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Kawasaki M, Sakai A, Ueta Y. Pain modulation by oxytocin. Peptides 2024; 179:171263. [PMID: 38897354 DOI: 10.1016/j.peptides.2024.171263] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/28/2024] [Revised: 05/16/2024] [Accepted: 06/07/2024] [Indexed: 06/21/2024]
Abstract
Oxytocin (OXT) was discovered in 1906 as a substance that promotes the pregnancy and childbirth. It affects uterine contraction and lactation. Furthermore, as one of its physiological properties, it exerts analgesic effects. The living body has an ascending pathway that transmits pain stimuli from the periphery to the center and a descending pathway that regulates the dorsal horn neurons from the upper center downward. OXT is involved in the pain-inhibitory descending pathway and generally assumed to exert analgesic effects. In this article, we describe the pain-suppressive effects of OXT, among its many physiological effects.
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Affiliation(s)
- Makoto Kawasaki
- Center for Joint Arthroplasty, Hospital of University of Occupational and Environmental Health, 1-1 Iseigaoka Yahatanishi-ku, Kitakyushu City, Fukuoka 807-8555, Japan.
| | - Akinori Sakai
- Department of Orthopaedic Surgery, School of Medicine, University of Occupational and Environmental Health, 1-1 Iseigaoka Yahatanishi-ku, Kitakyushu City, Fukuoka 807-8555, Japan
| | - Yoichi Ueta
- Department of Physiology, School of Medicine, University of Occupational and Environmental Health, 1-1 Iseigaoka Yahatanishi-ku, Kitakyushu City, Fukuoka 807-8555, Japan
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Boada MD, Gutierrez S, Eisenach JC. Effects of systemic oxytocin administration on ultraviolet B-induced nociceptive hypersensitivity and tactile hyposensitivity in mice. Mol Pain 2024; 20:17448069241226553. [PMID: 38172079 PMCID: PMC10846038 DOI: 10.1177/17448069241226553] [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: 10/09/2023] [Revised: 11/24/2023] [Accepted: 12/07/2023] [Indexed: 01/05/2024] Open
Abstract
Ultraviolet B (UVB) radiation induces cutaneous inflammation, leading to thermal and mechanical hypersensitivity. Here, we examine the mechanical properties and profile of tactile and nociceptive peripheral afferents functionally disrupted by this injury and the role of oxytocin (OXT) as a modulator of this disruption. We recorded intracellularly from L4 afferents innervating the irradiated area (5.1 J/cm2) in 4-6 old week male mice (C57BL/6J) after administering OXT intraperitoneally, 6 mg/Kg. The distribution of recorded neurons was shifted by UVB radiation to a pattern observed after acute and chronic injuries and reduced mechanical thresholds of A and C- high threshold mechanoreceptors while reducing tactile sensitivity. UVB radiation did not change somatic membrane electrical properties or fiber conduction velocity. OXT systemic administration rapidly reversed these peripheral changes toward normal in both low and high-threshold mechanoreceptors and shifted recorded neuron distribution toward normal. OXT and V1aR receptors were present on the terminals of myelinated and unmyelinated afferents innervating the skin. We conclude that UVB radiation, similar to local tissue surgical injury, cancer metastasis, and peripheral nerve injury, alters the distribution of low and high threshold mechanoreceptors afferents and sensitizes nociceptors while desensitizing tactile units. Acute systemic OXT administration partially returns all of those effects to normal.
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Affiliation(s)
- M Danilo Boada
- Department of Anesthesiology, Wake Forest School of Medicine, Winston-Salem, NC, USA
| | - Silvia Gutierrez
- Department of Anesthesiology, Wake Forest School of Medicine, Winston-Salem, NC, USA
| | - James C Eisenach
- Department of Anesthesiology, Wake Forest School of Medicine, Winston-Salem, NC, USA
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3
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Yang G, Wang XD, Chen LY, Wu ZY, Xi EP, Li H. Oxytocin increases itch sensitivity of mice in late pregnancy and its peripheral receptor mechanism of itch-promoting effect. Brain Res Bull 2023; 202:110749. [PMID: 37633617 DOI: 10.1016/j.brainresbull.2023.110749] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2023] [Revised: 08/22/2023] [Accepted: 08/22/2023] [Indexed: 08/28/2023]
Abstract
Oxytocin (OXT) is secreted in a large amount during the middle and late pregnancy. Except for the regulation of functions related to childbirth, OXT is involved in the regulation of cognition, social behavior, addiction, pain and so on. Our aim is to confirm the increase of OXT content in mice in late pregnancy is the main cause of itch during pregnancy and observe whether exogenously administered OXT can induce or increase itch sensitivity. The research shows that itch sensitivity of mice increased significantly in late pregnancy and basically returned to normal one day after delivery. The number of OXT-positive neurons in paraventricular nucleus (PVN) and the content of OXT in serum of the late pregnant mice increased significantly, and decreased sharply after delivery. Intradermal injection of low concentration of OXT (0.2 nmol/L) could not induce scratching behavior in mice, but high concentration of OXT (5 nmol/L, 10 nmol/L) could do this in a dose-dependent manner. Low concentration of OXT significantly increased the itch sensitivity to histamine. Intradermal injection of oxytocin receptor (OXTR) or arginine vasopressin-1a receptor (AVPR1A) antagonist did not affect histamine-induced scratching behavior, but both reversed the increase of itch sensitivity in late pregnant mice or the facilitated itch sensitivity by OXT. Study suggests that both endogenous and exogenous increases in OXT can increase the body's sensitivity to itch, and even induce itch directly. Pruritus during pregnancy is closely related to the increase of OXT content in vivo. In the periphery, the itch-promoting effect of OXT is mediated by OXTR and AVPR1A.
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Affiliation(s)
- Gang Yang
- Department of Human Anatomy, Histology and Embryology and K.K. Leung Brain Research Centre, Air Force Military Medical University, Xi'an, China; Department of Cardiothoracic Surgery, Central Theater Command General Hospital, WuHan, China
| | - Xiao-Dong Wang
- Department of Human Anatomy, Histology and Embryology and K.K. Leung Brain Research Centre, Air Force Military Medical University, Xi'an, China; Department of Emergency Medicine, Inner Mongolia Armed Police Corps Hospital, Hohhot, China
| | - Lu-Ying Chen
- Department of Human Anatomy, Histology and Embryology and K.K. Leung Brain Research Centre, Air Force Military Medical University, Xi'an, China
| | - Zhen-Yu Wu
- Department of Human Anatomy, Histology and Embryology and K.K. Leung Brain Research Centre, Air Force Military Medical University, Xi'an, China
| | - Er-Ping Xi
- Department of Cardiothoracic Surgery, Central Theater Command General Hospital, WuHan, China
| | - Hui Li
- Department of Human Anatomy, Histology and Embryology and K.K. Leung Brain Research Centre, Air Force Military Medical University, Xi'an, China.
