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Le Dorze C, Borreca A, Pignataro A, Ammassari-Teule M, Gisquet-Verrier P. Emotional remodeling with oxytocin durably rescues trauma-induced behavioral and neuro-morphological changes in rats: a promising treatment for PTSD. Transl Psychiatry 2020; 10:27. [PMID: 32066681 PMCID: PMC7026036 DOI: 10.1038/s41398-020-0714-0] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/15/2019] [Revised: 10/24/2019] [Accepted: 11/04/2019] [Indexed: 01/21/2023] Open
Abstract
Recent evidence indicates that reactivated memories are malleable and can integrate new information upon their reactivation. We injected rats with oxytocin to investigate whether the delivery of a drug which dampens anxiety and fear before the reactivation of trauma memory decreases the emotional load of the original representation and durably alleviates PTSD-like symptoms. Rats exposed to the single prolonged stress (SPS) model of PTSD were classified 15 and 17 days later as either resilient or vulnerable to trauma on the basis of their anxiety and arousal scores. Following 2 other weeks, they received an intracerebral infusion of oxytocin (0.1 µg/1 µL) or saline 40 min before their trauma memory was reactivated by exposure to SPS reminders. PTSD-like symptoms and reactivity to PTSD-related cues were examined 3-14 days after oxytocin treatment. Results showed that vulnerable rats treated with saline exhibited a robust PTSD syndrome including increased anxiety and decreased arousal, as well as intense fear reactions to SPS sensory and contextual cues. Exposure to a combination of those cues resulted in c-fos hypo-activation and dendritic arbor retraction in prefrontal cortex and amygdala neurons, relative to resilient rats. Remarkably, 83% of vulnerable rats subjected to oxytocin-based emotional remodeling exhibited a resilient phenotype, and SPS-induced morphological alterations in prelimbic cortex and basolateral amygdala were eliminated. Our findings emphasize the translational potential of the present oxytocin-based emotional remodeling protocol which, when administered even long after the trauma, produces deep re-processing of traumatic memories and durable attenuation of the PTSD symptomatology.
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Affiliation(s)
- Claire Le Dorze
- Université Paris-Saclay, CNRS, Institut des Neurosciences Paris-Saclay, 91190, Gif-sur-Yvette, France
| | - Antonella Borreca
- Santa Lucia Foundation, via del fosso di fiorano 64, 00143, Rome, Italy
| | - Annabella Pignataro
- Santa Lucia Foundation, via del fosso di fiorano 64, 00143, Rome, Italy
- Institute of Translational Pharmacology, National Research Council, Rome, Italy
| | | | - Pascale Gisquet-Verrier
- Université Paris-Saclay, CNRS, Institut des Neurosciences Paris-Saclay, 91190, Gif-sur-Yvette, France.
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A Preliminary Examination of Endogenous Peripheral Oxytocin in a Pilot Randomized Clinical Trial of Oxytocin-Enhanced Psychotherapy for Posttraumatic Stress Disorder. J Clin Psychopharmacol 2020; 40:401-404. [PMID: 32639293 PMCID: PMC7350551 DOI: 10.1097/jcp.0000000000001226] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
BACKGROUND Preclinical and clinical research suggests that the oxytocin system is implicated in the development and maintenance of stress and anxiety-related psychiatric conditions, such as posttraumatic stress disorder (PTSD). Recent research also suggests that intranasal oxytocin holds promise as a treatment for PTSD. However, little is known about the relationship between levels of peripheral oxytocin and PTSD symptom severity, PTSD treatment response, and repeated intranasal oxytocin administration. METHODS In the current study, we examined associations between PTSD symptom severity and peripheral oxytocin levels measured in plasma before and after a course of prolonged exposure (PE) for PTSD (n = 13); participants were randomized to adjunctive intranasal oxytocin (n = 6) or placebo (n = 7). RESULTS Baseline peripheral oxytocin levels were not associated with baseline PTSD symptom severity. Change in peripheral oxytocin levels did not differ by treatment condition and did not correspond to change in PTSD symptoms. CONCLUSIONS This proof-of-concept study illustrates the acceptability and feasibility of measuring peripheral oxytocin among individuals engaged in psychotherapy for PTSD and informs the utilization of these procedures in future adequately powered studies.
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Maguire J, McCormack C, Mitchell A, Monk C. Neurobiology of maternal mental illness. HANDBOOK OF CLINICAL NEUROLOGY 2020; 171:97-116. [PMID: 32736761 DOI: 10.1016/b978-0-444-64239-4.00005-9] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
This chapter provides an overview of current research discoveries beginning to uncover the neurobiology of maternal mental illness. Results are described according to standard diagnostic categories (specifically, perinatal depression, perinatal anxiety and OCD, postpartum psychosis and bipolar disorder, and trauma and posttraumatic stress disorder), yet we aim to put this approach in context with the introduction of a classification model for psychiatric research, the research domain criteria, gaining traction in basic and clinical translational fields. We first review a new area of study, the neuroplasticity of the pregnant and postpartum brain, as work here has relevance for understanding the pathophysiology of mental disorders and may provide clues to changes in brain functioning that are related to compromised parenting in the context of postpartum depression. We next provide background information on neuroendocrine and immune changes during pregnancy and, to a lesser extent, the postpartum period, as alterations in these systems are significantly implicated in underlying neurobiology of mental illness for peripartum women. Our discussion of the major mental illnesses for pregnant and postpartum women includes neuroendocrine changes, neuroinflammation, and neurotransmitter alterations, as well as circuit dysfunction. Overall, remarkable progress has been made in identifying variations in neurobiology (and related systems) involved in maternal mental illness; yet, it is clear that, as classified with standard diagnostic systems, these are heterogeneous disorders and there is individual variability in the alterations in neurobiology for the same illness.
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Affiliation(s)
- Jamie Maguire
- Department of Neuroscience, Tufts University School of Medicine, Boston, MA, United States
| | - Clare McCormack
- Center for Science and Society, Columbia University, New York, NY, United States
| | - Anika Mitchell
- Department of Obstetrics and Gynecology, Columbia University Irving Medical Center, New York, NY, United States
| | - Catherine Monk
- Department of Obstetrics and Gynecology, Columbia University Irving Medical Center, New York, NY, United States; Department of Psychiatry, Columbia University Irving Medical Center, New York, NY, United States; New York State Psychiatric Institute, New York, NY, United States.
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54
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Plasencia G, Luedicke JM, Nazarloo HP, Carter CS, Ebner NC. Plasma oxytocin and vasopressin levels in young and older men and women: Functional relationships with attachment and cognition. Psychoneuroendocrinology 2019; 110:104419. [PMID: 31606581 PMCID: PMC6943921 DOI: 10.1016/j.psyneuen.2019.104419] [Citation(s) in RCA: 42] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/25/2019] [Revised: 07/19/2019] [Accepted: 08/22/2019] [Indexed: 01/17/2023]
Abstract
A growing literature associates the neuropeptides oxytocin (OT) and arginine vasopressin (AVP) with affiliative and cognitive outcomes. The majority of this work in humans, however, considers these neuropeptides separately. Also, despite evidence that OT and AVP interact with gonadal hormones, still warranted is an examination of sex and age variations in endogenous neuropeptide levels, their interrelations, and their functional relationships with attachment and cognition in humans. This study measured endogenous plasma OT and AVP levels in generally healthy young (18-31 years) and older (63-81 years) men and women to (i) determine levels of and interrelations between OT and AVP; (ii) explore functional relationships with self-reported attachment (attachment anxiety and avoidance) and performance-based cognition (processing speed, verbal memory); and (iii) identify variations in these effects by sex and age. We observed sex- and age-differential patterns of results: Women had higher plasma OT levels than men and older adults had higher plasma AVP levels than young adults. The two neuropeptides were highly negatively intercorrelated across all groups. Functionally, higher AVP levels were associated with greater attachment anxiety and higher OT and lower AVP levels were associated with faster sensorimotor processing speed, with sex and age moderating these effects. This integrated approach identifies variations in endogenous peripheral neuropeptide levels in humans, supporting their sex- and age-specific role as "difference makers" in attachment and cognition.
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Affiliation(s)
- Gabriela Plasencia
- Department of Psychology, University of Florida, P.O. Box 112250, Gainesville, FL, 32611-2250, USA; Stritch School of Medicine, Loyola University of Chicago, 2160 S 1st Ave, Maywood, IL, 60153, USA.
| | - Joerg M Luedicke
- Department of Psychology, University of Florida, P.O. Box 112250, Gainesville, FL, 32611-2250, USA.
| | | | - C Sue Carter
- Kinsey Institute, Indiana University, Bloomington, IN, 47405, USA.
| | - Natalie C Ebner
- Department of Psychology, University of Florida, P.O. Box 112250, Gainesville, FL, 32611-2250, USA; Department of Aging and Geriatric Research, Institute on Aging, University of Florida, 2004 Mowry Road, Gainesville, FL, 32611, USA.
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Koch SBJ, van Zuiden M, Nawijn L, Frijling JL, Veltman DJ, Olff M. Effects of intranasal oxytocin on distraction as emotion regulation strategy in patients with post-traumatic stress disorder. Eur Neuropsychopharmacol 2019; 29:266-277. [PMID: 30554861 DOI: 10.1016/j.euroneuro.2018.12.002] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/15/2017] [Revised: 11/21/2018] [Accepted: 12/01/2018] [Indexed: 12/19/2022]
Abstract
Post-traumatic stress disorder (PTSD) is characterized by difficulty down-regulating emotional responses towards trauma-reminders. The neuropeptide oxytocin may enhance treatment response in PTSD, by dampening excessive fear and improving fear regulation. However, oxytocin effects on (neural correlates of) cognitive emotion regulation abilities have never been investigated in PTSD patients. Therefore, we investigated behavioral and neural effects of intranasal oxytocin administration (40IU) on distraction as emotion regulation strategy in male and female police officers with and without PTSD (n = 76), using a randomized placebo-controlled cross-over fMRI study. The distraction condition consisted of a working memory task while negative affective pictures were presented. Under placebo, male PTSD patients showed decreased right striatal activity during distraction compared to male trauma-exposed controls, which was unaffected by oxytocin. After oxytocin administration, left thalamus activity during distraction was enhanced in all participants, independent of PTSD status or sex. Although left thalamus activity during distraction did not differ between PTSD patients and controls under placebo, it was negatively correlated with error rates within PTSD patients. Furthermore, oxytocin administration increased functional connectivity between the left thalamus and amygdala in PTSD patients and male trauma-exposed controls. Upregulation of thalamus activity during distraction by oxytocin may enhance cognitive emotion regulation abilities during psychotherapy in PTSD, although this should still be investigated in a clinical setting. Our findings open an important research avenue into oxytocin effects on cognitive emotion regulation in PTSD and other psychiatric disorders characterized by deficient emotion regulation abilities. Registered in the Netherlands Trial Registry, registration number: NTR3516.
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Affiliation(s)
- Saskia B J Koch
- Amsterdam UMC, Location Academic Medical Center, University of Amsterdam, Department of Psychiatry, Amsterdam, The Netherlands; Donders Institute for Brain, Cognition and Behavior, Center for Cognitive Neuroimaging, Radboud University Nijmegen, Nijmegen, The Netherlands.
| | - Mirjam van Zuiden
- Amsterdam UMC, Location Academic Medical Center, University of Amsterdam, Department of Psychiatry, Amsterdam, The Netherlands
| | - Laura Nawijn
- Amsterdam UMC, Location Academic Medical Center, University of Amsterdam, Department of Psychiatry, Amsterdam, The Netherlands; Amsterdam UMC, Location VU University Medical Center, VU University, Department of Psychiatry, Amsterdam, The Netherlands
| | - Jessie L Frijling
- Amsterdam UMC, Location Academic Medical Center, University of Amsterdam, Department of Psychiatry, Amsterdam, The Netherlands
| | - Dick J Veltman
- Amsterdam UMC, Location VU University Medical Center, VU University, Department of Psychiatry, Amsterdam, The Netherlands
| | - Miranda Olff
- Amsterdam UMC, Location Academic Medical Center, University of Amsterdam, Department of Psychiatry, Amsterdam, The Netherlands; Arq Psychotrauma Expert Center, Diemen, The Netherlands
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56
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Joseph JE, McRae-Clark A, Sherman BJ, Baker NL, Moran-Santa Maria M, Brady KT. Neural correlates of oxytocin and cue reactivity in cocaine-dependent men and women with and without childhood trauma. Psychopharmacology (Berl) 2019:10.1007/s00213-019-05360-7. [PMID: 31701163 PMCID: PMC8815182 DOI: 10.1007/s00213-019-05360-7] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/28/2018] [Accepted: 09/11/2019] [Indexed: 02/07/2023]
Abstract
RATIONALE Women with cocaine use disorder have worse treatment outcomes compared with men. Sex differences in cocaine addiction may be driven by differences in neurobiology or stress reactivity. Oxytocin is a potential therapeutic for stress reduction in substance use disorders, but no studies have examined the effect of oxytocin on neural response to drug cues in individuals with cocaine use disorders or potential sex differences in this response. OBJECTIVES The goal of this study was to examine the effect of intranasal oxytocin on cocaine cue reactivity in cocaine dependence, modulated by gender and history of childhood trauma. METHODS Cocaine-dependent men with (n = 24) or without (n = 19) a history of childhood trauma and cocaine-dependent women with (n = 16) or without (n = 8) a history of childhood trauma completed an fMRI cocaine cue reactivity task under intranasal placebo or oxytocin (40 IU) on two different days. fMRI response was measured in the right amygdala and dorsomedial prefrontal cortex (DMPFC). RESULTS In the DMPFC, oxytocin reduced fMRI response to cocaine cues across all subject groups. However, in the amygdala, only men with a history of childhood trauma showed a significantly reduced fMRI response to cocaine cues on oxytocin versus placebo, while women with a history of childhood trauma showed an enhanced amygdala response to cocaine cues following oxytocin administration. Cocaine-dependent subjects with no history of childhood trauma showed no effect of oxytocin on amygdala response. CONCLUSIONS Oxytocin can reduce cue reactivity in cocaine dependence, but its effect is modified by sex and childhood trauma history. Whereas men with cocaine dependence may benefit from oxytocin administration, additional studies are needed to determine whether oxytocin can be an effective therapeutic for cocaine-dependent women.
