53. Brain Changes Across Pregnancy

Hi everyone, welcome to another episode of Mummy Brain Revisited. On today's episode I speak with Dr. Laura Pritchard about her recent research looking at how the brain changes across pregnancy. This study was recently published in Nature Neuroscience and the title is "Nearotomical Changes Observed Over the Course of a Human Pregnancy." It's a fascinating study, so I hope you enjoyed this episode. To remember if you have data to share or a topic you would like to hear more about, please let me know. You can find me on Instagram at Dr.JodyPoluski or contact me through my website at jodypoluski.com. Soundstrap. Very much looking forward to talking to you today. Before we could jump into your paper, I was wondering if you could tell us a bit about how you became interested in studying the female brain or the maternal brain and tell us a bit about your journey. It all starts as an undergraduate and it starts with menopause. I was in my behavioral neuroscience classes. It was actually Janus Draska's class who is big in endocrinology in the animal world. It was a laboratory class and I was just so fascinated by all the complexity of the brain. Just the way that they broke that down, this is so interesting. Thinking about all the neurotransmitters in the act and just looking at excitatory and inhibitory neurons, just all of that really mechanistic processing to get us to where I can sit in a class and hear and think and read. It's just how does that go from that scale to this scale? I was so fascinated with that. At the same time, we had this exercise every single week where we had to read a research paper and come back to our graduate student and post questions. Every single research paper that we read excluded female animals. I made it this bit where every single week I would be like, "Why weren't females included in this study?" You get the classic thing that if you're in our area, you know this by heart now, which is females are too variable. They have an estrus cycle, so it's really hard to study them. We'll study males and then we'll just apply it to females because that's super logical. That just got my gears turning a little bit. Because that doesn't make any sense. We should probably be just inclusive in including this, who knows whether there's going to be differences or not. That was the scientific kickstart. At the same time, my close friend in college, his mom was going through menopause. I've known her for a long time. Just see the switch where she was talking about walking into a room and cannot remember where her keys are or having to constantly either be fanning herself or go stand in front of a fireplace in front, you know, within 10 minutes. It was so fascinating to me this like budding cognitive neuroscientist. I'm like, "That's so interesting." And that's like four years. You know, that all of a sudden this sort of switched and this is a long process. And what is that? What's going on in the brain? Why would your brain be so involved in menopause? And so those two things together, I was like, "That's really fascinating and I bet we don't know." And it turns out, unfortunately, I was right, you know, about, you know, studying extensively menopause with the context of the brain. And so applying to grad school, I found Emily Jacobs Lab at University of California, Santa Barbara, who was really kind of at the forefront of combining, you know, human neuroscience techniques like non-invasive brain imaging with actually just dedicating her lab to studying women and studying menopause and how the brain is changing throughout that process. And she had done menstrual cycle research and all that. I didn't know that that could exist. It's like, this is exactly what I want to study because I'm interested in it personally. I'm interested in it professionally. And that will make grad school so fun and interesting. And that was the best decision I ever made. And so I actually joined the, my PhD program with the idea of studying menopause. And I just love the idea of looking at how our nervous and endocrine systems interact how that influences the brain and how we can measure that in humans. But then how that, you know, downstream has effects on cognition and behavior, mental health and all of that at large. And so that was kind of my gateway into studying hormones and female brain health. And then, you know, I just started my first kind of graduate year, really, into menopause. We brought women in at various stages of menopause, pre-menopausal, paramanopausal, post-menopausal. And just reading about it, this is a huge hormonal transition period. Like, that's not only impacting the brain, but all the other parts of our body and our physiology. And so that's kind of the primer of like, why I love pregnancy so much is it's similar to that. In the sense that it's a huge hormonal transition period that happens to a lot, a lot of people. And we don't really think of it in the context of the brain that much, at least with the neuroscience part. And so, yeah, I know, can keep going, but in my second year of grad school, I kind of flipped my interests a little bit because we had this unique opportunity to pursue a slightly different study that wasn't related to menopause. It wasn't traditional in our field, but we became really interested in this