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Yale Psychiatry Grand Rounds: "Infant Neurobehavioral Processing of the Parent and Trauma"

May 10, 2024

May 10, 2024

Flynn Lecture: "Infant Neurobehavioral Processing of the Parent and Trauma"

Regina Sullivan, PhD,

ID
11654

Transcript

  • 00:00So sweet, Thank you for that
  • 00:02lovely introduction and
  • 00:03thank you for the invitation.
  • 00:04It's a pleasure to be here.
  • 00:05I am honored to be on a list of
  • 00:07such incredible researches that
  • 00:09you've had come speak with you.
  • 00:12So thank you. You know,
  • 00:15it's really interesting to be here
  • 00:17to give my presentation when Charlie
  • 00:20Greer is in the audience because
  • 00:23he was instrumental in actually
  • 00:25starting this area out with maternal
  • 00:29odor and the neural circuitry in the
  • 00:31olfactory bulb really important work.
  • 00:33So it's lovely to see you
  • 00:35here when I give this talk,
  • 00:36what probably as I end my career to have.
  • 00:39Yeah. So it's really lovely.
  • 00:41Thank you.
  • 00:42Let me just go through about 8 slides
  • 00:45where I give background information.
  • 00:47So just so you understand my approach,
  • 00:51which is a a bit different from what
  • 00:53one typically hears and I want you to
  • 00:55be conscious of those distinctions.
  • 00:57So everybody here knows that early
  • 01:00life trauma impacts the brain,
  • 01:02but really it's in later life that
  • 01:05the psychiatric disorders emerge.
  • 01:06So it's a really horrible challenge
  • 01:09that to this day we really don't
  • 01:12understand what the roots of the
  • 01:14roots of that pathology are and what
  • 01:16initiates that pathway to pathology.
  • 01:19So that's what we're exploring.
  • 01:21So as we do that, we try to make sure that,
  • 01:28sorry, that was me,
  • 01:30we try to make sure that we only
  • 01:33use infant neurobiology to explain
  • 01:35the infant brain.
  • 01:37And I mention this because so much of
  • 01:40the literature uses the adult brain
  • 01:42to explain behaviors in the infant
  • 01:45and it can be troublesome because
  • 01:46the infant brain is still immature.
  • 01:48So even with an attachment,
  • 01:51there are different types of attachment
  • 01:54across development and frequently
  • 01:56you can see maternal behavior.
  • 01:58Neurobiology used to explain
  • 02:00infant attachment.
  • 02:01So as I give this data,
  • 02:04please don't upset with me if I
  • 02:06don't cite the adult attachment
  • 02:08data to explain the infant data.
  • 02:10I'm just using the infant's data and
  • 02:14some clear attendance that we use in
  • 02:16my lab is the infant brain is not
  • 02:18an immature version of the adult brain.
  • 02:20The infant doesn't go out and get a job,
  • 02:23but just do it.
  • 02:24Not very well because their
  • 02:25brain isn't fully matured.
  • 02:27They have specialized behaviors
  • 02:29that make them a great infant.
  • 02:32So for example,
  • 02:33the infant isn't capable of or the young
  • 02:36child isn't capable of defending themselves,
  • 02:39the parent does it.
  • 02:40So the infant has its system defense system,
  • 02:43which involves going to the parent,
  • 02:46not activating the amygdala as we would.
  • 02:49So that's just a classy example that I'm
  • 02:52going to talk about today is why it's
  • 02:55important to just look at the infant brain.
  • 02:56So the in the brain is not an
  • 02:58immature of a Nadel brain.
  • 02:59Clearly documented is that even if a
  • 03:01behavior looks the same across development,
  • 03:04it can use a different circuit,
  • 03:06and we've done that in my lab.
  • 03:08So avoidance,
  • 03:09for example,
  • 03:10involves the amygdala in adult
  • 03:13humans and and rodents.
  • 03:15But in the rodent we know that
  • 03:17it's the peripheral cortex or the
  • 03:19olfactory cortex and the Olfactu
  • 03:21bulb that has that information,
  • 03:23not the amygdala.
  • 03:24But the behavior looks the same,
  • 03:26no behavioral transition. And finally,
  • 03:29some brain areas look to be functioning,
  • 03:33but they're generating a different
  • 03:34behavior in infant than the adult.
  • 03:36So if I were to see a circuit activated
  • 03:38in the infant and then just use the
  • 03:40adult literature to explain what
  • 03:42that circuit of behavior's doing,
  • 03:44I could be presenting misleading information.
  • 03:46So those are the principles
  • 03:48that we try to adhere to here.
  • 03:52And I'm going to be talking today about
  • 03:54just the expression of attachment,
  • 03:57the circuitry for acquisition or learning,
  • 04:00who is the attacker figure and the
  • 04:02expression are very different circuits.
  • 04:04So I'm just talking about the expression.
  • 04:07And I will mention that there are
  • 04:09people here doing this lovely,
  • 04:10amazing circuit work trying to
  • 04:13explain all of this as well.
  • 04:15So please excuse me if I don't
  • 04:18talk about that work,
  • 04:19but I wish I could listen to each of
  • 04:22them give a talk rather than me honestly
  • 04:24because it's such amazing work anyway.
  • 04:27So when we talk about expression,
  • 04:29we typically say, OK,
  • 04:30there's an attachment circuit.
  • 04:32But the fact is when the infinite showing pro
  • 04:35social behavior to the attachment figure,
  • 04:38they're actually using many,
  • 04:39many,
  • 04:40many different behaviors.
  • 04:41And what we know about the brain
  • 04:44is it's likely each one of those
  • 04:46behaviors has its own circuit.
  • 04:47So I'm gonna be talking a lot about
  • 04:51proximity seeking circuits and safe
  • 04:54haven using the parent as as a as
  • 04:59a place to go to in under threat.
  • 05:03OK.
  • 05:04And then finally I'd like to say
  • 05:07that sometimes people say you
  • 05:09can't use a rodent to explain
  • 05:12attachment behavior in children.
  • 05:14It's true.
  • 05:15Attachment behaviors in humans
  • 05:17is incredibly complex.