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Affiliation(s)
- Jane E Joseph
- Department of Neuroscience, Medical University of South Carolina, 96 Jonathan Lucas St., Clinical Sciences Building Room 325E, Charleston, SC, 29425, USA.
| | - Aimee McRae-Clark
- Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, 96 Jonathan Lucas St., Clinical Sciences Building Room 325E, Charleston, SC, 29425, USA
- Ralph H. Johnson VA Medical Center, Charleston, SC, USA
| | - Brian J Sherman
- Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, 96 Jonathan Lucas St., Clinical Sciences Building Room 325E, Charleston, SC, 29425, USA
| | - Nathaniel L Baker
- Department of Public Health Sciences, Medical University of South Carolina, 96 Jonathan Lucas St., Clinical Sciences Building Room 325E, Charleston, SC, 29425, USA
| | - Megan Moran-Santa Maria
- Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, 96 Jonathan Lucas St., Clinical Sciences Building Room 325E, Charleston, SC, 29425, USA
| | - Kathleen T Brady
- Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, 96 Jonathan Lucas St., Clinical Sciences Building Room 325E, Charleston, SC, 29425, USA
- Ralph H. Johnson VA Medical Center, Charleston, SC, USA
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Bertolini F, Robertson L, Ostuzzi G, Meader N, Bisson JI, Churchill R, Barbui C. Early pharmacological interventions for preventing post-traumatic stress disorder (PTSD): a network meta-analysis. Hippokratia 2019. [DOI: 10.1002/14651858.cd013443] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Affiliation(s)
- Federico Bertolini
- University of Verona; Department of Neurosciences, Biomedicine and Movement Sciences, Section of Psychiatry; Verona Italy
| | - Lindsay Robertson
- University of York; Cochrane Common Mental Disorders; Heslington York UK YO10 5DD
- University of York; Centre for Reviews and Dissemination; York UK
| | - Giovanni Ostuzzi
- University of Verona; Department of Neurosciences, Biomedicine and Movement Sciences, Section of Psychiatry; Verona Italy
| | - Nicholas Meader
- University of York; Cochrane Common Mental Disorders; Heslington York UK YO10 5DD
- University of York; Centre for Reviews and Dissemination; York UK
| | - Jonathan I Bisson
- Cardiff University School of Medicine; Division of Psychological Medicine and Clinical Neurosciences; Hadyn Ellis Building Maindy Road Cardiff UK CF24 4HQ
| | - Rachel Churchill
- University of York; Cochrane Common Mental Disorders; Heslington York UK YO10 5DD
- University of York; Centre for Reviews and Dissemination; York UK
| | - Corrado Barbui
- University of Verona; Department of Neurosciences, Biomedicine and Movement Sciences, Section of Psychiatry; Verona Italy
- University of Verona; Cochrane Global Mental Health; Verona Italy
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58
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Grace SA, Labuschagne I, Castle DJ, Rossell SL. Intranasal oxytocin alters amygdala-temporal resting-state functional connectivity in body dysmorphic disorder: A double-blind placebo-controlled randomized trial. Psychoneuroendocrinology 2019; 107:179-186. [PMID: 31146138 DOI: 10.1016/j.psyneuen.2019.05.022] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/30/2018] [Revised: 05/21/2019] [Accepted: 05/21/2019] [Indexed: 12/21/2022]
Abstract
The aetiology of body dysmorphic disorder (BDD) is poorly understood. Recent evidence from functional brain imaging studies suggests that BDD is associated with aberrant task-based functional connectivity and that intranasal oxytocin (OXT) may improve network connectivity in BDD patients. Thus, the aim of this study was to investigate the effect of intranasal OXT on amygdala resting-state functional connectivity (rsFC) in BDD. In a randomized, double-blind, cross-over design, 19 BDD participants and 17 demographically matched healthy control participants received intranasal OXT (24 IU) or placebo prior to resting-state functional magnetic resonance imaging. The left and right amygdala were seeded as regions of interest, and temporal correlations between the amygdalae and all other voxels comprising cortical and subcortical grey matter were investigated. Compared to healthy controls, BDD patients showed greater baseline (placebo) rsFC between the left amygdala and two clusters within the left temporal lobe and one cluster within the superior frontal gyrus which was reversed following OXT administration. The control group also showed significantly greater rsFC between the left amygdala and anterior prefrontal cortex in the OXT session compared to placebo. Whilst preliminary, these findings suggest that BDD patients exhibit abnormal amygdala-temporal connectivity at rest, and OXT might have a role in changing this functional relationship.
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Affiliation(s)
- Sally A Grace
- Centre for Mental Health, Swinburne University, Melbourne, Australia; School of Behavioural and Health Sciences, Australian Catholic University, Melbourne, Australia.
| | - Izelle Labuschagne
- School of Behavioural and Health Sciences, Australian Catholic University, Melbourne, Australia
| | - David J Castle
- Psychiatry, St Vincent's Hospital, Melbourne, Australia; Psychiatry, University of Melbourne, Melbourne, Australia
| | - Susan L Rossell
- Centre for Mental Health, Swinburne University, Melbourne, Australia; Psychiatry, St Vincent's Hospital, Melbourne, Australia
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A Pilot Study of Oxytocin in Low-Income Women With a Low Birth-Weight Infant: Is Oxytocin Related to Posttraumatic Stress? Adv Neonatal Care 2019; 19:E12-E21. [PMID: 30893095 DOI: 10.1097/anc.0000000000000601] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND Negative outcomes related to prematurity may lead to maternal distress. Mothers of premature/low birth-weight infants report increased posttraumatic stress (50%) and depressive symptoms (63%) compared with mothers of full-term infants. Low-income, minority mothers with greater posttraumatic stress and depression have an increased risk for premature/low birth-weight delivery compared with their white counterparts. Variations in the neuropeptide oxytocin are implicated in lactation, perinatal depression, and maternal behavior. PURPOSE To examine the associations among posttraumatic stress, depressive symptoms, and oxytocin in a pilot sample of minority mothers with premature/low birth-weight infants in the neonatal intensive care unit (NICU). METHODS This study employed a descriptive, correlational pilot design of 8 minority, low-income mothers with premature/low birth-weight infants. Participants answered questionnaires pertaining to posttraumatic stress, depression, lactation, and demographics and oxytocin was measured. This is a substudy that added oxytocin values. RESULTS Four participants had elevated depressive symptoms and 5 supplied their own milk. Women who provided their own milk had lower depressive (t = 3.03, P = .023) and posttraumatic stress (t = 3.39, P = .015) symptoms compared with women not supplying their own milk. Women with elevated posttraumatic stress had higher levels of depressive symptoms (r(8) = 0.8, P = .006) and lower levels of oxytocin (r(8) = 0.77, P = .026). IMPLICATIONS FOR PRACTICE These results are congruent with previous literature on providing human milk and maternal mental health. In addition, we found a possible relationship between postpartum posttraumatic stress and oxytocin in minority women with premature/low birth-weight infants. NICU nurses should encourage lactation and assess mothers for posttraumatic stress and depressive symptoms. IMPLICATIONS FOR RESEARCH Research is needed to identify the biologic milieu associated with posttraumatic stress and depression in at-risk mothers.
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60
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Velasco ER, Florido A, Milad MR, Andero R. Sex differences in fear extinction. Neurosci Biobehav Rev 2019; 103:81-108. [PMID: 31129235 PMCID: PMC6692252 DOI: 10.1016/j.neubiorev.2019.05.020] [Citation(s) in RCA: 70] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2018] [Revised: 03/08/2019] [Accepted: 05/19/2019] [Indexed: 12/18/2022]
Abstract
Despite the exponential increase in fear research during the last years, few studies have included female subjects in their design. The need to include females arises from the knowledge gap of mechanistic processes underlying the behavioral and neural differences observed in fear extinction. Moreover, the exact contribution of sex and hormones in relation to learning and behavior is still largely unknown. Insights from this field could be beneficial as fear-related disorders are twice as prevalent in women compared to men. Here, we review an up-to-date summary of animal and human studies in adulthood that report sex differences in fear extinction from a structural and functional approach. Furthermore, we describe how these factors could contribute to the observed sex differences in fear extinction during normal and pathological conditions.
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Affiliation(s)
- E R Velasco
- Institut de Neurociències, Universitat Autònoma de Barcelona, Spain
| | - A Florido
- Institut de Neurociències, Universitat Autònoma de Barcelona, Spain
| | - M R Milad
- Department of Psychiatry, University of Illinois at Chicago, USA
| | - R Andero
- Institut de Neurociències, Universitat Autònoma de Barcelona, Spain; CIBERSAM, Corporació Sanitaria Parc Taulí, Sabadell, Spain; Department of Psychobiology and Methodology of Health Sciences, Universitat Autònoma de Barcelona, Spain.
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61
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Joseph JE, Vaughan BK, Camp CC, Baker NL, Sherman BJ, Moran-Santa Maria M, McRae-Clark A, Brady KT. Oxytocin-Induced Changes in Intrinsic Network Connectivity in Cocaine Use Disorder: Modulation by Gender, Childhood Trauma, and Years of Use. Front Psychiatry 2019; 10:502. [PMID: 31379621 PMCID: PMC6658612 DOI: 10.3389/fpsyt.2019.00502] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/01/2019] [Accepted: 06/25/2019] [Indexed: 12/11/2022] Open
Abstract
Cocaine use disorder (CUD) is a major public health concern with devastating social, economic, and mental health implications. A better understanding of the underlying neurobiology and phenotypic variations in individuals with CUD is necessary for the development of effective and targeted treatments. In this study, 39 women and 54 men with CUD completed a 6-min resting-state functional magnetic resonance imaging scan after intranasal oxytocin (OXY) or placebo administration. Graph-theory network analysis was used to quantify functional connectivity changes caused by OXY in striatum, anterior cingulate cortex (ACC), insula, and amygdala nodes of interest. OXY increased connectivity in the right ACC and left amygdala in males, whereas OXY increased connectivity in the right ACC and right accumbens in females. Machine learning was then used to associate treatment response (placebo minus OXY) in nodes of interest with years of cocaine use and severity of childhood trauma separately for males and females. Childhood trauma and years of cocaine use were associated with OXY-induced changes in ACC connectivity for both men and women, but connectivity changes in the amygdala were associated with years of cocaine use in men and connectivity changes in the right insula were associated with years of cocaine use in women. These findings suggest that salience network nodes (ACC and insula) are potential OXY treatment targets in CUD, with the amygdala as a treatment target for men and the accumbens as a treatment target for women.
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Affiliation(s)
- Jane E. Joseph
- Department of Neuroscience, Medical University of South Carolina, Charleston, SC, United States
| | - Brandon K. Vaughan
- Department of Neuroscience, Medical University of South Carolina, Charleston, SC, United States
| | - Christopher C. Camp
- Department of Neuroscience, Medical University of South Carolina, Charleston, SC, United States
| | - Nathaniel L. Baker
- Department of Public Health Sciences, Medical University of South Carolina, Charleston, SC, United States
| | - Brian J. Sherman
- Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, SC, United States
| | - Megan Moran-Santa Maria
- Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, SC, United States
| | - Aimee McRae-Clark
- Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, SC, United States
- Ralph H. Johnson VA Medical Center, Charleston, SC, United States
| | - Kathleen T. Brady
- Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, SC, United States
- Ralph H. Johnson VA Medical Center, Charleston, SC, United States
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62
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Jeong H, Park S, Dager SR, Lim SM, Lee SL, Hong H, Ma J, Ha E, Hong YS, Kang I, Lee EH, Yoon S, Kim JE, Kim J, Lyoo IK. Altered functional connectivity in the fear network of firefighters with repeated traumatic stress. Br J Psychiatry 2019; 214:347-353. [PMID: 30477594 DOI: 10.1192/bjp.2018.260] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
BACKGROUND Firefighters are routinely exposed to various traumatic events and often experience a range of trauma-related symptoms. Although these repeated traumatic exposures rarely progress to the development of post-traumatic stress disorder, firefighters are still considered to be a vulnerable population with regard to trauma.AimsTo investigate how the human brain responds to or compensates for the repeated experience of traumatic stress. METHOD We included 98 healthy firefighters with repeated traumatic experiences but without any diagnosis of mental illness and 98 non-firefighter healthy individuals without any history of trauma. Functional connectivity within the fear circuitry, which consists of the dorsal anterior cingulate cortex, insula, amygdala, hippocampus and ventromedial prefrontal cortex (vmPFC), was examined using resting-state functional magnetic resonance imaging. Trauma-related symptoms were evaluated using the Impact of Event Scale - Revised. RESULTS The firefighter group had greater functional connectivity between the insula and several regions of the fear circuitry including the bilateral amygdalae, bilateral hippocampi and vmPFC as compared with healthy individuals. In the firefighter group, stronger insula-amygdala connectivity was associated with greater severity of trauma-related symptoms (β = 0.36, P = 0.005), whereas higher insula-vmPFC connectivity was related to milder symptoms in response to repeated trauma (β = -0.28, P = 0.01). CONCLUSIONS The current findings suggest an active involvement of insular functional connectivity in response to repeated traumatic stress. Functional connectivity of the insula in relation to the amygdala and vmPFC may be potential pathways that underlie the risk for and resilience to repeated traumatic stress, respectively.Declaration of interestNone.
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Affiliation(s)
- Hyeonseok Jeong
- Research Assistant Professor,Department of Radiology,Incheon St. Mary's Hospital,College of Medicine,The Catholic University of Korea,South Korea
| | - Shinwon Park
- Ewha Brain Institute and Department of Brain and Cognitive Sciences, Ewha Womans University,South Korea
| | - Stephen R Dager
- Professor,Department of Radiology and Department of Bioengineering,University of Washington,US
| | - Soo Mee Lim
- Professor,Department of Brain and Cognitive Sciences and Department of Radiology,Ewha Womans University,South Korea
| | - Suji L Lee
- Ewha Brain Institute and Department of Brain and Cognitive Sciences, Ewha Womans University,South Korea
| | - Haejin Hong
- Ewha Brain Institute and Department of Brain and Cognitive Sciences, Ewha Womans University,South Korea
| | - Jiyoung Ma
- Postdoctoral Fellow,Ewha Brain Institute, Ewha Womans University,South Korea
| | - Eunji Ha
- Ewha Brain Institute and Department of Brain and Cognitive Sciences, Ewha Womans University,South Korea
| | - Young Sun Hong
- Professor,Department of Internal Medicine,School of Medicine, Ewha Womans University,South Korea
| | - Ilhyang Kang
- Postdoctoral Fellow,Ewha Brain Institute, Ewha Womans University,South Korea
| | - Eun Hee Lee
- President,Department of Laboratory Medicine,Green Cross Laboratories,South Korea
| | - Sujung Yoon
- Professor,Ewha Brain Institute and Department of Brain and Cognitive Sciences, Ewha Womans University,South Korea
| | - Jieun E Kim
- Associate Professor,Department of Brain and Cognitive Sciences,Ewha Womans University,South Korea
| | - Jungyoon Kim
- Assistant Professor,Ewha Brain Institute and Department of Brain and Cognitive Sciences,Ewha Womans University,South Korea
| | - In Kyoon Lyoo
- Director,Ewha Brain Institute and Professor,Graduate School of Pharmaceutical Sciences and Department of Brain and Cognitive Sciences,Ewha Womans University,South Korea and Department of Psychiatry,University of Utah,US
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63
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Schmidt U, Vermetten E. Integrating NIMH Research Domain Criteria (RDoC) into PTSD Research. Curr Top Behav Neurosci 2019; 38:69-91. [PMID: 28341942 DOI: 10.1007/7854_2017_1] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
Three and a half decades of research on posttraumatic stress disorder (PTSD) has produced substantial knowledge on the pathobiology of this frequent and debilitating disease. However, despite all research efforts, so far no drug that has specifically targeted PTSD core symptoms progressed to clinical use. Instead, although not overly efficient, serotonin re-uptake inhibitors continue to be considered the gold standard of PTSD pharmacotherapy. The psychotherapeutic treatment and symptom-oriented drug therapy options available for PTSD treatment today show some efficacy, although not in all PTSD patients, in particular not in a substantial percent of those suffering from the detrimental sequelae of repeated childhood trauma or in veterans with combat related PTSD. PTSD has this in common with other psychiatric disorders - in particular effective treatment for incapacitating conditions such as resistant major depression, chronic schizophrenia, and frequently relapsing obsessive-compulsive disorder as well as dementia has not yet been developed through modern neuropsychiatric research.In response to this conundrum, the National Institute of Mental Health launched the Research Domain Criteria (RDoC) framework which aims to leave diagnosis-oriented psychiatric research behind and to move on to the use of research domains overarching the traditional diagnosis systems. To the best of our knowledge, the paper at hand is the first that has systematically assessed the utility of the RDoC system for PTSD research. Here, we review core findings in neurobiological PTSD research and match them to the RDoC research domains and units of analysis. Our synthesis reveals that several core findings in PTSD such as amygdala overactivity have been linked to all RDoC domains without further specification of their distinct role in the pathophysiological pathways associated with these domains. This circumstance indicates that the elucidation of the cellular and molecular processes ultimately decisive for regulation of psychic processes and for the expression of psychopathological symptoms is still grossly incomplete. All in all, we find the RDoC research domains to be useful but not sufficient for PTSD research. Hence, we suggest adding two novel domains, namely stress and emotional regulation and maintenance of consciousness. As both of these domains play a role in various if not in all psychiatric diseases, we judge them to be useful not only for PTSD research but also for psychiatric research in general.