concept of dense sampling. And so, a lot of conversations were going on about how reliable and reproducible our features of our brain are given our current methods. So in biological and social sciences, the traditional approach to studying humans is bringing them in at one time point and scanning their brains and grouping people together. Can you see age effects in the brain? Can you see differences between people who are depressed versus healthy? And that has provided a lot of information for us. We've gotten a lot from it. But there's this overall question of how stable are we, how variable are we? Does that look the same to those patterns? Look the same if we actually are studying people over multiple days or months or years. And so, we flipped that cross-section model in our field recently and have said, "Well, we can also gain a lot of information in parallel if we lower our ends, lower our sample sizes, and just bring people in and study them extensively. Densely characterize them, deeply phenotype them." And so, Russ Pulldrak at Stanford did this and so he called it the MyConnectTone project. And he scanned his brain, I think, over 100 times in a year and a half or two, and just, you know, trapped himself. What was the weather? What did I eat? What did my blood look like that day? And that was a very unique way to study how the brain is adding and flowing with how you are and how you're living and all of that. And so, we said that would be exactly what we need to study female hormones or to hormones in general. You know, they're not this sort of static thing. The nature of hormones themselves are that they vary or they they ebb and flow. So, why don't we do that? Because what we've been doing this far is the same, you know, traditional model of bringing people in. One, maybe two or three time points of the menstrual cycle and trying to understand how the menstrual cycle impacts the brain, but it's so different for every single person and you're missing big gaps of hormonal change. And you can't get it super accurate. So, why not fill in that gap and do something unique? And so, I volunteered myself to be scanned every day of my menstrual cycle. So, 30 days straight, just for fun, scanned my brain, took my blood every day, filled out all these assessments. And we were able to see the brain kind of respond to that ebb and flow of hormones across 30 day period and just a single individual. And this is a long story to set up the pregnancy study. But at the same time that was happening, and I did it again the following summer on birth control. Just this unique test to myself of like, what can we do with someone who is willing to be a guinea pig and we have an IRB? At the same time, a woman approached us, Liz Crastel, who is the subject of our study and co-seeing your author, and said, you know, I'm going to try and get pregnant soon. Why don't we scan my brain throughout this whole process? And as a, you know, I'm sure your listeners are acutely aware of this literature, but what we've done thus far sort of is a snapshot approach for multiple reasons of scanning women before conception and then after and postpartum to try and see how the brain changes. And it's not because they didn't, you know, we have that method not because women or researchers weren't like, we don't need to know what happens during gestation. It's just a very, very hard protocol to do. There's multiple reasons why people have been very hesitant to scan pregnant women, the delicate topic. It's, you know, historically been a protected time. But we kind of wanted to challenge that dog in a little bit and say, you know, we can do this in a very safe and effective way. And it's actually a really important time period to study because we know there's a lot of changes that are occurring. We know A and B, but what about everything between that? And that could be the key to studying all of the things that happen during gestation and in postpartum. And we had someone willing to do it. And so the idea there was really just just like my study, sort of a proof of of concept of really important information. can happen and occur. If we do a study like this and maybe it can change the landscape a little bit and we can start to enter this new this new era of research. And so that was kind of the motivation is let's let's look into an unknown uncharted period of time and studies just someone just start with someone and scan their brain throughout pregnancy another hormonal transition period. That was a lot but that you know there's many layers to how the study came about. Yeah I love that story because you're also capturing all those changes except for adolescents but those major changes across the female lifespan or adult life anyway. Yeah interesting and I was like I want to ask you about your menstrual cycle study. I think I know that study but it was published right? Yes this is the 20-year-old study. We liked that funny name for it but yeah yeah it happened several years ago, five years ago now at this point and it's all open access and now follow-up studies are occurring and yeah it was really cool to just see brain connectivity change our ovulation and yeah it was just such an interesting approach to setting this and you know I always say I'm funded by the National Institutes on Aging and people get confused