The chronic psychosocial stress (CGS) paradigm employs clinically relevant stressors during pregnancy in mice to model psychiatric disorders of mothers and infants. Here, we provide a step-by-step procedure of applying the CGS paradigm and downstream assessments to validate this model.
The peripartum period is considered a sensitive period where adverse maternal exposures can result in long-term negative consequences for both mother and offspring, including the development of neuropsychiatric disorders. Risk factors linked to the emergence of affective dysregulation in the maternal-infant dyad have been extensively studied. Exposure to psychosocial stress during pregnancy has consistently emerged as one of the strongest predictors. Several rodent models have been created to explore this association; however, these models rely on the use of physical stressors or a limited number of psychosocial stressors presented in a repetitive fashion, which do not accurately capture the type, intensity, and frequency of stressors experienced by women. To overcome these limitations, a chronic psychosocial stress (CGS) paradigm was generated that employs various psychosocial insults of different intensity presented in an unpredictable fashion. The manuscript describes this novel CGS paradigm where pregnant female mice, from gestational day 6.5 to 17.5, are exposed to various stressors during the day and overnight. Day stressors, two per day separated by a 2 h break, range from exposure to foreign objects or predator odor to frequent changes in bedding, removal of bedding, and cage tilting. Overnight stressors include continuous light exposure, changing cage mates, or wetting bedding. We have previously shown that exposure to CGS results in the development of maternal neuroendocrine and behavioral abnormalities, including increased stress reactivity, the emergence of fragmented maternal care patterns, anhedonia, and anxiety-related behaviors, core features of women suffering from perinatal mood and anxiety disorders. This CGS model, therefore, becomes a unique tool that can be used to elucidate molecular defects underlying maternal affective dysregulation, as well as trans-placental mechanisms that impact fetal neurodevelopment and result in negative long-term behavioral consequences in the offspring.
The mechanisms underlying increased susceptibility to neuropsychiatric disorders in mothers and infants following adverse maternal exposures in the peripartum period remain largely unknown. Substantial maternal physiological alterations occur during pregnancy and the transition to the postpartum period, including several neuroendocrine adaptations that are hypothesized to be critical not only for healthy offspring neurodevelopment but also for preserving maternal mental health1,2. At the level of the maternal hypothalamic pituitary adrenal (HPA) axis, adaptions in both circadian and stress-induced levels of glucocorticoid release are observed, including a more flattened rhythm of diurnal HPA axis activity and dampened HPA axis response to acute stressors3,4,5. Given that enhanced HPA axis activity is reported in a subset of women with postpartum affective dysregulation, including increased levels of circulating glucocorticoids and inhibited negative feedback6,7,8, exposure to stressors that result in increased postpartum stress reactivity and prevent maternal HPA axis adaptions are thought to increase susceptibility to neuropsychiatric disorders.
To elucidate the effects of stress on affective dysregulation in mothers and infants, several rodent models of stress in the peripartum period have been generated. A majority of these models are characterized by the application of physical stressors that result in homeostatic challenges and alterations in dam physiological status9, such as chronic restraint stress10 and swim stress during gestation11, or postpartum shock exposure12. Although these paradigms have been shown to result in the emergence of postpartum depressive-like behaviors and alterations in maternal care10,11,12, they have been limited by their inability to accurately capture the psychosocial nature of stressors commonly experienced by human mothers. This becomes particularly important when attempting to reveal the neuroendocrine consequences of chronic stress in the peripartum period, given that processing of different types of stressors is thought to be mediated by varying neural networks orchestrating HPA axis activation9.
In order to overcome this limitation, several groups have designed stress paradigms employing psychosocial insults or a combination of physical and psychosocial stressors. The maternal separation model, where dams are separated from her pups for several hours per day during the postpartum period13,14, and the chronic social stress model, where the dams are exposed to a male intruder in the presence of their litters15,16, have been able to reproduce the emergence of abnormalities in maternal care and depressive-like phenotypes associated with physical stress paradigms. The chronic ultramild stress paradigm, where pregnant female mice are exposed to a variety of psychosocial insults, including cage tilt and overnight illumination, as well as substantial physiological insults, such as restraint stress and food restriction, has further revealed exposure to a mixed nature of stressors results in abnormalities in maternal behavior, including impairments in maternal aggression, as well as dysregulation in the circadian activity of the HPA axis17,18. Consistent with these results, an alternating restraint stress and overcrowding model during gestation results in elevations in postpartum maternal circadian corticosterone levels as well as alterations in maternal care, although no differences are observed in HPA axis re-activity following postpartum exposure to novel acute insults1.
An expansion of this work, generating a gestational stress paradigm that employs multiple psychosocial insults presented in an unpredictable fashion and minimizes the use of physiological stressors. Studies have previously shown this chronic psychosocial stress paradigm (CGS) results in the development of maternal HPA axis dysfunction, including enhanced stress reactivity in the early postpartum period19. These changes are associated with abnormalities in maternal behavior, including alterations in the quality of maternal care received by pups, and the emergence of anhedonic and anxiety-like behaviors19, features consistent with perinatal mood and anxiety disorders20,21. Furthermore, offspring weight gain reduces during the postnatal period following in-utero exposure to CGS19, suggesting CGS may have persistent negative programming effects in future generations.