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Lin C, Zhuo S, Zheng Q, Li X, Peng W. The relationship between oxytocin and empathy for others' pain: Testing the mediating effect of first-hand pain sensitivity. Physiol Behav 2023:114266. [PMID: 37301493 DOI: 10.1016/j.physbeh.2023.114266] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2023] [Revised: 06/06/2023] [Accepted: 06/08/2023] [Indexed: 06/12/2023]
Abstract
Although previous studies have shown that oxytocin attenuates first-hand pain sensitivity, studies of its effects on empathic reactions to the observation of others' pain have yielded inconsistent and controversial results. Given the link between first-hand pain and empathy for others' pain, we hypothesized that oxytocin affects empathy for others' pain by modulating first-hand pain sensitivity. Using a double-blind, placebo-controlled, between-participant experimental design, healthy participants (n = 112) were randomly assigned to either an intranasal oxytocin or placebo group. Pain sensitivity was evaluated by pressure pain threshold, and empathic responses were assessed by ratings in response to viewing video clips depicting others in physically painful scenarios. Results showed that pressure pain thresholds decreased over time in both groups, indicating increased sensitivity to first-hand pain after repeated measurements. However, this decrease was smaller for participants who received intranasal oxytocin, indicative of oxytocin-induced attenuation of first-hand pain sensitivity. In addition, although empathic ratings were comparable between oxytocin and placebo groups, first-hand pain sensitivity fully mediated the impact of oxytocin on pain empathetic ratings. Thus, intranasal oxytocin can indirectly affect pain empathic ratings by reducing first-hand pain sensitivity. These findings expand our understanding of the relationship among oxytocin, pain, and empathy.
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Affiliation(s)
- Chennan Lin
- School of Psychology, Shenzhen University, Shenzhen, China
| | - Shiwei Zhuo
- School of Psychology, Shenzhen University, Shenzhen, China
| | - Qianqian Zheng
- School of Psychology, Shenzhen University, Shenzhen, China
| | - Xiaoyun Li
- School of Psychology, Shenzhen University, Shenzhen, China
| | - Weiwei Peng
- School of Psychology, Shenzhen University, Shenzhen, China.
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Lopes S, Osório FDL. Effects of intranasal oxytocin on pain perception among human subjects: A systematic literature review and meta-analysis. Horm Behav 2023; 147:105282. [PMID: 36463692 DOI: 10.1016/j.yhbeh.2022.105282] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/24/2022] [Revised: 11/18/2022] [Accepted: 11/19/2022] [Indexed: 12/03/2022]
Abstract
INTRODUCTION Oxytocin (OXT) is a peptide hormone produced in the hypothalamus that plays a neuromodulatory role in emotion, stress, and anxiety. Due to its multidimensional role, OXT is a promising target for therapeutic interventions to treat pain. OBJECTIVE Perform a systematic literature review, followed by a meta-analysis to identify the effects of intranasal OXT on the self-perception of clinical and experimental pain among human subjects. METHOD A systematic review was conducted in the PubMed, PsycINFO, Scielo, Lilacs, and Web of Science databases, using the keywords Oxytocin, Pain, Analgesia, and Nociception. RESULTS Fifteen papers were included in the meta-analysis. None of the outcomes presented statistical significance in terms of the interventions' effect size: pain intensity (SMD = -0.02 (CI 95 %: -0.14 to 0.10; p = 0.76)) and pain unpleasantness (SMD = -0.15 (CI 95 %: -0.34 to 0.04; p = 0.12)). No meta-analysis was performed for pain threshold or tolerance because few papers address these outcomes. CONCLUSION There was no statistically significant effect of intranasal OXT administration on pain perception, considering equivalence limits between (-0.2 and 0.2). However, it must be considered that the study designs may not have been sensitive enough to detect minor analgesic effects of OXT, which, being weak, may also not be perceived at a conscious level. Additionally, OXT effects possibly depend on specific characteristics of the painful condition, such as pain complexity, intensity, and duration, contextual variables like the presence of social and affective support, and individual characteristics.
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Affiliation(s)
- Samuel Lopes
- Ribeirão Preto Medical School, University of São Paulo, Brazil
| | - Flávia de Lima Osório
- Ribeirão Preto Medical School, University of São Paulo, Brazil; National Institute for Science and Technology (INCT-TM, CNPq), Brazil.
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Bridging skin, brain, and behavior to understand pleasurable social touch. Curr Opin Neurobiol 2022; 73:102527. [PMID: 35453001 DOI: 10.1016/j.conb.2022.102527] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2021] [Revised: 02/09/2022] [Accepted: 02/15/2022] [Indexed: 02/07/2023]
Abstract
Social touch-the affiliative skin-to-skin contact between individuals-can rapidly evoke emotions of comfort, pleasure, or calm, and is essential for mental and physical well-being. Physical isolation from social support can be devastating. During the COVID-19 pandemic, we observed a global increase in suicidal ideation, anxiety, domestic violence, and worsening of pre-existing physical conditions, alerting society to our need to understand the neurobiology of social touch and how it promotes normal health. Gaining a mechanistic understanding of how sensory neuron stimulation induces pleasure, calm, and analgesia may reveal untapped therapeutic targets in the periphery for treatment of anxiety and depression, as well as social disorders and traumas in which social touch becomes aversive. Bridging the gap between stimulation in the skin and positive affect in the brain-especially during naturally occurring social touch behaviors-remains a challenge to the field. However, with advances in mouse genetics, behavioral quantification, and brain imaging approaches to measure neuronal firing and neurochemical release, completing this mechanistic picture may be on the horizon. Here, we summarize some exciting new findings about social touch in mammals, emphasizing both the peripheral and central nervous systems, with attempts to bridge the gap between external stimulation and internal representations in the brain.
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Rung JM, Kidder QA, Horta M, Nazarloo HP, Carter CS, Berry MS, Ebner NC. Associations between alcohol use and peripheral, genetic, and epigenetic markers of oxytocin in a general sample of young and older adults. Brain Behav 2022; 12:e2425. [PMID: 35146961 PMCID: PMC8933764 DOI: 10.1002/brb3.2425] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/15/2021] [Revised: 09/30/2021] [Accepted: 10/27/2021] [Indexed: 12/04/2022] Open
Abstract
INTRODUCTION Human and nonhuman animal research suggests that greater oxytocin (OT) activity is protective against harmful substance use. Most research on this topic is preclinical, with few studies evaluating the association between substance use and individual differences in the human OT system. The present study sought to fill this gap by evaluating the relationship between alcohol use and multiple biological measures of OT activity in an overall low to moderate-drinking sample. METHOD As part of a larger study, generally healthy young (n = 51) and older (n = 53) adults self-reported whether they regularly used alcohol and how much alcohol they consumed per week. Participants also provided blood samples from which peripheral OT, and in an age-heterogeneous subset of participants (n = 56) variation in the oxytocin receptor gene (the OXTR rs53576 polymorphism) and OXTR DNA methylation levels (at cytosine-guanine dinucleotide sites -860, -924, -934), were obtained. RESULTS A-allele carriers of the OXTR rs53579 polymorphism were less likely to regularly consume alcohol. Among regular alcohol consumers, number of alcoholic drinks per week was positively associated with peripheral OT in regression models excluding observations of high influence (postdiagnostic models). Number of alcoholic drinks per week was consistently negatively associated with OXTR DNA methylation at site -860; and with OXTR DNA methylation at site -924 in postdiagnostic models. CONCLUSIONS The significant associations between alcohol use and individual differences in OT activity support the involvement of the OT system in alcohol use, which most likely reflect the role of OT when alcohol use is under control of its rewarding properties and/or the acute impacts of alcohol on the OT system. Additional research with markers of OT activity and alcohol use, particularly longitudinal, is needed to clarify the bidirectional effects of OT and alcohol use in moderate to harmful drinking and dependence.