  • 05:18There's a lot of cognitive baggage
  • 05:21that that children have when
  • 05:23they're when they're responding
  • 05:24to their attachment figure.
  • 05:26But the fact is, attachment theory,
  • 05:28the guiding force of so
  • 05:30much of the human data,
  • 05:32is based on animals other than humans.
  • 05:35So, for example,
  • 05:36Bolby,
  • 05:37the father of attachment theory,
  • 05:39began to think of attachment as a
  • 05:42biological circuit because of the
  • 05:44imprinting literature on chicks.
  • 05:45And what he saw is that imprinting
  • 05:48looks like a innate process,
  • 05:49but the fact is the infant birds have
  • 05:53to learn to target their attachment
  • 05:56figure and that activates A biological
  • 05:59predisposed circuit for attachment.
  • 06:02And so it's not necessarily the mother
  • 06:05has to mother bird has to do something
  • 06:07nurturing to to get that attachment.
  • 06:10It's not maternal behavior at all.
  • 06:11It's just movement.
  • 06:13So the and we know that the quality of
  • 06:16care in this imprinting doesn't matter.
  • 06:18They they imprint.
  • 06:20And then there's also work
  • 06:22by Conrad by Harlow.
  • 06:24I think Harlow's work is particularly
  • 06:26important in informing attachment
  • 06:28theory is because at that time
  • 06:30there was this predisposition that
  • 06:31you need to have a nurturing,
  • 06:34loving parent to have attachment.
  • 06:36And what Harlow showed is that's not true.
  • 06:39The horribly abusive mothers were
  • 06:43attached to just as strongly.
  • 06:46It was just as difficult to break
  • 06:48that attachment as it was when
  • 06:50you saw a nurturing parent. So.
  • 06:51So taking the romance out of
  • 06:54attachment and setting it into a a
  • 06:58theoretical framework that we can
  • 07:00actually test and learn more about
  • 07:03attachment has been important.
  • 07:05So Bolby has a paradigm shifting
  • 07:09approach that ran across species that
  • 07:12has been really important in so much
  • 07:16of our work understanding development.
  • 07:18So you know attachment,
  • 07:20when a child becomes attached to a caregiver,
  • 07:24there are many,
  • 07:25many behaviors that are expressed
  • 07:27towards that attachment figure.
  • 07:28I focus on a few One is proximity seeking,
  • 07:32the other is homeostasis.
  • 07:34So the immature infant child cannot
  • 07:37have homeost perfect homeostasis.
  • 07:39So they use the caregiver
  • 07:41to regulate the homeostasis,
  • 07:43cognitive function and emotion.
  • 07:45And finally,
  • 07:47I'll talk a lot about a safe base using
  • 07:50the parent as A to approach safety.
  • 07:53So I'm studying attachment in the infant,
  • 07:56but I'm using very,
  • 07:58very specific selective behaviors
  • 08:01because it's complex and I feel
  • 08:03that we have to just say,
  • 08:04OK, it's incredibly complex.
  • 08:05We want to understand this.
  • 08:07We all have to listen to talks
  • 08:09that are and read papers that
  • 08:12are incredibly overly complex,
  • 08:14but it's that complex,
  • 08:15embracing that complexity I feel
  • 08:17that will help us finally make some
  • 08:19inroads into impacting the clinical
  • 08:21help that we need to give children.
  • 08:23And neuroscience hasn't been
  • 08:25particularly successful in doing that.
  • 08:26And I take that to heart and
  • 08:29really try to work hard using
  • 08:32the human literature to inform,
  • 08:35much as like Dylan's work using
  • 08:38that literature to help inform what
  • 08:41we know about to help clinicians.
  • 08:44So what we what we do know and I'll
  • 08:47talk about today is that when there's
  • 08:50adversity within attachment that
  • 08:52these features of attachment towards
  • 08:55the caregiver are are disrupted.
  • 08:57So there's the proximity seeking
  • 08:59is disrupted,
  • 09:00there's decreased approach and increased
  • 09:03avoidance regulation is disrupted.
  • 09:04And I'm gonna give you some examples
  • 09:07of learning and the infants has
  • 09:09compromised use of the mother as a safe face.
  • 09:13So the mother isn't actually
  • 09:14doing anything to be a safe face.
  • 09:17It's sensory stimuli that the child's
  • 09:19picking up from the caregiver.
  • 09:21So that sensory information
  • 09:23that they're getting,
  • 09:24that child is still getting the
  • 09:26same information but can't use it.
  • 09:28So there are neural circuits that are
  • 09:30compromised and using sensory stimuli
  • 09:32from the mother as a safe haven.
  • 09:35So it's so when we talk about
  • 09:37regulation of the infant and the
  • 09:39caregiver regulating the infant,
  • 09:40it's actually the infant's use
  • 09:42of that sensory stimuli which
  • 09:44is permitting the regulation.
  • 09:46Does that make sense?
  • 09:47It's a bit of a turn how we
  • 09:49typically think of it.
  • 09:51OK.
  • 09:51So I'm going to use these few
  • 09:53core features to try to better
  • 09:56understand attachment expression,
  • 09:58to understand the infant brain
  • 10:00in the hopes that we'll
  • 10:02figure out something to better inform
  • 10:04clinical treatment of children,
  • 10:06but also to how we how we rear
  • 10:09children in a normal family.
  • 10:11So we use this low bedding paradigm that was
  • 10:14felt in my lab by Tanya Roth a long time ago.
  • 10:19Basically all we do is we take
  • 10:21bedding away from the mother,
  • 10:23and the mother can't build a nest.
  • 10:26So she repeatedly tries to build a nest and
  • 10:29inadvertently hurts the hurts her infants.
  • 10:31So it's not like the mother's aggressive,
  • 10:33it's inadvertent.
  • 10:34She gets actually almost too worrisome.
  • 10:38She keeps fixing the nest.
  • 10:39She but has normal maternal care.
  • 10:43These rats do not lose weight,
  • 10:45so they're they're not malnourished.
