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Watanabe H, Kobikov Y, Nosova O, Sarkisyan D, Galatenko V, Carvalho L, Maia GH, Lukoyanov N, Lavrov I, Ossipov MH, Hallberg M, Schouenborg J, Zhang M, Bakalkin G. The Left-Right Side-Specific Neuroendocrine Signaling from Injured Brain: An Organizational Principle. FUNCTION 2024; 5:zqae013. [PMID: 38985004 PMCID: PMC11237900 DOI: 10.1093/function/zqae013] [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: 03/06/2024] [Accepted: 03/06/2024] [Indexed: 07/11/2024] Open
Abstract
A neurological dogma is that the contralateral effects of brain injury are set through crossed descending neural tracts. We have recently identified a novel topographic neuroendocrine system (T-NES) that operates via a humoral pathway and mediates the left-right side-specific effects of unilateral brain lesions. In rats with completely transected thoracic spinal cords, unilateral injury to the sensorimotor cortex produced contralateral hindlimb flexion, a proxy for neurological deficit. Here, we investigated in acute experiments whether T-NES consists of left and right counterparts and whether they differ in neural and molecular mechanisms. We demonstrated that left- and right-sided hormonal signaling is differentially blocked by the δ-, κ- and µ-opioid antagonists. Left and right neurohormonal signaling differed in targeting the afferent spinal mechanisms. Bilateral deafferentation of the lumbar spinal cord abolished the hormone-mediated effects of the left-brain injury but not the right-sided lesion. The sympathetic nervous system was ruled out as a brain-to-spinal cord-signaling pathway since hindlimb responses were induced in rats with cervical spinal cord transections that were rostral to the preganglionic sympathetic neurons. Analysis of gene-gene co-expression patterns identified the left- and right-side-specific gene co-expression networks that were coordinated via the humoral pathway across the hypothalamus and lumbar spinal cord. The coordination was ipsilateral and disrupted by brain injury. These findings suggest that T-NES is bipartite and that its left and right counterparts contribute to contralateral neurological deficits through distinct neural mechanisms, and may enable ipsilateral regulation of molecular and neural processes across distant neural areas along the neuraxis.
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Affiliation(s)
- Hiroyuki Watanabe
- Department of Pharmaceutical Biosciences, Uppsala University, Uppsala, SE-751 24, Sweden
- Department of Molecular Medicine, University of Southern Denmark, Odense, DK-5230, Denmark
| | - Yaromir Kobikov
- Volunteer Associate at Department of Pharmaceutical Biosciences, Uppsala University, Uppsala, SE-751 24, Sweden
| | - Olga Nosova
- Department of Pharmaceutical Biosciences, Uppsala University, Uppsala, SE-751 24, Sweden
| | - Daniil Sarkisyan
- Department of Pharmaceutical Biosciences, Uppsala University, Uppsala, SE-751 24, Sweden
- Department of Immunology, Genetics and Pathology and Science for Life Laboratory, Uppsala University, Uppsala, SE-751 08, Sweden
| | | | - Liliana Carvalho
- Departamento de Biomedicina da Faculdade de Medicina da Universidade do Porto, Porto 4200-319, Portugal
| | - Gisela H Maia
- Centro de Investigação em Saúde Translacional e Biotecnologia Médica (TBIO)/Rede de Investigação em Saúde (RISE-Health), Escola Superior de Saúde, Instituto Politécnico do Porto, Porto 4200-072, Portugal
- Medibrain, Vila do Conde 4480-807, Portugal
- Brain Research Institute, Porto 4450-208, Portugal