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Affiliation(s)
- Jillian M Rung
- Department of Psychology, University of Florida, Gainesville, Florida, USA.,Department of Epidemiology, University of Florida, Gainesville, Florida, USA.,Department of Health Education and Behavior, University of Florida, Gainesville, Florida, USA
| | - Quintin A Kidder
- Department of Psychology, University of Florida, Gainesville, Florida, USA
| | - Marilyn Horta
- Department of Psychology, University of Florida, Gainesville, Florida, USA.,Department of Epidemiology, University of Florida, Gainesville, Florida, USA
| | - H P Nazarloo
- Kinsey Institute, Indiana University, Bloomington, Indiana, USA.,Department of Psychology, University of Virginia, Charlottesville, Virginia, USA
| | - C Sue Carter
- Kinsey Institute, Indiana University, Bloomington, Indiana, USA.,Department of Psychology, University of Virginia, Charlottesville, Virginia, USA
| | - Meredith S Berry
- Department of Psychology, University of Florida, Gainesville, Florida, USA.,Department of Health Education and Behavior, University of Florida, Gainesville, Florida, USA.,Pain Research and Intervention Center of Excellence (PRICE), College of Medicine, Clinical and Translational Science Institute (CTSI), University of Florida, Gainesville, Florida, USA
| | - Natalie C Ebner
- Department of Psychology, University of Florida, Gainesville, Florida, USA.,Pain Research and Intervention Center of Excellence (PRICE), College of Medicine, Clinical and Translational Science Institute (CTSI), University of Florida, Gainesville, Florida, USA.,Department of Aging & Geriatric Research, Institute on Aging, University of Florida, Gainesville, Florida, USA
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Medication-enhanced psychotherapy for posttraumatic stress disorder: Recent findings on oxytocin’s involvement in the neurobiology and treatment of posttraumatic stress disorder. CLINICAL PSYCHOLOGY IN EUROPE 2021; 3:e3645. [DOI: 10.32872/cpe.3645] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2020] [Accepted: 08/25/2021] [Indexed: 11/25/2022] Open
Abstract
Background
Traumatic experiences may result in Posttraumatic Stress Disorder (PTSD), which is characterized as an exaggerated fear response that cannot be extinguished over time or in safe environments. What are beneficial psychotherapeutic treatment options for PTSD patients? Can oxytocin (OXT), which is involved in the stress response, and safety learning, ameliorate PTSD symptomatology and enhance psychotherapeutic effects? Here, we will review recent studies regarding OXT’s potential to enhance psychotherapeutic therapies for PTSD treatment.
Method
We conducted a literature review on the neurobiological underpinnings of PTSD especially focusing on OXT’s involvement in the biology and memory formation of PTSD. Furthermore, we researched successful psychotherapeutic treatments for PTSD patients and discuss how OXT may facilitate observed psychotherapeutic effects.
Results
For a relevant proportion of PTSD patients, existing psychotherapies are not beneficial. OXT may be a promising candidate to enhance psychotherapeutic effects, because it dampens responses to stressful events and allows for a faster recovery after stress. On a neural basis, OXT modulates processes that are involved in stress, arousal and memory. OXT effectively counteracts memory impairments caused by stress and facilitates social support seeking which is a key resilience factor for PTSD and which is beneficial in psychotherapeutic settings.
Conclusion
OXT has many characteristics that are promising to positively influence psychotherapy for PTSD patients. It potentially reduces intrusions, but preserves memory of the event itself. Introducing OXT into psychotherapeutic settings may result in better treatment outcomes for PTSD patients. Future research should directly investigate OXT’s effects on PTSD, especially in psychotherapeutic settings.
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Zhang X, Li P, Otieno SCSA, Li H, Leppänen PHT. Oxytocin reduces romantic rejection-induced pain in online speed-dating as revealed by decreased frontal-midline theta oscillations. Psychoneuroendocrinology 2021; 133:105411. [PMID: 34537623 DOI: 10.1016/j.psyneuen.2021.105411] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/29/2021] [Revised: 09/02/2021] [Accepted: 09/02/2021] [Indexed: 10/20/2022]
Abstract
BACKGROUND Romantic rejection is an emotionally distressful experience profoundly affecting life, possibly leading to mental illness or suicide. Oxytocin (OT) is a neuropeptide widely implicated in reducing physical pain and negative emotions; however, whether OT has an effect on reducing intense social pain (e.g., romantic rejection) remains unknown. Here, we tested the effect of OT on social pain and investigated its role in the outcome evaluation phase of social decision-making. METHODS Electroencephalographic recordings were obtained between August 2nd and October 20th, 2020 in Shenzhen University from 61 healthy participants in a double-blind, placebo-controlled study with a between-subject design. We defined frontal-midline theta oscillation as a neural signature of social pain and assessed self-reported pleasantness ratings for four possible romantic outcomes in an online speed-dating task. RESULTS In the placebo group, greater theta power was induced by romantic rejection, being associated with rejection distress. This pattern was not observed in the OT group, where romantic rejection induced significantly decreased theta power compared to the placebo group; in the OT group, there was no association between theta power and rejection distress. Furthermore, the frontal-midline theta oscillation could be source-localized to brain areas overlapping with the physical-social pain matrix (i.e., somatosensory cortex, anterior cingulate cortex, frontal pole, and supplementary motor area). CONCLUSIONS OT relieves social pain caused by romantic rejection, reflected in decreased frontal-midline theta oscillations and a diminished connection between theta power and rejection distress. These findings can help understand and harness OT's pain-reducing effect on social pain.
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Affiliation(s)
- Xukai Zhang
- School of Psychology, Shenzhen University, Shenzhen, China; Faculty of Education and Psychology, University of Jyväskylä, Jyväskylä, Finland; School of Psychology, South China Normal University, Guangzhou, China; Institute for Brain and Psychological Sciences, Sichuan Normal University, Chengdu, China
| | - Peng Li
- School of Psychology, Shenzhen University, Shenzhen, China; Shenzhen Key Laboratory of Affective and Social Cognitive Science, Shenzhen University, Shenzhen, China.
| | | | - Hong Li
- School of Psychology, South China Normal University, Guangzhou, China; Institute for Brain and Psychological Sciences, Sichuan Normal University, Chengdu, China; Center for Emotion and Brain, Shenzhen Institute of Neuroscience, Shenzhen, China
| | - Paavo H T Leppänen
- Faculty of Education and Psychology, University of Jyväskylä, Jyväskylä, Finland
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Rash JA, Campbell TS, Cooper L, Flusk D, MacInnes A, Nasr-Esfahani M, Mekhael AA, Poulin PA, Robert M, Yi Y. Evaluating the efficacy of intranasal oxytocin on pain and function among individuals who experience chronic pain: a protocol for a multisite, placebo-controlled, blinded, sequential, within-subjects crossover trial. BMJ Open 2021; 11:e055039. [PMID: 34556520 PMCID: PMC8461687 DOI: 10.1136/bmjopen-2021-055039] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
Abstract
INTRODUCTION Current treatments for chronic pain (eg, opioids) can have adverse side effects and rarely result in resolution of pain. As such, there is a need for adjuvant analgesics that are non-addictive, have few adverse side effects and are effective for pain management across several chronic pain conditions. Oxytocin is a naturally occurring hormone that has gained attention for its potential analgesic properties. The objective of this trial is to evaluate the efficacy of intranasal oxytocin on pain and function among adults with chronic pain. METHODS AND ANALYSIS This is a placebo-controlled, triple-blind, sequential, within-subject crossover trial. Adults with chronic neuropathic, pelvic and musculoskeletal pain will be recruited from three Canadian provinces (British Columbia, Alberta and Newfoundland and Labrador, respectively). Enrolled patients will provide one saliva sample pretreatment to evaluate basal oxytocin levels and polymorphisms of the oxytocin receptor gene before being randomised to one of two trial arms. Patients will self-administer three different oxytocin nasal sprays twice daily for a period of 2 weeks (ie, 24 IU, 48 IU and placebo). Patients will complete daily diaries, including standardised measures on day 1, day 7 and day 14. Primary outcomes include pain and pain-related interference. Secondary outcomes include emotional function, sleep disturbance and global impression of change. Intention-to-treat analyses will be performed to evaluate whether improvement in pain and physical function will be observed posttreatment. ETHICS AND DISSEMINATION Trial protocols were approved by the Newfoundland and Labrador Health Research Ethics Board (HREB #20227), University of British Columbia Clinical Research Ethics Board (CREB #H20-00729), University of Calgary Conjoint Health Research Ethics Board (REB20 #0359) and Health Canada (Control # 252780). Results will be disseminated through publication in peer-reviewed journals and presentations at scientific conferences. TRIAL REGISTRATION NUMBER NCT04903002; Pre-results.