  • 10:48And I will say that there's a more
  • 10:50more stressful paradigm also called
  • 10:53lobe and recall our scarcity,
  • 10:55diversity,
  • 10:55low bedding where they also
  • 10:57have a screen under the floor
  • 10:59and they don't clean the cage.
  • 11:01So there's it's really ammonia
  • 11:03smell and pretty stinky.
  • 11:05I think that we need to embrace
  • 11:07diversity in animal models
  • 11:08and understand that there's a
  • 11:10distinction between an animal model,
  • 11:12not with malnutrition and an animal model
  • 11:15that has adversity plus malnutrition,
  • 11:17all are great.
  • 11:20So,
  • 11:23and I want to give a nod to that,
  • 11:26these rat pups that have low bedding
  • 11:30grow up to be aggressive and that
  • 11:34was work done by Maya Opendoc
  • 11:36in an in both animals in a cage.
  • 11:39So introducing a stranger into the cage.
  • 11:41And so these animals are aggressive.
  • 11:43They're also antisocial,
  • 11:46low social behavior.
  • 11:48Interestingly, if you take the odor
  • 11:51associated with this maltreatment
  • 11:53and presented them to adulthood,
  • 11:55it it repairs a poor swim test
  • 11:57and repairs social behavior.
  • 11:59So there's something really,
  • 12:02really special about this odor in
  • 12:05early life that's changing, that,
  • 12:08that has a great deal of value
  • 12:09not only to the baby but for the
  • 12:12rat continues across the lifespan.
  • 12:16OK, So for those of you who don't work
  • 12:18with rats, I want to have this slide to
  • 12:20tell you what a rat mother does in the
  • 12:22cage 'cause I think this is incredibly
  • 12:24important in understanding the literature.
  • 12:26So their mother rat has nursing bouts
  • 12:29and has many of these across the day.
  • 12:32So she goes into the nest,
  • 12:33she nurses the animal,
  • 12:35and then when she gets too warm,
  • 12:37she leaves the nest.
  • 12:38So an incredibly simplistic mechanism based
  • 12:41on the metabolic load and overheating in
  • 12:43the female When the mother enters the nest,
  • 12:46that's when all this rough handling produced
  • 12:50by low bedding occurs and grooming occurs.
  • 12:52Then in Michael Mini's paradigm
  • 12:54with licking and grooming,
  • 12:55this is where it occurs.
  • 12:57So this goes on for a couple of minutes
  • 13:00and then the mother settles down and
  • 13:03non nutritively nurses the pups.
  • 13:05Everybody falls asleep and that's what
  • 13:07you see mostly in the nest is the
  • 13:10mother with the baby rats just sleeping.
  • 13:13Periodically the mother
  • 13:14gives a milk ejection.
  • 13:16It's, you know, lasts 4 milliseconds.
  • 13:19Pups respond to it for, you know,
  • 13:21less than a minute and then
  • 13:23everybody goes back to sleep.
  • 13:25And then the mother leaves the nest.
  • 13:28A little bit of handling
  • 13:29as she leaves the nest,
  • 13:30but usually it's pretty rapid.
  • 13:33And then this is repeated over
  • 13:35and over again.
  • 13:36So if we look at when the
  • 13:39mother's hurting the rat pups or
  • 13:41having normal maternal care,
  • 13:43we're really just looking here.
  • 13:44Oops,
  • 13:45sorry,
  • 13:48We're really just looking here.
  • 13:49And otherwise everything looks normal.
  • 13:53The only time we can identify an
  • 13:56abused animal in the nest is when
  • 13:58the mother's actively abusing it.
  • 13:59Other than that,
  • 14:00everybody the behavior looks the same.
  • 14:03And I think this is analogous to children
  • 14:05where you can't tell an abused child.
  • 14:08I mean, a seasoned therapist
  • 14:10obviously can tell things,
  • 14:11but within the classroom, for example,
  • 14:13it's incredibly difficult to find out who
  • 14:16that child is unless they're stressed.
  • 14:17And Mary Ainsworth showed decades ago
  • 14:20in the strange situation procedure
  • 14:22that a bit of stress can help uncover
  • 14:24problems behaviorally in children.
  • 14:26So, So in the nest, they look fine.
  • 14:32And So what we did is,
  • 14:35can we uncover deficits early in life?
  • 14:38And we just did a simple test in a wine maze.
  • 14:41We put maternal odor on one side and
  • 14:44a familiar odor on the other side.
  • 14:46Even the abused animals approach the
  • 14:48maternal odor. It's a strong attachment.
  • 14:52They respond a little bit less robustly.
  • 14:55But there's nothing we can do
  • 14:57to get rid of this attachment.
  • 14:59No matter how horribly the mother treats the
  • 15:02animal or how whatever we do to the animal,
  • 15:05it remains intact.
  • 15:07So Justice Boldb talked about maltreated
  • 15:11children still attached to their caregiver.
  • 15:15So we did something a
  • 15:17little bit more intrusive.
  • 15:18We took an anesthetized mother and
  • 15:20measured the amount of time that the
  • 15:23the pup stayed with the mother or not.
  • 15:25There's no difference in the amount of time.
  • 15:27So even the maltreated pups
  • 15:29stay with their caregiver,
  • 15:31their social behavior is a bit different.
  • 15:33So remember, their social behavior towards
  • 15:34the mother is not different in the nest,
  • 15:36but if you stress them a bit by
  • 15:39having an anesthetized mother,
  • 15:41their social behavior is a bit
  • 15:43different towards the mother.
  • 15:45They are more likely to go behind her back,
  • 15:47less likely to ****** attached,
  • 15:48for example.
  • 15:52The amygdala is causal for
  • 15:54this social behavior deficit,
  • 15:56and we know that corticostral increases
  • 15:59are critical in producing the expression
  • 16:02of this bad social behavior by the
  • 16:05infant rats that are maltreated.
  • 16:07Maya Opentek and John Wilson did some
  • 16:11optogenetics suppressing the amygdala
  • 16:13in these in the maltreated animals,
  • 16:16and it repairs social behavior.
  • 16:18So we know that the core of the social
  • 16:22behavior deficit in early life is the
  • 16:25amygdala because we can suppress it.