The goal in developing the CGS paradigm was to primarily utilize clinically relevant stressors, which accurately capture the type, intensity, and frequency of insults often associated with neuroendocrine dysregulation and the development of perinatal mood and anxiety disorders. Here, the study provides a detailed protocol of how to subject pregnant female mice to CGS, as well as downstream assessments that can be used to test the validity of the model.
All animal experiments described were approved by the Animal Care and Use Committee at Cincinnati Children's Medical Center and were in accordance with the National Institutes of Health guidelines. Ad libitum access to standard rodent chow and water was provided at all times to mice, including during the CGS paradigm. Mice were housed on a 14 h/10 h light-dark cycle (lights on 06:00 h) unless otherwise specified (i.e., exposure to lights overnight).
1. Preparing for timed matings
2. Setting up timed matings
3. Checking the copulatory plug, designated as gestational day 0.5 (G0.5)
4. Preparing for CGS paradigm
5. Performing the CGS paradigm
6. Monitoring the experimental mice during the CGS paradigm
7. Measuring the percentage body weight gain during gestation in the experimental mice (optional)
8. Measuring the postpartum relative adrenal gland weights in experimental mice (optional)
9. Measuring the postpartum hypothalamic pituitary adrenal (HPA) axis activity in the experimental mice (optional)
10. Measuring the postpartum behavioral changes in the experimental mice (optional)
11. Measuring the postnatal offspring weight changes (optional)
Exposing the pregnant female mice to CGS results in changes in chronic stress-relevant parameters, including a reduction in body weight gain during pregnancy (Figure 2A) and increased adrenal gland weights in the early postpartum period (Figure 2B)19. Importantly, exposure to CGS results in postpartum abnormalities in maternal neuroendocrine function. CGS dams exhibit a hyperactive HPA axis as evidenced by the increased serum corticosterone levels following the application of a novel acute insult (Figure 3)19.
Exposing the pregnant female mice to CGS further results in behavioral abnormalities in the early postpartum period that appear to reflect the emergence of a depressive-like phenotype. CGS dams display alterations in maternal care as reflected by an increase in the degree of fragmentation of maternal signals received by the pups. The average duration of licking/grooming bouts is reduced and associated with an increase in the mean number of bouts following CGS, indicating numerous short episodes of nurturing behavior (Figure 4A,B)19. Sucrose preference is also depressed in CGS dams when compared to control dams, suggesting the presence of anhedonia (Figure 4C)19. Lastly, the CGS dams also display increased anxiety-related behaviors as measured by a reduction in the time spent in the open quadrants of the EZM when compared to control dams (Figure 4D)19.
In the offspring, exposure to CGS in-utero results in decreased weight gain during the postnatal period, from postnatal day 7 to 21, although no changes are observed at birth. This reduction in body weight gain is present in offspring of both sexes (Figure 5)19. Of note, the CGS paradigm did not have any effect on gestational length, litter size, or sex ratio per litter (data not shown)19.
Figure 1: Schematic of CGS paradigm and functional assessments for validation. This figure has been modified from Zoubovsky, S.P. et al.19. Please click here to view a larger version of this figure.
Figure 2: Changes in the chronic stress-related parameters in the dams following CGS exposure. (A) Body weight changes from G6.5-G17.5, Control = 17, CGS = 17. (B) Relative maternal adrenal gland weights at PP2, Control = 20, CGS = 15. Data presented as mean + SEM. *p < 0.05, ****p < 0.0001. This figure has been modified from Zoubovsky, S.P. et al.19. Please click here to view a larger version of this figure.
Figure 3: Maternal HPA axis measurements following CGS exposure. Maternal serum corticosterone levels measured after 20 min of restraint stress on PP2, Control = 8, CGS = 5. Data presented as mean + SEM. *p < 0.05. This figure has been modified from Zoubovsky, S.P. et al.19. Please click here to view a larger version of this figure.
Figure 4: Behavioral changes in the early postpartum period in dams following CGS exposure. (A) Mean duration and (B) number of licking/grooming bouts recorded from PP2-PP5, Control = 17, CGS = 17. (C) Percent sucrose preference in SPT, Control = 17, CGS = 19. (D) Total amount of time spent in open quadrant of EZM during the 5 min period, Control = 17, CGS = 19. Data presented as mean + SEM *p < 0.05, **p < 0.01. This figure has been modified from Zoubovsky, S.P. et al.19. Please click here to view a larger version of this figure.
Figure 5: Changes in the offspring body weight during postnatal development following in-utero exposure to CGS. The offspring body weight measured from PN0 to PN21, Control = 17 litters, CGS = 17 litters.Data presented as mean + SEM. *p < 0.05, ****p < 0.0001. This figure has been modified from Zoubovsky, S.P. et al.19. Please click here to view a larger version of this figure.