| | - Nikolay Lukoyanov
- Departamento de Biomedicina da Faculdade de Medicina da Universidade do Porto, Porto 4200-319, Portugal
- Brain Research Institute, Porto 4450-208, Portugal
- i3S—Instituto de Investigação e Inovação em Saúde, Universidade do Porto, Porto 4200-135, Portugal
| | - Igor Lavrov
- Department of Neurology, Mayo Clinic, Rochester, MN 55905, USA
| | - Michael H Ossipov
- Department of Pharmacology, University of Arizona College of Medicine, Tucson, AZ 85724-5050, USA
| | - Mathias Hallberg
- Department of Pharmaceutical Biosciences, Uppsala University, Uppsala, SE-751 24, Sweden
| | - Jens Schouenborg
- Neuronano Research Center, Department of Experimental Medical Science, Lund University, Lund 223 63, Sweden
| | - Mengliang Zhang
- Department of Molecular Medicine, University of Southern Denmark, Odense, DK-5230, Denmark
- Neuronano Research Center, Department of Experimental Medical Science, Lund University, Lund 223 63, Sweden
| | - Georgy Bakalkin
- Department of Pharmaceutical Biosciences, Uppsala University, Uppsala, SE-751 24, Sweden
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Wilhelm RA, Lacey MF, Masters SL, Breeden CJ, Mann E, MacDonald HV, Gable PA, White EJ, Stewart JL. Greater weekly physical activity linked to left resting frontal alpha asymmetry in women: A study on gender differences in highly active young adults. PSYCHOLOGY OF SPORT AND EXERCISE 2024; 74:102679. [PMID: 38797225 DOI: 10.1016/j.psychsport.2024.102679] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/30/2023] [Revised: 04/29/2024] [Accepted: 05/22/2024] [Indexed: 05/29/2024]
Abstract
Physical activity, beneficial for physical and psychological health, may facilitate affective mechanisms of positive emotion and approach-motivation. Greater resting frontal alpha asymmetry (FAA), an index of greater relative left than right frontal cortical activity, is a neural correlate of affective mechanisms possibly associated with active lifestyles. This study sought to amplify limited literature on the relationship between physical (in)activity, FAA, and gender differences. College students (n = 70) self-reported physical activity (Total PA) and sedentary activity (Total Sitting) via the International Physical Activity Questionnaire-Short Form (IPAQ-SF), followed by a resting electroencephalography session to record FAA. A Total PA × gender interaction (β = 0.462, t = 3.163, p = 0.002) identified a positive relationship between Total PA and FAA in women (β = 0.434, t = 2.221, p = 0.030) and a negative relationship for men (β = -0.338, t = -2.300, p = 0.025). Total Sitting was positively linked to FAA (β = 0.288, t = 2.228, p = 0.029; no gender effect). Results suggest affective mechanisms reflected by FAA (e.g., positive emotion, approach-motivation) are associated with physical activity for women, indicating a possible mechanism of the psychological benefits linked with physically active lifestyles. A positive relationship between sedentary behavior and greater left FAA may also reflect motivated mechanisms of behavior that aid in minimizing energy expenditure, particularly within the context of our highly active sample.
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Affiliation(s)
- Ricardo A Wilhelm
- Laureate Institute for Brain Research (LIBR), Tulsa, OK, USA; Department of Psychology, University of Alabama, Tuscaloosa, AL, USA.
| | - Micayla F Lacey
- Department of Psychology, University of Alabama, Tuscaloosa, AL, USA; Department of Behavioral & Social Sciences, Wilkes University, Wilkes-Barre, PA, USA.
