’s structural and functional alterations predict the onset of depression. To that end, 157 euthymic postpartum women were subjected to a multimodal MRI scan within the first 6 days of childbirth, and were subsequently followed up for 12 weeks. Based on a clinical interview 12 weeks postpartum, participants were classified as mentally healthy or having either PPD or adjustment disorder (AD). Voxel-based morphometry and resting-state functional connectivity comparisons were performed between the three groups. Results: 13.4% of women in our study developed PPD (n=21) and 12.1% (n=19) adjustment disorder (AD). The risk factors for PPD were a psychiatric history and the experience and severity of baby blues and the history of premenstrual syndrome. Despite the different risk profiles, no differences between the PPD, AD and control group were apparent based on the structural and functional neuroimaging data. At 12 weeks postpartum, a significant association was observed between Integrated Local Correlation (LCor) and the Edinburgh Postnatal Depression Score (EPDS). Conclusion: Our findings do not support the notion that the brain’s structural and resting-state functional alterations, if present, can be used as an early biomarker of PPD or AD. However, effects may become apparent if continuous measures of symptom severity are chosen

Examining early structural and functional brain alterations in postpartum depression through multimodal neuroimaging

Postpartum depression (PPD) affects approximately 1 in 10 women after childbirth. A thorough understanding of a preexisting vulnerability to PPD will likely aid the early detection and treatment of PPD. Using a within-sample association, the study examined whether the brain's structural and functional alterations predict the onset of depression. 157 euthymic postpartum women were subjected to a multimodal MRI scan within the first 6 days of childbirth and were followed up for 12 weeks. Based on a clinical interview 12 weeks postpartum, participants were classified as mentally healthy or having either PPD or adjustment disorder (AD). Voxel-based morphometry and resting-state functional connectivity comparisons were performed between the three groups. 13.4% of women in our study developed PPD (n = 21) and 12.1% (n = 19) adjustment disorder (AD). The risk factors for PPD were a psychiatric history and the experience and severity of baby blues and the history of premenstrual syndrome. Despite the different risk profiles, no differences between the PPD, AD and control group were apparent based on structural and functional neuroimaging data immediately after childbirth. At 12 weeks postpartum, a significant association was observed between Integrated Local Correlation (LCor) and the Edinburgh Postnatal Depression Score (EPDS). Our findings do not support the notion that the brain's structural and resting-state functional alterations, if present, can be used as an early biomarker of PPD or AD. However, effects may become apparent if continuous measures of symptom severity are chosen

Accurate early identification of postpartum depression using demographic, clinical and digital phenotyping

Introduction: Postpartum depression (PPD) affects up to 13% of women. Although demographic and clinical risk factors have been identified, there are no accurate predictors for PPD to such an extent that at risk mothers can be identified and benefit from early interventions.Methods: We recruited 308 mothers at the University Hospital Aachen. Demographic and clinical measures incl. self-reported mood and stress assessment scales were collected from two to five days to 12 weeks postpartum, on a weekly and daily basis respectively. After 12 weeks, participants were defined into three groups according to DSM-5 criteria: healthy controls (HC; N=247), women with PPD (N=28), and women with adjustment disorder (AD; N=33). We used a logistic regression algorithm to evaluate the potential predictive power of baseline demographic, clinical, and digital phenotyping for early identification of PPD. We performed 1000 permutations using three-fold cross validation to obtain accuracy estimates.Results: Most accurate early differentiation between PPD vs. HC and AD vs. HC was achieved by using baseline demographic and clinical risk factors in addition to postnatal depression scores at week 3 (PPD vs. HC: balanced accuracy: 0.78, sensitivity: 0.73, specificity: 0.82; AD vs. HC: balanced accuracy: 0.89, sensitivity: 0.85, specificity: 0.93). Accurate differentiation of PPD vs. AD was only possible at week 6 with mood scores being most accurate resulting in a balanced accuracy of 0.76 (sensitivity: 0.76, specificity: 0.76).Conclusion: In conclusion, combinations of mood level, postnatal depression scores, and baseline risk factors allowed for an accurate early identification of women at risk for PPD

Early identification of postpartum depression using demographic, clinical, and digital phenotyping

Postpartum depression (PPD) and adjustment disorder (AD) affect up to 25% of women after childbirth. However, there are no accurate screening tools for either disorder to identify at-risk mothers and enable them to benefit from early intervention. Combinations of anamnestic, clinical, and remote assessments were evaluated for an early and accurate identification of PPD and AD. Two cohorts of mothers giving birth were included in the study (N = 308 and N = 193). At baseline, participants underwent a detailed sociodemographic-anamnestic and clinical interview. Remote assessments were collected over 12 weeks comprising mood and stress levels as well as depression and attachment scores. At 12 weeks postpartum, an experienced clinician assigned the participants to three distinct groups: women with PPD, women with AD, and healthy controls (HC). Combinations of these assessments were assessed for an early an accurate detection of PPD and AD in the first cohort and, after pre-registration, validated in a prospective second cohort. Combinations of postnatal depression, attachment (for AD) and mood scores at week 3 achieved balanced accuracies of 93 and 79% for differentiation of PPD and AD from HC in the validation cohort and balanced accuracies of 87 and 91% in the first cohort. Differentiation between AD and PPD, with a balanced accuracy of 73% was possible at week 6 based on mood levels only with a balanced accuracy of 73% in the validation cohort and a balanced accuracy of 76% in the first cohort. Combinations of in clinic and remote self-assessments allow for early and accurate detection of PPD and AD as early as three weeks postpartum, enabling early intervention to the benefit of both mothers and children