Translation by Patrizia Rustichelli-Stirgwolt

The review of the Italian association of psycho-neuro-endocrine-immunology Edited by Francesco Bottaccioli

PNEI NEWS The new knowledge of science and health

PREGNANCYCHANGESTHEBRAIN

PneiNews–bimonthlyreview–nr1–yearXI–January–February2017

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PNEI NEWS NR 1 – January- February 2016 EDITORIAL Page 3. Brain and pregnancy Francesco Bottaccioli INTERVIEW Page 4. The future of Psychoneuroendocrineimmunology The value of international collaboration, prospectives for research, reached goals and future objectives. These are some of the themes of our interview with Adriana del Rey, immunophysiologist at the University of Marburg and general secretary of the International Society of NeuroImmunoModulation (ISNIM). In anticipation of the International ISNIM-SIPNEI Meeting that will be held on the 25th-28th May in Rome. Paola Emilia Cicerone PREGNANCY Page 8. Post traumatic stress disorder in pregnant women with primary cytomegalovirus infection and the risk of mother-to-fetus transmission Francesco Vadini PSYCHOTHERAPY Page 13. Are we all psychotherapists? Guidelines for users and operators in the world of counselling Listening is the magic formula of our daily work. It is mainly a psychotherapeutic relationship engaged with the patient. Is the use of the word as a therapeutic method only ours? Apparently not, over the last years there has been a significant increase of variety in the counselling profession. It is now time for us to answer some questions. Cinzia Caputo, Flavia Donadoni Page 16. The psychologist is a warranty David Lazzari SCIENCE AND NUTRITION

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Page 18. The flavoured liver: Mediterranean herbs protect it from steatosis. Oregano, marjorane, savory, thyme, mint, sage and other herbs which are typically used in the Mediterranean cuisine not only turn a simple meal into an excellent dish but they also activate biochemical mechanisms that improve the lipid metabolism thus protecting the liver from fat accumulation. Ilaria Demori, Elena Grasselli, Adriana Voci BOOKS Page 22. Integrative Cardiology Page 23. Bilancia il tuo stress – David Lazzari, L’arte dell’ascolto – Cracolici, Pianigiani, Rinaldi

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EDITORIAL BRAIN AND PREGNANCY Francesco Bottaccioli – Master Director of “PNEI and Science of Integrative Care”, University of Aquila. The traditional biomedical conception of pregnancy considers the mother-fetus exchange in a unidirectional way. The medically recorded biological modifications follow this direction as the parameters taken into examination are: the increased iron requirements, the increased volume of circulating blood, the reduction of insulin sensitivity in relation to the increased metabolic request coming from the needs of the developing fetus. Also the psychological models (from Bion to Winnicott) emphasize the nutritional role of the mother for the new life being formed. Immunologic and neurologic studies now change this viewpoint and underline the bidirectional exchange between mother and child. It is not only the mother who influences the child through nutrition, emotions and style of life, but it is also the child who modifies the mother’s body and mind. Immunologic researches are long-established and consolidated, yet some points are still left in the dark. We know that the immune system of a pregnant woman shifts from the Th1 to the Th2 circuit. This shift is functional to the continuation of pregnancy as it prevents it being interrupted by an excessive activity of the Th1 circuit stimulated by the partial heterogeneity of the fetus which differs genetically from the mother’s body. In most cases an immune alteration goes back to balance during post-partum and acts as a protective factor towards autoimmune disease, such as multiple sclerosis, activated by the hyperactivity of Th1 circuit. Now we know that also the brain of the woman changes during pregnancy. A study lead by a group of neuroscientists from the University of Barcelona has shown that crucial cortical areas change and such long-lasting change predicts the quality of the mother’s attachment to her baby1. The researchers compared magnetic resonance brain images of 25 women monitored before and after their pregnancy and of a group of women equal in age who had never been pregnant. The results showed changes in the pregnant women group in grey matters brain regions associated to the so-called “theory of the mind” namely the ability of understanding thoughts and feelings of others. This function underlies the skills to build human relationships and sociality. A control performed two and half months after birth showed that the

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greater the changes were and greater was the mother’s attachment to the baby. It is remarkable that in a 2 years post-pregnancy period some cerebral areas, such has hippocampus, were still showing such changes. Lastly, it is very interesting to observe that such changes involved a reduction of the total volume of grey matter. This means that a reduction of grey matter is not by itself negative. It is a phenomen that takes place in crucial life passages, as during adolescence, where the restructuring and stabilisation of cerebral circuits occurs along with a total volume reduction in some key areas to allow a greater stability and efficiency in the circuits2. Thus the mother’s brain becomes more refined and ready to pay less attention to her own ego and aggressiveness. It becomes smaller to better enjoy the mother-child love relationship. 1. Hoekzema E et al (2017) Pregnancy leads to long-lasting changes in human brain structure, Nature Neuroscience 20, 287–296 doi:10.1038/nn.4458 2. Barha CK, Galea LA (2017) The maternal “baby brain” revisited, Nature Neuroscience 20, 134-135