  • 16:26It doesn't mean that there aren't
  • 16:28other pieces in the network of the
  • 16:30brain contributing to this deficit,
  • 16:31but the amygdala is one place in that
  • 16:35pathway where we can repair the behavior.
  • 16:39Sorry. So here you see example of
  • 16:44normal behavior and suppress the
  • 16:46amygdala and the behaviors normalized.
  • 16:49So I'm gonna go back to the nest
  • 16:51because we really don't understand well
  • 16:53what is this maltreating mother do.
  • 16:55I showed you that there are
  • 16:57limited periods of time when she
  • 16:59is not treating the pups well.
  • 17:01So we did some local field potential
  • 17:04recording in the amygdala and in the and
  • 17:06in the PFCI have a lot more data in the
  • 17:09Pfc and that's what I'm gonna show you.
  • 17:11But the amygdala and the prefrontal
  • 17:13cortex mirror one another in
  • 17:15the local field potential. So
  • 17:20anyway, so here's for those
  • 17:24of you unfamiliar with LFP.
  • 17:25It's like EEG, but the electrodes
  • 17:28placed within a specific brain area.
  • 17:30So I'm going to show you that in red.
  • 17:34This is where we see behavioral differences.
  • 17:36These are in yellow or places where
  • 17:39we see differences in LFP in the
  • 17:42prefrontal cortex and amygdala.
  • 17:44So where we're seeing deficits
  • 17:45in the Pfc and the amygdala,
  • 17:47I mean and and the behavior don't match up.
  • 17:52The Pfc is probably not developed
  • 17:54yet in this age animal.
  • 17:56In fact we know that in rats that
  • 17:58it's a late developing brain area.
  • 18:01Anyway let me show you the data so oh sorry.
  • 18:06OK so here we looked at the mother
  • 18:08during a milk ejection and you can
  • 18:11see that the control reared animals
  • 18:14show an increase in in gamma power
  • 18:20but the adversity rear pups don't.
  • 18:23So the response of the animals
  • 18:26to maternal behavior is blunted
  • 18:29in the adversity reared animals.
  • 18:32And this is just comparing the
  • 18:34adversity reared and the control
  • 18:35reared in one slide and also
  • 18:38grooming the control animals.
  • 18:40Reared animals show a change in power in
  • 18:43the gamma range to the mother grooming them,
  • 18:46which which the low bedding animals don't.
  • 18:49So there's a fundamental difference
  • 18:51in how these animals are responding
  • 18:54to nurturing maternal behaviors.
  • 18:59We don't see a different with
  • 19:02maltreat with maltreated behaviors,
  • 19:03shocking results to us.
  • 19:06Honestly, if anybody had predicted
  • 19:07what would go wrong in the brain,
  • 19:09we'd say maltreatment would be
  • 19:12something horrible to these infant rats,
  • 19:15and that's where you'd see
  • 19:16the normal differences.
  • 19:17But the fact is, we didn't.
  • 19:18We saw it in the nurturing behaviors.
  • 19:21So that helps us begin to think
  • 19:23about what's going wrong in the
  • 19:25brain in a maltreatment situation.
  • 19:27And I think it helps us get
  • 19:29out of our cultural bias.
  • 19:31Well, of course,
  • 19:32the thing that might be most horrible is
  • 19:34that they're being hurt by the caregiver.
  • 19:36And this suggests that instead
  • 19:39it's the change in the hedonic
  • 19:41value potentially of nurturing
  • 19:43behaviors that may be one of
  • 19:45the things contributing to this.
  • 19:47And I love this experiment because
  • 19:49it went against what we our bias is
  • 19:52when we went into the experiment.
  • 19:54So.
  • 19:56So the problem with doing neuroscience
  • 19:59like this is that sometimes it doesn't
  • 20:02make any sense to a human researcher.
  • 20:05We have a jargon.
  • 20:06So I was at a meeting, and Mary Dozier,
  • 20:10who is an incredible attachment researcher,
  • 20:13does amazing intervention
  • 20:15work with foster parents.
  • 20:18Lovely work, she said.
  • 20:19You know the social behavior of your
  • 20:21animals and our social behavior tests.
  • 20:23Remember,
  • 20:24I showed you they were with the mother,
  • 20:25but there was this weird behavior,
  • 20:27she said.
  • 20:28It looks like a disordered attachment to me.
  • 20:30So she helped us develop a strain
  • 20:33situation procedure in the RAT.
  • 20:35And we grasped this because we really
  • 20:38and truly wanted to make an impact
  • 20:42and present our data in a way that,
  • 20:45in a way that actually made it,
  • 20:48would make sense to people.
  • 20:49So here's our rodents behavior.
  • 20:52For those of you unfamiliar with
  • 20:54the strain situation procedure,
  • 20:55it's just a series of presenting the mother,
  • 20:57removing the mother,
  • 20:58presenting a stranger, removing a stranger.
  • 21:00And the only data that's used in
  • 21:02the strange situation procedure is
  • 21:04this final reunion with the mother
  • 21:06and it's actually a stress paradigm,
  • 21:0920 minutes stress paradigm.
  • 21:11So by the end of this the the
  • 21:15kid is is a bit shaken up.
  • 21:17Anyway,
  • 21:18we showed here that our maltreated
  • 21:21animals show deficits here.
  • 21:23So not surprising.
  • 21:25Of course we I showed you
  • 21:26data on that already
  • 21:30so we did local fuel
  • 21:31potential on these animals.
  • 21:33And here's the adversity reared animals.
  • 21:36Here's control reared animals
  • 21:38response to reunion with the mother.
  • 21:40So this is the normal behavior that an
  • 21:43animal has when they're with the mother.
  • 21:45There's a change in the power
  • 21:48and the and the adversity.
  • 21:51Reared animals are not having
  • 21:53a change in the response of
  • 21:55the of the prefrontal cortex,
  • 21:56so the behavior seems to be blunted.
  • 21:59And actually we've done experiments
  • 22:01recording from the mother,
  • 22:02live recordings of the mother
  • 22:04and the pup in the nest,
  • 22:06and both of them have
  • 22:08blunted LFP responses so
  • 22:13we could repair both the
  • 22:16social behavior and the LFP by
  • 22:20decreasing stress hormone levels.