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Affiliation(s)
- Ulrike Schmidt
- Trauma Outpatient Unit and RG Molecular Psychotraumatology, Clinical Department, Max Planck Institute of Psychiatry, Kraepelinstrasse 10, Munich, 80804, Germany
| | - Eric Vermetten
- Department Psychiatry, Leiden University Medical Center Utrecht, Albinusdreef 2, Leiden, 2333 ZA, The Netherlands.
- Arq Psychotruama Research Group, Diemen, The Netherlands.
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64
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Stevens JS, van Rooij SJH, Jovanovic T. Developmental Contributors to Trauma Response: The Importance of Sensitive Periods, Early Environment, and Sex Differences. Curr Top Behav Neurosci 2019; 38:1-22. [PMID: 27830573 PMCID: PMC5425320 DOI: 10.1007/7854_2016_38] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
This review considers early factors that interact with development to contribute to later trauma responses, including developmental sensitive periods, the effects of early environment, and the emergence of sex differences. We also describe development of neural substrates that have been associated with posttraumatic stress disorder and specifically focus on fear behavior and circuitry. Emerging evidence suggests that there may be developmental shifts around age 10 in these underlying circuits that may contribute to vulnerability. We also discuss age-related changes in the importance of caregiver availability as positive buffering factors. Hormonal changes later in development with onset during puberty appear to further shape development trajectories toward risk or resilience. We highlight these recent findings as well as the great need for further longitudinal research from middle childhood through early adulthood.
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Affiliation(s)
- Jennifer S Stevens
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, 49 Jesse Hill Jr Dr, Suite 331, Atlanta, GA, 30303, USA
| | - Sanne J H van Rooij
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, 49 Jesse Hill Jr Dr, Suite 331, Atlanta, GA, 30303, USA
| | - Tanja Jovanovic
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, 49 Jesse Hill Jr Dr, Suite 331, Atlanta, GA, 30303, USA.
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65
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Koek RJ, Luong TN. Theranostic pharmacology in PTSD: Neurobiology and timing. Prog Neuropsychopharmacol Biol Psychiatry 2019; 90:245-263. [PMID: 30529001 DOI: 10.1016/j.pnpbp.2018.12.001] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/26/2018] [Revised: 11/17/2018] [Accepted: 12/05/2018] [Indexed: 02/06/2023]
Abstract
Recent reviews and treatment guidelines regard trauma-focused cognitive-behavior therapies as the treatments of choice for chronic post-traumatic stress disorder (PTSD). However, many patients do not engage in this treatment when it is available, drop out before completion, or do not respond. Medications remain widely used, alone and in conjunction with psychotherapy, although the limitations of traditional monoamine-based pharmacotherapy are increasingly recognized. This article will review recent developments in psychopharmacology for PTSD, with a focus on current clinical data that apply putative neurobiologic mechanisms to medication use-i.e., a theranostic approach. A theranostic approach however, also requires consideration of timing, pre, peri or post trauma in conjunction with underlying dynamic processes affecting synaptic plasticity, the HPA axis, hippocampal activation, PFC-amygdala circuitry and fear memory.
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Affiliation(s)
- Ralph J Koek
- Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA; Sepulveda Ambulatory Care Center, VA Greater Los Angeles Healthcare System, North Hills, CA, USA.
| | - Tinh N Luong
- Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA; Olive View Medical Center, Sylmar, CA, USA
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66
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Yoon S, Kim YK. Neuroendocrinological treatment targets for posttraumatic stress disorder. Prog Neuropsychopharmacol Biol Psychiatry 2019; 90:212-222. [PMID: 30502374 DOI: 10.1016/j.pnpbp.2018.11.021] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/28/2018] [Revised: 11/16/2018] [Accepted: 11/27/2018] [Indexed: 10/27/2022]
Abstract
Posttraumatic stress disorder (PTSD) is prevalent, disabling, and frequently becomes chronic. Despite this, only two selective serotonergic reuptake inhibitors have been approved to date for its treatment by the United States Food and Drug Administration, and treatment results are often disappointing, with a remission rate of <30%. Certain neuroendocrinological systems are currently gaining attention with respect to their use for PTSD prevention and treatment as standalone options or medication-enhanced psychotherapy due to their involvement in physiological stress reactions, memory consolidation and extinction, cognitive appraisal to stress, and attachment and resilient coping strategies, which are important in the pathogenesis of PTSD. The hypothalamic-pituitary-adrenal axis system takes the most important role in stress reactions. Hydrocortisone has been studied for the prevention of PTSD, and some meta-analyses have suggested its possible efficacy; furthermore, it has been considered both as monotherapy and as an augmentation to psychotherapy in PTSD patients, with some positive results. Glucocorticoid receptor antagonists and corticotropin-releasing factor type 1 antagonists have also been considered for clinical use in PTSD treatment. Additionally, other neuroendocrinological systems have been studied in PTSD including the use of oxytocin for PTSD prevention and augmentation to psychotherapy, allopregnanolone, and neuropeptide Y (NPY) for PTSD treatment. For now, however, these studies offer only limited evidence of efficacy, thus it is prudent to study this issue more vigorously.
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Affiliation(s)
- Seoyoung Yoon
- Department of Psychiatry, Catholic University of Daegu school of Medicine, Daegu, Republic of Korea
| | - Yong-Ku Kim
- Department of Psychiatry, Korea University College of Medicine, Seoul, Republic of Korea.
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Alaerts K, Bernaerts S, Vanaudenaerde B, Daniels N, Wenderoth N. Amygdala-Hippocampal Connectivity Is Associated With Endogenous Levels of Oxytocin and Can Be Altered by Exogenously Administered Oxytocin in Adults With Autism. BIOLOGICAL PSYCHIATRY: COGNITIVE NEUROSCIENCE AND NEUROIMAGING 2019; 4:655-663. [PMID: 30846366 DOI: 10.1016/j.bpsc.2019.01.008] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/09/2018] [Revised: 01/22/2019] [Accepted: 01/22/2019] [Indexed: 12/12/2022]
Abstract
BACKGROUND Oxytocin (OT) plays a pivotal role in interpersonal bonding, affiliation, and trust, and its intranasal administration is increasingly considered as a potential treatment for autism spectrum disorder. METHODS We explored whether variations in endogenous salivary OT concentration are related to interindividual differences in core autism symptoms and expressions of attachment in 38 male adults with autism spectrum disorder. Further, resting-state functional magnetic resonance imaging was adopted to specifically explore whether interindividual differences are reflected in the intrinsic network organization of key regions of the central oxytocinergic system. RESULTS Positive correlations were identified between peripheral OT and expressions of secure attachment (the State Adult Attachment Measure and the Inventory of Peer Attachment), but no significant relationships were identified with scales assessing core autism symptom domains (the Social Responsiveness Scale and the Repetitive Behavior Scale). At the neural level, higher levels of endogenous OT were associated with lower degrees of interregional functional coupling between the amygdala and hippocampal regions. Interestingly, a single dose of exogenously administered OT induced a further reduction in amygdala-hippocampal connectivity, indicating that a higher availability of OT can alter the degree of amygdala-hippocampal connectivity. CONCLUSIONS The identified associations between the oxytocinergic system, expressions of secure attachment, and amygdala-hippocampal pathways are anticipated to be of relevance for understanding the role of OT in modulating appropriate neural and physiological responses to stress and restoring homeostasis.
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Affiliation(s)
- Kaat Alaerts
- Department of Rehabilitation Sciences, Group Biomedical Sciences, Neuromotor Rehabilitation Research Group, University of Leuven, Katholieke Universiteit Leuven, Belgium.
| | - Sylvie Bernaerts
- Department of Rehabilitation Sciences, Group Biomedical Sciences, Neuromotor Rehabilitation Research Group, University of Leuven, Katholieke Universiteit Leuven, Belgium
| | - Bart Vanaudenaerde
- Department of Chronic Diseases, Metabolism and Ageing, Group Biomedical Sciences, Pneumology Research Group, University of Leuven, Katholieke Universiteit Leuven, Belgium
| | - Nicky Daniels
- Department of Rehabilitation Sciences, Group Biomedical Sciences, Neuromotor Rehabilitation Research Group, University of Leuven, Katholieke Universiteit Leuven, Belgium
| | - Nicole Wenderoth
- Department of Health Sciences and Technology, Neural Control of Movement Lab, Eidgenössische Technische Hochschule, Zurich, Switzerland
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68
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Oxytocin for learning calm and safety. Int J Psychophysiol 2019; 136:5-14. [DOI: 10.1016/j.ijpsycho.2018.06.004] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2017] [Revised: 06/21/2018] [Accepted: 06/26/2018] [Indexed: 12/22/2022]
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69
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Kobylinska L, Panaitescu AM, Gabreanu G, Anghel CG, Mihailescu I, Rad F, Nedelcu C, Mocanu I, Constantin C, Badescu SV, Dobrescu I, Neagu M, Geicu OI, Zagrean L, Zagrean AM. PLASMATIC LEVELS OF NEUROPEPTIDES, INCLUDING OXYTOCIN, IN CHILDREN WITH AUTISM SPECTRUM DISORDER, CORRELATE WITH THE DISORDER SEVERITY. ACTA ENDOCRINOLOGICA-BUCHAREST 2019; -5:16-24. [PMID: 31149055 DOI: 10.4183/aeb.2019.16] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
Context Oxytocin has been investigated as a potential medication for psychiatric disorders. Objective and design This study prospectively investigates correlations between oxytocin and other neuropeptides plasma levels in patients with autism spectrum disorders (ASD) according to severity and treatment, as compared to controls. Subjects and methods Thirty-one children (6 neurotypical as control) participated in this study. The patients were classified into mildly and severely-affected, according to Autism Diagnostic Observation Schedule (ADOS) scores. Oxytocin, orexin A and B, α-MSH, β-endorphins, neurotensin and substance P were investigated using a quantitative multiplex assay or a competitive-ELISA method. Results Plasma oxytocin levels differed between the groups (F (2, 24) =6.48, p=0.006, η2=0.35, observed power=86%): patients with the mild ASD had higher values of plasma oxytocin than those with the severe form (average difference=74.56±20.74pg/mL, p=0.004). Conclusions These results show a negative correlation between plasma levels of oxytocin and the severity of ASD and support the involvement of oxytocinergic mechanisms in ASD.
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Affiliation(s)
- L Kobylinska
- "Prof. Dr. Al. Obregia" Clinical Psychiatry Hospital - Child and Adolescent Psychiatry, Bucharest, Romania.,"Carol Davila" University of Medicine and Pharmacy - Division of Physiology and Fundamental Neuroscience, Bucharest, Romania
| | | | - G Gabreanu
- "Victor Babes" National Institute of Research-Development in the Pathology Domain and Biomedical Sciences - Dept. of Immunohistochemistry, Bucharest, Romania
| | - C G Anghel
- "Prof. Dr. Al. Obregia" Clinical Psychiatry Hospital - Child and Adolescent Psychiatry, Bucharest, Romania.,"Carol Davila" University of Medicine and Pharmacy - Dept. of Child and Adolescent Psychiatry, Bucharest, Romania
| | - I Mihailescu
- "Prof. Dr. Al. Obregia" Clinical Psychiatry Hospital - Child and Adolescent Psychiatry, Bucharest, Romania
| | - F Rad
- "Prof. Dr. Al. Obregia" Clinical Psychiatry Hospital - Child and Adolescent Psychiatry, Bucharest, Romania.,"Carol Davila" University of Medicine and Pharmacy - Dept. of Child and Adolescent Psychiatry, Bucharest, Romania
| | - C Nedelcu
- "Prof. Dr. Al. Obregia" Clinical Psychiatry Hospital - Child and Adolescent Psychiatry, Bucharest, Romania
| | - I Mocanu
- "Prof. Dr. Al. Obregia" Clinical Psychiatry Hospital - Child and Adolescent Psychiatry, Bucharest, Romania
| | - C Constantin
- "Victor Babes" National Institute of Research-Development in the Pathology Domain and Biomedical Sciences - Dept. of Immunology, Bucharest, Romania
| | - S V Badescu
- "Carol Davila" University of Medicine and Pharmacy - Division of Physiology and Fundamental Neuroscience, Bucharest, Romania
| | - I Dobrescu
- "Prof. Dr. Al. Obregia" Clinical Psychiatry Hospital - Child and Adolescent Psychiatry, Bucharest, Romania.,"Carol Davila" University of Medicine and Pharmacy - Dept. of Child and Adolescent Psychiatry, Bucharest, Romania
| | - M Neagu
- "Victor Babes" National Institute of Research-Development in the Pathology Domain and Biomedical Sciences - Dept. of Immunology, Bucharest, Romania
| | - O I Geicu
- University of Bucharest, Faculty of Biology, Dept. of Biochemistry and Molecular Biology, Bucharest, Romania
| | - L Zagrean
- "Carol Davila" University of Medicine and Pharmacy - Division of Physiology and Fundamental Neuroscience, Bucharest, Romania
| | - A M Zagrean
- "Carol Davila" University of Medicine and Pharmacy - Division of Physiology and Fundamental Neuroscience, Bucharest, Romania
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70
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Oxytocin receptor gene methylation in male and female PTSD patients and trauma-exposed controls. Eur Neuropsychopharmacol 2019; 29:147-155. [PMID: 30415783 DOI: 10.1016/j.euroneuro.2018.10.006] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/10/2017] [Revised: 09/30/2018] [Accepted: 10/23/2018] [Indexed: 12/18/2022]
Abstract
Oxytocin receptor gene (OXTR) DNA-methylation levels have been associated with trauma-exposure, mood- and anxiety disorders, and social processes relevant to posttraumatic stress disorder (PTSD). We hypothesized that OXTR methylation may play a role in the neurobiological underpinnings of PTSD. In the current study, we compared OXTR methylation between PTSD patients (n = 31, 14 females) and trauma-exposed controls (n = 36, 19 females). Additionally, the association between OXTR methylation and PTSD symptom severity and amygdala reactivity to an emotional faces task was assessed, as a neural hallmark of PTSD. DNA-methylation was investigated in the CpG island located at exon 3 of the OXTR, previously associated with OXTR expression. We observed a significant interaction between PTSD-status, sex and CpG-position on methylation levels. Post-hoc testing revealed that methylation levels at two specific CpG-sites were significantly higher in PTSD females compared to female trauma-exposed controls and PTSD males (CpGs Chr3:8809437, Chr3:8809413). No significant differences in methylation were observed between male PTSD patients and controls. Furthermore, within PTSD females, methylation in these CpG-sites was positively associated with anhedonia symptoms and with left amygdala responses to negative emotional faces, although this was no longer significant after stringent correction for multiple-comparisons. Though the modest size of the current sample is an important limitation, we are the first to report on OXTR methylation in PTSD, replicating previously observed (sex-specific) associations of OXTR methylation with other psychiatric disorders.