| | - Stephanie L Masters
- Department of Psychology, University of Alabama, Tuscaloosa, AL, USA; Department of Psychology & Counseling, Hood College, Frederick, MD, USA
| | - Christopher J Breeden
- Department of Psychology, University of Alabama, Tuscaloosa, AL, USA; Department of Psychology, Wingate University, Wingate, NC, USA
| | - Eric Mann
- Laureate Institute for Brain Research (LIBR), Tulsa, OK, USA
| | | | - Philip A Gable
- Department of Psychology, University of Alabama, Tuscaloosa, AL, USA; Department of Psychological & Brain Sciences, University of Delaware, Newark, DE, USA
| | - Evan J White
- Laureate Institute for Brain Research (LIBR), Tulsa, OK, USA; Oxley School of Community Medicine, University of Tulsa, Tulsa, OK, USA
| | - Jennifer L Stewart
- Laureate Institute for Brain Research (LIBR), Tulsa, OK, USA; Oxley School of Community Medicine, University of Tulsa, Tulsa, OK, USA
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Alaerts K, Moerkerke M, Daniels N, Zhang Q, Grazia R, Steyaert J, Prinsen J, Boets B. Chronic oxytocin improves neural decoupling at rest in children with autism: an exploratory RCT. J Child Psychol Psychiatry 2024. [PMID: 38400592 DOI: 10.1111/jcpp.13966] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 01/17/2024] [Indexed: 02/25/2024]
Abstract
BACKGROUND Shifts in peak frequencies of oscillatory neural rhythms are put forward as a principal mechanism by which cross-frequency coupling/decoupling is implemented in the brain. During active neural processing, functional integration is facilitated through transitory formations of "harmonic" cross-frequency couplings, whereas "nonharmonic" decoupling among neural oscillatory rhythms is postulated to characterize the resting, default state of the brain, minimizing the occurrence of spurious, noisy, background couplings. METHODS Within this exploratory, randomized, placebo-controlled trial, we assessed whether the transient occurrence of nonharmonic and harmonic relationships between peak-frequencies in the alpha (8-14 Hz) and theta (4-8 Hz) bands is impacted by intranasal administration of oxytocin, a neuromodulator implicated in improving homeostasis and reducing stress/anxiety. To do so, resting-state electroencephalography was acquired before and after 4 weeks of oxytocin administration (12 IU twice-daily) in children with autism spectrum disorder (8-12 years, n = 33 oxytocin; n = 34 placebo). At the baseline, neural assessments of children with autism were compared with those of a matched cohort of children without autism (n = 40). RESULTS Compared to nonautistic peers, autistic children displayed a lower incidence of nonharmonic alpha-theta cross-frequency decoupling, indicating a higher incidence of spurious "noisy" coupling in their resting brain (p = .001). Dimensionally, increased neural coupling was associated with more social difficulties (p = .002) and lower activity of the parasympathetic "rest & digest" branch of the autonomic nervous system (p = .018), indexed with high-frequency heart-rate-variability. Notably, after oxytocin administration, the transient formation of nonharmonic cross-frequency configurations was increased in the cohort of autistic children (p < .001), indicating a beneficial effect of oxytocin on reducing spurious cross-frequency-interactions. Furthermore, parallel epigenetics changes of the oxytocin receptor gene indicated that the neural effects were likely mediated by changes in endogenous oxytocinergic signaling (p = .006). CONCLUSIONS Chronic oxytocin induced important homeostatic changes in the resting-state intrinsic neural frequency architecture, reflective of reduced noisy oscillatory couplings and improved signal-to-noise properties.
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Affiliation(s)
- Kaat Alaerts
- Research Group for Neurorehabilitation, Neuromodulation Laboratory, KU Leuven, Leuven, Belgium
- Leuven Autism Research (LAuRes), KU Leuven, Leuven, Belgium
| | - Matthijs Moerkerke
- Leuven Autism Research (LAuRes), KU Leuven, Leuven, Belgium
- Department of Neurosciences, Center for Developmental Psychiatry, KU Leuven, Leuven, Belgium
| | - Nicky Daniels
- Research Group for Neurorehabilitation, Neuromodulation Laboratory, KU Leuven, Leuven, Belgium
- Leuven Autism Research (LAuRes), KU Leuven, Leuven, Belgium
| | - Qianqian Zhang