  • 22:23Amazingly, it's just systemic stress
  • 22:27hormones and we know that stress
  • 22:30hormones activate the amygdala.
  • 22:32So the idea, in fact,
  • 22:34we have some data showing that yes,
  • 22:36it's the amygdala being activated by the
  • 22:38high corticostral levels and reduction
  • 22:40of that normalizes the amygdala.
  • 22:44So, so why is that bad and why is how
  • 22:51does that ever get to be abnormal?
  • 22:54A parent in humans and in rats is supposed
  • 22:58when they're present and there's a trauma.
  • 23:01They're supposed to be reduction
  • 23:03of the stress hormones,
  • 23:04social buffering, social buffering,
  • 23:06occurs throughout the lifespan.
  • 23:08I'll talk a little bit of that later,
  • 23:09but in the rat pups, it's in children,
  • 23:11it's massively strong and has
  • 23:13massive effects on the brain
  • 23:15that we don't see in the adult.
  • 23:17Anyway.
  • 23:18So here we did an experiment showing
  • 23:20that when the mother is present and
  • 23:23this is a normally reared animal
  • 23:25and she's she shuts off the HPA axis
  • 23:28at the level of the hypothalamus
  • 23:31and it's norepinephrine from the
  • 23:34to the hypothalamus to the PVN.
  • 23:36Exactly that gets reduced to
  • 23:38the mother's year.
  • 23:39So here's an animal getting shocked alone.
  • 23:41This is time and this is
  • 23:42norepinephrine levels.
  • 23:43Shock alone increased norepinephrine.
  • 23:44Here's an odor only animal
  • 23:46not getting shocked.
  • 23:48And here's an animal getting
  • 23:49shocked with its mother Looks
  • 23:51like it's not getting shocked.
  • 23:52So norepinephrine.
  • 23:53The mother is blocking norepinephrine to
  • 23:57the HPA axis and not activating the HPA axis.
  • 24:00And that's how it works in pups.
  • 24:03In the adult,
  • 24:04it's a much much more complex
  • 24:06procedure in order to socially buffer,
  • 24:08but the rat pup has a simplistic
  • 24:11circle circuit.
  • 24:12OK,
  • 24:13my open doc did a optogenetic
  • 24:17experiment where she manipulated
  • 24:19dopamine from the ventral
  • 24:21tegmental area to the basolateral
  • 24:24amygdala and showed you could.
  • 24:26You don't need a massive
  • 24:29change in corticostron.
  • 24:30Change in dopamine to the amygdala
  • 24:34could repair social behavior as well.
  • 24:37And corticostral levels
  • 24:38are changing dopamine.
  • 24:39So we think of corticostron
  • 24:41as a system wide change,
  • 24:43but dopamine is this very targeted
  • 24:46circuit that's also working with the
  • 24:49courticosterone to shut down the amygdala,
  • 24:52make sense?
  • 24:55OK, so this is an interim summary.
  • 24:59So what do these findings suggest?
  • 25:02There is pup behavior circuitry.
  • 25:04One attachment remains
  • 25:06intact in maltreatment.
  • 25:08The expression towards some other changes,
  • 25:10but there is a strong attachment.
  • 25:13I'm 2A Perturbation into social
  • 25:15behavior deficits with the mother is
  • 25:17causally linked to the amygdala and
  • 25:19then next programming and then the Pfc.
  • 25:22So remember the Pfc actually isn't
  • 25:23mature enough to be functionally
  • 25:25integrated into behavior in the rack up.
  • 25:27And these are rack ups younger
  • 25:29than 14 days of age.
  • 25:30So we know that the Pfc in the rack isn't
  • 25:33isn't contributing to behavior yet.
  • 25:37It's a great way of understanding
  • 25:39programming of the Pfc
  • 25:43to look at a pre and area brain area
  • 25:46that's not participating in behavior
  • 25:48yet and to watch how maternal behavior
  • 25:51is changing the neural activity of
  • 25:53that brain area in a way that we know
  • 25:57is critical for brain maturation.
  • 25:59So anyway, so next I'm going
  • 26:03to use some threat behavior to
  • 26:06better understand what's going on.
  • 26:08And I in all honesty,
  • 26:09I did these threat experiments
  • 26:11first and ended the social behavior.
  • 26:14But I start with the social
  • 26:16behavior because it's so much
  • 26:17more clinically relevant.
  • 26:18And now I'm gonna show you some a
  • 26:21bit more complex threat experiments
  • 26:23that helped really define what was
  • 26:26going on in the in the infant rat.
  • 26:28And without these threat experiments,
  • 26:30I would not have found anything about
  • 26:34the mother suppressing the amygdala.
  • 26:36It was back.
  • 26:38So social behavior, social buffering,
  • 26:40the mother's social figures,
  • 26:42ability to reduce a stress hormone levels
  • 26:46is present throughout our lifetime.
  • 26:48In the baby,
  • 26:50it's just much more strong.
  • 26:53And what I'm going to show you in
  • 26:56these next experiments is that there's
  • 26:58an age specific neurobehavioral
  • 27:00transitions in social buffering and
  • 27:02it's not really social buffering,
  • 27:03it's complete shutting off of the
  • 27:05stress system at the level of the HPA axis.
  • 27:08So the mother is blocking stress
  • 27:10hormone social buffering.
  • 27:11It's typically just an attenuation.
  • 27:13So anyway,
  • 27:14and all of this was found through
  • 27:17fear conditioning,
  • 27:18because I started out looking
  • 27:20at the development of learning
  • 27:21using the olfactory system.
  • 27:23And when I was a graduate student
  • 27:27looking at milk odor pairings,
  • 27:31I found out through a control
  • 27:33group that if you tail pinch
  • 27:36the pup while the odor was on,
  • 27:38that they actually liked the odor.
  • 27:41So that was the first indication
  • 27:42that there was for me that there was
  • 27:44something massively different about
  • 27:45the reward system in the infant rats.