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71
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Flanagan JC, Sippel LM, Santa Maria MMM, Hartwell KJ, Brady KT, Joseph JE. Impact of Oxytocin on the neural correlates of fearful face processing in PTSD related to childhood Trauma. Eur J Psychotraumatol 2019; 10:1606626. [PMID: 31105906 PMCID: PMC6508045 DOI: 10.1080/20008198.2019.1606626] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/24/2018] [Revised: 03/25/2019] [Accepted: 03/28/2019] [Indexed: 01/04/2023] Open
Abstract
Background: Posttraumatic stress disorder (PTSD) related to exposure to abuse and neglect during childhood is associated with particularly severe and persistent deleterious outcomes. Amygdala hyperreactivity has been observed in childhood trauma survivors and implicated in symptoms of PTSD. Objective: The neuropeptide oxytocin holds promise as a potential treatment for PTSD due to its ability to attenuate amygdala response to threat cues. However, the effect of oxytocin on amygdala reactivity in individuals with childhood trauma-related PTSD has not been investigated. Method: We employed a double-blind, randomized, placebo-controlled crossover design to examine the effects of intranasal oxytocin (24 IU) versus placebo on amygdala reactivity to fearful faces among childhood-trauma exposed individuals with PTSD (n = 17) and without PTSD (control group; n = 16). Results: Region-of-interest based amygdala fMRI signal magnitude did not differ by group, drug, or group x drug interaction. Self-report of childhood trauma exposure severity was negatively associated with the oxytocin-related change in left amygdala response in the PTSD group, but not in the control group. Supplementary and exploratory whole-brain analyses conducted separately in each group revealed that left amygdala reactivity to fearful faces was absent on placebo but increased on oxytocin in the control group. The PTSD group showed right amygdala activation to fearful faces in both the oxytocin and placebo conditions, but the left amygdala response observed in the placebo condition was diminished on oxytocin. Conclusions: Findings extend the literature pertaining to the potential for oxytocin to attenuate neural correlates of PTSD to a childhood trauma-related PTSD sample.
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Affiliation(s)
- Julianne C Flanagan
- Department of Psychiatry & Behavioral Sciences, Medical University of South Carolina, Charleston, SC, USA
| | - Lauren M Sippel
- National Center for PTSD, White River Junction, VT, USA.,Department of Psychiatry, Geisel School of Medicine at Dartmouth, Lebanon, NH, USA
| | - Megan M Moran Santa Maria
- Department of Psychiatry & Behavioral Sciences, Medical University of South Carolina, Charleston, SC, USA
| | - Karen J Hartwell
- Department of Psychiatry & Behavioral Sciences, Medical University of South Carolina, Charleston, SC, USA.,Ralph H. Johnson VAMC, Charleston, SC, USA
| | - Kathleen T Brady
- Department of Psychiatry & Behavioral Sciences, Medical University of South Carolina, Charleston, SC, USA.,Ralph H. Johnson VAMC, Charleston, SC, USA
| | - Jane E Joseph
- Department of Neuroscience, Medical University of South Carolina, Charleston, SC, USA
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72
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Xin F, Zhou F, Zhou X, Ma X, Geng Y, Zhao W, Yao S, Dong D, Biswal BB, Kendrick KM, Becker B. Oxytocin Modulates the Intrinsic Dynamics Between Attention-Related Large-Scale Networks. Cereb Cortex 2018; 31:1848-1860. [PMID: 30535355 DOI: 10.1093/cercor/bhy295] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2018] [Revised: 10/01/2018] [Accepted: 11/02/2018] [Indexed: 12/11/2022] Open
Abstract
Attention and salience processing have been linked to the intrinsic between- and within-network dynamics of large-scale networks engaged in internal (default network [DN]) and external attention allocation (dorsal attention network [DAN] and salience network [SN]). The central oxytocin (OXT) system appears ideally organized to modulate widely distributed neural systems and to regulate the switch between internal attention and salient stimuli in the environment. The current randomized placebo (PLC)-controlled between-subject pharmacological resting-state fMRI study in N = 187 (OXT, n = 94; PLC, n = 93; single-dose intranasal administration) healthy male and female participants employed an independent component analysis approach to determine the modulatory effects of OXT on the within- and between-network dynamics of the DAN-SN-DN triple network system. OXT increased the functional integration between subsystems within SN and DN and increased functional segregation of the DN with both attentional control networks (SN and DAN). Whereas no sex differences were observed, OXT effects on the DN-SN interaction were modulated by autistic traits. Together, the findings suggest that OXT may facilitate efficient attention allocation by modulating the intrinsic functional dynamics between DN components and large-scale networks involved in external attentional demands (SN and DAN).
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Affiliation(s)
- Fei Xin
- The Clinical Hospital of Chengdu Brain Science Institute, MOE Key Laboratory for Neuroinformation, University of Electronic Science and Technology of China, 611731 Chengdu, China
| | - Feng Zhou
- The Clinical Hospital of Chengdu Brain Science Institute, MOE Key Laboratory for Neuroinformation, University of Electronic Science and Technology of China, 611731 Chengdu, China
| | - Xinqi Zhou
- The Clinical Hospital of Chengdu Brain Science Institute, MOE Key Laboratory for Neuroinformation, University of Electronic Science and Technology of China, 611731 Chengdu, China
| | - Xiaole Ma
- The Clinical Hospital of Chengdu Brain Science Institute, MOE Key Laboratory for Neuroinformation, University of Electronic Science and Technology of China, 611731 Chengdu, China
| | - Yayuan Geng
- The Clinical Hospital of Chengdu Brain Science Institute, MOE Key Laboratory for Neuroinformation, University of Electronic Science and Technology of China, 611731 Chengdu, China
| | - Weihua Zhao
- The Clinical Hospital of Chengdu Brain Science Institute, MOE Key Laboratory for Neuroinformation, University of Electronic Science and Technology of China, 611731 Chengdu, China
| | - Shuxia Yao
- The Clinical Hospital of Chengdu Brain Science Institute, MOE Key Laboratory for Neuroinformation, University of Electronic Science and Technology of China, 611731 Chengdu, China
| | - Debo Dong
- The Clinical Hospital of Chengdu Brain Science Institute, MOE Key Laboratory for Neuroinformation, University of Electronic Science and Technology of China, 611731 Chengdu, China
| | - Bharat B Biswal
- The Clinical Hospital of Chengdu Brain Science Institute, MOE Key Laboratory for Neuroinformation, University of Electronic Science and Technology of China, 611731 Chengdu, China.,Department of Biomedical Engineering, New Jersey Institute of Technology, Newark, NJ 07102, USA
| | - Keith M Kendrick
- The Clinical Hospital of Chengdu Brain Science Institute, MOE Key Laboratory for Neuroinformation, University of Electronic Science and Technology of China, 611731 Chengdu, China
| | - Benjamin Becker
- The Clinical Hospital of Chengdu Brain Science Institute, MOE Key Laboratory for Neuroinformation, University of Electronic Science and Technology of China, 611731 Chengdu, China
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73
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Intranasal oxytocin and OXTR genotype effects on resting state functional connectivity: A systematic review. Neurosci Biobehav Rev 2018; 95:17-32. [DOI: 10.1016/j.neubiorev.2018.09.011] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2018] [Revised: 08/08/2018] [Accepted: 09/15/2018] [Indexed: 01/09/2023]
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74
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Kabasakalian A, Ferretti CJ, Hollander E. Oxytocin and Prader-Willi Syndrome. Curr Top Behav Neurosci 2018; 35:529-557. [PMID: 28956320 DOI: 10.1007/7854_2017_28] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
In the chapter, we explore the relationship between the peptide hormone, oxytocin (OT), and behavioral and metabolic disturbances observed in the genetic disorder Prader-Willi Syndrome (PWS). Phenotypic and genotypic characteristics of PWS are described, as are the potential implications of an abnormal OT system with respect to neural development including the possible effects of OT dysfunction on interactions with other regulatory mediators, including neurotransmitters, neuromodulators, and hormones. The major behavioral characteristics are explored in the context of OT dysfunction, including hyperphagia, impulsivity, anxiety and emotion dysregulation, sensory processing and interoception, repetitive and restrictive behaviors, and dysfunctional social cognition. Behavioral overlaps with autistic spectrum disorders are discussed. The implications of OT dysfunction on the mechanisms of reward and satiety and their possible role in informing behavioral characteristics are also discussed. Treatment implications and future directions for investigation are considered.
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Affiliation(s)
- Anahid Kabasakalian
- Albert Einstein College of Medicine, Montefiore Medical Center, Bronx, NY, USA
| | - Casara J Ferretti
- Ferkauf Graduate School of Psychology, Yeshiva University, Albert Einstein College of Medicine, Bronx, NY, USA
| | - Eric Hollander
- Albert Einstein College of Medicine, Montefiore Medical Center, Bronx, NY, USA.
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75
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Zhu X, Suarez-Jimenez B, Lazarov A, Helpman L, Papini S, Lowell A, Durosky A, Lindquist MA, Markowitz JC, Schneier F, Wager TD, Neria Y. Exposure-based therapy changes amygdala and hippocampus resting-state functional connectivity in patients with posttraumatic stress disorder. Depress Anxiety 2018; 35:974-984. [PMID: 30260530 PMCID: PMC6168398 DOI: 10.1002/da.22816] [Citation(s) in RCA: 51] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/09/2018] [Revised: 04/19/2018] [Accepted: 05/29/2018] [Indexed: 02/02/2023] Open
Abstract
BACKGROUND Recent research suggests that posttraumatic stress disorder (PTSD) is associated with altered amygdala and hippocampal resting-state functional connectivity (rsFC). However, less research has examined whether Prolonged Exposure (PE), a first line exposure-based treatment for PTSD, has the potential to alter resting state neural networks. METHODS A total of 24 patients with PTSD and 26 matched trauma-exposed healthy controls (TEHCs) underwent resting-state functional magnetic resonance imaging (fMRI) at baseline. PTSD patients were scanned a second time after completing 10-session PE in which patients narrated a detailed trauma account (imaginal exposure) and confronted trauma reminders (in vivo exposure) to extinguish trauma-related fear responses. TEHC were scanned again following a 10-week waiting period. Seed regions of interest (ROIs) included centromedial amygdala (CMA), basolateral amygdala (BLA), and the hippocampus. RESULTS Post- versus pretreatment comparisons indicated increased rsFC of the BLA and CMA with the orbitofrontal cortex (OFC), and hippocampus-medial prefrontal cortex (mPFC) among patients with PTSD, but not among TEHC participants. CONCLUSIONS Enhanced amygdala and hippocampus rsFC with prefrontal cortical regions following PE could underlie improved capacity for inhibition and re-evaluation of threat, and heightened memory encoding and retrieval ability, respectively. These findings encourage further investigation of this circuitry as a therapeutic target in PTSD.
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Affiliation(s)
- Xi Zhu
- Columbia University, Department of Psychiatry, New York, NY,New York State Psychiatric Institute, New York, NY
| | - Benjamin Suarez-Jimenez
- Columbia University, Department of Psychiatry, New York, NY,New York State Psychiatric Institute, New York, NY
| | - Amit Lazarov
- Columbia University, Department of Psychiatry, New York, NY,New York State Psychiatric Institute, New York, NY
| | - Liat Helpman
- Columbia University, Department of Psychiatry, New York, NY,New York State Psychiatric Institute, New York, NY
| | - Santiago Papini
- The University of Texas at Austin, Department of Psychology and Institute for Mental Health Research, TX
| | - Ari Lowell
- Columbia University, Department of Psychiatry, New York, NY,New York State Psychiatric Institute, New York, NY
| | | | | | - John C. Markowitz
- Columbia University, Department of Psychiatry, New York, NY,New York State Psychiatric Institute, New York, NY
| | - Franklin Schneier
- Columbia University, Department of Psychiatry, New York, NY,New York State Psychiatric Institute, New York, NY
| | - Tor D. Wager
- University of Colorado Boulder, Department of Psychology and Neuroscience, CO
| | - Yuval Neria
- Columbia University, Department of Psychiatry, New York, NY,New York State Psychiatric Institute, New York, NY
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76
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Grace SA, Rossell SL, Heinrichs M, Kordsachia C, Labuschagne I. Oxytocin and brain activity in humans: A systematic review and coordinate-based meta-analysis of functional MRI studies. Psychoneuroendocrinology 2018; 96:6-24. [PMID: 29879563 DOI: 10.1016/j.psyneuen.2018.05.031] [Citation(s) in RCA: 78] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/11/2018] [Revised: 04/20/2018] [Accepted: 05/23/2018] [Indexed: 02/02/2023]
Abstract
Oxytocin (OXT) is a neuropeptide which has a critical role in human social behaviour and cognition. Research investigating the role of OXT on functional brain changes in humans has often used task paradigms that probe socioemotional processes. Preliminary evidence suggests a central role of the amygdala in the social cognitive effects of intranasal OXT (IN-OXT), however, inconsistencies in task-design and analysis methods have led to inconclusive findings regarding a cohesive model of the neural mechanisms underlying OXT's actions. The aim of this meta-analysis was to systematically investigate these findings. A systematic search of PubMed, PsycINFO, and Scopus databases was conducted for fMRI studies which compared IN-OXT to placebo in humans. First, we systematically reviewed functional magnetic resonance imaging (fMRI) studies of IN-OXT, including studies of healthy humans, those with clinical disorders, and studies examining resting-state fMRI (rsfMRI). Second, we employed a coordinate-based meta-analysis for task-based neuroimaging literature using activation likelihood estimation (ALE), whereby, coordinates were extracted from clusters with significant differences in IN-OXT versus placebo in healthy adults. Data were included for 39 fMRI studies that reported a total of 374 distinct foci. The meta-analysis identified task-related IN-OXT increases in activity within a cluster of the left superior temporal gyrus during tasks of emotion processing. These findings are important as they implicate regions beyond the amygdala in the neural effects of IN-OXT. The outcomes from this meta-analysis can guide a priori predictions for future OXT research, and provide an avenue for targeted treatment interventions.