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Affiliation(s)
- Joshua A Rash
- Department of Psychology, Faculty of Science, Memorial University of Newfoundland, St. John's, Newfoundland, Canada
| | - Tavis S Campbell
- Department of Psychology, Faculty of Arts, University of Calgary, Calgary, Alberta, Canada
| | - Lynn Cooper
- Canadian Injured Workers Alliance, Thunder Bay, Ontario, Canada
| | - David Flusk
- Anesthesia and Pain Medicine, Faculty of Medicine, Memorial University of Newfoundland, St. John's, Newfoundland and Labrador, Canada
| | - Aaron MacInnes
- Anesthesiology, Pharmacology and Therapeutics, Faculty of Medicine, University of British Columbia, Vancouver, British Columbia, Canada
| | - Maryam Nasr-Esfahani
- Department of Anesthesiology, Perioperative and Pain Medicine, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
- Obstetrics and Gynecology, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Anastasia A Mekhael
- Department of Psychology, Faculty of Science, Memorial University of Newfoundland, St. John's, Newfoundland, Canada
| | - Patricia A Poulin
- The Ottawa Hospital Research Institute, Ottawa, Ontario, Canada
- Department of Anesthesiology and Pain Medicine, University of Ottawa, Ottawa, Ontario, Canada
- The Ottawa Hospital Pain Clinic, Ottawa, Ontario, Canada
| | - Magali Robert
- Department of Anesthesiology, Perioperative and Pain Medicine, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
- Obstetrics and Gynecology, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Yanqing Yi
- Community Health and Humanities, Faculty of Medicine, Memorial University of Newfoundland, St. John's, Newfoundland, Canada
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Biurrun Manresa JA, Schliessbach J, Vuilleumier PH, Müller M, Musshoff F, Stamer U, Stüber F, Arendt-Nielsen L, Curatolo M. Anti-nociceptive effects of oxytocin receptor modulation in healthy volunteers-A randomized, double-blinded, placebo-controlled study. Eur J Pain 2021; 25:1723-1738. [PMID: 33884702 DOI: 10.1002/ejp.1781] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2020] [Accepted: 04/09/2021] [Indexed: 11/11/2022]
Abstract
BACKGROUND There is increasing evidence for oxytocin as a neurotransmitter in spinal nociceptive processes. Hypothalamic oxytocinergic neurons project to the spinal dorsal horn, where they activate GABA-ergic inhibitory interneurons. The present study tested whether the long-acting oxytocin-analogue carbetocin has anti-nociceptive effects in multi-modal experimental pain in humans. METHODS Twenty-five male volunteers received carbetocin 100 mcg and placebo (0.9% NaCl) on two different sessions in a randomized, double-blinded, cross-over design. Multi-modal quantitative sensory testing (QST) including a model of capsaicin-induced hyperalgesia and allodynia were performed at baseline and at 10, 60 and 120 min after drug administration. QST data were analysed using mixed linear and logistic regression models. Carbetocin plasma concentrations and oxytocin receptor genotypes were quantified and assessed in an exploratory fashion. RESULTS An anti-nociceptive effect of carbetocin was observed on intramuscular electrical temporal summation (estimated difference: 1.26 mA, 95% CI 1.01 to 1.56 mA, p = .04) and single-stimulus electrical pain thresholds (estimated difference: 1.21 mA, 95% CI 1.0 to 1.47 mA, p = .05). Furthermore, the area of capsaicin-induced allodynia was reduced after carbetocin compared to placebo (estimated difference: -6.5 cm2 , 95% CI -9.8 to -3.2 cm2 , p < .001). CONCLUSIONS This study provides evidence of an anti-nociceptive effect of carbetocin on experimental pain in humans. SIGNIFICANCE This study provides evidence of the anti-nociceptive effect of intravenous administration of the oxytocin agonist carbetocin in healthy male volunteers.
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Affiliation(s)
- José A Biurrun Manresa
- Center for Sensory-Motor Interaction, Department of Health Science and Technology, Aalborg University, Aalborg, Denmark.,Instituto de Investigación y Desarrollo en Bioingeniería y Bioinformática (IBB), CONICET-UNER, Oro Verde, Argentina
| | - Jürg Schliessbach
- Department of Anesthesiology and Pain Medicine, Bern University Hospital, University of Bern, Bern, Switzerland.,Institute of Anesthesiology, University Hospital of Zurich, Zurich, Switzerland
| | - Pascal H Vuilleumier
- Department of Anesthesiology and Pain Medicine, Bern University Hospital, University of Bern, Bern, Switzerland.,Clinic of Anesthesiology, Intensive Care and Pain Medicine, Hirslandenklinik St. Anna, Lucerne, Switzerland
| | - Monika Müller
- Department of Anesthesiology and Pain Medicine, Bern University Hospital, University of Bern, Bern, Switzerland.,Translational Research Center, University Hospital of Psychiatry, University of Bern, Bern, Switzerland
| | | | - Ulrike Stamer
- Department of Anesthesiology and Pain Medicine, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Frank Stüber
- Department of Anesthesiology and Pain Medicine, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Lars Arendt-Nielsen
- Center for Sensory-Motor Interaction, Department of Health Science and Technology, Aalborg University, Aalborg, Denmark
| | - Michele Curatolo
- Center for Sensory-Motor Interaction, Department of Health Science and Technology, Aalborg University, Aalborg, Denmark.,Department of Anesthesiology and Pain Therapy, University of Washington, Seattle, WA, USA
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Pfeifer AC, Schroeder-Pfeifer P, Schneider E, Schick M, Heinrichs M, Bodenmann G, Ehlert U, Herpertz SC, Läuchli S, Eckstein M, Ditzen B. Oxytocin and positive couple interaction affect the perception of wound pain in everyday life. Mol Pain 2021; 16:1744806920918692. [PMID: 32308117 PMCID: PMC7171986 DOI: 10.1177/1744806920918692] [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] [Indexed: 11/15/2022] Open
Abstract
A large body of animal and human laboratory research has linked social interaction and support to pain perception, with a possible role for the neuropeptide oxytocin as a neuroendocrine mediator. However so far, it has been unclear whether these effects translate to ecologically valid everyday life behavior and pain perception. In a randomized placebo-controlled study, a standard suction blister skin wound was induced to N = 80 romantic couples (N = 160 individuals). Couples then received intranasal oxytocin or placebo twice daily and were either instructed to perform a positive social interaction (partner appraisal task, PAT) once in the laboratory and two times during the following five days, or not. During these days, all participants reported their subjective pain levels multiple times a day using ecologically momentary assessment. Results from hierarchical linear modeling suggest that pain levels within the couples were inter-related. In men, but not in women, oxytocin reduced pain levels. Women reported lower pain levels in the group of positive social interaction, while this effect did not show in men. These results suggest that intranasal oxytocin might have sex-specific effects with pain reducing effects in men but the opposite effects in women. In contrast, especially women benefit from positive interaction in terms of dampened pain levels after positive interaction. The results add to the evidence for health-beneficial effects of positive couple interaction and point to underlying neuroendocrine mechanisms in everyday life pain specifically. The sex-specific effects, in particular, may have implications for psychopharmacological treatment of pain in men and women.
