SA86. Neuroinflammation in Puerperal Psychosis: The Relationship Between Myelin Content and Peripheral Inflammatory Markers

Abstract Background: Postpartum Psychosis (PP) is a severe psychiatric disorder that usually occurs in the first 4 weeks after giving birth. Although PP occurs in conjunction with the biological changes in childbirth, its neurobiological basis is still poorly understood. Brain vulnerability and inflammation may play a role in the onset of PP, but little research has been done in this area. The aim of this study was to investigate the role of dysmyelination and markers of inflammation in the onset of PP. Methods: Fourteen women at risk of PP and 16 healthy women matched for age, ethnicity, education, and postpartum period were recruited in South London (United Kingdom). Blood samples were collected to measure high sensitivity C-reactive protein (hsCRP), interleukins (IL)-1β, IL-6, IL-10, TNF-a, and vascular endothelial growth factor (VEGF). MRI mcDESPOT sequences were acquired in a GE 3T scanner to measure myelin content. Myelin content and peripheral biomarkers were compared between the 2 groups, and the relationship between myelin content and inflammatory markers was investigated. Results: Women at risk of PP (N = 14) had higher serum level of IL-10 (Mean = 1.57 ng/L, SD = 1.16) and TNF-a (Mean = 2.36 ng/L, SD = 0.89) compared to controls (N = 16, M = 0.87 ng/L, SD = 0.65; M = 1.72 ng/L, SD=0.54, for IL-10 and TNF-a; P < .05), suggestive of a hyperactivation of the immune system in women at risk of PP. There was no significant difference in hs-CRP, IL-6, IL-1b, and VEGF serum levels between women at risk of PP and healthy controls. Women at risk of PP also showed significantly lower myelin content than controls in temporal lobes and sublobar areas (P < .05, corrected). Moreover, no significant association was found between myelin content and markers of inflammation. Conclusion: These findings suggest that peripheral inflammatory markers are raised in postpartum psychosis women. This work represents the first in vivo visualization of myelin content in first women at risk of PP. The lower myelin content in patients was found in areas implicated in psychosis, and this could be related to the vulnerability of the onset of symptoms after giving birth. Furthermore, we did not found any correlation between myelin content and markers of inflammation. Further work is needed to clarify the role of markers of inflammation in postpartum psychosis women.