Exposing the pregnant mice to CGS perturbs postpartum maternal neuroendocrine function, including HPA axis response to novel stressors, and is associated with various behavioral abnormalities relevant to perinatal mood and anxiety disorders. Given that the model employs utilization of an environmental risk factor, higher phenotypic variation is expected than otherwise observed in genetic models22. Nevertheless, results obtained from application of the CGS paradigm can be consistent across research laboratories if care is taken to minimize variables that may confound results.
Critical steps in the protocol include steps related to general husbandry practices, including housing control mice separate from CGS mice, and timed-mating steps. Co-housing control and CGS mice could in itself be a stressful stimulus for the control group and therefore confound neuroendocrine or behavioral results23,24. Likewise, initiating experiments with pregnant mice shipped from the supplier is not recommended. To maximize the efficiency of timed matings, it is recommended to house adult female mice together at least 2 weeks prior to setting up timed matings to synchronize their estrus cycles. Likewise, using sexually experienced adult male mice and preventing males from mating at least 1 week prior to setting up timed matings will maximize their fertility and increase the potential for successful pregnancies. The timeline of the CGS paradigm must also be carefully followed. Applying these stressors of varying intensity too early in gestation could affect uterine decidualization and inhibit embryo implantation25. Stress exposure during different gestational time windows has also been found to carry varying sex-specific neurodevelopmental disease risk for offspring, where male offspring are significantly more vulnerable than female offspring to stressors during early gestation26,27. CGS schedule must be designed in such a way that it ensures unpredictability to prevent the development of adaptation mechanisms and acclimation often associated with repeated exposure to predictable stressors28. Lastly, litters should be culled to six pups on the day of birth to ensure comparable conditions across all dams and prevent litter size variabilities from confounding maternal hormone or behavior analysis. Likewise, different cohorts should be employed for neuroendocrine and behavioral assessments to minimize confounding effects of restraint stress and submandibular bleeds on behavior. Different cohorts should also be used for maternal care assessment and analysis of other behavioral parameters to minimize disruption of maternal interaction with the pups.
There are several limitations to the current protocol. The inability to accurately predict the number of pregnant mice prior to the start of the CGS paradigm can pose a considerable financial and animal use burden. Modifications could be made to the protocol to achieve more predictable success with timed matings, including evaluating vaginal cytology to identify mice in estrus stage, where both mating and ovulation typically occur29. Ultrasonographic examination of mice could also be incorporated into the CGS paradigm as an alternative non-invasive technique to accurately identify pregnancies from very early stages of gestation30. The use of special breeding chow, with increased fat content, has also been employed by other groups to improve mating success31. However, caution must be taken when instituting changes in diet, given that this could affect maternal stress reactivity and behavior32. In addition, the current protocol has been shown to be effective in wild-type C57BL/6 mice, but modifications of the protocol may be needed for different strains or genetic backgrounds as well as species, for they may have large variations in stress sensitivity, maternal care, and emotional regulation.
Compared to currently existing peripartum stress models, the CGS paradigm proves to be more translationally relevant given the resulting disease-relevant endophenotypes observed, including enhanced maternal stress reactivity and postpartum abnormalities in maternal care, anhedonia, and anxiety. These alterations seem to recapitulate clinical findings associated with perinatal mood and anxiety disorders. Future applications of this model include utilizing the CGS paradigm to identify sex-specific effects of maternal psychosocial stress on offspring brain development and disease susceptibility. Studying the effects of CGS on placental function should be considered, given that dysfunction in key placental functions have been shown to impact fetal brain development33. Incorporating cross-fostering experiments with the CGS paradigm would further help understand the individual contributions in-utero CGS exposure and associated maternal hormonal milieu changes versus postpartum abnormalities in nurturing behavior play in shaping offspring emotional development.
The authors have nothing to disclose.
The authors wish to acknowledge support from the National Institute of General Medical Sciences T32 GM063483-14 grant and Cincinnati Children's Research Foundation. For data adapted from Zoubovsky et al., 2019, Creative Common License can be found at the following location: http://creativecommons.org/licenses/by/4.0/.
Animal lancet | Braintree Scientific Inc. | GR4MM | |
Blunt end probe | Fine Science Tools | 10088-15 | Used to check for copulatory plugs |
Bottles for SPT | Braintree Scientific Inc. | WTRBTL S-BL | 100 mL glass water bottle with stopper and sipper ball point tube, graduted by 1 mL. |
Conical tubes (50 mL) | Corning Inc. | 352098 | Used for restraining mice to measure HPA axis response to acute stress. Make sure conical tube has small opening at the end for ventilation. |
Legos | Amazon | – | |
Marbles | Amazon | – | |
Mouse Corticosterone ELISA kit | Biovendor | RTC002R | |
Mouse EZM | TSE Systems | – | |
Reciprocal laboratory shaker | Labnet international | S2030-RC-B | |
Serum separator tubes | Becton Dickinson | 365967 | |
Static cage- bottom | Alternative Design Manufacturing and Supply Inc. | RC71D-PC | |
Static cage – filtered ventilated tops | Alternative Design Manufacturing and Supply Inc. | FT71H-PC |