by that because of all the different areas of the women's female lifespan I studied and I say well I'm really want to know how women go through menopause and age but in order to do that I need to kind of understand and I from the perspective of all of these reproductive events shape the brain and they're important but I need to go into each one of these and understand how they're actually impacting the brain before I can model that in aging and so I'm working my way up to it I think I'll eventually go back to menopause but I'm really now still in the pregnancy period. So then let's get back to your study and why don't you tell us then about this study so we know we have this one person donating her brain essentially across pregnancy and postpartum but yeah tell us more about how you did it because you couldn't do that every day like you did with the menstrual cycle so yeah walk us through it. Yes absolutely so that was a different protocol that had to be done and so we you know with these sorts of studies there's both the you know the the scientific rationale of like what would a what would we want to see how would we how deeply would we want to map the brain and of course every you know the kindness guys like let's get as much information as possible but you still have to contend with what safety protocols and the subject themselves and all of that and so we kind of settled on let's look at her brain every two weeks across gestation so she came in and the other aspect of the study is that she was going to go through IVF and this is all disclosed in the paper and she and you know I dealt with the topic but she's such a superhero she's like give all the information and that helps with these sorts of studies in the sense that you know you don't necessarily know when you're going to get pregnant with IVF it's a little bit tighter of a window and all so she we scanned her brain a couple times in baseline meaning she came in to you know do all of her mood assessments blood draws she went into an MRI scanner and we did structural sequences we can quantify volume of the brain thickness of the brain fluid in the brain she did some functional scans to where we can look at brain function and connectivity and look at how brain networks are interacting and changing over gestation and she also did a spatial navigation task each time because she's a spatial navigation researcher we know they hit the campus changes during pregnancy we know it is involved in that cognitive aspect and so she did that every two weeks or so it's not you know a perfect static rate but we were able to capture her in her sort of baseline preconception through IVF and with that we know kind of precisely when her conception date was and then our implementation date and then scanned her and captured her brain during the first trimester second trimester third trimester early postpartum I think she got her first postpartum scan within the month of giving birth and then we scanned her a few more times in that early six month period and then far out into less frequently but into two years postpartum and so that allows us to say okay take this one measure of the brain we're interested in say prefrontal cortex volume and you can map just that across the whole period in conjunction with not only what her gestation week looked like but her hormone levels and everything and we have this idea we had these hypotheses based on the wonderful work by all the people in the field who who've done this thus far including that sort of revolutionary else Celine Hexma study and just had this idea that things will you know you know all great matter volume will decrease through a postpartum but which does it look linear does it look not linear what areas are changing what aren't and it was kind of you know crazy and I'll go into the results in a second but just doing the study itself was really fun because we're sitting with the data and at one point we said we have a look into someone's brain throughout pregnancy and I don't think anyone else in the world has this right now and so what does this look like it was kind of like Christmas you know like we have all of this information and it's just what is it what is it look like we it's such a big signal like really truly it's hard to think of another time point in life that is as physiologically demanding and things will change you know menopause is titrated out a lot longer um humidity is also a longer period it's maybe those you know you can compare to other hormonal transition periods but truly this is something that 85% of the population will go through 140 million women each year and we're sitting on one person right now in 2025 being mapped throughout that revolutionary nine month gestational window and it was so it was very exciting and very thrilling to be sitting with that data and just thanks props to Liz for for volunteering to do it because it's not easy to do you know you're not feeling the greatest maybe in the third trimester and these sequences are short to clarify you know they're not in the scanner laying down for more than 30 minutes again you have to follow certain safety you know protocols of laying on your back or your side but wow it was very fun yeah yeah I mean it's yeah it's a great study it's a great thing to be able to do which as you said this is something