  • 27:48So pain paired with an odor
  • 27:50made the rat pup like the odor.
  • 27:53And the fact is,
  • 27:54not only did they like the odor,
  • 27:56they use that odor for ****** attachment.
  • 27:58So the odor became like the maternal odor.
  • 28:03And Charlie Greer did some of
  • 28:05that work while you were in,
  • 28:08in Gordon's Shepherd's lab, right.
  • 28:10And Patty Peterson was the postdoc
  • 28:12amazing work and was the first one
  • 28:14to show that this odor learning was
  • 28:17changing the olfactory bulbs there.
  • 28:22So anyway, looking at this in
  • 28:24the fear conditioning system,
  • 28:26I think this computer is on a timer.
  • 28:30Yeah. So anyway, So what we figured
  • 28:36out with fear conditioning is that
  • 28:38there is a read period where whatever
  • 28:40you do is a reward to the infant rat,
  • 28:43They're going to like the odor,
  • 28:44and the odor is going to become
  • 28:46a new maternal odor.
  • 28:47So there's something about massive bias
  • 28:49in the brain for attachment learning.
  • 28:52And this ends when pups are ten
  • 28:54days old and it's a robust fast
  • 28:56transition and it's dependent
  • 28:59upon maturation of the amygdala.
  • 29:02So before PN 10,
  • 29:04you have this new maternal odor and this
  • 29:08learning during the attachment fee is
  • 29:11due to norepinephrine and the locus Aurelius.
  • 29:14And other people had shown that the
  • 29:16locus Aurelius has a transition where
  • 29:18it becomes much more specialized at
  • 29:2010 days of age and that's critical
  • 29:23for ending the sensitive period.
  • 29:25The other thing that happens is
  • 29:27the amygdala becomes functional,
  • 29:28begins to participate in fear conditioning
  • 29:32and we think that's due to changes
  • 29:35in GABA receptors within the amygdala.
  • 29:38This is a slice Physiology
  • 29:40experiment we did ages ago.
  • 29:42I will say that the rainy lab at
  • 29:46Emory has done this in a much more
  • 29:48sophisticated way since then.
  • 29:51Really lovely work.
  • 29:52But anyway just blocking this is this is age.
  • 29:57So as the animal gets older
  • 30:00it you get young animal,
  • 30:02you're an older animal,
  • 30:04you get changes from Ltd to LLTP
  • 30:07and picrotoxin just looking at these
  • 30:10animals being manipulated here.
  • 30:13So GAB is changing everything.
  • 30:16So the next thing we figured out
  • 30:19was that after the amygdala is
  • 30:22present in fear conditioning,
  • 30:23the mother can turn it off.
  • 30:25And why we did this experiment
  • 30:28is incredibly complicated.
  • 30:29There was work at Levine's lab showing
  • 30:33that corticosterone can change,
  • 30:35the mother can change corticosterone
  • 30:37levels in the pup,
  • 30:39and we knew that the shock was
  • 30:42increasing corticosterone and
  • 30:43that the amygdala needed the
  • 30:46corticosterone to be had plasticity.
  • 30:48So we knew that.
  • 30:49So we simply tried having some other present
  • 30:53during fear Conditioning and lo and behold,
  • 30:56she was blocking amygdala
  • 30:58and Fear Conditioning.
  • 30:59And it isn't.
  • 31:00So.
  • 31:00She's just blocking fear conditioning.
  • 31:02Actually,
  • 31:03what she's doing is she's reverting
  • 31:06the pup back to the Sensitive Period.
  • 31:08The amygdala's acting like the
  • 31:11Sensitive period amygdala rather
  • 31:13than functional amygdala and so
  • 31:16pups again in this age range,
  • 31:20these pups are learning to like the odor.
  • 31:24So it's two things are happening
  • 31:26suppression of amygdala and fear.
  • 31:27And two back to odor preference learning.
  • 31:31So and the fact is that you can
  • 31:36toggle these circuits just with
  • 31:38the mother present or through
  • 31:41manipulation of of corticostron
  • 31:44within the amygdala or within
  • 31:47the hypothalamus in the PDN
  • 31:51or with dopamine.
  • 31:53So this goes away when pups are
  • 31:56about peeing 15 to 16 and then
  • 31:59odor shock conditioning is never
  • 32:01shut off by the mother.
  • 32:03Again we're working on the
  • 32:07mechanisms for this using
  • 32:10intracellular plasticity molecules,
  • 32:12but with no success yet.
  • 32:16OK so as bizarre as this sounds,
  • 32:22Nim Tottenham was able to replicate this
  • 32:25in the behavioral Level in Children The
  • 32:29mothers present 4 year olds don't learn.
  • 32:31Fear, Conditioning and Work by Dylan
  • 32:36G has shown that maternal presence can
  • 32:40actually turn off the amygdala in children.
  • 32:42So as bizarre as this system sounds in
  • 32:47wrap UPS and completely unexpected and
  • 32:50really found through the back door has
  • 32:54been massively helpful in understanding
  • 32:57rapid transitions in the sensitive period.
  • 33:00Before that we simply thought things
  • 33:02were came on slowly and ended slowly.
  • 33:04But here's this rapid, you see,
  • 33:07I'm not doing anything this rapid transition.
  • 33:11And anyway, you don't want the brain
  • 33:15to change one day from, you know,
  • 33:17attachment learning to fear learning.
  • 33:19So there's sort of the mother being
  • 33:21present is this intermediary system.
  • 33:23So when the pups are with the mother,
  • 33:25their attachment system is active.
  • 33:27When they're off on their own,
  • 33:28their fear system is activated.
  • 33:31So and lovely work by Dylan G honestly.
  • 33:36OK, so I told you we're working
  • 33:39on trying to find mechanisms.
  • 33:42So one thing we did find is that
  • 33:44we can manipulate URK,
  • 33:46which is an intracellular molecular
  • 33:49cascade associated with plasticity.
  • 33:53We have found that manipulating URK
  • 33:55can turn on and off the circuit.
  • 33:57So the mother seems to be changing
  • 34:00URK within the cell and suppressing
  • 34:05URK activation so that the pups can't
  • 34:09can't learn is what we're finding and
  • 34:11we can do causal experiments here.