- Research Group for Neurorehabilitation, Neuromodulation Laboratory, KU Leuven, Leuven, Belgium
- Leuven Autism Research (LAuRes), KU Leuven, Leuven, Belgium
| | - Ricchiuti Grazia
- Research Group for Neurorehabilitation, Neuromodulation Laboratory, KU Leuven, Leuven, Belgium
- Leuven Autism Research (LAuRes), KU Leuven, Leuven, Belgium
| | - Jean Steyaert
- Leuven Autism Research (LAuRes), KU Leuven, Leuven, Belgium
| | - Jellina Prinsen
- Research Group for Neurorehabilitation, Neuromodulation Laboratory, KU Leuven, Leuven, Belgium
- Leuven Autism Research (LAuRes), KU Leuven, Leuven, Belgium
| | - Bart Boets
- Leuven Autism Research (LAuRes), KU Leuven, Leuven, Belgium
- Department of Neurosciences, Center for Developmental Psychiatry, KU Leuven, Leuven, Belgium
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Pavăl D. The dopamine hypothesis of autism spectrum disorder: A comprehensive analysis of the evidence. INTERNATIONAL REVIEW OF NEUROBIOLOGY 2023; 173:1-42. [PMID: 37993174 DOI: 10.1016/bs.irn.2023.08.009] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/24/2023]
Abstract
Despite intensive research into the etiopathogenesis of autism spectrum disorder (ASD), limited progress has been achieved so far. Among the plethora of models seeking to clarify how ASD arises, a coherent dopaminergic model was lacking until recently. In 2017, we provided a theoretical framework that we designated "the dopamine hypothesis of ASD". In the meantime, numerous studies yielded empirical evidence for this model. 4 years later, we provided a second version encompassing a refined and reconceptualized framework that accounted for these novel findings. In this chapter, we will review the evidence backing the previous versions of our model and add the most recent developments to the picture. Along these lines, we intend to lay out a comprehensive analysis of the supporting evidence for the dopamine hypothesis of ASD.
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Affiliation(s)
- Denis Pavăl
- The Romanian Association for Autoimmune Encephalitis, Cluj-Napoca, Romania; Department of Psychiatry, "Iuliu Hațieganu" University of Medicine and Pharmacy, Cluj-Napoca, Romania.
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Being watched by a humanoid robot and a human: Effects on affect-related psychophysiological responses. Biol Psychol 2022; 175:108451. [DOI: 10.1016/j.biopsycho.2022.108451] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2022] [Revised: 10/27/2022] [Accepted: 10/31/2022] [Indexed: 11/06/2022]
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Sinisalo H, Bakermans‐Kranenburg MJ, Peltola MJ. Hormonal and behavioral responses to an infant simulator in women with and without children. Dev Psychobiol 2022; 64:e22321. [PMID: 36282748 PMCID: PMC9545496 DOI: 10.1002/dev.22321] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2022] [Revised: 08/01/2022] [Accepted: 08/02/2022] [Indexed: 01/27/2023]
Abstract
We investigated the impact of maternal status on hormonal reactivity and behavioral responses to an infant simulator in 117 women (54 primiparous, 63 nulliparous). The amount of affectionate touch and motherese were analyzed as behavioral measures of caregiving. Saliva was collected before and 10 min after interaction with the infant simulator to analyze oxytocin, testosterone, cortisol, and estradiol levels. Nulliparous women also provided information about their fertility motivation. Linear mixed models indicated that greater use of affectionate touch was associated with lower overall testosterone levels. Cortisol decreased in response to the interaction in both groups. In the primiparous group, the amount of affectionate touch associated inversely with cortisol levels, whereas in the nulliparous group such association was not found. Oxytocin or estradiol reactivity to the simulator did not differ between the groups, nor were these hormones associated with behavior. Higher fertility motivation in nulliparous women was related to more motherese, and lower testosterone levels. Our results indicate that the simulator elicits hormonal reactivity both in mothers and nonmothers, but the patterns of associations between caregiving behavior and hormonal levels may be partially different. These results encourage using the infant simulator to explore hormonal processes related to the transition to parenthood.