that people have thought about but haven't had the capacity or the ethical approval because pregnancy to put a pregnant woman in the scanner and I know in France it's unacceptable unless there's an illness a reason for it and so you know that has kind of delayed science of the science of pregnancy in many ways so okay so this is it was like Christmas with all the data so then what did you find yeah so I looked specifically at Gray matter volume and I was really interested in trying to replicate and fill in the gaps and you know I want to blanket all these all these results and we can talk about it further of what it means to do an end of one study what you can say what you can't say but again this was just let's start somewhere and so I was like let's replicate what people have done this far so when we look at Gray matter volume you know the area where neurons are and like of the cortical ribbon we see the sort of widespread decrease from pre to post part of them and it's pretty linear so as gestational week advances Gray matter volume was decreasing these are not massive wild changes you know and people you know ask that question a lot of like oh is it shrinking it's like this is it looks pretty linear pretty natural pretty you can contextualize that percent change but it was pretty prominent in most areas of the brain you know of the mask that we looked at to kind of you know put regions together and extrapolate from that 80% of them changed some more than others and at the same time cerebral spinal fluid increased blood or ventricles increased because you're not going to see gaps in your brain you're gonna and so it was this beautiful sort of choreographed dance of some things decreasing over the gestational window and others increasing we need more evidence and science to figure out what happens first you can have serious strong hypotheses of what's happening first but at the same time white matter we looked at a measure of white matter microstructure using diffusion MRI so tracking sort of water diffusion of the tracks themselves to look at the integrity of those so how kind of solid they are you can think of celery stalks how stiff they are versus loose and water can travel faster their communication between neurons can increase and we saw that increasing sort of in a non-linear fashion over the gestational window so it wasn't like everything is shrinking your brain is not working it was just adapting and so we saw the sort of white matter increase, screen matter decrease over the gestational window and then some areas in postpartum just went back to baseline and others didn't including areas that really kind of traditionally belong to these association networks these higher order networks default mode network executive control network attention networks themselves and that's kind of fits within the literature of what people have found is that some areas have the slower recovering. What we mean by that is their gray matter volume is sort of at the lowest in that third trimester. And it rises back. It doesn't continue to keep decreasing in postpartum, but it doesn't go back. And it's so nice to have those baseline scans to and we had a couple of them. So we were able to kind of see that you I don't even know what letter that would be. It wasn't a perfect you in the same and you know, four grand matter volume, but it didn't kind of go back to baseline even into the second, you know, the two years post. And so that was really, really interesting. And I think two things are happening there and our studies surely can't answer that. But one, I think some of the things that we found given it's, you know, so widespread is that just like you're the uterus, just like every other part of your body, your brain is adapting to the physiological demands of pregnancy itself. So you can think of, so you know, there could be swelling or fluid retention, just like it is happening out elsewhere in the body. It could be happening in the brain. And that can, you know, muck around with some of the measures. And so there's just this aspect of this physiological change itself that MRI is just picking up on. And the other half is that, well, if that were the case, everything would go back to, you know, what it would be in baseline eventually in the postpartum. And that's not the case. And that's not the case just for the study, for other studies and animal studies as well. And so I think the other part of this is that yes, there is probably this fine tuning of certain circuits. And this sort of change is happening for a reason. And again, like you have said in your, in your body work, you don't have to think of it as this sort of death of these neurons that your brain is shrinking and that it's bad, but rather just adjusting and reorganizing and fine tuning of these circuits themselves for a specific reason. And I think both of those things are happening. And I think now we need to go in with other modalities and more people to just track and try and figure out what those are and what's the most replicable finding we're seeing over pregnancy of what's changing and staying changed and tying that to behavior outcomes and all that. But yeah, that's kind of what I think of when I trying to understand those findings a bit. Yeah. And I think really the value of this study was really that you could