  • 34:13We haven't been able to figure
  • 34:15out what ends here.
  • 34:16We know that the mother
  • 34:18can no longer change IRK,
  • 34:20but a lot of changes occur
  • 34:22as the sensitive period ends.
  • 34:24We just haven't found.
  • 34:27It's probably a multi faceted
  • 34:29system honestly which is
  • 34:35suggests our inability to find it.
  • 34:37So I'm not going to show you data
  • 34:39and please excuse me for that,
  • 34:41I'm just going to tell you some
  • 34:43things that we found in about this.
  • 34:44But so as the mother is,
  • 34:48we found something about the circuitry
  • 34:52engaged at different stages of
  • 34:53development in the rat pops being used
  • 34:56to identify using for air conditioning.
  • 34:59So as the mother is blocking amygdala,
  • 35:05the signal seeming to mediate the mother's
  • 35:08input to the amygdala is the VTA.
  • 35:11And this was done by Maya Opendoc.
  • 35:15And you know, you would expect
  • 35:17that the VTA to the amygdala would
  • 35:20have this abrupt change at 15 when
  • 35:22the mother can no longer turn,
  • 35:24no longer turn off the amygdala.
  • 35:27But the fact is the VTA is staying
  • 35:29active for a little bit longer and then
  • 35:32with some maturation the the prefrontal
  • 35:35cortex which is the adult system comes on.
  • 35:39So here you have this unique infant
  • 35:42circuit relaying information about the
  • 35:45mother to suppress to to suppress fear.
  • 35:48And then the social buffering
  • 35:50circuit comes on.
  • 35:53So adversity messes up this system.
  • 35:58So we looked at animals that were
  • 35:59reared with an abusive mother
  • 36:00using the low vetting procedure,
  • 36:02scarcity, adversity, procedure.
  • 36:03And what they found is 1 is that the
  • 36:08attachment the the mothers, the the,
  • 36:10the system where anything paired with
  • 36:12odor produces a new maternal odor that
  • 36:15goes away earlier at a younger age.
  • 36:17And the amygdala becomes involved
  • 36:20in fear conditioning.
  • 36:21So there's earlier incorporation of
  • 36:24the amygdala and emergence of fear.
  • 36:27Two,
  • 36:27the mother cannot no can no longer
  • 36:30turn off the fear system.
  • 36:32So that made us interested in the
  • 36:35mother as a safety signal being degraded,
  • 36:39which we feel has massive clinical
  • 36:41significance because we knew that
  • 36:43in the strange situation procedure
  • 36:45that in the reunion the child was
  • 36:47acting poorly with the mother.
  • 36:49But to understand that potentially
  • 36:51the safety signal is a very discreet
  • 36:55fixable because it's learned aspect
  • 36:58of the caregiver is is absolutely
  • 37:01heart warming to us
  • 37:05and the that was done by
  • 37:07my open doc and Patrice
  • 37:11drummer anyway, OK,
  • 37:13so here's are my last slides actually.
  • 37:17So why once so this is during adversity,
  • 37:22this attachment figure. So far.
  • 37:24So with this adversity rearing,
  • 37:27what are the critical variables
  • 37:29initiating the pathology?
  • 37:31You know the the pups are still wanting to
  • 37:33stay with the mother still receiving this,
  • 37:36this abnormal behavior.
  • 37:38What is the what is the things that
  • 37:40are going wrong in that in that system.
  • 37:43So Maya has shown that the dopamine
  • 37:47signal is really important.
  • 37:50So she did this heroic experiment
  • 37:53where for 90 minutes each day she
  • 37:56had rat pups have adversity with a
  • 37:59mother a sufficient to produce the
  • 38:01short term and long term the infant
  • 38:04and the adult outcome effects.
  • 38:06So every day she,
  • 38:08while she shock,
  • 38:10gave shock to the pups with the mother,
  • 38:12which mimics the adversity rearing.
  • 38:17Surprisingly enough,
  • 38:20she blocked dopamine during that 90 minutes,
  • 38:24hurt the animals blocked dopamine
  • 38:26within the amygdala systemically or
  • 38:28within the amygdala, and the social
  • 38:31behavior deficits did not emerge so.
  • 38:34So not only is the amygdala important
  • 38:38in the expression of the aberrant
  • 38:40social behavior in early life,
  • 38:42but it's also the amygdala and
  • 38:44dopamine is important in setting
  • 38:46up the amygdala in a way to produce
  • 38:49that abnormal social behavior.
  • 38:50So, so we've identified two
  • 38:53major factors here,
  • 38:54dopamine and stress hormones that
  • 38:57are really important working in
  • 38:59harmony to produce these deficits,
  • 39:01but are also important in the expression.
  • 39:07So we did this really bizarre experiment.
  • 39:12It's the last thing I'm going to talk about.
  • 39:13I'm sorry. I'm going 5 minutes over.
  • 39:17Great. OK, great.
  • 39:18So these are my last few slides. So,
  • 39:22so I'm going to explain these very carefully.
  • 39:25It's a little complex.
  • 39:26So we know that a normal rear pup
  • 39:29produces good social behavior, right?
  • 39:31And we know the diversity rear pups
  • 39:33produces abnormal social behavior.
  • 39:35We know that it produces changes in
  • 39:37the image of the in hippocampus,
  • 39:39well documented at this point.
  • 39:42And we know from many labs that
  • 39:44those effects are enduring.
  • 39:45OK, so we know that corticostron
  • 39:50is elevated here and we know
  • 39:54it's can be problematic.
  • 39:56So what we did is we injected
  • 40:00these normal pups,
  • 40:02normally rear pups,
  • 40:03with stress hormones
  • 40:07while they're with a mother.
  • 40:09So about a 90 minute treatment
  • 40:12and that was sufficient to produce
  • 40:14all of the deficits in the pups.
  • 40:16So here's a mother engaged in
  • 40:19absolutely normal maternal behavior,
  • 40:22but high stress levels with normal
  • 40:24maternal behavior was sufficient
  • 40:27to produce these changes.