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Affiliation(s)
- Hanneli Sinisalo
- Human Information Processing Laboratory, Faculty of Social Sciences, PsychologyTampere UniversityTampereFinland
| | - Marian J. Bakermans‐Kranenburg
- Faculty of Behavioural and Movement Sciences, Educational and Family StudiesVrije Universiteit AmsterdamAmsterdamThe Netherlands
| | - Mikko J. Peltola
- Human Information Processing Laboratory, Faculty of Social Sciences, PsychologyTampere UniversityTampereFinland,Tampere Institute for Advanced StudyTampere UniversityTampereFinland
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Alaerts K, Taillieu A, Prinsen J, Daniels N. Tracking transient changes in the intrinsic neural frequency architecture: Oxytocin facilitates non-harmonic relationships between alpha and theta rhythms in the resting brain. Psychoneuroendocrinology 2021; 133:105397. [PMID: 34481326 DOI: 10.1016/j.psyneuen.2021.105397] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/23/2021] [Revised: 08/20/2021] [Accepted: 08/21/2021] [Indexed: 11/29/2022]
Abstract
Shifts in the peak frequencies of oscillatory neural rhythms have been put forward as a principal mechanism by which cross-frequency coupling and decoupling is implemented in the brain. This notion is based on the mathematical reality that neural oscillations can only fully synchronize when their peak frequencies form harmonic 2:1 relationships (e.g., f2=f1/2). Non-harmonic cross-frequency relationships, on the other hand (based on the irrational golden mean 1.618.:1), provide the highest physiologically possible desynchronized state (reducing the occurrence of spurious, noisy, background coupling), and are therefore anticipated to characterize the resting state of the brain, in which no selective information processing takes place. The present study sought to assess whether the transient occurrence of 1.6:1 non-harmonic and 2:1 harmonic relationships between peak frequencies in the alpha (8-14 Hz) and theta (4-8 Hz) bands - respectively facilitating states of decoupling or coupling between oscillatory rhythms - are impacted by the intranasal administration of a single-dose of oxytocin (OT) or placebo. To do so, continuous resting-state electroencephalography (5 min eyes open, 19 electrodes) was obtained from 96 healthy adult men before and after nasal spray administration. The transient formation of non-harmonic cross-frequency configurations between alpha and theta peak frequencies was significantly increased after OT nasal spray administration, indicating an effect of OT on reducing the intrinsic occurrence of spurious (noisy) background phase synchronizations during resting-state. As a group, the OT group also showed a significant parallel increase in high-frequency and decrease in low-frequency heart rate variability, confirming a homeostatic role of OT in balancing parasympathetic drive. Overall, non-harmonic cross-frequency configurations have been put forward to lay the ground for a healthy neural network allowing the opportunity for an efficient transition from resting state to activity. The observed effects of OT on cross-frequency dynamics are therefore interpreted to reflect a homeostatic role of OT in increasing the signal-to-noise properties of the intrinsic EEG neural frequency architecture, i.e., by precluding the occurrence of 'noisy', unwanted, spurious couplings among neural rhythms in the resting brain.
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Affiliation(s)
- Kaat Alaerts
- KU Leuven, Department of Rehabilitation Sciences, Research Group for Neurorehabilitation, Tervuursevest 101 box 1501, 3001 Leuven, Belgium.
| | - Aymara Taillieu
- KU Leuven, Department of Rehabilitation Sciences, Research Group for Neurorehabilitation, Tervuursevest 101 box 1501, 3001 Leuven, Belgium
| | - Jellina Prinsen
- KU Leuven, Department of Rehabilitation Sciences, Research Group for Neurorehabilitation, Tervuursevest 101 box 1501, 3001 Leuven, Belgium
| | - Nicky Daniels
- KU Leuven, Department of Rehabilitation Sciences, Research Group for Neurorehabilitation, Tervuursevest 101 box 1501, 3001 Leuven, Belgium
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Pavăl D, Micluția IV. The Dopamine Hypothesis of Autism Spectrum Disorder Revisited: Current Status and Future Prospects. Dev Neurosci 2021; 43:73-83. [PMID: 34010842 DOI: 10.1159/000515751] [Citation(s) in RCA: 32] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2021] [Accepted: 03/09/2021] [Indexed: 11/19/2022] Open
Abstract
Autism spectrum disorder (ASD) comprises a group of neurodevelopmental disorders characterized by social deficits and stereotyped behaviors. Despite intensive research, its etiopathogenesis remains largely unclear. Although studies consistently reported dopaminergic anomalies, a coherent dopaminergic model of ASD was lacking until recently. In 2017, we provided a theoretical framework for a "dopamine hypothesis of ASD" which proposed that autistic behavior arises from a dysfunctional midbrain dopaminergic system. Namely, we hypothesized that malfunction of 2 critical circuits originating in the midbrain, that is, the mesocorticolimbic and nigrostriatal pathways, generates the core behavioral features of ASD. Moreover, we provided key predictions of our model along with testing means. Since then, a notable number of studies referenced our work and numerous others provided support for our model. To account for these developments, we review all these recent data and discuss their implications. Furthermore, in the light of these new insights, we further refine and reconceptualize our model, debating on the possibility that various etiologies of ASD converge upon a dysfunctional midbrain dopaminergic system. In addition, we discuss future prospects, providing new means of testing our hypothesis, as well as its limitations. Along these lines, we aimed to provide a model which, if confirmed, could provide a better understanding of the etiopathogenesis of ASD along with new therapeutic strategies.