track someone over time. Also, your findings replicate what we know, you know, of the limited data of just a cross pregnancy, but not within pregnancy. So that must have given you some, you know, feeling some confidence where again, we're proving and seeing that the brain changes across pregnancy and you've really shown here's what happens at first trimester, second trimester, every two weeks. And I think this is really foundational because we can go back then and be like, well, there was that study and they showed that this was kind of the time frame where there's some really big changes. So let's investigate that. And we've never had that before. Not even with the animal models so much when looking at the brain in pregnancy because pregnancy has been really not the focus of so much research because often even the animal research and that's where I come from is been to understand how the brain changes to coordinate caregiving of offspring. So it's often that, you know, immediate, that early, late pregnancy and then immediate postpartum time frame, but not this whole idea of what does pregnancy do to your brain, which you've captured in a human. So amazing. Yes. I know that that was why I was called like Christmas. And yes, it was really validating that once again, we're not, I always say this, we're not reinventing the wheel of these findings. They're ground breaking for all the reasons you laid out. They're not in a sense of like, oh, I didn't know that was going to happen. I'll be it. Some people have that thought of if I go to my very close friend, Magdalena Martinez Garcia, who's led a lot of this work. She's like, yeah, this makes sense. This is what we're seeing down to like the specific regions being impacted. And there was a paper that came out a couple weeks ago from Catherine Humphrey's group at Vanderbilt. They had more people fewer time points, but they found the same patterns, right? Gray matter volume decreasing of a pregnancy, white matter increasing, cerebral spinal fluid increasing. And so and just to put Magdalena, it's like this is the most consistent finding in human neuroscience. Like this is real and this is this is important. And I think we have really thought of pregnancy. I go through the I'm doing this huge literature review project of all women's health papers and a lot of the, you know, pregnancy related investigations really have to do with the child or the infant or yeah, the postpartum period. That's great. But I'm also thinking of it in the context of like we won't know the full capacity of the brain unless you study this because it's it you'd remove that from the equation. We're showing in a nine month period a few mongous percent and not humongous. I just said it wasn't big, but like a significant percent change of the brain. We're showing how adaptive the brain can be. And this happens constantly for people. And why are we not interested in it just in general of like how powerful and cool the brain is, how flexible and adaptive it is. And we're showing just like this beautiful pattern that is already being replicated. It is no surprise to anyone else. And you know, not everyone goes through pregnancy in the exact same way. Some people are reporting no cognitive change. Some people are reporting a lot of cognitive change. And then of course everything that happens neurologically, a clampsia, preeclampsia, stroke, headache, migraine. And then into postpartum, this is a brain hormonal transition period. It is very much impacting the brain. Studying pregnancy is very important to not only understand the brain, but to understand the health of the brain. And I think that the the throws and the benefit we get from studying gestation itself outweigh the risks of like should we study pregnant women should we revisit how to our safety protocols and revisit the sort of dogma that unless a woman is coming to the ER we cannot scan them. We do fetal imaging. We do clinical imaging. We do ultrasounds. Let's try and get this because I think it's going to be really informative and help people. And I think that's what I think from a mile away this study is doing and it's already we've shared our IRBs people at different institutes at least within the US have started to change that protocol and it's been coming approved now. You know, we it's not that we're not we're just letting it be a free for all. It is overseen by physicians and these are research studies, meaning women volunteer. They read all the information they volunteer, but I think we're in that new era of like people understanding the power of studying and tracking pregnancy changes for postpartum, but just for the brain too. Yeah, just for understanding what the female body goes through, right? Like why can't that also be interesting? Yeah. Yeah. Wow, this is this is just something that happens and it's like it's just I still blown away by pregnancy itself. I just think it's so fascinating, but yeah, no. You know, you know what's interesting is this is a comment I often get because I am a mother of two and so people are like, oh, so then that's why you study like the maternal brain. And I said, well, no, because people also use this whole story about well, it's so great. We have more information about the female brain across pregnancy and motherhood and that's because there are more moms