  • 40:31And then next we took the adversity rear
  • 40:33pups and we blocked hercorticosterone
  • 40:36every day and we were able to prevent
  • 40:40the amygdala and hippocampus deficits.
  • 40:42We didn't look at every single thing in
  • 40:45the amygdala and hippocampus obviously.
  • 40:47So it's quite you know we will
  • 40:49assume that there are things still
  • 40:51going wrong in the brain.
  • 40:53We're just focusing on the amygdala.
  • 40:55Obviously the effects of trauma are
  • 40:57throughout the brain and we will expect some
  • 41:01brain areas to be corticostro independent,
  • 41:03some not and completely different system.
  • 41:06And I think it's important
  • 41:08to to note that this is not,
  • 41:10this is a very small piece of
  • 41:13information in a complex situation.
  • 41:15OK.
  • 41:16So finally we did this experiment
  • 41:19where we repeated this abusive pups,
  • 41:23they are getting they have the
  • 41:25natural increase in court and
  • 41:26we've injected A pups being reared
  • 41:28by a normal level with court.
  • 41:30And then we also injected pups with
  • 41:32court with an anesthetized mother.
  • 41:34No maternal behavior whatsoever.
  • 41:40They all produced the same deficits.
  • 41:43The only condition that we did
  • 41:45that produced a normal amygdala was
  • 41:48injection of pups when they were alone.
  • 41:53The hippocampus still changed,
  • 41:56but the amygdala changes did not happen.
  • 41:59So it looks like the amygdala is
  • 42:03incredibly sensitive to combination of
  • 42:06stress within a social context and the
  • 42:10hippocampus just responds to the trauma.
  • 42:12And that does explain a huge amount
  • 42:15of variability in the literature.
  • 42:17I will say that sometimes people have said
  • 42:19that injecting pups with corticostrone
  • 42:21is enough to produce problems.
  • 42:23But in my lab we are so careful
  • 42:28about handling the pups and our
  • 42:30colony is gets massive oversight.
  • 42:33We don't have a stressed colony,
  • 42:35our animals, our mothers response.
  • 42:37So controlling the colony,
  • 42:39making sure it gets good animal care,
  • 42:42we can inject court.
  • 42:45And anyway, so
  • 42:50I gave you a lot of information,
  • 42:51hopefully not too much and I've
  • 42:54hopefully placed it within a
  • 42:56framework that lets you maintain it.
  • 42:58But I'm going to review everything.
  • 43:01So first, there's a sensitive
  • 43:03period prior to amygdala maturation
  • 43:06in the human and the rat.
  • 43:07We know the amygdala is late developing.
  • 43:10We don't we know in the rat that it
  • 43:12occurs at 10 days of age in the human.
  • 43:14We think it's around crawling.
  • 43:18We'll never know because it's impossible
  • 43:21to do those experiments in in children
  • 43:23and Jill is probably the expert on that.
  • 43:28So trauma during this time pre amygdala
  • 43:30is engaging the attachment system.
  • 43:36So such as in fear conditioning
  • 43:37repaired the odor with we got an odor
  • 43:40preference and a new maternal odor.
  • 43:42So when the pups are a little bit
  • 43:43older and the amygdala is activated,
  • 43:45we have this transitional sensitive period
  • 43:47where the amygdala responds to trauma,
  • 43:49but if the mother's present,
  • 43:51the mother shuts it off.
  • 43:54So this has been identified in
  • 43:58rodents and replicated in children,
  • 44:00including Dylan's work and Nim,
  • 44:04Tottenham's work.
  • 44:06So this data helps us take that
  • 44:09wonderful human literature and go beyond
  • 44:12mathematical models of causation and
  • 44:15actually test directly test causation.
  • 44:18And I think that that's important
  • 44:20because many things that make
  • 44:22sense to us end up not to be true.
  • 44:24So we know that our framework
  • 44:26of development is incorrect.
  • 44:28Otherwise we would have made
  • 44:30much much much better progress in
  • 44:32helping children than we have.
  • 44:34So.
  • 44:37So the mother suppresses age
  • 44:38specific mechanisms distinct
  • 44:40from adult social buffering.
  • 44:41We have transition of a circuit
  • 44:44going from the dopaminergic VTA
  • 44:46to the Pfc used in older animals.
  • 44:48The mother controls initiation of
  • 44:51the HPA axis via norepinephrine from
  • 44:54the NST and we know that the infant
  • 44:56initiation of the HP axis is far more
  • 44:59simplistic than it is in the adult.
  • 45:01The adult still has norepinephrine is a major
  • 45:04driver of the initiation of the HPA axis,
  • 45:07but it also access to have many,
  • 45:09many,
  • 45:10many other pathways to activation
  • 45:12and suppression of the HPA axis.
  • 45:14So we may think that may be the
  • 45:17reason why that goes away anyway.
  • 45:20And we've identified at least
  • 45:22one H specific intracellular
  • 45:24molecular signal signal to block
  • 45:27plasticity within the amygdala.
  • 45:29That's IRC.
  • 45:30P IRC Anyway,
  • 45:32finally the quality of care received by
  • 45:34the infant from the mother appears to
  • 45:37degrade these age specific mechanisms.
  • 45:39So the mother's ability to have high
  • 45:42hedonic value is reduced based on
  • 45:45pups approaching less and also the
  • 45:48mother's inability to turn off the
  • 45:51amygdala and stop the air conditioning.
  • 45:54And finally understanding these age
  • 45:56specific mechanisms supports the well
  • 45:59documented age specific clinical approach.
  • 46:01We already know we a clinician,
  • 46:04a good clinician knows something
  • 46:06already about how to about this
  • 46:09complex attachment system and it's up
  • 46:12to the animal researchers I think to
  • 46:14begin to show these these mechanisms.
  • 46:16So that's it, Major.
  • 46:19I've given you a presentation
  • 46:22including work spanning over 20 years.
  • 46:25Many,
  • 46:26many people have been involved in that work,
  • 46:27but I think I've picked out
  • 46:29pieces of it that I hope make a
  • 46:33story that's understandable.
  • 46:34So thank you so much.