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Affiliation(s)
- Sally A Grace
- Centre for Mental Health, Swinburne University of Technology, Melbourne, Australia.
| | - Susan L Rossell
- Centre for Mental Health, Swinburne University of Technology, Melbourne, Australia; Monash Alfred Psychiatry Research Centre, Monash University, Melbourne, Australia; Psychiatry, St Vincent's Hospital, Melbourne, Australia
| | - Markus Heinrichs
- School of Psychology, Australian Catholic University, Melbourne, Australia; Department of Psychology, Albert-Ludwigs-University of Freiburg, Freiburg, Germany; Freiburg Brain Imaging Center, University Medical Center, Albert-Ludwigs-University of Freiburg, Freiburg, Germany
| | | | - Izelle Labuschagne
- School of Psychology, Australian Catholic University, Melbourne, Australia
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77
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Zhao Z, Ma X, Geng Y, Zhao W, Zhou F, Wang J, Markett S, Biswal BB, Ma Y, Kendrick KM, Becker B. Oxytocin differentially modulates specific dorsal and ventral striatal functional connections with frontal and cerebellar regions. Neuroimage 2018; 184:781-789. [PMID: 30266264 DOI: 10.1016/j.neuroimage.2018.09.067] [Citation(s) in RCA: 30] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2017] [Revised: 07/30/2018] [Accepted: 09/24/2018] [Indexed: 12/21/2022] Open
Abstract
Interactions between oxytocin and the basal ganglia are central in current overarching conceptualizations of its broad modulatory effects on behavior. Whereas evidence from animal models emphasizes the critical role of the ventral striatum in the behavioral effects of oxytocin, region-specific contributions of the basal ganglia have not been systematically explored in humans. The present study combined the randomized placebo-controlled administration of oxytocin versus placebo in healthy men (n = 144) with fMRI-based resting-state functional connectivity to determine the modulatory role of oxytocin on the major basal ganglia pathways. Oxytocin specifically increased connectivity between ventral striatal and pallidal nodes with upstream frontal regions, whereas it decreased the strengths of downstream pathways between the dorsal striatum and posterior cerebellum. These pathways have previously been implicated in salience, reward and behavioral flexibility, thus shaping goal-directed behavior. Given the importance of aberrant striatal intrinsic organization in autism, addiction and schizophrenia the present findings may suggest new mechanistic perspectives for the therapeutic potential of oxytocin in these disorders.
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Affiliation(s)
- Zhiying Zhao
- The Clinical Hospital of Chengdu Brain Science Institute, MOE Key Laboratory for Neuroinformation, University of Electronic Science and Technology of China, Chengdu, China
| | - Xiaole Ma
- The Clinical Hospital of Chengdu Brain Science Institute, MOE Key Laboratory for Neuroinformation, University of Electronic Science and Technology of China, Chengdu, China
| | - Yayuan Geng
- The Clinical Hospital of Chengdu Brain Science Institute, MOE Key Laboratory for Neuroinformation, University of Electronic Science and Technology of China, Chengdu, China
| | - Weihua Zhao
- The Clinical Hospital of Chengdu Brain Science Institute, MOE Key Laboratory for Neuroinformation, University of Electronic Science and Technology of China, Chengdu, China
| | - Feng Zhou
- The Clinical Hospital of Chengdu Brain Science Institute, MOE Key Laboratory for Neuroinformation, University of Electronic Science and Technology of China, Chengdu, China
| | - Jiaojian Wang
- The Clinical Hospital of Chengdu Brain Science Institute, MOE Key Laboratory for Neuroinformation, University of Electronic Science and Technology of China, Chengdu, China
| | - Sebastian Markett
- Department of Psychology, Humboldt University Berlin, Berlin, Germany
| | - Bharat B Biswal
- The Clinical Hospital of Chengdu Brain Science Institute, MOE Key Laboratory for Neuroinformation, University of Electronic Science and Technology of China, Chengdu, China; Department of Biomedical Engineering, New Jersey Institute of Technology, Newark, NJ, USA
| | - Yina Ma
- State Key Laboratory of Cognitive Neuroscience and Learning, IDG/McGovern Institute of Brain Research, Beijing Normal University, Beijing, China
| | - Keith M Kendrick
- The Clinical Hospital of Chengdu Brain Science Institute, MOE Key Laboratory for Neuroinformation, University of Electronic Science and Technology of China, Chengdu, China
| | - Benjamin Becker
- The Clinical Hospital of Chengdu Brain Science Institute, MOE Key Laboratory for Neuroinformation, University of Electronic Science and Technology of China, Chengdu, China.
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78
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Abstract
PURPOSE OF REVIEW We review the published literature over the last 24 months in the treatment of PTSD for our military men and women. We examined the updated clinical practice guidelines published in June 2017 by the Veteran's administration and Department of Defense and contrasted the guidelines with the most recent literature. We also discuss new directions in PTSD research. RECENT FINDINGS Psychotherapy remains one of the most effective treatments for PTSD; unfortunately, few participants remain in treatment to completion. Many of the emerging therapies target NMDA receptor antagonists, cannabinoid receptor modulators, glucocorticoid receptor agonists, non-SSRI antidepressants, and opioid receptor agonists. The newer therapies fall into the drug classes of anti-hypertensives, glutamate modulators, oxytocin, and medication targeting insomnia/hyperarousal. PTSD symptoms are often chronic in our veteran population. While current treatments are helpful, there are often significant residual symptoms. We reviewed the most recent improvements in treatment and discuss therapies that are in the research phase.
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Affiliation(s)
- Durga Bestha
- Department of Psychiatry, Atrium Health, Charlotte, NC, USA
| | - Layla Soliman
- Department of Psychiatry, Atrium Health, Charlotte, NC, USA
| | | | - James Rachal
- Department of Psychiatry, Atrium Health, Charlotte, NC, USA.
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79
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Ma X, Zhao W, Luo R, Zhou F, Geng Y, Xu L, Gao Z, Zheng X, Becker B, Kendrick KM. Sex- and context-dependent effects of oxytocin on social sharing. Neuroimage 2018; 183:62-72. [PMID: 30086408 DOI: 10.1016/j.neuroimage.2018.08.004] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2018] [Revised: 06/15/2018] [Accepted: 08/03/2018] [Indexed: 12/12/2022] Open
Abstract
We interact socially and form bonds with others because such experiences are rewarding. However, an insecure attachment style or social anxiety can reduce these rewarding effects. The neuropeptide oxytocin (OXT) may facilitate social interactions either by increasing their rewarding experience or by attenuating anxiety, although effects can be sex- and attachment-style dependent. In this study, 128 pairs of same-sex friends completed a social sharing paradigm in a double-blind, placebo-controlled, between-subject design with one friend inside an MRI scanner and the other in a remote behavioral testing room. In this way we could examine whether intranasal-OXT differentially modulated the emotional impact of social sharing and associated neural processing. Additionally, we investigated if OXT effects were modulated by sex and attachment style. Results showed that in women, but not men, OXT increased ratings for sharing stimuli with their friend but not with a stranger, particularly in the friend in the scanner. Corresponding neuroimaging results showed that OXT decreased both amygdala and insula activity as well as their functional connectivity in women when they shared with friends but had the opposite effect in men. On the other hand, OXT did not enhance responses in brain reward circuitry. In the PLC treated group amygdala responses in women when they shared pictures with their friend were positively associated with attachment anxiety and OXT uncoupled this. Our findings demonstrate that OXT facilitates the impact of sharing positive experiences with others in women, but not men, and that this is associated with differential effects on the amygdala and insula and their functional connections. Furthermore, OXT particularly reduced increased amygdala responses during sharing in individuals with higher attachment anxiety. Thus, OXT effects in this context may be due more to reduced anxiety when sharing with a friend than to enhanced social reward.
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Affiliation(s)
- Xiaole Ma
- The Clinical Hospital of Chengdu Brain Science Institute, MOE Key Laboratory for NeuroInformation, University of Electronic Science and Technology of China, Chengdu, Sichuan, 611731, China
| | - Weihua Zhao
- The Clinical Hospital of Chengdu Brain Science Institute, MOE Key Laboratory for NeuroInformation, University of Electronic Science and Technology of China, Chengdu, Sichuan, 611731, China
| | - Ruixue Luo
- The Clinical Hospital of Chengdu Brain Science Institute, MOE Key Laboratory for NeuroInformation, University of Electronic Science and Technology of China, Chengdu, Sichuan, 611731, China
| | - Feng Zhou
- The Clinical Hospital of Chengdu Brain Science Institute, MOE Key Laboratory for NeuroInformation, University of Electronic Science and Technology of China, Chengdu, Sichuan, 611731, China
| | - Yayuan Geng
- The Clinical Hospital of Chengdu Brain Science Institute, MOE Key Laboratory for NeuroInformation, University of Electronic Science and Technology of China, Chengdu, Sichuan, 611731, China
| | - Lei Xu
- The Clinical Hospital of Chengdu Brain Science Institute, MOE Key Laboratory for NeuroInformation, University of Electronic Science and Technology of China, Chengdu, Sichuan, 611731, China
| | - Zhao Gao
- The Clinical Hospital of Chengdu Brain Science Institute, MOE Key Laboratory for NeuroInformation, University of Electronic Science and Technology of China, Chengdu, Sichuan, 611731, China
| | - Xiaoxiao Zheng
- The Clinical Hospital of Chengdu Brain Science Institute, MOE Key Laboratory for NeuroInformation, University of Electronic Science and Technology of China, Chengdu, Sichuan, 611731, China
| | - Benjamin Becker
- The Clinical Hospital of Chengdu Brain Science Institute, MOE Key Laboratory for NeuroInformation, University of Electronic Science and Technology of China, Chengdu, Sichuan, 611731, China.
| | - Keith M Kendrick
- The Clinical Hospital of Chengdu Brain Science Institute, MOE Key Laboratory for NeuroInformation, University of Electronic Science and Technology of China, Chengdu, Sichuan, 611731, China.
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80
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Flanagan JC, Hand A, Jarnecke AM, Moran-Santa Maria MM, Brady KT, Joseph JE. Effects of oxytocin on working memory and executive control system connectivity in posttraumatic stress disorder. Exp Clin Psychopharmacol 2018; 26:391-402. [PMID: 30070567 PMCID: PMC6075739 DOI: 10.1037/pha0000197] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
Posttraumatic stress disorder (PTSD) is a chronic, debilitating condition for which effective medications are scant and little is known about neural correlates of risk versus resilience. Oxytocin is a hypothalamic neuropeptide that has demonstrated promise in modulating neurobiological and behavioral correlates of PTSD. Cognitive deficits in areas such as working memory and executive control are highly prevalent among individuals with PTSD and oxytocin might modulate these impairments in individuals with PTSD. Using a double-blind, placebo-controlled design, this study employed functional MRI (fMRI) and the n-back working memory task to examine the effects of oxytocin (24 IU) versus placebo on working memory and dorsolateral prefrontal cortex (DLPFC) connectivity among individuals with PTSD (n = 16) as compared with a trauma-exposed control group (n = 18). Results indicate that individuals with PTSD on oxytocin performed better in the 2-back condition of the n-back task compared with individuals with PTSD on placebo. Results also indicate that connectivity between DLPFC and anterior cingulate increased in the 2-back condition among individuals with PTSD on oxytocin as compared with placebo. These findings provide preliminary evidence of an effect of oxytocin on working memory among individuals with PTSD and insights into the neurobiological mechanisms underlying this association. Future studies are necessary to understand the mechanisms responsible for working memory deficits in PTSD and to examine the potential of oxytocin for use as a treatment for PTSD. (PsycINFO Database Record
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Affiliation(s)
- Julianne C. Flanagan
- Department of Psychiatry & Behavioral Sciences, Medical University of South Carolina, Charleston, SC
| | - Anne Hand
- Department of Neuroscience, Medical University of South Carolina, Charleston, SC
| | - Amber M. Jarnecke
- Department of Psychiatry & Behavioral Sciences, Medical University of South Carolina, Charleston, SC
| | | | - Kathleen T. Brady
- Department of Psychiatry & Behavioral Sciences, Medical University of South Carolina, Charleston, SC
- Ralph H. Johnson VAMC, Charleston, SC
| | - Jane E. Joseph
- Department of Neuroscience, Medical University of South Carolina, Charleston, SC
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81
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Janeček M, Dabrowska J. Oxytocin facilitates adaptive fear and attenuates anxiety responses in animal models and human studies-potential interaction with the corticotropin-releasing factor (CRF) system in the bed nucleus of the stria terminalis (BNST). Cell Tissue Res 2018; 375:143-172. [PMID: 30054732 DOI: 10.1007/s00441-018-2889-8] [Citation(s) in RCA: 44] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2018] [Accepted: 07/04/2018] [Indexed: 01/28/2023]
Abstract
Despite its relatively well-understood role as a reproductive and pro-social peptide, oxytocin (OT) tells a more convoluted story in terms of its modulation of fear and anxiety. This nuanced story has been obscured by a great deal of research into the therapeutic applications of exogenous OT, driving more than 400 ongoing clinical trials. Drawing from animal models and human studies, we review the complex evidence concerning OT's role in fear learning and anxiety, clarifying the existing confusion about modulation of fear versus anxiety. We discuss animal models and human studies demonstrating the prevailing role of OT in strengthening fear memory to a discrete signal or cue, which allows accurate and rapid threat detection that facilitates survival. We also review ostensibly contrasting behavioral studies that nonetheless provide compelling evidence of OT attenuating sustained contextual fear and anxiety-like behavior, arguing that these OT effects on the modulation of fear vs. anxiety are not mutually exclusive. To disambiguate how endogenous OT modulates fear and anxiety, an understudied area compared to exogenous OT, we survey behavioral studies utilizing OT receptor (OTR) antagonists. Based on emerging evidence about the role of OTR in rat dorsolateral bed nucleus of stria terminalis (BNST) and elsewhere, we postulate that OT plays a critical role in facilitating accurate discrimination between stimuli representing threat and safety. Supported by human studies, we demonstrate that OT uniquely facilitates adaptive fear but reduces maladaptive anxiety. Last, we explore the limited literature on endogenous OT and its interaction with corticotropin-releasing factor (CRF) with a special emphasis on the dorsolateral BNST, which may hold the key to the neurobiology of phasic fear and sustained anxiety.
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Affiliation(s)
- Michael Janeček
- Department of Cellular and Molecular Pharmacology, Chicago Medical School, Rosalind Franklin University of Medicine and Science, North Chicago, IL, 60064, USA
| | - Joanna Dabrowska
- Department of Cellular and Molecular Pharmacology, Chicago Medical School, Rosalind Franklin University of Medicine and Science, North Chicago, IL, 60064, USA. .,Department of Neuroscience, Chicago Medical School, Rosalind Franklin University of Medicine and Science, North Chicago, IL, 60064, USA.