who are neuroscientists who are doing this. And I say, actually, there's a lot of men that also have traditionally, I mean, started this field and there's a lot of interest in it. But it shouldn't be moms that are interested. We should all be interested in this phase of life because it's fascinating, biologically, from a societal perspective, if you're doing sociology, psychologically, like this is pretty phenomenal, particularly for a female, for a male also, but the gestational parent has loads of things going on. So I was interested in this whole topic of motherhood before I ever thought I was going to have kids. And I think that this is where the narrative also has to shift and realize that it's cool because it's cool, not because we experienced it, and then we thought it was cool or that because we're females. I mean, I know men without children who are steady pregnancy and find it incredibly fascinating. I think this is also where things are hopefully starting to go in the future is that people are like, "Oh, yeah, but it's pretty amazing what happens." I mean, it's amazing what the female body can do. Yeah. It is such a nuanced thing because when I talk about it and I'm like, just like mapping this in a person and, you know, we can compare it to people who were skin over nine month period to see how their brains are not changing much and this is changing a lot. And then you can trace it and aging cohorts, like this is just so cool. And it's so, the thing I get held up on so much is just like I'm like 140 million a year. Yeah. 140 million new, like this is, and Winnie Orchard says this in her paper, which is like, this is an optional life sage, but the majority of people who will go on into the aging cohorts have experienced this and I'm like, so as a scientist, why are we not like, "Oh, the brain is doing something so cool?" And I guess why I'm saying it's nuances because I get so hung up on that. Obviously, get very excited about that. And then the first question you get is, like, does this confirm that mommy brain is real? And I'm like, "Oh, - Wow. - Is there this? Because why don't we just take a moment? You're like, this is awesome. This is so cool. And let's just continue to study it. And it's not obviously in a bubble, but I think it deserves, it's time to just, let's study it and just see how cool. And it could be so informative for people who study, again, aging, people who study stroke recovery, you could learn things from this. They did this with multiple sclerosis. I mean, there's so much information you can get and it doesn't have to just be for females. - Yeah, exactly. Motherhood, being female is a very interesting topic in general. I also always think when it comes to all those animal models we use, not only do we need to use females more often, but then most people and most living things actually reproduce or actually have intercourse. So they're not virgins and we're often using mice that have never been paired with the member of the opposite sex. And then that's supposed to inform us, right? And so when we do, I think we have to remember that we're not necessarily mimicking what's happening in the human condition. We could do better, basically. We could have reproductively experienced males and females in our research and then see what's going on because many, many, many people will be parents anyway. - I wouldn't even think about that. That is so true. And then the age factor too of when they go through this, you need to time it in animal models of post birth and all that, but I'm like, there are women who are 45, there are people who are 16. I mean, that's a whole lot of-- - Yeah, that's a whole lot of thing. But this does actually come up in animal models 'cause often you'll see weight differences or different effects depending on or weight gain differences, how old your animals are when you bred them. So yeah, it's a different time window and it has a new study in detail, but there's definitely something to be said about early reproduces versus later reproducers, probably pros and cons to both stages, depending what you're looking at. But that also becomes very interesting. And I get this question a lot about what about teen moms and their brains because we're dealing with the transition already in physiologically and neurologic, or yeah, in neuroscience perspective, but also you add in their parenting, which is kind of traditionally what females were often doing was reproducing at a younger age than now. But yeah, there's always questions than about what does this look like in the brain? - I think it's one of the most fascinating that not to say that every age is an interesting with those tail ends 'cause we really think about it, and even just I think maybe the easiest way and even scientifically, what makes the most sense is to contextualize these findings of, gray matter reduction, all that is like, well, this is the same pattern in adolescents. You see the sort of pruning of gray matter volume, this increase of white matter volume in association with cognitive change and mental health risk. You have, it's a period of flexibility, and no plasticity in the brain. And it starts after puberty. And so I often make that parallel and I always say, don't go up to a pregnant woman and say, oh, this is second puberty, don't do that. But it's a way