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Affiliation(s)
- Ann-Christin Pfeifer
- Department of Orthopedics, Trauma Surgery and Paraplegiology, University Hospital Heidelberg, Germany.,Institute of Medical Psychology, Center for Psychosocial Medicine, University Hospital Heidelberg, Heidelberg, Germany
| | - Paul Schroeder-Pfeifer
- Institute of Psychosocial Prevention, Center for Psychosocial Medicine, University Hospital Heidelberg, Heidelberg, Germany
| | - Ekaterina Schneider
- Institute of Medical Psychology, Center for Psychosocial Medicine, University Hospital Heidelberg, Heidelberg, Germany
| | - Maren Schick
- Institute of Medical Psychology, Center for Psychosocial Medicine, University Hospital Heidelberg, Heidelberg, Germany
| | - Markus Heinrichs
- Differential and Biological Psychology, Institute of Psychology, Freiburg University, Freiburg, Germany
| | - Guy Bodenmann
- Family Psychology, Institute of Psychology, University of Zurich, Zurich, Switzerland
| | - Ulrike Ehlert
- Clinical Psychology and Psychotherapy, University of Zurich, Zurich, Switzerland
| | - Sabine C Herpertz
- Department of General Psychiatry, University Hospital Heidelberg, Heidelberg, Germany
| | - Severin Läuchli
- Dermatological Clinic, University Hospital Zurich, Zurich, Switzerland
| | - Monika Eckstein
- Institute of Medical Psychology, Center for Psychosocial Medicine, University Hospital Heidelberg, Heidelberg, Germany
| | - Beate Ditzen
- Institute of Medical Psychology, Center for Psychosocial Medicine, University Hospital Heidelberg, Heidelberg, Germany
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13
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Intranasal oxytocin and the stress-buffering effects of social support during experimentally induced pain: The role of attachment security. J Affect Disord 2021; 278:149-156. [PMID: 32961410 DOI: 10.1016/j.jad.2020.09.057] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/08/2020] [Revised: 09/08/2020] [Accepted: 09/11/2020] [Indexed: 11/22/2022]
Abstract
BACKGROUND This study examined whether intranasal oxytocin enhances the stress-buffering effects of social support during experimentally induced pain, taking into account the role of individual differences in attachment security. METHODS Female participants (N = 193) were randomly assigned to oxytocin (24 IU intranasal) or placebo and to receive support or no support from a friend (2 × 2 factorial design with repeated measures)). Participants underwent the Cold Pressor Task (CPT) and were monitored for heart rate variability (HRV: RMSSD) and heart rate and reported pain levels. The Experiences in Close Relationships Questionnaire was used to measure attachment. RESULTS Oxytocin reduced RMSSD (p = 0.003, partial ɳ2 = 0.03) and increased heart rate (p = 0.039, partial ɳ2 = 0.03) in individuals who received support, possibly reflecting an enhanced attentional state. Oxytocin did not enhance beneficial effects of social support on perceived pain, but increased pain intensity in avoidantly attached individuals who were supported by a friend (p = 0.009, partial ɳ2 = 0.06). LIMITATIONS Only female participants were examined. Future studies are needed to determine sex differences in how oxytocin shapes stress-buffering effects of support. CONCLUSIONS Oxytocin may enhance the salience of social proximity and may be a mechanism underlying previously reported social influences on cardiovascular and mental health. However, oxytocin effects depend on interpersonal insecurities and may trigger discomfort in avoidantly attached individuals. Caution about oxytocin's therapeutic promise is warranted.
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14
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Flynn MJ, Campbell TS, Robert M, Nasr-Esfahani M, Rash JA. Intranasal oxytocin as a treatment for chronic pelvic pain: A randomized controlled feasibility study. Int J Gynaecol Obstet 2020; 152:425-432. [PMID: 33112417 DOI: 10.1002/ijgo.13441] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2020] [Revised: 07/20/2020] [Accepted: 10/26/2020] [Indexed: 01/27/2023]
Abstract
OBJECTIVE To investigate the effect of intranasal oxytocin on chronic pelvic pain in a randomized, double-blind, within-subject crossover trial. Aims included: (1) determine intranasal oxytocin's effect on pain intensity and pain interference relative to placebo; (2) assess feasibility and acceptability. METHODS Women with chronic pelvic pain were recruited from chronic pain and gynecology clinics between September 2017 and December 2018. Pain was recorded at pre-trial screening, and while administering intranasal oxytocin and placebo. Pain and pain-related interference were measured using the Brief Pain Inventory - Short Form. Feasibility and acceptability were measured using validated measures and interviews. RESULTS Twenty-one women were randomized with sufficient data available from 12 to permit analyses. Relative to placebo, a 2-week course of oxytocin administration resulted in improvement in pain severity with no effect on pain-related interference. This effect was driven by four women who demonstrated a minimal clinically significant improvement in pain following intranasal oxytocin (no women met this threshold for placebo). Adherence to dosing was excellent and occurrence of adverse effects did not differ between oxytocin and placebo. CONCLUSION Intranasal oxytocin may represent an adjuvant analgesic that could result in a minimal clinically significant improvement in pain among one in three women with chronic pelvic pain. Registration: ClinicalTrials.gov (Registration# NCT02888574).
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Affiliation(s)
- Michelle J Flynn
- Department of Psychology, University of Calgary, Calgary, AB, Canada
| | - Tavis S Campbell
- Department of Psychology, University of Calgary, Calgary, AB, Canada
| | - Magali Robert
- Department of Obstetrics & Gynecology, University of Calgary, Calgary, AB, Canada.,Department of Anesthesiology, Perioperative and Pain Medicine, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
| | - Maryam Nasr-Esfahani
- Department of Obstetrics & Gynecology, University of Calgary, Calgary, AB, Canada.,Department of Anesthesiology, Perioperative and Pain Medicine, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
| | - Joshua A Rash
- Department of Psychology, Memorial University of Newfoundland, St. John's, NL, Canada
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15
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Skvortsova A, Veldhuijzen DS, van Middendorp H, Colloca L, Evers AWM. Effects of Oxytocin on Placebo and Nocebo Effects in a Pain Conditioning Paradigm: A Randomized Controlled Trial. THE JOURNAL OF PAIN 2020; 21:430-439. [PMID: 31494273 PMCID: PMC7408480 DOI: 10.1016/j.jpain.2019.08.010] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 02/05/2019] [Revised: 08/06/2019] [Accepted: 08/23/2019] [Indexed: 12/19/2022]
Abstract
Oxytocin has been shown to increase trust, decrease anxiety, and affect learning as has been observed in conditioning paradigms. Trust, anxiety, and learning are important factors that influence placebo effects. In this study, we investigated whether oxytocin can increase placebo analgesia, decrease nocebo hyperalgesia, and influence extinction processes of both. Eighty male volunteers were assigned to a 40 IU of oxytocin nasal spray group, or to a placebo control group. Placebo analgesia and nocebo hyperalgesia were induced by a conditioning procedure in combination with verbal suggestions. The results demonstrate that the conditioning procedure successfully elicited significant placebo analgesia and nocebo hyperalgesia responses (P < .001). Furthermore, extinction was observed (P < .001), although placebo and nocebo responses did not return to baseline and remained significant. Oxytocin did not influence placebo analgesia or nocebo hyperalgesia and had no effect on extinction. This study provides support against the placebo-boosting effects of oxytocin and was the first one to demonstrate that it also did not influence nocebo effects or extinction processes, however, these results pertain to only a male sample. As managing placebo and nocebo effects has widespread clinical implications, further research should investigate other neurobiological or behavioral pathways to boost placebo and decrease nocebo effects. PERSPECTIVE: The present study demonstrated that placebo analgesia and nocebo hyperalgesia can be successfully induced by conditioning and verbal suggestions. We could not confirm the hypothesis that oxytocin affects either of these phenomena. Other pharmacological agents and behavioral manipulations for increasing placebo and decreasing nocebo effects should be investigated.