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82
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Brodmann K, Gruber O, Goya-Maldonado R. Intranasal Oxytocin Selectively Modulates Large-Scale Brain Networks in Humans. Brain Connect 2018; 7:454-463. [PMID: 28762756 PMCID: PMC5647506 DOI: 10.1089/brain.2017.0528] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
A growing body of evidence indicates that the neuropeptide oxytocin (OT) alters the neural correlates of socioemotional and salience processing. Yet the effects of OT over important large-scale networks involved in these processes, such as the default mode (DM), ventral attention (VA), and cingulo-opercular (CO) networks, remain unknown. Therefore, we conducted a placebo-controlled crossover study with intranasal 24 IU OT in 38 healthy male subjects using a resting-state functional magnetic resonance imaging paradigm to investigate its impact over these three networks candidates. To understand the underlying mechanisms of the neuropeptide, we compared the intranetwork connectivity for each network candidate and also the internetwork connectivity across all networks between both treatment conditions. Based on the relevance of interindividual factors for OT effects, we correlated individual network changes with behavioral performance in a decision-making task and with impulsivity scores. Our results show that OT mainly alters connectivity in the VA, on one side reducing the coupling to regions that typically form the nodes of DM, an introspective and self-referential network, and on the other side increasing the coupling to the edges of the CO, which is involved in salience processing. The results of the internetwork analyses confirmed the specificity of the OT effects. Indeed, we observed significant correlations with the erroneous performance during decision-making but not with the obtained impulsivity scores. Overall, our data support that the modulation of functional connectivity within the VA is a basic mechanism by which OT directs attentional resources from internal to external cues, preparing the brain for context-dependent salience processing.
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Affiliation(s)
- Katja Brodmann
- 1 Department of Psychiatry and Psychotherapy, Center for Translational Research in Systems Neuroscience and Psychiatry, University Medical Center , Göttingen, Germany .,2 Faculdade de Medicina da Universidade de Lisboa, Instituto de Medicina Molecular , Lisbon, Portugal
| | - Oliver Gruber
- 1 Department of Psychiatry and Psychotherapy, Center for Translational Research in Systems Neuroscience and Psychiatry, University Medical Center , Göttingen, Germany .,3 Section for Experimental Psychopathology and Neuroimaging, Department of General Psychiatry, Heidelberg University , Heidelberg, Germany
| | - Roberto Goya-Maldonado
- 1 Department of Psychiatry and Psychotherapy, Center for Translational Research in Systems Neuroscience and Psychiatry, University Medical Center , Göttingen, Germany .,4 The Systems Neuroscience and Imaging in Psychiatry (SNIP) Lab, Department of Psychiatry and Psychotherapy, University Medical Center , Göttingen, Germany
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83
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Donadon MF, Martin-Santos R, Osório FDL. The Associations Between Oxytocin and Trauma in Humans: A Systematic Review. Front Pharmacol 2018; 9:154. [PMID: 29545749 PMCID: PMC5838009 DOI: 10.3389/fphar.2018.00154] [Citation(s) in RCA: 69] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2017] [Accepted: 02/13/2018] [Indexed: 01/01/2023] Open
Abstract
Studies have shown that traumatic experiences may affect hormonal systems mediated by the hypothalamic-pituitary-adrenal (HPA) axis and the oxytocinergic system. This effect is the result of long-term impairments in hypothalamic structures and negative feedback mechanisms within the HPA axis, structures that mediate the response to stress. This deregulation reduces the production and release of cortisol and oxytocin (OXT), which may alter stress responses and lead to increased vulnerability to impairments from stressful experiences. The presence of gene polymorphisms might also have an impact on the vulnerability to psychopathology. We made a systematic review of articles dealing with the relationship between OXT and traumatic emotional experiences in humans. Thirty-five studies were reviewed and significant associations between experiences of emotional trauma (ET) and OXT were found. The main results showed that the presence of ET and post-traumatic stress disorder (PTSD) is strongly associated with reductions in endogenous OXT, and also that the acute effects of OXT administrations in individuals with ET tend to be anxiolytic only in less severe forms. In victims of recent traumatic experiences (RTE), OXT increased the re-experience of traumas and restored the function of different neural networks associated with fear control/extinction in PTSD patients. The results available also suggest that gene receptor polymorphisms may have a protective function in different outcomes after the experience of traumatic events. We conclude that the relationship between ET and OXT is multifaceted, complex, and mediated by contextual and individual factors. Directions for future studies are suggested considering the gaps in the available literature.
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Affiliation(s)
- Mariana Fortunata Donadon
- Department of Neuroscience and Behavior, Medical School of Ribeirão Preto, University of São Paulo, São Paulo, Brazil
| | - Rocio Martin-Santos
- Department of Psychiatry and Psychology, Hospital Clínic, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Centro de Investigación en Red de Salud Mental (CIBERSAM), Barcelona, Spain.,Department of Medicine, University of Barcelona, Barcelona, Spain.,Technology Institute for Translational Medicine (INCT), National Council for Scientific and Technological Development (CNPq), Brasília, Brazil
| | - Flávia de Lima Osório
- Department of Neuroscience and Behavior, Medical School of Ribeirão Preto, University of São Paulo, São Paulo, Brazil.,Technology Institute for Translational Medicine (INCT), National Council for Scientific and Technological Development (CNPq), Brasília, Brazil
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84
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Augmenting Prolonged Exposure therapy for PTSD with intranasal oxytocin: A randomized, placebo-controlled pilot trial. J Psychiatr Res 2018; 98:64-69. [PMID: 29294429 PMCID: PMC5800951 DOI: 10.1016/j.jpsychires.2017.12.014] [Citation(s) in RCA: 76] [Impact Index Per Article: 12.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/14/2017] [Revised: 12/21/2017] [Accepted: 12/21/2017] [Indexed: 01/04/2023]
Abstract
Posttraumatic stress disorder (PTSD) is a chronic, debilitating condition for which Prolonged Exposure (PE) therapy is highly efficacious. However, for some individuals, premature dropout and residual PTSD symptoms remain obstacles. The neuropeptide oxytocin is a promising candidate to enhance PE due to its ability to enhance 1) prosocial cognition and behavior, which are theorized to promote positive working alliance, and 2) extinction learning, which is the central mechanism of action underlying successful PE treatment. Despite a robust theoretical rationale, no studies to date have combined evidence-based psychotherapy for PTSD with oxytocin. This randomized, placebo-controlled, double-blind pilot trial examined the feasibility, safety, and preliminary efficacy of augmenting PE with oxytocin. Participants were 17 individuals with diverse index traumas. Participants self-administered intranasal oxytocin (40 IU) or matching placebo 45 min prior to each weekly PE therapy session. One adverse event occurred in the placebo group and three individuals dropped out (17.6%; 2 oxytocin group and 1 placebo group). The oxytocin group demonstrated lower PTSD and depression symptoms during PE, and had higher working alliance scores, although these differences did not reach statistical significance. Although preliminary, the findings support the feasibility of oxytocin combined with PE. Adequately powered studies are necessary to determine whether oxytocin enhances PE treatment outcomes and to examine potential mechanisms, such as accelerating extinction learning, enhancing early response, and preventing premature dropout. NCT03238924.
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85
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Yang Y, Babygirija R, Zheng J, Shi B, Sun W, Zheng X, Zhang F, Cao Y. Central Neuropeptide Y Plays an Important Role in Mediating the Adaptation Mechanism Against Chronic Stress in Male Rats. Endocrinology 2018; 159:1525-1536. [PMID: 29425286 DOI: 10.1210/en.2018-00045] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/11/2018] [Accepted: 01/17/2018] [Indexed: 12/31/2022]
Abstract
Exposure to continuous life stress often causes gastrointestinal (GI) symptoms. Studies have shown that neuropeptide Y (NPY) counteracts the biological actions of corticotrophin-releasing factor (CRF) and is involved in the termination of the stress response. However, in chronic repeated restraint stress (CRS) conditions, the actions of NPY on GI motility remain controversial. To evaluate the role of NPY in mediation of the adaptation mechanism and GI motility in CRS conditions, a CRS rat model was set up. Central CRF and NPY expression levels were analyzed, serum corticosterone and NPY concentrations were measured, and GI motor function was evaluated. The NPY Y1 receptor antagonist BIBP-3226 was centrally administered before stress loading, and on days 1 through 5 of repeated stress, the central CRF and the serum corticosterone concentrations were measured. In addition, gastric and colonic motor functions were evaluated. The elevated central CRF expression and corticosterone concentration caused by acute stress began to fall after 3 days of stress loading, whereas central NPY expression and serum NPY began to increase. GI dysmotility also returned to a normal level. Pretreatment with BIBP-3226 abolished the adaptation mechanism and significantly increased CRF expression and the corticosterone concentration, which resulted in delayed gastric emptying and accelerated fecal pellet output. Inhibited gastric motility and enhanced distal colonic motility were also recorded. CRS-produced adaptation, overexpressed central CRF, and GI dysmotility observed in acute restraint stress were restored to normal levels. Central NPY via the Y1 receptor plays an important role in mediating the adaptation mechanism against chronic stress.
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Affiliation(s)
- Yu Yang
- Department of Physiology, College of Basic Medical Science, China Medical University, Shenyang, Liaoning Province, China
| | - Reji Babygirija
- Department of Surgery, Medical College of Wisconsin and Zablocki VA Medical Center, Milwaukee, Wisconsin
| | - Jun Zheng
- Department of Physiology, College of Basic Medical Science, China Medical University, Shenyang, Liaoning Province, China
| | - Bei Shi
- Department of Physiology, College of Basic Medical Science, China Medical University, Shenyang, Liaoning Province, China
| | - Weinan Sun
- Department of Physiology, College of Basic Medical Science, China Medical University, Shenyang, Liaoning Province, China
| | - Xiaojiao Zheng
- Department of Physiology, College of Basic Medical Science, China Medical University, Shenyang, Liaoning Province, China
| | - Fan Zhang
- Department of Physiology, College of Basic Medical Science, China Medical University, Shenyang, Liaoning Province, China
| | - Yu Cao
- Department of Physiology, College of Basic Medical Science, China Medical University, Shenyang, Liaoning Province, China
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86
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Gordon EM, Scheibel RS, Zambrano-Vazquez L, Jia-Richards M, May GJ, Meyer EC, Nelson SM. High-Fidelity Measures of Whole-Brain Functional Connectivity and White Matter Integrity Mediate Relationships between Traumatic Brain Injury and Post-Traumatic Stress Disorder Symptoms. J Neurotrauma 2018; 35:767-779. [PMID: 29179667 PMCID: PMC8117405 DOI: 10.1089/neu.2017.5428] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
Traumatic brain injury (TBI) disrupts brain communication and increases risk for post-traumatic stress disorder (PTSD). However, mechanisms by which TBI-related disruption of brain communication confers PTSD risk have not been successfully elucidated in humans. This may be in part because functional MRI (fMRI), the most common technique for measuring functional brain communication, is unreliable for characterizing individual patients. However, this unreliability can be overcome with sufficient within-individual data. Here, we examined whether relationships could be observed among TBI, structural and functional brain connectivity, and PTSD severity by collecting ∼3.5 hours of resting-state fMRI and diffusion tensor imaging (DTI) data in each of 26 United States military veterans. We observed that a TBI history was associated with decreased whole-brain resting-state functional connectivity (RSFC), while the number of lifetime TBIs was associated with reduced whole-brain fractional anisotropy (FA). Both RSFC and FA explained independent variance in PTSD severity, with RSFC mediating the TBI-PTSD relationship. Finally, we showed that large amounts of per-individual data produced highly reliable RSFC measures, and that relationships among TBI, RSFC/FA, and PTSD could not be observed with typical data quantities. These results demonstrate links among TBI, brain connectivity, and PTSD severity, and illustrate the need for precise characterization of individual patients using high-data fMRI scanning.
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Affiliation(s)
- Evan M. Gordon
- VISN 17 Center of Excellence for Research on Returning War Veterans, Waco, TX
- Center for Vital Longevity, School of Behavioral and Brain Sciences, University of Texas at Dallas, Dallas, TX
- Department of Psychology and Neuroscience, Baylor University, Waco, TX
| | - Randall S. Scheibel
- Michael E. DeBakey Veterans Affairs Medical Center, Houston, TX
- Department of Physical Medicine and Rehabilitation, Baylor College of Medicine, Houston, TX
| | | | | | - Geoffrey J. May
- VISN 17 Center of Excellence for Research on Returning War Veterans, Waco, TX
- Center for Vital Longevity, School of Behavioral and Brain Sciences, University of Texas at Dallas, Dallas, TX
- Department of Psychology and Neuroscience, Baylor University, Waco, TX
- Department of Psychiatry and Behavioral Science, Texas A&M Health Science Center, College of Medicine, College Station, TX
| | - Eric C. Meyer
- VISN 17 Center of Excellence for Research on Returning War Veterans, Waco, TX
- Department of Psychiatry and Behavioral Science, Texas A&M Health Science Center, College of Medicine, College Station, TX
| | - Steven M. Nelson
- VISN 17 Center of Excellence for Research on Returning War Veterans, Waco, TX
- Center for Vital Longevity, School of Behavioral and Brain Sciences, University of Texas at Dallas, Dallas, TX
- Department of Psychology and Neuroscience, Baylor University, Waco, TX
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Tully J, Gabay AS, Brown D, Murphy DGM, Blackwood N. The effect of intranasal oxytocin on neural response to facial emotions in healthy adults as measured by functional MRI: A systematic review. Psychiatry Res 2018; 272:17-29. [PMID: 29272737 PMCID: PMC6562202 DOI: 10.1016/j.pscychresns.2017.11.017] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/16/2017] [Revised: 11/24/2017] [Accepted: 11/25/2017] [Indexed: 12/28/2022]
Abstract
Abnormalities in responses to human facial emotions are associated with a range of psychiatric disorders. Addressing these abnormalities may therefore have significant clinical applications. Previous meta-analyses have demonstrated effects of the neuropeptide oxytocin on behavioural response to facial emotions, and effects on brain, as measured by functional MRI. Evidence suggests that these effects may be mediated by sex and the role of eye gaze. However, the specific effect of oxytocin on brain response to facial emotions in healthy adults has not been systematically analysed. To address this question, this further systematic review was conducted. Twenty-two studies met our inclusion criteria. In men, oxytocin consistently attenuated brain activity in response to negative emotional faces, particularly fear, compared with placebo, while in women, oxytocin enhanced activity. Brain regions consistently involved included the amygdala, fusiform gyrus and anterior cingulate cortex. In some studies, oxytocin increased fixation changes towards the eyes with enhanced amygdala and/or fusiform gyrus activation. By enhancing understanding of emotion processing in healthy subjects, these pharmacoimaging studies provide a theoretical basis for studying deficits in clinical populations. However, progress to date has been limited by low statistical power, methodological heterogeneity, and a lack of multimodal studies.