to kind of contextualize that change and adaptation during a plastic period is not this sort of like your brain is shrinking and it's not good. But what happens when those are kind of intersecting a little bit like in younger pregnancy is just an unexpl. I mean, we haven't even studied second time mothers. Like, you know this, though, that the low hanging fruit questions to be applicable to the human condition is so large. But that is really interesting too. You hear this idea that the brain sort of like hits its full development at 25. And it's not just a flip of the switch. But one, okay, so what does that mean when you have a pregnancy at 20 or 16? Second is like, oh, no, we're showing pregnancy. This is a 37-year-old woman who is showing these sorts of changes that persisted after pregnancy. So the brain, we need to kind of think of how we explain brain development, brain plasticity with the context of pregnancy. So those two things are true. But then if you have a little bit, if you're a little bit older, what does that look like? If you're 41, 42, however old, what does that look like in the brain? Does it maybe have less pronounced change, more pronounced change? What, I mean, all of those questions are so interesting and impact the lives of women. - Mm-hmm, yeah, we have, there's a lot of questions that need to be answered. And not only do they impact the lives of women, but they're gonna impact the lives of men, right? - Yeah. - I mean, and the elf's spring, I mean, - And everyone, if we have better payments, better understanding, more acceptance of what's normal and healthy, better support, that can be a game changer for everyone. - Yeah, yeah. So I guess what, I'm gonna go off script a bit here, but I mean, if you were going to translate what you found for moms or what would you tell, like what does the study mean for moms out there? This is my question. What does the study mean for moms and parents? - Yeah, I think, you know, I'm very acutely aware of what our study can and cannot say. And so specifically for this study, what I hope it does is sort of provide validity that things in your brain are changing, and we can quantify it. And so all of these things you're feeling, it's not just in your head, or you know, it's not just mommy brain or your hormonal, all these quick excuses or quick explanations, but rather like your brain is changing for a reason, it's adapting to your pregnancy, and it doesn't mean that it's bad. And what I like to say, I have my best friend, just was pregnant and gave birth last year. And I like to say is your brain's not shrinking, and yeah, you're telling me if some attention issues and all that, but look, you are maybe forgetting where your keys are, but you are acutely aware of every single time that your child just ate how much they slept, and you're listening to them. I mean, your brain is adapting. It's not all getting worse and shrinking, and you're so flustered. Think about all of the cognitive improvements that are happening right now. It's just kind of different. It's flexible, it's adaptive. And that's how the brain has to work, because otherwise, to be high, speak hyperperfectly, that's not the word. You're brain will explode. So you're, you know, you're maybe having some cognitive complaint here for this domain, but the others are improving, and you made your sensory systems have changed, and it's all a part of the process. And so I hope that it's showing some sort of validity to them of saying, okay, they've actually quantified it, and the brain is changing, but it's adapting for a specific reason, and maybe that matches on with what I'm experiencing, and I just try to flip the script a little bit. I think that's what you're trying to do, too, in the sense of like opening it up, and making it less sweeping, and try to bring in some science to explain it. And I hope that's kind of what it does, 'cause we didn't study behavior. I can't explain, you know, map on these changes to sort of cognition. You couldn't do that in the study in the first place. You need more people, but I'm hoping that is just like, wow, that's really interesting, and okay, I want to hit like and subscribe to this whole domain now and take back that power, and again, be like, this is very cool. And you get a lot of interview requests for this sort of study, and as you know, you've experienced this, too. But the things that meant the most were people that I've even interacted with a couple times. Text me and say, this is going around to their parent team group and all of that. And like, wow, this is really fascinating. And I don't know, we feel like heard or we feel represented a little bit now. And it does feel like the change wasn't like, this explains the mommy brain, but rather like the brain, the pregnancy is a profound period of change, and it's really cool in the brain, and I'm happy with how that played out. - Yeah, yeah, and I think that's a great message, just to accept, yes, there's lots of changes going on, and therefore reason, they're adaptive, and you can feel, you know, often we're just focusing too much on the deficits, you know, as mothers, because it feels uncomfortable we're forgetting all the amazing things that the brain is doing. And I think that's important, so important in the message. - Yeah. - So what's next in terms of