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Affiliation(s)
- Aleksandrina Skvortsova
- Health, Medical and Neuropsychology Unit, Institute of Psychology, Faculty of Social and Behavioural Sciences, Leiden University, Leiden, The Netherlands; Leiden Institute for Brain and Cognition, Leiden, The Netherlands.
| | - Dieuwke S Veldhuijzen
- Health, Medical and Neuropsychology Unit, Institute of Psychology, Faculty of Social and Behavioural Sciences, Leiden University, Leiden, The Netherlands; Leiden Institute for Brain and Cognition, Leiden, The Netherlands
| | - Henriët van Middendorp
- Health, Medical and Neuropsychology Unit, Institute of Psychology, Faculty of Social and Behavioural Sciences, Leiden University, Leiden, The Netherlands; Leiden Institute for Brain and Cognition, Leiden, The Netherlands
| | - Luana Colloca
- Department of Pain Translational Symptoms Science, School of Nursing and Department of Anaesthesiology, Medicine, University of Maryland Baltimore, Baltimore, Maryland
| | - Andrea W M Evers
- Health, Medical and Neuropsychology Unit, Institute of Psychology, Faculty of Social and Behavioural Sciences, Leiden University, Leiden, The Netherlands; Leiden Institute for Brain and Cognition, Leiden, The Netherlands; Department of Psychiatry, Leiden University Medical Center, Leiden, The Netherlands
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16
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Dolan SB, Berry MS, Johnson PS, Johnson MW. Potential for limited reinforcing and abuse-related subjective effects of intranasal oxytocin. J Psychopharmacol 2020; 34:336-347. [PMID: 31475622 PMCID: PMC8977072 DOI: 10.1177/0269881119867607] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
Abstract
BACKGROUND There has been growing interest in using oxytocin as a pharmacotherapy for psychiatric disorders, including substance use disorder. Limited data exist regarding oxytocin's reinforcing efficacy, which is a necessary consideration for novel pharmacotherapies, especially in substance-using populations. AIMS This study aimed to determine the potential reinforcing effects of intranasally administered oxytocin by assessing behavioral economic demand and subjective effects. METHODS Healthy adults (n = 23) participated in a double-blind, repeated-measures, laboratory study wherein they received intranasal oxytocin (40 IU) or placebo in a randomized order across two sessions. Participants completed drug purchasing tasks at the conclusion of both sessions. Throughout both sessions, subjective and physiological effects were assessed. RESULTS Demand-curve analysis of purchasing tasks revealed greater median purchasing for oxytocin relative to placebo. Physiological and subjective effects did not significantly differ between oxytocin and placebo. However, a nonsignificant trend was observed for moderately greater drug liking for oxytocin relative to placebo. There was a significant, positive correlation between the difference in drug liking (between oxytocin and placebo) and the difference in lowest-price purchasing (between oxytocin and placebo). CONCLUSIONS These data suggest the potential for limited reinforcing and abuse-related subjective effects of intranasal oxytocin. Given the small sample, the greater drug liking of oxytocin compared to placebo, and the positive relation between demand and drug liking, it is possible that oxytocin may produce reinforcing effects in some participants. Therefore, additional studies of oxytocin reinforcement are warranted.
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Affiliation(s)
- Sean B Dolan
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Meredith S Berry
- Department of Health Education and Behavior, University of Florida, Gainesville, FL, USA
- Department of Psychology, University of Florida, Gainesville, FL, USA
| | - Patrick S Johnson
- Department of Psychology, California State University, Chico, CA, USA
| | - Matthew W Johnson
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, USA
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17
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Ende HB, Soens MA, Nandi M, Strichartz GR, Schreiber KL. Association of Interindividual Variation in Plasma Oxytocin With Postcesarean Incisional Pain. Anesth Analg 2020; 129:e118-e121. [PMID: 29916862 DOI: 10.1213/ane.0000000000003567] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Oxytocin has known antinociceptive effects and is upregulated perinatally. This pilot study investigated the association of plasma oxytocin and postcesarean incisional pain. Plasma samples from 18 patients undergoing elective cesarean delivery were drawn at 1 hour preoperatively and 1 and 24 hours postoperatively and analyzed by using enzyme-linked immunosorbent assay. Pain was assessed at 1 day, 8 weeks, 3 months, and 6 months postoperatively. Incisional pain at 24 hours was inversely correlated with 1- and 24-hour oxytocin levels, with higher plasma oxytocin associated with lower pain (ρ, -0.52 and -0.66; P < .05).
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Affiliation(s)
- Holly B Ende
- From the Department of Anesthesiology, Perioperative and Pain Medicine
| | - Mieke A Soens
- From the Department of Anesthesiology, Perioperative and Pain Medicine.,Women's Pain Group, Connors Center for Women's Health and Gender Biology, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts
| | - Meghna Nandi
- From the Department of Anesthesiology, Perioperative and Pain Medicine
| | - Gary R Strichartz
- From the Department of Anesthesiology, Perioperative and Pain Medicine.,Women's Pain Group, Connors Center for Women's Health and Gender Biology, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts
| | - Kristin L Schreiber
- From the Department of Anesthesiology, Perioperative and Pain Medicine.,Women's Pain Group, Connors Center for Women's Health and Gender Biology, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts
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18
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Li YX, An H, Wen Z, Tao ZY, Cao DY. Can oxytocin inhibit stress-induced hyperalgesia? Neuropeptides 2020; 79:101996. [PMID: 31776011 DOI: 10.1016/j.npep.2019.101996] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/22/2019] [Revised: 11/13/2019] [Accepted: 11/13/2019] [Indexed: 11/19/2022]
Abstract
Stress-induced hyperalgesia is a problematic condition that lacks an effective therapeutic measure, and hence impairs health-related quality of life. The regulation of stress by oxytocin (OT) has overlapping effects on pain. OT can alleviate pain directly mainly at the spinal level and the peripheral tissues. Additionally, OT plays an analgesic role by dealing with stress and fear learning. When OT relieves stress by targeting the prefrontal brain regions and the hypothalamic-pituitary-adrenal axis, the body's sensitivity to pain is attenuated. Meanwhile, OT facilitates fear learning and may, in turn, enhance the anticipatory actions to painful stimulation. The unique therapeutic value of OT in patients suffering from stress and stress-related hyperalgesia conditions is worth considering. We reviewed recent advances in animal and human studies involving the effects of OT on stress and pain, and discussed the possible targets of OT within the descending and ascending pathways in the central nervous system. This review provides an overview of the evidence on the role of OT in alleviating stress-induced hyperalgesia.