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Affiliation(s)
- John Tully
- Department of Forensic and Neurodevelopmental Sciences, Institute of Psychiatry, Psychology and Neuroscience, Kings College London, London, United Kingdom.
| | - Anthony S Gabay
- Department of Neuroimaging, Kings College London, London, United Kingdom
| | - Danielle Brown
- Institute of Psychiatry, Psychology and Neuroscience, Kings College London, London, United Kingdom
| | - Declan G M Murphy
- Department of Forensic and Neurodevelopmental Sciences, Institute of Psychiatry, Psychology and Neuroscience, Kings College London, London, United Kingdom
| | - Nigel Blackwood
- Department of Forensic and Neurodevelopmental Sciences, Institute of Psychiatry, Psychology and Neuroscience, Kings College London, London, United Kingdom
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88
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Aghajani M, Klapwijk ET, Colins OF, Ziegler C, Domschke K, Vermeiren RRJM, van der Wee NJA. Interactions Between Oxytocin Receptor Gene Methylation and Callous-Unemotional Traits Impact Socioaffective Brain Systems in Conduct-Disordered Offenders. BIOLOGICAL PSYCHIATRY: COGNITIVE NEUROSCIENCE AND NEUROIMAGING 2018; 3:379-391. [PMID: 29628070 DOI: 10.1016/j.bpsc.2017.12.010] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/27/2017] [Revised: 12/21/2017] [Accepted: 12/21/2017] [Indexed: 01/10/2023]
Abstract
BACKGROUND The developmental trajectory of psychopathy seemingly begins early in life and includes the presence of callous-unemotional (CU) traits (e.g., perturbed socioaffective reactivity and empathy, callousness) in youths with conduct disorder (CD). Whereas oxytocin receptor gene methylation (OXTRMeth) and its downstream neuromodulatory effects are deemed relevant to CU traits, nothing is known of how OXTRMeth interacts with CU traits to impact socioaffective brain systems in youngsters with CD. METHODS Hence, we uniquely probed OXTRMeth × CU trait interactions on corticolimbic activity and amygdala subregional connections during recognition and resonance of distressing socioaffective stimuli (angry and fearful faces), in juvenile offenders with CD (n = 39) versus matched healthy control youths (n = 27). RESULTS Relative to healthy control youths, elevated OXTRMeth and CU levels in youths with CD essentially interacted to predict frontoparietal hyperactivity and amygdalo-frontoparietal disconnection during task performance. Specifically, increasing OXTRMeth and CU levels in youths with CD interactively predicted midcingulate hyperactivity during both emotion conditions, with insular, temporoparietal, and precuneal hyperactivity additionally emerging during emotion recognition. Interactions between high OXTRMeth and CU levels in youths with CD additionally predicted centromedial amygdala decoupling from ventromedial/orbitofrontal regions during emotion recognition, along with basolateral amygdala decoupling from precuneal and temporoparietal cortices during emotion resonance. CONCLUSIONS These results uniquely suggest that interactions between OXTRMeth and CU traits in youths with CD may affect brain systems critical to decoding and integrating socioaffective information. Developmental models of CU traits and psychopathy could thus possibly advance by further examining OXTR epigenetic effects, which may hold promise for indicated prevention and personalized treatment by targeting oxytocinergic function.
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Affiliation(s)
- Moji Aghajani
- Department of Child and Adolescent Psychiatry, Curium, Leiden University Medical Center, Leiden, the Netherlands; Leiden Institute for Brain and Cognition, Leiden, the Netherlands; Department of Psychiatry, VU University Medical Center, Amsterdam, the Netherlands.
| | - Eduard T Klapwijk
- Department of Child and Adolescent Psychiatry, Curium, Leiden University Medical Center, Leiden, the Netherlands; Leiden Institute for Brain and Cognition, Leiden, the Netherlands; Brain and Development Research Center, Institute of Psychology, Leiden University, Leiden, the Netherlands
| | - Olivier F Colins
- Department of Child and Adolescent Psychiatry, Curium, Leiden University Medical Center, Leiden, the Netherlands; Leiden Institute for Brain and Cognition, Leiden, the Netherlands
| | - Christiane Ziegler
- Department of Psychiatry and Psychotherapy, University Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Germany; Department of Psychiatry, University of Würzburg, Würzburg, Germany
| | | | - Robert R J M Vermeiren
- Department of Child and Adolescent Psychiatry, Curium, Leiden University Medical Center, Leiden, the Netherlands; Leiden Institute for Brain and Cognition, Leiden, the Netherlands
| | - Nic J A van der Wee
- Department of Pschiatry, Curium, Leiden University Medical Center, Leiden, the Netherlands; Leiden Institute for Brain and Cognition, Leiden, the Netherlands
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89
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Xu S, Qin B, Shi A, Zhao J, Guo X, Dong L. Oxytocin inhibited stress induced visceral hypersensitivity, enteric glial cells activation, and release of proinflammatory cytokines in maternal separated rats. Eur J Pharmacol 2017; 818:578-584. [PMID: 29162434 DOI: 10.1016/j.ejphar.2017.11.018] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2017] [Revised: 11/13/2017] [Accepted: 11/13/2017] [Indexed: 12/13/2022]
Abstract
Visceral hypersensitivity (VH) is a significant contributor to irritable bowel syndrome (IBS). Oxytocin (OT) possesses analgesic effects on the central nervous system (CNS) and attenuates microglial activation, however, little is known about its peripheral effects and involvement in VH of IBS. Reactive enteric glial cells (EGCs) contributes to abnormal motility in gastrointestinal (GI) diseases. The aim of this study was to evaluate the peripheral use of OT to maintain VH and activation of EGCs through involvement of the Toll-like receptor (TLR) 4/MyD88/NF-κB signaling. After assessing a baseline visceromotor response (VMR) to colorectal distension (CRD), rats were exposed to a 1h water avoidance stress (WAS) session. Before each WAS session, intraperitoneal injection of OT (1mg/kg body weight, in phosphate-buffered saline (PBS)) atosiban (0.5mg/kg body weight, in PBS) or PBS (as a vehicle control, 1ml/kg body weight) was administered. Animas are killed 24h after the last WAS session. EGCs activity, relative OT receptor expression, glial fibrillary acidic protein (GFAP) expression and TLR4/MyD88/NF-κB signaling were evaluated. Neonatal maternal separation (MS) significantly increased the OT receptor expression and enhanced VMR to CRD. WAS improved VMR to CRD only during neonatal MS. OT treatment prevented WAS-induced higher VMRs to CRD, which was reversed by an OT receptor antagonist administration. Compared to the vehicle, OT pre-treated rats reduced EGCs activation, GFAP expression and TLR4/MyD88/NF-κB signaling. We conclude that neonatal MS induces VH and visceral pain in rats. Furthermore, exogenous OT attenuated stress-induced VH and EGCs activation, which was mediated by TLR4/MyD88/NF-κB signaling.
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Affiliation(s)
- Shaoxian Xu
- Department of Gastroenterology, Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an 710004, China
| | - Bin Qin
- Department of Gastroenterology, Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an 710004, China
| | - Ameng Shi
- Department of Gastroenterology, Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an 710004, China
| | - Jing Zhao
- Department of Gastroenterology, Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an 710004, China
| | - Xiaoyan Guo
- Department of Gastroenterology, Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an 710004, China
| | - Lei Dong
- Department of Gastroenterology, Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an 710004, China.
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90
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Oxytocin receptor gene polymorphisms, attachment, and PTSD: Results from the National Health and Resilience in Veterans Study. J Psychiatr Res 2017; 94:139-147. [PMID: 28715704 PMCID: PMC5605420 DOI: 10.1016/j.jpsychires.2017.07.008] [Citation(s) in RCA: 43] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/27/2017] [Revised: 06/23/2017] [Accepted: 07/07/2017] [Indexed: 01/08/2023]
Abstract
The human oxytocin system is implicated in social behavior and stress recovery. Polymorphisms in the oxytocin receptor gene (OXTR) may interact with attachment style to predict stress-related psychopathology like posttraumatic stress disorder (PTSD). The objective of this study was to examine independent and interactive effects of the OXTR single nucleotide polymorphism (SNP) rs53576, which has been associated with stress reactivity, support-seeking, and PTSD in prior studies, and attachment style on risk for PTSD in a nationally representative sample of 2163 European-American (EA) U.S. military veterans who participated in two independent waves of the National Health and Resilience in Veterans Study (NHRVS). Results revealed that insecure attachment style [adjusted odds ratio (OR) = 4.29; p < 0.001] and the interaction of rs53576 and attachment style (OR = 2.58, p = 0.02) were associated with probable lifetime PTSD. Among individuals with the minor A allele, the prevalence of probable PTSD was significantly higher among those with an insecure attachment style (23.9%) than those with a secure attachment style (2.0%), equivalent to an adjusted OR of 10.7. We attempted to replicate these findings by utilizing dense marker data from a genome-wide association study of 2215 high-risk civilians; one OXTR variant, though not rs53576, was associated with PTSD. Exploratory analyses in the veteran sample revealed that the interaction between this variant and attachment style predicting probable PTSD approached statistical significance. Results indicate that polymorphisms in the OXTR gene and attachment style may contribute to vulnerability to PTSD in U.S. military veterans.
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91
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Johnson ZV, Young LJ. Oxytocin and vasopressin neural networks: Implications for social behavioral diversity and translational neuroscience. Neurosci Biobehav Rev 2017; 76:87-98. [PMID: 28434591 DOI: 10.1016/j.neubiorev.2017.01.034] [Citation(s) in RCA: 179] [Impact Index Per Article: 25.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2016] [Revised: 12/15/2016] [Accepted: 01/25/2017] [Indexed: 12/11/2022]
Abstract
Oxytocin- and vasopressin-related systems are present in invertebrate and vertebrate bilaterian animals, including humans, and exhibit conserved neuroanatomical and functional properties. In vertebrates, these systems innervate conserved neural networks that regulate social learning and behavior, including conspecific recognition, social attachment, and parental behavior. Individual and species-level variation in central organization of oxytocin and vasopressin systems has been linked to individual and species variation in social learning and behavior. In humans, genetic polymorphisms in the genes encoding oxytocin and vasopressin peptides and/or their respective target receptors have been associated with individual variation in social recognition, social attachment phenotypes, parental behavior, and psychiatric phenotypes such as autism. Here we describe both conserved and variable features of central oxytocin and vasopressin systems in the context of social behavioral diversity, with a particular focus on neural networks that modulate social learning, behavior, and salience of sociosensory stimuli during species-typical social contexts.
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Affiliation(s)
- Zachary V Johnson
- Silvio O. Conte Center for Oxytocin and Social Cognition, Center for Translational Social Neuroscience, Department of Psychiatry and Behavioral Sciences, Yerkes National Primate Research Center, Emory University, Atlanta, GA 30329, USA; School of Biological Sciences, Georgia Institute of Technology, Atlanta, GA 30332, USA.
| | - Larry J Young
- Silvio O. Conte Center for Oxytocin and Social Cognition, Center for Translational Social Neuroscience, Department of Psychiatry and Behavioral Sciences, Yerkes National Primate Research Center, Emory University, Atlanta, GA 30329, USA.
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92
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Woodward SH, Jamison AL, Gala S, Holmes TH. Canine companionship is associated with modification of attentional bias in posttraumatic stress disorder. PLoS One 2017; 12:e0179912. [PMID: 29020064 PMCID: PMC5636264 DOI: 10.1371/journal.pone.0179912] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2017] [Accepted: 06/06/2017] [Indexed: 12/01/2022] Open
Abstract
Attentional bias towards aversive stimuli has been demonstrated in the anxiety disorders and in posttraumatic stress disorder, and attentional bias modification has been proposed as a candidate treatment. This study rigorously assessed attentional bias towards aversive and pleasant visual imagery associated with the presence or absence of a familiar service canine in 23 veterans with chronic military-related posttraumatic stress disorder. Participants were repeatedly tested with and without their service canines present on two tasks designed to elicit spontaneous visual attention to facial and scenic image pairs, respectively. Each stimulus contrasted an emotive image with a neutral image. Via eye-tracking, the difference in visual attention directed to each image was analyzed as a function of the valence contrast and presence/absence of the canine. Across both tasks, the presence of a familiar service canine attenuated the normative attentional bias towards aversive image content. In the facial task, presence of the service canine specifically reduced attention toward angry faces. In that task, as well, accumulated days with the service canine similarly modulated attention toward facial emotion. The results suggest that the presence of a familiar service canine is associated with attenuation of attentional bias to aversive stimuli in chronic military-service-related posttraumatic stress disorder. Questions remain regarding the generalization of such effects to other populations, their dependence on the familiarity, breed, and training of the canine, and on social context.
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Affiliation(s)
- Steven H. Woodward
- National Center for PTSD, Dissemination and Training Division, VA Palo Alto Health Care System, Palo Alto, CA, United States of America
- * E-mail:
| | - Andrea L. Jamison
- National Center for PTSD, Dissemination and Training Division, VA Palo Alto Health Care System, Palo Alto, CA, United States of America
| | - Sasha Gala
- National Center for PTSD, Dissemination and Training Division, VA Palo Alto Health Care System, Palo Alto, CA, United States of America
| | - Tyson H. Holmes
- Human Immune Monitoring Center (HIMC), Institute for Immunity, Transplantation and Infection, Stanford University School of Medicine, Stanford, CA, United States of America
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93
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Abstract
PURPOSE OF REVIEW This review aims to evaluate the most recent literature examining the oxytocin (OXT) system's role in human anxiety by surveying various fields of preclinical and clinical research supporting this role, and queries whether the OXT system might be a target for novel anxiolytics. RECENT FINDINGS Evidence from the diverse body of literature presented here, from translational research, genetic and neuroimaging studies, to clinical trials of intranasal (IN) OXT reveals a positive association. In addition, some moderators (e.g., sex, specificities to cues) of OXT's anxiolytic effects can have an important influence on its outcomes, awaiting further research. Evidence for the role of OXT in regulating anxiety is undeniable. We expect that the diverse particularities of the OXT system will help broaden our understanding of anxiety and stress-related disorders. We conclude that OXT promises an enticing treatment option for human anxiety disorders especially those associated with socio-emotional dysfunctions.