research for you? - Yeah, so it's actually very exciting 'cause I'm staying in the pregnancy space. And I, you know, when we talk about done sampling studies, so the study is now being done, and you've spoken Emily, and she's probably highlighted the maternal brain project. So we're not stopping at one person. It was more of just like, let's get her foot in the door. We can share this, I believe. We can motivate people to volunteer and be interested. And now they have, you know, so many people being scanned, and there have been several women who've already completed the protocol and their partners, which I think is the extra fascinating step of that study. So stay tuned on all the results there. The fun part is that a lot is replicating, so that's great. But at the same time, there's sort of this fork in the road of science of like, do we study population level data, do we densely sample people? What's gonna get us to this question of, what does the brain look like over the lifespan? Should we set the individual, should we study the group? And ultimately it comes down to like, We have to do both and it just depends on the question you're asking. The trade-off of if we do the maternal brain project, you're going to get 20, 30 people and maybe it'll expand, but that takes years and years and years and you're still not going to get those really large numbers you need to really showcase these sort of to use models to show normative brain charting and all of that. We really need this other angle which is a lot of data, maybe a smaller amounts per person but a lot of data. That's what I'm pursuing now. So the kind of flipping what I did in the last couple of years, the opposite and I'm at University of Pennsylvania School of Medicine and I'm working with Dr. Shilishan Mugen and this is her sort of project, her idea that we sit on and I say this isn't a known thing as much but it's becoming more and more known is that hospital systems scan people all the time and they sit with that data. And if you actually leveraged that, you'd have millions of data points. And so she said, well, anytime anyone comes, this speaks to kind of what we had talked about at the beginning, anytime someone comes to the hospital, whether it's a doctor's appointment, ER or whatever, and if they're pregnant and they say they have a headache or some other condition, they get their brain scanned. And it turns out that a lot of the times in those cases, they're fine, they have radiologists looks at it and it's okay. So if you look over the past 25 years of hospital systems, we're sitting on thousands of data points of women at various stages of gestation or women who just recently given birth or just right before it. And now we can harness that and we can ask, okay, let's take that data. We'll clean it up, you'll lose people for medical conditions in your exclusionary criteria but you're still sitting on a lot more data than we'd ever have elsewhere, including in a research study. Now the images themselves are not, you know, research grade but there's a lot of really interesting machine learning techniques to improve those images. And so now we can ask the question of like, okay, on the other hand, can we chart the brain over pregnancy with the building from these big samples, then you can integrate it, you can bring in a single person's seat, are they kind of above or below on average, what that trait that trend should look like in gestation? How does that differ for women who've had two children, three children? How does that differ by socioeconomic status? How does that postpartum brain change based on labor complications or delivery method? Those types of questions you can get from large samples with a lot of electronic medical records and diversity. And that's kind of what we're pursuing right now is really flipping that model and trying to figure how we can integrate all of this together. But a lot of low-hanging fruit still and the exciting part is just, let's just dedicate doing what people are doing to the brain to like, specifically pregnancy now and take all those cool methods and really just unapologetically focus there. Yeah, I love this. Very cool. Well, thank you. Sound strut. Sound strut. I got to wear it in my hair. It come like a train running through it. They keep it on my school, but I want to know where you're going. I think we're at your grade. Cause I'm never on the stage. Hey, she's gonna walk away. What it takes to get here to stay? Cause you're gonna fall again. Come in if I hold this place. I'm gonna tell me it's all in my head cause this could be something to make. And if we don't get right, I'm fall back into orbit. Tell me it's all in my head. Don't say it's all in my head. Sound strut. We tend to stick close to the light. But there ain't no star shining tonight. There have been good echo parties. So I'll stay until it's too late. I got a warning light. What is the meaning of your fight on the roadside? It's all in the pushing way. It's so bad that you're gonna stay. Been queer and you're at your grade. Cause whenever I'm on the stage. Well, fall again this Sunday. Don't tell me it's all in my head. Cause this could be something to listen. And if we don't get it. I'm making too much of it too late. We'll be in the next Sunday. Cause we're gonna fall again. I see it. Sound straight.