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Affiliation(s)
- Yue-Xin Li
- Key Laboratory of Shaanxi Province for Craniofacial Precision Medicine Research, Research Center of Stomatology, Xi'an Jiaotong University College of Stomatology, 98 West 5th Road, Xi'an, Shaanxi 710004, PR China; Department of Special Dental Care, Xi'an Jiaotong University College of Stomatology, 98 West 5th Road, Xi'an, Shaanxi 710004, PR China
| | - Hong An
- Department of Special Dental Care, Xi'an Jiaotong University College of Stomatology, 98 West 5th Road, Xi'an, Shaanxi 710004, PR China.
| | - Zhuo Wen
- Department of Special Dental Care, Xi'an Jiaotong University College of Stomatology, 98 West 5th Road, Xi'an, Shaanxi 710004, PR China
| | - Zhuo-Ying Tao
- Key Laboratory of Shaanxi Province for Craniofacial Precision Medicine Research, Research Center of Stomatology, Xi'an Jiaotong University College of Stomatology, 98 West 5th Road, Xi'an, Shaanxi 710004, PR China
| | - Dong-Yuan Cao
- Key Laboratory of Shaanxi Province for Craniofacial Precision Medicine Research, Research Center of Stomatology, Xi'an Jiaotong University College of Stomatology, 98 West 5th Road, Xi'an, Shaanxi 710004, PR China.
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19
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Skvortsova A, Veldhuijzen DS, Pacheco-Lopez G, Bakermans-Kranenburg M, van IJzendoorn M, Smeets MAM, Wilderjans TF, Dahan A, van den Bergh O, Chavannes NH, van der Wee NJA, Grewen KM, van Middendorp H, Evers AWM. Placebo Effects in the Neuroendocrine System: Conditioning of the Oxytocin Responses. Psychosom Med 2020; 82:47-56. [PMID: 31609920 PMCID: PMC6946094 DOI: 10.1097/psy.0000000000000759] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/11/2009] [Revised: 08/15/2019] [Indexed: 12/30/2022]
Abstract
OBJECTIVE There is evidence that placebo effects may influence hormone secretion. However, few studies have examined placebo effects in the endocrine system, including oxytocin placebo effects. We studied whether it is possible to trigger oxytocin placebo effects using a classical conditioning paradigm. METHODS Ninety-nine women were assigned to a conditioned, control, or drug control group. In the two-phase conditioning paradigm, participants in the conditioned and drug control groups received an oxytocin nasal spray combined with a distinctive smell (conditioned stimulus [CS]) for three acquisition days, whereas the control group received placebo spray. Subsequently, the conditioned and control groups received placebo spray with the CS and the drug control group received oxytocin spray for three evocation days. Salivary oxytocin was measured several times during each day. Pain sensitivity and facial evaluation tests previously used in oxytocin research were also administered. RESULTS On evocation day 1, in the conditioned group, oxytocin significantly increased from baseline to 5 minutes after CS (B[slope] = 19.55, SE = 5.88, p < .001) and remained increased from 5 to 20 (B = -10.42, SE = 5.81, p = .071) and 50 minutes (B = -0.70, SE = 3.37, p = .84). On evocation day 2, a trend for increase in oxytocin was found at 5 minutes (B = 15.22, SE = 8.14, p = .062). No placebo effect was found on evocation day 3 (B = 3.57, SE = 3.26, p = .28). Neither exogenous nor conditioned oxytocin affected pain or facial tasks. CONCLUSIONS Results indicate that oxytocin release can be conditioned and that this response extinguishes over time. Triggering hormonal release by placebo manipulation offers various clinical possibilities, such as enhancing effects of pharmacological treatments or reducing dosages of medications. TRIAL REGISTRATION The study was registered as a clinical trial on www.trialregister.nl (number NTR5596).
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Affiliation(s)
- Aleksandrina Skvortsova
- From the Health, Medical and Neuropsychology Unit (Skvortsova, Veldhuijzen, Pacheco-Lopez, van Middendorp, Evers), Faculty of Social and Behavioural Sciences, Leiden University; Leiden Institute for Brain and Cognition (Skvortsova, Veldhuijzen, Pacheco-Lopez, Bakermans-Kranenburg, Wilderjans, van Middendorp, Evers), Leiden, the Netherlands; Department of Health Sciences (Pacheco-Lopez), Metropolitan Autonomous University, Campus Lerma, Lerma, Edo. Mex., Mexico; Leiden Consortium on Individual Development (Bakermans-Kranenburg), Leiden University, Leiden; Department of Psychology, Education and Child Studies (van IJzendoorn), Erasmus University Rotterdam, Rotterdam, the Netherlands; Primary Care Unit (van IJzendoorn), School of Clinical Medicine, University of Cambridge, Cambridge, United Kingdom; Department of Social, Health, and Organizational Psychology (Smeets), Utrecht University, Utrecht; Methodology and Statistics Research Unit (Wilderjans), Institute of Psychology, Faculty of Social and Behavioural Sciences, Leiden University, Leiden, the Netherlands; Research Group of Quantitative Psychology and Individual Differences (Wilderjans), University of Leuven - KU Leuven, Leuven, Belgium; Department of Anaesthesiology (Dahan), Leiden University Medical Center, Leiden, the Netherlands; Health Psychology (van den Bergh), University of Leuven - KU Leuven, Leuven, Belgium; Departments of Public Health and Primary Care (Chavannes) and Psychiatry (van der Wee, Evers), Leiden University Medical Center, Leiden, the Netherlands; and Department of Psychiatry (Grewen), University of North Carolina, Charlotte, North Carolina
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20
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Lussier D, Cruz-Almeida Y, Ebner NC. Musculoskeletal Pain and Brain Morphology: Oxytocin's Potential as a Treatment for Chronic Pain in Aging. Front Aging Neurosci 2019; 11:338. [PMID: 31920621 PMCID: PMC6923678 DOI: 10.3389/fnagi.2019.00338] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2019] [Accepted: 11/22/2019] [Indexed: 11/13/2022] Open
Abstract
Chronic pain disproportionately affects older adults, severely impacting quality of life and independent living, with musculoskeletal pain most prevalent. Chronic musculoskeletal pain is associated with specific structural alterations in the brain and interindividual variability in brain structure is likely an important contributor to susceptibility for the development of chronic pain. However, understanding of age-related structural changes in the brain and their associations with chronic musculoskeletal pain is currently limited. Oxytocin (OT), a neuropeptide present in the periphery and central nervous system, has been implicated in pain attenuation. Variation of the endogenous OT system (e.g., OT receptor genotype, blood, saliva, and cerebrospinal fluid OT levels) is associated with morphology in brain regions involved in pain processing and modulation. Intranasal OT administration has been shown to attenuate pain. Yet, studies investigating the efficacy of OT for management of chronic musculoskeletal pain are lacking, including among older individuals who are particularly susceptible to the development of chronic musculoskeletal pain. The goal of this focused narrative review was to synthesize previously parallel lines of work on the relationships between chronic pain, brain morphology, and OT in the context of aging. Based on the existing evidence, we propose that research on the use of intranasal OT administration as an intervention for chronic pain in older adults is needed and constitutes a promising future direction for this field. The paper concludes with suggestions for future research in the emerging field, guided by our proposed Model of Oxytocin’s Anagelsic and Brain Structural Effects in Aging.
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Affiliation(s)
- Désirée Lussier
- Department of Psychology, University of Florida, Gainesville, FL, United States
| | - Yenisel Cruz-Almeida
- Pain Research and Intervention Center of Excellence, University of Florida, Gainesville, FL, United States.,Claude D. Pepper Older American Independence Center, Institute on Aging, University of Florida, Gainesville, FL, United States.,Department of Clinical and Health Psychology, Center for Cognitive Aging and Memory, University of Florida, Gainesville, FL, United States.,Department of Community Dentistry & Behavioral Science, College of Dentistry, University of Florida, Gainesville, FL, United States.,Departments of Aging & Geriatric Research, Epidemiology and Neuroscience, College of Medicine, University of Florida, Gainesville, FL, United States
| | - Natalie C Ebner
- Department of Psychology, University of Florida, Gainesville, FL, United States.,Pain Research and Intervention Center of Excellence, University of Florida, Gainesville, FL, United States.,Claude D. Pepper Older American Independence Center, Institute on Aging, University of Florida, Gainesville, FL, United States.,Department of Clinical and Health Psychology, Center for Cognitive Aging and Memory, University of Florida, Gainesville, FL, United States.,Department of Community Dentistry & Behavioral Science, College of Dentistry, University of Florida, Gainesville, FL, United States
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21
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Herpertz SC, Schmitgen MM, Fuchs C, Roth C, Wolf RC, Bertsch K, Flor H, Grinevich V, Boll S. Oxytocin Effects on Pain Perception and Pain Anticipation. THE JOURNAL OF PAIN 2019; 20:1187-1198. [PMID: 31009765 DOI: 10.1016/j.jpain.2019.04.002] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/27/2018] [Revised: 02/11/2019] [Accepted: 04/02/2019] [Indexed: 12/20/2022]
Abstract
There is an ongoing debate whether the neuropeptide oxytocin (OT) modulates pain processing in humans. This study differentiates behavioral and neuronal OT effects on pain perception and pain anticipation by using a Pavlovian conditioning paradigm. Forty-six males received intranasally administered OT in a randomized, double-blind, placebo-controlled group design. Although OT exerted no direct effect on perceived pain, OT was found to modulate the blood oxygen level-dependent response in the ventral striatum for painful versus warm unconditioned stimuli and to decrease activity in the anterior insula (IS) with repeated thermal pain stimuli. Regarding pain anticipation, OT increased responses to CSpain versus CSminus in the nucleus accumbens. Furthermore, in the OT condition increased correct expectations, particularly for the most certain conditioned stimuli (CS)-unconditioned stimuli associations (CSminus and CSpain) were found, as well as greatest deactivations in the right posterior IS in response to the least certain condition (CSwarm) with posterior IS activity and correct expectancies being positively correlated. In conclusion, OT seems to have both a direct effect on pain processing via the ventral striatum and by inducing habituation in the anterior IS as well as on pain anticipation by boostering associative learning in general and the neuronal conditioned fear of pain response in particular. PERSPECTIVE: The neuropeptide OT has recently raised the hope to offer a novel avenue for modulating pain experience. This study found OT to modulate pain processing and to facilitate the anticipation of pain, inspiring further research on OT effects on the affective dimension of the pain experience.
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Affiliation(s)
- Sabine C Herpertz
- Department of General Psychiatry, University Hospital of Heidelberg, Heidelberg, Germany.
| | - Mike M Schmitgen
- Department of General Psychiatry, University Hospital of Heidelberg, Heidelberg, Germany
| | - Christine Fuchs
- Department of General Psychiatry, University Hospital of Heidelberg, Heidelberg, Germany
| | - Corinna Roth
- Department of General Psychiatry, University Hospital of Heidelberg, Heidelberg, Germany
| | - Robert Christian Wolf
- Department of General Psychiatry, University Hospital of Heidelberg, Heidelberg, Germany
| | - Katja Bertsch
- Department of General Psychiatry, University Hospital of Heidelberg, Heidelberg, Germany
| | - Herta Flor
- Institute of Cognitive and Clinical Neuroscience, Central Institute of Mental Health Mannheim, University of Heidelberg, Mannheim, Germany
| | - Valery Grinevich
- Schaller Research Group on Neuropeptides, German Cancer Research Center DKFZ, Heidelberg, Germany
| | - Sabrina Boll
- Department of General Psychiatry, University Hospital of Heidelberg, Heidelberg, Germany
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22
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Solomon DT, Nietert PJ, Calhoun C, Smith DW, Back SE, Barden E, Brady KT, Flanagan JC. Effects of Oxytocin on Emotional and Physiological Responses to Conflict in Couples with Substance Misuse. ACTA ACUST UNITED AC 2019; 7:91-102. [PMID: 30740265 DOI: 10.1037/cfp0000103] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
Social stress, especially dyadic conflict among couples, is an important correlate of addiction. Several authors have suggested that the neuropeptide oxytocin (OT) may be useful in the treatment of couples with substance misuse. However, the literature examining OT among couples is scant and has yielded mixed findings. The current study examined the effects of OT versus placebo on emotional (e.g., warmth and anger) and physiological (e.g., skin conductance and heart rate) reactivity to a conflict resolution task in 30 heterosexual couples (N=60) in which one or both members misused substances. Using a randomized, double-blind, placebo-controlled design, both partners within each dyad were randomized to the same treatment condition. Participants completed a standardized conflict resolution task at baseline and 45 minutes following drug self-administration. Physiological measures were examined continuously during the laboratory tasks and emotional reactivity was self-reported at baseline and at 5 time points over the course of 1 hour following the second conflict resolution task. Results of a multi-level growth curve model accounting for baseline scores, gender and drug condition indicate that positive emotional experiences and skin conductance measures increased over the 5 time points. Neither drug condition nor gender was significantly related to outcomes, and no interaction effects were observed. These findings highlight the complexities involved in translational OT research and suggest that the impact of OT on key outcomes requires further exploration in regards to OT's potential therapeutic benefit.
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Affiliation(s)
| | | | - Casey Calhoun
- Medical University of South Carolina, Charleston, SC
| | | | - Sudie E Back
- Medical University of South Carolina, Charleston, SC.,Ralph H. Johnson VAMC, Charleston, SC
| | - Eileen Barden
- Medical University of South Carolina, Charleston, SC
| | - Kathleen T Brady
- Medical University of South Carolina, Charleston, SC.,Ralph H. Johnson VAMC, Charleston, SC
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23
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Peripheral oxytocin restores light touch and nociceptor sensory afferents towards normal after nerve injury. Pain 2019; 160:1146-1155. [DOI: 10.1097/j.pain.0000000000001495] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
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Urtado Silva J, Galhardoni R, Ciampi de Andrade D, Brito I. Effects of intranasal oxytocin on tactile perception. Neurosci Lett 2018; 698:64-68. [PMID: 30582971 DOI: 10.1016/j.neulet.2018.12.032] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2018] [Revised: 12/15/2018] [Accepted: 12/20/2018] [Indexed: 10/27/2022]
Abstract
In addition to its role in childbirth labor and lactation, oxytocin is a well-known neurohormone, having several prosocial effects. Moreover, oxytocin seems to play a significant modulatory role in painful experiences, due to its participation in central and peripheral processing of nociceptive somatosensory information. Despite studies on oxytocin in pain modulation, there is a scarce literature investigating the role of oxytocin in tactile perception. Here we investigate the effects of 24 and 40 IU intranasal administration of oxytocin in the non-harmful mechanical tactile detection threshold in men. The data showed a significant increase in tactile perception in an experimental 40 IU oxytocin group. We suggest that this effect could be the basis for the oxytocin-bonding effect via touch.
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Affiliation(s)
- Jessica Urtado Silva
- School of Arts, Sciences and Humanities, University of São Paulo, São Paulo, Brazil
| | - Ricardo Galhardoni
- Institute of Psychiatry, Faculty of Medicine, University of São Paulo, São Paulo, Brazil
| | | | - Ivana Brito
- School of Arts, