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Tomescu MI, Van der Donck S, Perisanu EM, Berceanu AI, Alaerts K, Boets B, Carcea I. Social functioning predicts individual changes in EEG microstates following intranasal oxytocin administration: A double-blind, cross-over randomized clinical trial. Psychophysiology 2024; 61:e14581. [PMID: 38594888 DOI: 10.1111/psyp.14581] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2023] [Revised: 03/20/2024] [Accepted: 03/21/2024] [Indexed: 04/11/2024]
Abstract
Oxytocin (OXT) modulates social behaviors. However, the administration of exogenous OXT in humans produces inconsistent behavioral changes, affecting future consideration of OXT as a treatment for autism and other disorders with social symptoms. Inter-individual variability in social functioning traits might play a key role in how OXT changes brain activity and, therefore, behavior. Here, we investigated if inter-individual variability might dictate how single-dose intranasal OXT administration (IN-OXT) changes spontaneous neural activity during the eyes-open resting state. We used a double-blinded, randomized, placebo-controlled, cross-over design on 30 typically developing young adult men to investigate the dynamics of EEG microstates corresponding to activity in defined neural networks. We confirmed previous reports that, at the group level, IN-OXT increases the representation of the attention and salience microstates. Furthermore, we identified a decreased representation of microstates associated with the default mode network. Using multivariate partial least square statistical analysis, we found that social functioning traits associated with IN-OXT-induced changes in microstate dynamics in specific spectral bands. Correlation analysis further revealed that the higher the social functioning, the more IN-OXT increased the appearance of the visual network-associated microstate, and suppressed the appearance of a default mode network-related microstate. The lower the social functioning, the more IN-OXT increases the appearance of the salience microstate. The effects we report on the salience microstate support the hypothesis that OXT regulates behavior by enhancing social salience. Moreover, our findings indicate that social functioning traits modulate responses to IN-OXT and could partially explain the inconsistent reports on IN-OXT effects.
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Affiliation(s)
- Miralena I Tomescu
- Faculty of Educational Sciences, Department of Psychology, University "Stefan cel Mare" of Suceava, Bucharest, Romania
- CINETic Center, National University of Theatre and Film "I.L. Caragiale" Bucharest, Bucharest, Romania
- Faculty of Psychology and Educational Sciences, Department of Psychology, University of Bucharest, Bucharest, Romania
| | - Stephanie Van der Donck
- Center for Developmental Psychiatry, Department of Neurosciences, KU Leuven, Leuven, Belgium
- Leuven Autism Research (LAuRes), KU Leuven, Leuven, Belgium
| | - Emanuela M Perisanu
- Institute of Cardiovascular Diseases, Timisoara, Romania
- Faculty of Medicine, University of Sibiu, Sibiu, Romania
| | - Alexandru I Berceanu
- CINETic Center, National University of Theatre and Film "I.L. Caragiale" Bucharest, Bucharest, Romania
| | - Kaat Alaerts
- Neuromodulation Laboratory, Research Group for Neurorehabilitation, KU Leuven, Leuven, Belgium
| | - Bart Boets
- Center for Developmental Psychiatry, Department of Neurosciences, KU Leuven, Leuven, Belgium
- Leuven Autism Research (LAuRes), KU Leuven, Leuven, Belgium
| | - Ioana Carcea
- CINETic Center, National University of Theatre and Film "I.L. Caragiale" Bucharest, Bucharest, Romania
- Department of Pharmacology, Physiology, and Neuroscience, Rutgers Brain Health Institute, Rutgers, The State University of New Jersey, Newark, New Jersey, USA
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Dam VH, Andersen SH, Pedersen ST, Stenbæk DS, Frokjaer VG. Serotonin 4 receptor brain binding and oxytocin-promoted affective and social cognition in healthy women - A randomized controlled trial. COMPREHENSIVE PSYCHONEUROENDOCRINOLOGY 2024; 17:100224. [PMID: 38288372 PMCID: PMC10823092 DOI: 10.1016/j.cpnec.2023.100224] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2023] [Accepted: 12/29/2023] [Indexed: 01/31/2024] Open
Abstract
Background Oxytocin is a neuropeptide known for its prosocial properties and role in social bonding, and intervention with intranasal oxytocin is posited to modulate affective and social cognition (i.e., hot cognition). Serotonin (5-HT) neurotransmission is also involved in emotional and social behaviors and appear to work in concert with oxytocin. However, this interaction so far remains elusive in humans. Therefore, we here investigate the relation between brain 5-HT 4 receptor (5-HT4R) levels and oxytocin-modulated hot cognition. Methods Using a double blind, placebo-controlled, randomized crossover design, 35 healthy women received a dose of 24 IU intranasal oxytocin or placebo one month apart. The women were naturally cycling and to control for hormonal fluctuations across the menstrual cycle, intervention days were placed during the early follicular phase. Following intervention cognitive domains including affective memory, affective bias in emotion processing, moral emotions and social information preference were assessed. In a subgroup (n = 25), Positron Emission Tomography (PET) was used to image 5-HT4R brain binding at baseline with the [11C]SB207145 radiotracer. Results No effect of oxytocin intervention relative to placebo was observed for any of the cognitive outcomes. Likewise, regional brain 5-HT4R binding at baseline was not associated with cognitive responses to oxytocin intervention. Conclusion Our data suggest that intervention with intranasal oxytocin does not have an overall effect on hot cognition in healthy women and further that 5-HT4R brain architecture does not mediate cognitive effects of oxytocin in the healthy state.
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Affiliation(s)
- Vibeke Høyrup Dam
- Neurobiology Research Unit, The Neuroscience Centre, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark
| | - Sidsel Høgsgaard Andersen
- Neurobiology Research Unit, The Neuroscience Centre, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark
- Department of Psychology, University of Copenhagen, Copenhagen, Denmark
| | - Sofie Trolle Pedersen
- Neurobiology Research Unit, The Neuroscience Centre, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark
| | - Dea Siggaard Stenbæk
- Neurobiology Research Unit, The Neuroscience Centre, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
- Department of Psychology, University of Copenhagen, Copenhagen, Denmark
| | - Vibe Gedsoe Frokjaer
- Neurobiology Research Unit, The Neuroscience Centre, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
- Mental Health Services in the Capital Region of Copenhagen, Denmark
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Grossman-Giron A, Fisher H, Atzil-Slonim D, Maoz H, Nitzan U, Tzur Bitan D. The effect of Oxytocin administration on patient-therapist alliance congruence: Results from a randomized controlled trial. Psychother Res 2023:1-11. [PMID: 37856680 DOI: 10.1080/10503307.2023.2269300] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/11/2023] [Accepted: 10/05/2023] [Indexed: 10/21/2023] Open
Abstract
OBJECTIVES The effects of oxytocin (OT) administration on psychotherapeutic processes have thus far been elusive. This study explored the effect of OT administration on patient-therapist congruence of the working alliance. METHOD Inpatients with mental disorders (N = 87) participating in a randomized controlled trial received OT (n = 44) or placebo (n = 43) intranasally twice a day, for four weeks. Patients and therapists rated the alliance after each session. RESULTS Oxytocin significantly moderated the level of agreement (b = -0.56, SE = 0.25, t = -2.30, p = 0.02), such that patients receiving OT demonstrated lower discrepancy (b = -0.73, p < 0.001) than did those receiving placebo (b = -1.30, p < 0.001). On the other hand, the mutual covariance of patient-therapist ratings across sessions was positive and significant for patients receiving placebo (b = 0.26, p = 0.01) but not for patients in the OT group (b = -0.06, p = .56). CONCLUSION Oxytocin can reduce discrepancies of patient-therapist perceptions of the alliance, although additional studies are needed to explore OT's effect on alliance development over time. As alliance congruence is associated with therapy outcomes, such intervention may lead to enhancement of therapeutic gains.
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Affiliation(s)
- Ariella Grossman-Giron
- Department of Behavioral Sciences, Ariel University, Ariel, Israel
- Shalvata Mental Health Center, Affiliated with the Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Hadar Fisher
- Department of Psychology, Haifa University, Haifa, Israel
| | | | - Hagai Maoz
- Shalvata Mental Health Center, Affiliated with the Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Uri Nitzan
- Shalvata Mental Health Center, Affiliated with the Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Dana Tzur Bitan
- Shalvata Mental Health Center, Affiliated with the Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
- Department of Community Mental Health, University of Haifa, Haifa, Israel
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Berendzen KM. Understanding social attachment as a window into the neural basis of prosocial behavior. Front Neurol 2023; 14:1247480. [PMID: 37869145 PMCID: PMC10585278 DOI: 10.3389/fneur.2023.1247480] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2023] [Accepted: 09/12/2023] [Indexed: 10/24/2023] Open
Abstract
The representation and demonstration of human values are intimately tied to our status as a social species. Humans are relatively unique in our ability to form enduring social attachments, characterized by the development of a selective bond that persists over time. Such relationships include the bonds between parents and offspring, pair bonds between partners and other affiliative contacts, in addition to group relationships to which we may form direct and symbolic affiliations. Many of the cognitive and behavioral processes thought to be linked to our capacity for social attachment-including consolation, empathy, and social motivation, and the implicated neural circuits mediating these constructs, are shared with those thought to be important for the representation of prosocial values. This perspective piece will examine the hypothesis that our ability to form such long-term bonds may play an essential role in the construction of human values and ethical systems, and that components of prosocial behaviors are shared across species. Humans are one of a few species that form such long-term and exclusive attachments and our understanding of the neurobiology underlying attachment behavior has been advanced by studying behavior in non-human animals. The overlap in behavioral and affective constructs underlying attachment behavior and value representation is discussed, followed by evidence from other species that demonstrate attachment behavior that supports the overlapping neurobiological basis for social bonds and prosocial behavior. The understanding of attachment biology has broad implications for human health as well as for understanding the basis for and variations in prosocial behavior.
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Affiliation(s)
- Kristen M. Berendzen
- Department of Psychiatry and Biological Sciences, University of California, San Francisco, San Francisco, CA, United States
- Weill Institute for Neurosciences, University of California, San Francisco, San Francisco, CA, United States
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Wei J, Zheng H, Li G, Chen Z, Fang G, Yan J. Involvement of oxytocin receptor deficiency in psychiatric disorders and behavioral abnormalities. Front Cell Neurosci 2023; 17:1164796. [PMID: 37153633 PMCID: PMC10159063 DOI: 10.3389/fncel.2023.1164796] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2023] [Accepted: 03/24/2023] [Indexed: 05/10/2023] Open
Abstract
Oxytocin and its target receptor (oxytocin receptor, OXTR) exert important roles in the regulation of complex social behaviors and cognition. The oxytocin/OXTR system in the brain could activate and transduce several intracellular signaling pathways to affect neuronal functions or responses and then mediate physiological activities. The persistence and outcome of the oxytocin activity in the brain are closely linked to the regulation, state, and expression of OXTR. Increasing evidence has shown that genetic variations, epigenetic modification states, and the expression of OXTR have been implicated in psychiatric disorders characterized by social deficits, especially in autism. Among these variations and modifications, OXTR gene methylation and polymorphism have been found in many patients with psychiatric disorders and have been considered to be associated with those psychiatric disorders, behavioral abnormalities, and individual differences in response to social stimuli or others. Given the significance of these new findings, in this review, we focus on the progress of OXTR's functions, intrinsic mechanisms, and its correlations with psychiatric disorders or deficits in behaviors. We hope that this review can provide a deep insight into the study of OXTR-involved psychiatric disorders.
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Affiliation(s)
- Jinbao Wei
- Department of Pharmacy, Fujian Maternity and Child Health Hospital, College of Clinical Medicine for Obstetrics and Gynecology and Pediatrics, Fujian Medical University, Fuzhou, Fujian, China
- Department of Pharmacy, Ningde Municipal Hospital Affiliated to Ningde Normal University, Ningde, Fujian, China
| | - Huanrui Zheng
- Department of Pharmacy, Fujian Maternity and Child Health Hospital, College of Clinical Medicine for Obstetrics and Gynecology and Pediatrics, Fujian Medical University, Fuzhou, Fujian, China
- Fujian Key Laboratory of Women and Children's Critical Diseases Research, Fujian Maternity and Child Health Hospital, Fuzhou, Fujian, China
| | - Guokai Li
- Fujian Key Laboratory of Women and Children's Critical Diseases Research, Fujian Maternity and Child Health Hospital, Fuzhou, Fujian, China
| | - Zichun Chen
- Department of Pharmacy, Ningde Municipal Hospital Affiliated to Ningde Normal University, Ningde, Fujian, China
| | - Gengjing Fang
- Fujian Key Laboratory of Women and Children's Critical Diseases Research, Fujian Maternity and Child Health Hospital, Fuzhou, Fujian, China
- NHC Key Laboratory of Technical Evaluation of Fertility Regulation for Non-human Primate (Fujian Maternity and Child Health Hospital), Fuzhou, Fujia, China
- Gengjing Fang
| | - Jianying Yan
- Fujian Key Laboratory of Women and Children's Critical Diseases Research, Fujian Maternity and Child Health Hospital, Fuzhou, Fujian, China
- Department of Obstetrics, Fujian Maternity and Child Health Hospital, College of Clinical Medicine for Obstetrics and Gynecology and Pediatrics, Fujian Medical University, Fuzhou, Fujian, China
- *Correspondence: Jianying Yan
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Morita A, Shikano A, Nakamura K, Noi S, Fujiwara T. Oxytocin Reactivity during a Wilderness Program without Parents in Adolescents. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:15437. [PMID: 36497512 PMCID: PMC9737778 DOI: 10.3390/ijerph192315437] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/22/2022] [Revised: 11/05/2022] [Accepted: 11/15/2022] [Indexed: 06/17/2023]
Abstract
While wilderness programs are recognized as a feasible intervention to promote psychological independence in adolescence, little is known about physiological changes. The present study focused on oxytocin, a key hormone for social cognition and behavior, and investigated changes in OT concentrations during a wilderness program among adolescents. Twenty-one 4th-7th graders were separated from parents and immersed with adventures and challenges in the woodlands of Motegi, Tochigi Prefecture, Japan for 31 days, and dataset of 20 boys aged 9-13 years-old were used for analysis. OT concentrations in early morning saliva samples on days 2, 5, 8, 13, 18, 20, 21, 22 and 30 were determined using ELIZA. We performed multi-level regression analyses to compare the OT concentrations before and after solo and team-based survival challenges, and across the nine observational points, adjusting for potential covariates. We found that adolescents increased OT level in a situation where they needed others' cooperation and support for survival (coefficient: 2.86, SE: 1.34, p = 0.033). Further, we found that adolescents gradually decreased their basal OT level during a long separation from parents (coefficient: -0.083, SE: 0.034, p = 0.016). A combination of these findings suggest the OT level may be a marker for psychological independence.
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Affiliation(s)
- Ayako Morita
- Department of Global Health Promotion, Tokyo Medical and Dental University, Tokyo 113-8510, Japan
| | - Akiko Shikano
- Research Institute for Health and Sport Science, Nippon Sport Science University, Tokyo 158-8508, Japan
| | - Kazuaki Nakamura
- Department of Pharmacology, National Research Institute for Child Health and Development, Tokyo 157-0074, Japan
| | - Shingo Noi
- Research Institute for Health and Sport Science, Nippon Sport Science University, Tokyo 158-8508, Japan
| | - Takeo Fujiwara
- Department of Global Health Promotion, Tokyo Medical and Dental University, Tokyo 113-8510, Japan
- Department of Social Medicine, National Research Institute for Child Health and Development, Tokyo 157-0074, Japan
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Nitschke JP, Pruessner JC, Bartz JA. Stress and Stress-Induced Glucocorticoids Facilitate Empathic Accuracy in Men but Have No Effects for Women. Psychol Sci 2022; 33:1783-1794. [DOI: 10.1177/09567976221101315] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Empathy, the ability to understand the feelings of other people, is critical for navigating our social world and maintaining social connections. Given that acute stress, and resulting increased glucocorticoids, triggers a shift in two large-scale brain networks, prioritizing salience over executive control, we predicted that acute psychosocial stress would facilitate empathic accuracy. We also investigated the moderating role of gender, given that men typically show a more robust glucocorticoid response to acute stress than women. As predicted, results from two independent experiments ( N = 267 college-age participants; 2,256 observations) showed that acute psychosocial stress facilitated empathic accuracy for men, an effect related to their glucocorticoid response in the stress condition. Conversely, psychosocial stress had no effect on empathic accuracy for women, who also showed a smaller cortisol response to stress than men. Exploratory analyses further revealed that women taking oral contraceptives performed worse on the empathic-accuracy task than regularly cycling women. This research highlights the important, but complex, role of stress in cognitive empathy.
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Affiliation(s)
- Jonas P. Nitschke
- Department of Psychology, McGill University
- Department of Cognition, Emotion, and Methods in Psychology, University of Vienna
| | - Jens C. Pruessner
- Douglas Hospital Research Centre, Department of Psychiatry, McGill University
- Department of Psychology, University of Konstanz
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Wong SF, Cardoso C, Orlando MA, Brown CA, Ellenbogen MA. Depressive symptoms and social context modulate oxytocin's effect on negative memory recall. Soc Cogn Affect Neurosci 2021; 16:1234-1243. [PMID: 34100542 PMCID: PMC8717011 DOI: 10.1093/scan/nsab072] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2020] [Revised: 05/11/2021] [Accepted: 06/07/2021] [Indexed: 11/14/2022] Open
Abstract
Oxytocin promotes social affiliation across various species, in part by altering social cognition to facilitate approach behaviour. However, the effects of intranasal oxytocin on human social cognition are mixed, perhaps because its effects are context dependent and subject to inter-individual differences. Few studies have included explicit manipulations of social context to test this supposition. We examined oxytocin's effects on autobiographical memory recall in two contexts, with and without social contact, and evaluated whether these effects were moderated by depressive symptoms. Two non-clinical samples (Study 1, n = 48; Study 2, n = 63) completed randomised, placebo-controlled, within-subject experiments. We assessed autobiographical memory recall across two sessions (intranasal oxytocin or placebo) and two contexts (memories elicited by an experimenter or by computer). Overall, intranasal oxytocin increased ratings of the vividness of recalled memories during the social context only. Individuals with elevated depressive symptoms also recalled memories that were more negative following oxytocin relative to placebo only in the non-social context across the two studies. Findings highlight the negative consequences of increasing oxytocin bioavailability in vulnerable persons in the absence of social contact. Contextual factors such as social isolation among depressed populations may complicate the clinical use of oxytocin.
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Affiliation(s)
- Shiu F Wong
- Department of Psychology, Concordia University, Montreal, QC H4B 1R6, Canada
| | - Christopher Cardoso
- Department of Psychology, Concordia University, Montreal, QC H4B 1R6, Canada
| | - Mark A Orlando
- Department of Psychology, Concordia University, Montreal, QC H4B 1R6, Canada
| | | | - Mark A Ellenbogen
- Department of Psychology, Concordia University, Montreal, QC H4B 1R6, Canada
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9
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Trofimova IN, Gaykalova AA. Emotionality vs. Other Biobehavioural Traits: A Look at Neurochemical Biomarkers for Their Differentiation. Front Psychol 2021; 12:781631. [PMID: 34987450 PMCID: PMC8720768 DOI: 10.3389/fpsyg.2021.781631] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2021] [Accepted: 12/01/2021] [Indexed: 12/15/2022] Open
Abstract
This review highlights the differential contributions of multiple neurochemical systems to temperament traits related and those that are unrelated to emotionality, even though these systems have a significant overlap. The difference in neurochemical biomarkers of these traits is analysed from the perspective of the neurochemical model, Functional Ensemble of Temperament (FET) that uses multi-marker and constructivism principles. Special attention is given to a differential contribution of hypothalamic-pituitary hormones and opioid neuropeptides implicated in both emotional and non-emotional regulation. The review highlights the role of the mu-opioid receptor system in dispositional emotional valence and the role of the kappa-opioid system in dispositional perceptual and behavioural alertness. These opioid receptor (OR) systems, microbiota and cytokines are produced in three neuroanatomically distinct complexes in the brain and the body, which all together integrate dispositional emotionality. In contrast, hormones could be seen as neurochemical biomarkers of non-emotional aspects of behavioural regulation related to the construction of behaviour in fast-changing and current situations. As examples of the role of hormones, the review summarised their contribution to temperament traits of Sensation Seeking (SS) and Empathy (EMP), which FET considers as non-emotionality traits related to behavioural orientation. SS is presented here as based on (higher) testosterone (fluctuating), adrenaline and (low) cortisol systems, and EMP, as based on (higher) oxytocin, reciprocally coupled with vasopressin and (lower) testosterone. Due to the involvement of gonadal hormones, there are sex and age differences in these traits that could be explained by evolutionary theory. There are, therefore, specific neurochemical biomarkers differentiating (OR-based) dispositional emotionality and (hormones-based) body's regulation in fast-changing events. Here we propose to consider dispositional emotionality associated with OR systems as emotionality in a true sense, whereas to consider hormonal ensembles regulating SS and EMP as systems of behavioural orientation and not emotionality.
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Affiliation(s)
- Irina N. Trofimova
- Laboratory of Collective Intelligence, Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON, Canada
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10
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Fastman J, Foss-Feig J, Frank Y, Halpern D, Harony-Nicolas H, Layton C, Sandin S, Siper P, Tang L, Trelles P, Zweifach J, Buxbaum JD, Kolevzon A. A randomized controlled trial of intranasal oxytocin in Phelan-McDermid syndrome. Mol Autism 2021; 12:62. [PMID: 34593045 PMCID: PMC8482590 DOI: 10.1186/s13229-021-00459-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2021] [Accepted: 07/19/2021] [Indexed: 12/20/2022] Open
Abstract
Background Phelan-McDermid syndrome (PMS) is a rare neurodevelopmental disorder caused by haploinsufficiency of the SHANK3 gene and characterized by global developmental delays, deficits in speech and motor function, and autism spectrum disorder (ASD). Monogenic causes of ASD such as PMS are well suited to investigations with novel therapeutics, as interventions can be targeted based on established genetic etiology. While preclinical studies have demonstrated that the neuropeptide oxytocin can reverse electrophysiological, attentional, and social recognition memory deficits in Shank3-deficient rats, there have been no trials in individuals with PMS. The purpose of this study is to assess the efficacy and safety of intranasal oxytocin as a treatment for the core symptoms of ASD in a cohort of children with PMS. Methods Eighteen children aged 5–17 with PMS were enrolled. Participants were randomized to receive intranasal oxytocin or placebo (intranasal saline) and underwent treatment during a 12-week double-blind, parallel group phase, followed by a 12-week open-label extension phase during which all participants received oxytocin. Efficacy was assessed using the primary outcome of the Aberrant Behavior Checklist-Social Withdrawal (ABC-SW) subscale as well as a number of secondary outcome measures related to the core symptoms of ASD. Safety was monitored throughout the study period. Results There was no statistically significant improvement with oxytocin as compared to placebo on the ABC-SW (Mann–Whitney U = 50, p = 0.055), or on any secondary outcome measures, during either the double-blind or open-label phases. Oxytocin was generally well tolerated, and there were no serious adverse events.
Limitations The small sample size, potential challenges with drug administration, and expectancy bias due to relying on parent reported outcome measures may all contribute to limitations in interpreting results. Conclusion Our results suggest that intranasal oxytocin is not efficacious in improving the core symptoms of ASD in children with PMS. Trial registration NCT02710084. Supplementary Information The online version contains supplementary material available at 10.1186/s13229-021-00459-1.
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Affiliation(s)
- J Fastman
- Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - J Foss-Feig
- Seaver Autism Center for Research and Treatment, Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, Box 1230, New York, NY, 10029, USA.,Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Y Frank
- Seaver Autism Center for Research and Treatment, Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, Box 1230, New York, NY, 10029, USA.,Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - D Halpern
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - H Harony-Nicolas
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA.,Department of Neuroscience, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - C Layton
- Seaver Autism Center for Research and Treatment, Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, Box 1230, New York, NY, 10029, USA.,Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - S Sandin
- Seaver Autism Center for Research and Treatment, Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, Box 1230, New York, NY, 10029, USA.,Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA.,Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - P Siper
- Seaver Autism Center for Research and Treatment, Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, Box 1230, New York, NY, 10029, USA.,Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - L Tang
- Seaver Autism Center for Research and Treatment, Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, Box 1230, New York, NY, 10029, USA.,Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - P Trelles
- Seaver Autism Center for Research and Treatment, Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, Box 1230, New York, NY, 10029, USA.,Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - J Zweifach
- Seaver Autism Center for Research and Treatment, Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, Box 1230, New York, NY, 10029, USA.,Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - J D Buxbaum
- Seaver Autism Center for Research and Treatment, Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, Box 1230, New York, NY, 10029, USA.,Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA.,Department of Genetics and Genomic Sciences, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - A Kolevzon
- Seaver Autism Center for Research and Treatment, Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, Box 1230, New York, NY, 10029, USA. .,Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA. .,Department of Pediatrics, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
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Divergent effects of oxytocin on "mind-reading" in healthy males. COGNITIVE AFFECTIVE & BEHAVIORAL NEUROSCIENCE 2021; 22:112-122. [PMID: 34519018 PMCID: PMC8791897 DOI: 10.3758/s13415-021-00936-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Accepted: 07/15/2021] [Indexed: 12/25/2022]
Abstract
The neuropeptide oxytocin (OT) has been associated with a broad range of human behaviors, particularly in the domain of social cognition, and is being discussed to play a role in a range of psychiatric disorders. Studies using the Reading The Mind In The Eyes Test (RMET) to investigate the role of OT in mental state recognition reported inconsistent outcomes. The present study applied a randomized, double-blind, cross-over design, and included measures of serum OT. Twenty healthy males received intranasal placebo or OT (24 IU) before performing the RMET. Frequentist and Bayesian analyses showed that contrary to previous studies (Domes et al., 2007; Radke & de Bruijn, 2015), individuals performed worse in the OT condition compared to the placebo condition (p = 0.023, Cohen’s d = 0.55, 95% confidence interval [CI] [0.08, 1.02], BF10 = 6.93). OT effects did not depend on item characteristics (difficulty, valence, intensity, sex) of the RMET. Furthermore, OT serum levels did not change after intranasal OT administration. Given that similar study designs lead to heterogeneous outcomes, our results highlight the complexity of OT effects and support evidence that OT might even interfere with social cognitive abilities. However, the Bayesian analysis approach shows that there is only moderate evidence that OT influences mind-reading, highlighting the need for larger-scale studies considering the discussed aspects that might have led to divergent study results.
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12
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Kurokawa H, Kinari Y, Okudaira H, Tsubouchi K, Sai Y, Kikuchi M, Higashida H, Ohtake F. Oxytocin-Trust Link in Oxytocin-Sensitive Participants and Those Without Autistic Traits. Front Neurosci 2021; 15:659737. [PMID: 34113232 PMCID: PMC8186783 DOI: 10.3389/fnins.2021.659737] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2021] [Accepted: 04/30/2021] [Indexed: 11/13/2022] Open
Abstract
There have been numerous studies in which the biological role of oxytocin in trusting behavior has been investigated. However, a link between oxytocin and trust in humans was discovered only in one early study. We hypothesized that there is a large interindividual variation in oxytocin sensitivity, and that such variation is one reason for the doubt surrounding the role of oxytocin in trusting behavior. Here, in a double-blind, prospective, case-control study, we administered intranasal oxytocin to participants of trust and risk games. We measured salivary oxytocin concentration, relating it to the amount of money transferred among participants (a proxy for trust) and the autism-spectrum quotient (AQ). A one-sided Fisher’s exact test was performed to detect differences between the oxytocin and placebo groups in the proportions of investors who transferred the maximum amount of money. We discovered a tendency for participants who received oxytocin to transfer higher amounts of money to co-participants than those who received a placebo (P = 0.04). We also revealed a high degree of interindividual variation in salivary oxytocin concentrations after oxytocin administration. After stratifying the samples with respect to oxytocin sensitivity, oxytocin-sensitive participants in the oxytocin group also transferred higher amounts of money than those in the placebo group (P = 0.03), while such a tendency was not observed for oxytocin-insensitive participants (P = 0.34). Participants with lower AQ scores (less severe autistic traits) exhibited a greater tendency toward trusting behavior after oxytocin administration than did those with higher AQ scores (P = 0.02). A two-sample t-test that was performed to detect significant differences in the mean transfers between the oxytocin and placebo groups indicated no significant between-group difference in the mean transfers (P = 0.08). There are two possible interpretations of these results: First, there is no effect of oxytocin on trust in humans; second, the effects of oxytocin on trust in humans is person-dependent. However, the results should be interpreted with caution as the effect size was not larger than the minimal detectable effect size and the results were not statistically significant (P > 0.05) after Bonferroni corrections.
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Affiliation(s)
- Hirofumi Kurokawa
- School of Economics and Management, University of Hyogo, Kobe, Japan
| | - Yusuke Kinari
- Hirao School of Management, Konan University, Nishinomiya, Japan
| | | | | | - Yoshimichi Sai
- Department of Hospital Pharmacy, Kanazawa University, Kanazawa, Japan
| | - Mitsuru Kikuchi
- Department of Psychiatry and Neurobiology, Graduate School of Medical Science, Kanazawa University, Kanazawa, Japan
| | - Haruhiro Higashida
- Research Center for Child Mental Development, Kanazawa University, Kanazawa, Japan
| | - Fumio Ohtake
- Center for Infectious Disease Education and Research, Osaka University, Suita, Japan
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13
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Chen K, Ye Y, Troje NF, Zhou W. Oxytocin modulates human chemosensory decoding of sex in a dose-dependent manner. eLife 2021; 10:59376. [PMID: 33439831 PMCID: PMC7806258 DOI: 10.7554/elife.59376] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2020] [Accepted: 01/04/2021] [Indexed: 12/17/2022] Open
Abstract
There has been accumulating evidence of human social chemo-signaling, but the underlying mechanisms remain poorly understood. Considering the evolutionarily conserved roles of oxytocin and vasopressin in reproductive and social behaviors, we examined whether the two neuropeptides are involved in the subconscious processing of androsta-4,16,-dien-3-one and estra-1,3,5 (10),16-tetraen-3-ol, two human chemosignals that convey masculinity and femininity to the targeted recipients, respectively. Psychophysical data collected from 216 heterosexual and homosexual men across five experiments totaling 1056 testing sessions consistently showed that such chemosensory communications of masculinity and femininity were blocked by a competitive antagonist of both oxytocin and vasopressin receptors called atosiban, administered nasally. On the other hand, intranasal oxytocin, but not vasopressin, modulated the decoding of androstadienone and estratetraenol in manners that were dose-dependent, nonmonotonic, and contingent upon the recipients’ social proficiency. Taken together, these findings establish a causal link between neuroendocrine factors and subconscious chemosensory communications of sex-specific information in humans.
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Affiliation(s)
- Kepu Chen
- State Key Laboratory of Brain and Cognitive Science, CAS Center for Excellence in Brain Science and Intelligence Technology, Institute of Psychology, Chinese Academy of Sciences, Beijing, China
| | - Yuting Ye
- Department of Psychology, University of Chinese Academy of Sciences, Beijing, China
| | | | - Wen Zhou
- State Key Laboratory of Brain and Cognitive Science, CAS Center for Excellence in Brain Science and Intelligence Technology, Institute of Psychology, Chinese Academy of Sciences, Beijing, China.,Department of Psychology, University of Chinese Academy of Sciences, Beijing, China.,Chinese Institute for Brain Research, Beijing, China
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14
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Horta M, Pehlivanoglu D, Ebner NC. The Role of Intranasal Oxytocin on Social Cognition: An Integrative Human Lifespan Approach. Curr Behav Neurosci Rep 2020; 7:175-192. [PMID: 33717829 PMCID: PMC7951958 DOI: 10.1007/s40473-020-00214-5] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 08/31/2020] [Indexed: 12/26/2022]
Abstract
PURPOSE OF REVIEW This narrative review synthesizes research from the last two decades on the modulatory role of intranasal OT administration (IN-OT) on social cognition in early life, young/middle adulthood, and older adulthood. Advances and knowledge gaps are identified, and future research directions are discussed within an integrative human lifespan framework to guide novel research on IN-OT and social cognition. RECENT FINDINGS Current evidence regarding IN-OT modulation of social-cognitive processes, behavior, and related neurocircuitry is mixed, with some studies suggesting benefits (e.g., improved social perception/interactions, emotion processing) depending on contextual (e.g., social stimuli) and interindividual factors (e.g., age, sex, clinical status). Current research, however, is limited by a focus on isolated life phases, males, and select clinical populations as well as a lack of standardized protocols. SUMMARY This literature-based reflection proposes that greater generalizability of findings and scientific advancement on social-cognitive modulation via IN-OT require standardized, multi-method, longitudinal, and cross-sequential assessments in well-powered, well-controlled, and representative samples in line with an integrative lifespan approach, which considers development as a lifelong dynamic process involving both change and stability characterized by the interplay between genetic, neurobiological, and socio-behavioral factors.
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Affiliation(s)
- Marilyn Horta
- Department of Psychology, University of Florida, Gainesville, FL, USA
- Department of Epidemiology, University of Florida, Gainesville, FL, USA
| | | | - Natalie C. Ebner
- Department of Psychology, University of Florida, Gainesville, FL, USA
- Institute on Aging, Department of Aging & Geriatric Research, University of Florida, Gainesville, FL, USA
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Soriano JR, Daniels N, Prinsen J, Alaerts K. Intranasal oxytocin enhances approach-related EEG frontal alpha asymmetry during engagement of direct eye contact. Brain Commun 2020; 2:fcaa093. [PMID: 32954338 PMCID: PMC7475692 DOI: 10.1093/braincomms/fcaa093] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2020] [Revised: 06/02/2020] [Accepted: 06/08/2020] [Indexed: 01/09/2023] Open
Abstract
The neuropeptide oxytocin is suggested to play a major role in a variety of complex human behaviours, including interpersonal bonding, trust and attachment. Recent theories have suggested that the role oxytocin plays in these complex social behaviours involves a modulation of motivational tendencies of approach-/avoidance-related behaviours. However, to date, direct neurophysiological evidence supporting this notion is limited. In this double-blind, randomized, placebo-controlled study with parallel design, we assessed the effects of administered intranasal oxytocin in 40 adult men on gaze behaviour and a neural marker of approach/avoidance motivational tendencies. Specifically, electroencephalography recordings were performed during the engagement of eye contact with a live model in a naturalistic two-person social context and electroencephalographic frontal alpha asymmetry, an established neurophysiological index of motivational tendencies for approach-/avoidance-related behaviours, was assessed. Compared to placebo, a single dose of oxytocin (24 international units) was shown to increase relative left-sided frontal asymmetry upon direct eye contact with a live model, which is indicative of an increase in approach-related motivational tendencies towards the presented eye contact stimulus. Notably, the treatment effect was most prominently observed in participants with lower self-reported social motivation (higher Motivation subscale scores on the Social Responsiveness Scale), indicating that participants with lower social motivation benefitted the most from the administered oxytocin. No treatment-specific changes were identified in terms of gaze behaviour towards the eye region of the live model. Together, these observations add neurophysiological evidence to the hypothesized role of oxytocin in modulating approach-/avoidance-related tendencies and suggest that inter-subject variability in person-dependent factors need to be considered to evaluate the potential benefit of intranasal oxytocin as a treatment. This notion is of particular relevance to the variety of neuropsychiatric populations such as autism spectrum disorder, social anxiety disorder and depression, for which intranasal oxytocin is increasingly considered a potential treatment.
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Affiliation(s)
- Javier R Soriano
- Research Group for Neurorehabilitation, Department of Rehabilitation Sciences, KU Leuven, 3001 Leuven, Belgium
| | - Nicky Daniels
- Research Group for Neurorehabilitation, Department of Rehabilitation Sciences, KU Leuven, 3001 Leuven, Belgium
| | - Jellina Prinsen
- Research Group for Neurorehabilitation, Department of Rehabilitation Sciences, KU Leuven, 3001 Leuven, Belgium
| | - Kaat Alaerts
- Research Group for Neurorehabilitation, Department of Rehabilitation Sciences, KU Leuven, 3001 Leuven, Belgium
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16
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Harvey AR. Links Between the Neurobiology of Oxytocin and Human Musicality. Front Hum Neurosci 2020; 14:350. [PMID: 33005139 PMCID: PMC7479205 DOI: 10.3389/fnhum.2020.00350] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2020] [Accepted: 08/04/2020] [Indexed: 12/22/2022] Open
Abstract
The human species possesses two complementary, yet distinct, universal communication systems—language and music. Functional imaging studies have revealed that some core elements of these two systems are processed in closely related brain regions, but there are also clear differences in brain circuitry that likely underlie differences in functionality. Music affects many aspects of human behavior, especially in encouraging prosocial interactions and promoting trust and cooperation within groups of culturally compatible but not necessarily genetically related individuals. Music, presumably via its impact on the limbic system, is also rewarding and motivating, and music can facilitate aspects of learning and memory. In this review these special characteristics of music are considered in light of recent research on the neuroscience of the peptide oxytocin, a hormone that has both peripheral and central actions, that plays a role in many complex human behaviors, and whose expression has recently been reported to be affected by music-related activities. I will first briefly discuss what is currently known about the peptide’s physiological actions on neurons and its interactions with other neuromodulator systems, then summarize recent advances in our knowledge of the distribution of oxytocin and its receptor (OXTR) in the human brain. Next, the complex links between oxytocin and various social behaviors in humans are considered. First, how endogenous oxytocin levels relate to individual personality traits, and then how exogenous, intranasal application of oxytocin affects behaviors such as trust, empathy, reciprocity, group conformity, anxiety, and overall social decision making under different environmental conditions. It is argued that many of these characteristics of oxytocin biology closely mirror the diverse effects that music has on human cognition and emotion, providing a link to the important role music has played throughout human evolutionary history and helping to explain why music remains a special prosocial human asset. Finally, it is suggested that there is a potential synergy in combining oxytocin- and music-based strategies to improve general health and aid in the treatment of various neurological dysfunctions.
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Affiliation(s)
- Alan R Harvey
- School of Human Sciences, The University of Western Australia, Perron Institute for Neurological and Translational Science, Perth, WA, Australia
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Schiller B, Domes G, Heinrichs M. Oxytocin changes behavior and spatio-temporal brain dynamics underlying inter-group conflict in humans. Eur Neuropsychopharmacol 2020; 31:119-130. [PMID: 31883637 DOI: 10.1016/j.euroneuro.2019.12.109] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/19/2019] [Revised: 11/15/2019] [Accepted: 12/08/2019] [Indexed: 01/10/2023]
Abstract
Inter-group conflicts drive human discrimination, mass migration, and violence, but their psychobiological mechanisms remain largely unknown. Here, we investigated whether the neuropeptide oxytocin modulates behavior and spatio-temporal brain dynamics in naturalistic inter-group conflict. Eighty-six male members of natural rival social groups received either oxytocin or placebo intranasally. In a decision-making paradigm involving real monetary stakes, participants could sacrifice their own resources to modulate the monetary gains and losses of in- and out-group members. Oxytocin eliminated the reduction in out-group gains - particularly in individuals with low emotional empathy, whereas those given placebo exhibited this negative social behavior. Our spatio-temporal analysis of event-related potentials elicited by outcome valuation revealed that oxytocin replaced a neurophysiological process associated with the negative valuation of out-group gains via a process associated with positive valuation between 200-500ms after outcome presentation. Oxytocin thus seems to modulate inter-group behavior in humans via a specific alteration of valuation-related brain dynamics.
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Affiliation(s)
- Bastian Schiller
- Department of Psychology, Laboratory for Biological and Personality Psychology, University of Freiburg, D-79104 Freiburg, Germany; Freiburg Brain Imaging Center, University Medical Center, University of Freiburg, D-79106 Freiburg, Germany.
| | - Gregor Domes
- Department of Psychology, Laboratory for Biological and Personality Psychology, University of Freiburg, D-79104 Freiburg, Germany; Freiburg Brain Imaging Center, University Medical Center, University of Freiburg, D-79106 Freiburg, Germany; Department of Biological and Clinical Psychology, University of Trier, D-54290 Trier, Germany
| | - Markus Heinrichs
- Department of Psychology, Laboratory for Biological and Personality Psychology, University of Freiburg, D-79104 Freiburg, Germany; Freiburg Brain Imaging Center, University Medical Center, University of Freiburg, D-79106 Freiburg, Germany.
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Peripheral Blood Mononuclear Cell Oxytocin and Vasopressin Receptor Expression Positively Correlates with Social and Behavioral Function in Children with Autism. Sci Rep 2019; 9:13443. [PMID: 31530830 PMCID: PMC6748974 DOI: 10.1038/s41598-019-49617-9] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2019] [Accepted: 08/28/2019] [Indexed: 12/17/2022] Open
Abstract
The peptide hormone oxytocin is an established regulator of social function in mammals, and dysregulated oxytocin signaling is implicated in autism spectrum disorder (ASD). Several clinical trials examining the effects of intranasal oxytocin for improving social and behavioral function in ASD have had mixed or inclusive outcomes. The heterogeneity in clinical trials outcomes may reflect large inter-individual expression variations of the oxytocin and/or vasopressin receptor genes OXTR and AVPR1A, respectively. To explore this hypothesis we examined the expression of both genes in peripheral blood mononuclear cells (PBMC) from ASD children, their non-ASD siblings, and age-matched neurotypical children aged 3 to 16 years of age as well as datamined published ASD datasets. Both genes were found to have large inter-individual variations. Higher OXTR and AVPR1A expression was associated with lower Aberrant Behavior Checklist (ABC) scores. OXTR expression was associated with less severe behavior and higher adaptive behavior on additional standardized measures. Combining the sum expression levels OXTR, AVPR1A, and IGF1 yielded the strongest correlation with ABC scores. We propose that future clinical trials in ASD children with oxytocin, oxytocin mimetics and additional tentative therapeutics should assess the prognostic value of their PBMC mRNA expression of OXTR, AVPR1A, and IGF1.
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