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Affiliation(s)
- Denis Pavăl
- Psychiatry Clinic, Emergency County Hospital, Cluj-Napoca, Romania
| | - Ioana Valentina Micluția
- Department of Psychiatry, "Iuliu Hațieganu" University of Medicine and Pharmacy, Cluj-Napoca, Romania
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Daniels N, Prinsen J, Soriano JR, Alaerts K. Oxytocin enhances the recovery of eye-contact induced autonomic arousal: A treatment mechanism study with placebo-controlled design. Eur Neuropsychopharmacol 2020; 39:87-98. [PMID: 32868176 DOI: 10.1016/j.euroneuro.2020.08.004] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/06/2020] [Revised: 07/22/2020] [Accepted: 08/09/2020] [Indexed: 12/19/2022]
Abstract
The neuropeptide oxytocin (OT) is suggested to exert a pivotal role in a variety of complex human behaviors, including trust, attachment, social perception and fear regulation. Previous studies have demonstrated that intranasal administration of OT reduces subjective and neuroendocrine stress responses and dampens amygdala reactivity. OT has also been proposed to modulate activity of the autonomic nervous system. Here, a randomized double-blind, placebo-controlled study (with parallel design) was conducted with 56 healthy adult men to investigate whether a single-dose of OT (24 IU) modulates sympathetic autonomic arousal upon live dyadic gaze interactions. To do so, electrodermal recordings of skin conductance were performed during the engagement of eye contact with a live model in a two-person social context. In accordance to prior research, direct eye gaze elicited a significant enhancement in skin conductance responses, but OT did not specifically enhance or dampen the overall magnitude (amplitude) of the skin conductance response. Administration of OT did facilitate the recovery of skin conductance responses back to baseline (reduced recovery time), indicating a role of OT in restoring homeostatic balance. Notably, the treatment-effect on autonomic recovery was most prominent in participants with low self-reported social responsiveness, indicating that person-dependent factors play an important role in determining OT treatment-responses. Exploratory, it was shown that OT also significantly reduced self-reported feelings of tension and (at trend-level) worrying about how one presents oneself. Together, these observations add further evidence to a role of OT in modulating activity of the autonomic nervous system, primarily by facilitating a restoration of homeostatic balance after stimulus-induced increases in sympathetically-driven autonomic arousal.
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Affiliation(s)
- Nicky Daniels
- KU Leuven, Department of Rehabilitation Sciences, Research Group for Neuromotor Rehabilitation, Tervuursevest 101 box 1501, 3001 Leuven, Belgium
| | - Jellina Prinsen
- KU Leuven, Department of Rehabilitation Sciences, Research Group for Neuromotor Rehabilitation, Tervuursevest 101 box 1501, 3001 Leuven, Belgium
| | - Javier R Soriano
- KU Leuven, Department of Rehabilitation Sciences, Research Group for Neuromotor Rehabilitation, Tervuursevest 101 box 1501, 3001 Leuven, Belgium
| | - Kaat Alaerts
- KU Leuven, Department of Rehabilitation Sciences, Research Group for Neuromotor Rehabilitation, Tervuursevest 101 box 1501, 3001 Leuven, Belgium.
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