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Affiliation(s)
- Wadih Jean Naja
- Department of Psychiatry, Lebanese University, Beirut, Lebanon. .,Gharios Medical Center, Mount Lebanon Hospital, Hazmieh, Beirut, Lebanon.
| | - Michaelangelo Pietro Aoun
- Department of Psychiatry, Lebanese University, Beirut, Lebanon.,Gharios Medical Center, Mount Lebanon Hospital, Hazmieh, Beirut, Lebanon
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94
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Moaddab M, Dabrowska J. Oxytocin receptor neurotransmission in the dorsolateral bed nucleus of the stria terminalis facilitates the acquisition of cued fear in the fear-potentiated startle paradigm in rats. Neuropharmacology 2017; 121:130-139. [PMID: 28456687 PMCID: PMC5553312 DOI: 10.1016/j.neuropharm.2017.04.039] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2017] [Revised: 04/04/2017] [Accepted: 04/25/2017] [Indexed: 01/25/2023]
Abstract
Oxytocin (OT) is a hypothalamic neuropeptide that modulates fear and anxiety-like behaviors. Dorsolateral bed nucleus of the stria terminalis (BNSTdl) plays a critical role in the regulation of fear and anxiety, and expresses high levels of OT receptor (OTR). However, the role of OTR neurotransmission within the BNSTdl in mediating these behaviors is unknown. Here, we used adult male Sprague-Dawley rats to investigate the role of OTR neurotransmission in the BNSTdl in the modulation of the acoustic startle response, as well as in the acquisition and consolidation of conditioned fear using fear potentiated startle (FPS) paradigm. Bilateral intra-BNSTdl administration of OT (100 ng) did not affect the acquisition of conditioned fear response. However, intra-BNSTdl administration of specific OTR antagonist (OTA), (d(CH2)51, Tyr(Me)2, Thr4, Orn8, des-Gly-NH29)-vasotocin, (200 ng), prior to the fear conditioning session, impaired the acquisition of cued fear, without affecting a non-cued fear component of FPS. Neither OTA, nor OT affected baseline startle or shock reactivity during fear conditioning. Therefore, the observed impairment of cued fear after OTA infusion resulted from the specific effect on the formation of cued fear. In contrast to the acquisition, neither OTA nor OT affected the consolidation of FPS, when administered after the completion of fear conditioning session. Taken together, these results reveal the important role of OTR neurotransmission in the BNSTdl in the formation of conditioned fear to a discrete cue. This study also highlights the role of the BNSTdl in learning to discriminate between threatening and safe stimuli.
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Affiliation(s)
- Mahsa Moaddab
- Department of Cellular and Molecular Pharmacology, Chicago Medical School, Rosalind Franklin University of Medicine and Science, North Chicago, IL 60064, USA
| | - Joanna Dabrowska
- Department of Cellular and Molecular Pharmacology, Chicago Medical School, Rosalind Franklin University of Medicine and Science, North Chicago, IL 60064, USA; Department of Neuroscience, Chicago Medical School, Rosalind Franklin University of Medicine and Science, North Chicago, IL 60064, USA.
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95
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Intranasal Oxytocin to Prevent Posttraumatic Stress Disorder Symptoms: A Randomized Controlled Trial in Emergency Department Patients. Biol Psychiatry 2017; 81:1030-1040. [PMID: 28087128 DOI: 10.1016/j.biopsych.2016.11.012] [Citation(s) in RCA: 96] [Impact Index Per Article: 13.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/03/2016] [Revised: 11/23/2016] [Accepted: 11/23/2016] [Indexed: 12/25/2022]
Abstract
BACKGROUND There are currently few preventive interventions available for posttraumatic stress disorder (PTSD). Intranasal oxytocin administration early after trauma may prevent PTSD, because oxytocin administration was previously found to beneficially impact PTSD vulnerability factors, including neural fear responsiveness, peripheral stress reactivity, and socioemotional functioning. Therefore, we investigated the effects of intranasal oxytocin administration early after trauma on subsequent clinician-rated PTSD symptoms. We then assessed whether baseline characteristics moderated the intervention's effects. METHODS We performed a multicenter, randomized, double-blind, placebo-controlled clinical trial. Adult emergency department patients with moderate to severe acute distress (n = 120; 85% accident victims) were randomized to intranasal oxytocin (8 days/40 IU twice daily) or placebo (8 days/10 puffs twice daily), initiated within 12 days posttrauma. The Clinician-Administered PTSD Scale (CAPS) was administered at baseline (within 10 days posttrauma) and at 1.5, 3, and 6 months posttrauma. The intention-to-treat sample included 107 participants (oxytocin: n = 53; placebo: n = 54). RESULTS We did not observe a significant group difference in CAPS total score at 1.5 months posttrauma (primary outcome) or across follow-up (secondary outcome). Secondary analyses showed that participants with high baseline CAPS scores receiving oxytocin had significantly lower CAPS scores across follow-up than participants with high baseline CAPS scores receiving placebo. CONCLUSIONS Oxytocin administration early after trauma did not attenuate clinician-rated PTSD symptoms in all trauma-exposed participants with acute distress. However, participants with high acute clinician-rated PTSD symptom severity did show beneficial effects of oxytocin. Although replication is warranted, these findings suggest that oxytocin administration is a promising preventive intervention for PTSD for individuals with high acute PTSD symptoms.
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96
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Intranasal oxytocin enhances intrinsic corticostriatal functional connectivity in women. Transl Psychiatry 2017; 7:e1099. [PMID: 28418398 PMCID: PMC5416709 DOI: 10.1038/tp.2017.72] [Citation(s) in RCA: 58] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/12/2016] [Revised: 02/02/2017] [Accepted: 02/14/2017] [Indexed: 12/18/2022] Open
Abstract
Oxytocin may influence various human behaviors and the connectivity across subcortical and cortical networks. Previous oxytocin studies are male biased and often constrained by task-based inferences. Here, we investigate the impact of oxytocin on resting-state connectivity between subcortical and cortical networks in women. We collected resting-state functional magnetic resonance imaging (fMRI) data on 26 typically developing women 40 min following intranasal oxytocin administration using a double-blind placebo-controlled crossover design. Independent components analysis (ICA) was applied to examine connectivity between networks. An independent analysis of oxytocin receptor (OXTR) gene expression in human subcortical and cortical areas was carried out to determine plausibility of direct oxytocin effects on OXTR. In women, OXTR was highly expressed in striatal and other subcortical regions, but showed modest expression in cortical areas. Oxytocin increased connectivity between corticostriatal circuitry typically involved in reward, emotion, social communication, language and pain processing. This effect was 1.39 standard deviations above the null effect of no difference between oxytocin and placebo. This oxytocin-related effect on corticostriatal connectivity covaried with autistic traits, such that oxytocin-related increase in connectivity was stronger in individuals with higher autistic traits. In sum, oxytocin strengthened corticostriatal connectivity in women, particularly with cortical networks that are involved in social-communicative, motivational and affective processes. This effect may be important for future work on neurological and psychiatric conditions (for example, autism), particularly through highlighting how oxytocin may operate differently for subsets of individuals.
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97
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Eckstein M, Markett S, Kendrick KM, Ditzen B, Liu F, Hurlemann R, Becker B. Oxytocin differentially alters resting state functional connectivity between amygdala subregions and emotional control networks: Inverse correlation with depressive traits. Neuroimage 2017; 149:458-467. [PMID: 28161309 DOI: 10.1016/j.neuroimage.2017.01.078] [Citation(s) in RCA: 50] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2016] [Revised: 01/03/2017] [Accepted: 01/31/2017] [Indexed: 02/01/2023] Open
Abstract
The hypothalamic neuropeptide oxytocin (OT) has received increasing attention for its role in modulating social-emotional processes across species. Previous studies on using intranasal-OT in humans point to a crucial engagement of the amygdala in the observed neuromodulatory effects of OT under task and rest conditions. However, the amygdala is not a single homogenous structure, but rather a set of structurally and functionally heterogeneous nuclei that show distinct patterns of connectivity with limbic and frontal emotion-processing regions. To determine potential differential effects of OT on functional connectivity of the amygdala subregions, 79 male participants underwent resting-state fMRI following randomized intranasal-OT or placebo administration. In line with previous studies OT increased the connectivity of the total amygdala with dorso-medial prefrontal regions engaged in emotion regulation. In addition, OT enhanced coupling of the total amygdala with cerebellar regions. Importantly, OT differentially altered the connectivity of amygdala subregions with distinct up-stream cortical nodes, particularly prefrontal/parietal, and cerebellar down-stream regions. OT-induced increased connectivity with cerebellar regions were largely driven by effects on the centromedial and basolateral subregions, whereas increased connectivity with prefrontal regions were largely mediated by right superficial and basolateral subregions. OT decreased connectivity of the centromedial subregions with core hubs of the emotional face processing network in temporal, occipital and parietal regions. Preliminary findings suggest that effects on the superficial amygdala-prefrontal pathway were inversely associated with levels of subclinical depression, possibly indicating that OT modulation may be blunted in the context of increased pathological load. Together, the present findings suggest a subregional-specific modulatory role of OT on amygdala-centered emotion processing networks in humans.
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Affiliation(s)
- Monika Eckstein
- Institute of Medical Psychology, Center for Psychosocial Medicine, University Hospital Heidelberg, D-69115 Heidelberg, Germany
| | - Sebastian Markett
- Department of Psychology, University of Bonn, D-53127 Bonn, Germany; Center for Economics and Neuroscience, University of Bonn, D-53127 Bonn, Germany
| | - Keith M Kendrick
- Key Laboratory for NeuroInformation of Ministry of Education, Center for Information in Medicine, University of Electronic Science and Technology of China, Chengdu, Sichuan 611731, China
| | - Beate Ditzen
- Institute of Medical Psychology, Center for Psychosocial Medicine, University Hospital Heidelberg, D-69115 Heidelberg, Germany
| | - Fang Liu
- Department of Radiology, University of Wisconsin-Madison, Madison, WI 53705-2275, USA
| | - Rene Hurlemann
- Department of Psychiatry and Division of Medical Psychology, University of Bonn, D-53127 Bonn, Germany
| | - Benjamin Becker
- Key Laboratory for NeuroInformation of Ministry of Education, Center for Information in Medicine, University of Electronic Science and Technology of China, Chengdu, Sichuan 611731, China.
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98
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Sippel LM, Allington CE, Pietrzak RH, Harpaz-Rotem I, Mayes LC, Olff M. Oxytocin and Stress-related Disorders: Neurobiological Mechanisms and Treatment Opportunities. CHRONIC STRESS (THOUSAND OAKS, CALIF.) 2017; 1:2470547016687996. [PMID: 28649672 PMCID: PMC5482285 DOI: 10.1177/2470547016687996] [Citation(s) in RCA: 31] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/15/2016] [Revised: 12/14/2016] [Accepted: 12/15/2016] [Indexed: 11/16/2022]
Abstract
Novel pharmacotherapies that improve outcomes for individuals with stress-related psychiatric disorders are needed. The neurohormone oxytocin (OT) is a promising candidate given its influence on the social-emotional brain. In this review, we present an overview of evidence supporting OT's utility for treating major depressive disorder and posttraumatic stress disorder. We first discuss endogenous OT, which research suggests is not yet a reliable biomarker of stress-related disorders. Second, we review effects of intranasal (IN) OT on processes relevant to stress-related disorders in healthy populations (anhedonia, reward processing, psychosocial stress reactivity, fear/anxiety, and social behavior) and their neurobiological mechanisms (e.g., the salience network and hypothalamic-pituitary-adrenal axis). Third, we present the sparse but promising findings from clinical populations, followed by discussion of critical moderating variables to consider in the service of maximizing the therapeutic potential of OT (e.g., patient sex and child maltreatment). We also identify heterogeneous findings and limitations of existing research, including reliance on single-dose studies in psychiatrically healthy samples and unanswered questions regarding the effectiveness of IN drug delivery and dosing schedules. Well-controlled multidose studies including women and measures of potentially moderating variables are sorely needed and would inform our understanding of the utility of OT for preventing and treating stress-related psychiatric disorders.
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Affiliation(s)
- Lauren M. Sippel
- U.S. Department of Veterans Affairs
National Center for Posttraumatic Stress Disorder, Clinical Neurosciences Division,
VA Connecticut Healthcare System, West Haven, CT, USA
- Department of Psychiatry, Yale
University School of Medicine, New Haven, CT, USA
| | | | - Robert H. Pietrzak
- U.S. Department of Veterans Affairs
National Center for Posttraumatic Stress Disorder, Clinical Neurosciences Division,
VA Connecticut Healthcare System, West Haven, CT, USA
- Department of Psychiatry, Yale
University School of Medicine, New Haven, CT, USA
| | - Ilan Harpaz-Rotem
- U.S. Department of Veterans Affairs
National Center for Posttraumatic Stress Disorder, Clinical Neurosciences Division,
VA Connecticut Healthcare System, West Haven, CT, USA
- Department of Psychiatry, Yale
University School of Medicine, New Haven, CT, USA
| | | | - Miranda Olff
- Department of Psychiatry, Academic
Medical Center, University of Amsterdam, The Netherlands
- Arq Psychotrauma Expert Group, Diemen,
The Netherlands
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99
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Olff M, van Zuiden M. Neuroendocrine and neuroimmune markers in PTSD: pre-, peri- and post-trauma glucocorticoid and inflammatory dysregulation. Curr Opin Psychol 2017; 14:132-137. [PMID: 28813312 DOI: 10.1016/j.copsyc.2017.01.001] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2016] [Revised: 01/03/2017] [Accepted: 01/03/2017] [Indexed: 01/04/2023]
Abstract
We review current knowledge on how posttraumatic stress disorder (PTSD) is associated with dysregulation of the most commonly studied markers of the endocrine and immune systems pre-, peri- and post-trauma. Lower basal cortisol output, enhanced glucocorticoid receptor function, and a proinflammatory state have been most consistently found in PTSD, with considerable variability among studies and participants. Longitudinal research is scarce, but there is converging evidence that biological dysregulation is present before PTSD onset. Biological dysregulation may become more apparent with increasing time since trauma, and may be reversible with and predict effective treatment. However, considering the variability of findings and the complex interplay of these systems with other factors, the current clinical application of these findings remains limited.
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Affiliation(s)
- Miranda Olff
- Department of Psychiatry, Academic Medical Center at the University of Amsterdam, The Netherlands; Arq Psychotrauma Expert Group, Diemen, The Netherlands.
| | - Mirjam van Zuiden
- Department of Psychiatry, Academic Medical Center at the University of Amsterdam, The Netherlands
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100
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Fear extinction and memory reconsolidation as critical components in behavioral treatment for posttraumatic stress disorder and potential augmentation of these processes. Neurosci Lett 2017; 649:170-175. [PMID: 28065842 DOI: 10.1016/j.neulet.2017.01.006] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2016] [Revised: 01/03/2017] [Accepted: 01/04/2017] [Indexed: 12/20/2022]
Abstract
Posttraumatic stress disorder (PTSD) is associated with alterations in critical brain regions such as the amygdala, hippocampus, and prefrontal cortex. This brief review has two objectives: (1) to discuss research examining extinction and reconsolidation processes as mechanisms in PTSD psychotherapy, and (2) present possibilities for augmenting extinction and reconsolidation within treatment through alterations to therapeutic interventions and novel approaches. A key component of many effective PTSD therapies is exposure, which involves intentional confrontation and processing of the traumatic memory. Our review suggests that extinction and reconsolidation processes underlie effective exposure-based treatment, but the neurobiological mechanisms of these processes in behavioral treatments for PTSD remains unclear. We argue that enhancing extinction and/or disrupting reconsolidation of a feared memory may improve the efficacy of existing treatments (e.g., increased change for limited/non-responders, faster/greater changes for responders), which can be done through multiple channels. Potential avenues for augmentation of the processes of extinction and reconsolidation in PTSD psychotherapies are reviewed, including behavioral modifications, pharmacotherapy agents, and the use of devices during therapy. We further suggest that investigations towards understanding the extent to which extinction and reconsolidation processes are necessary in effective PTSD psychotherapy is an important future direction for enhancing clinical care among PTSD populations.
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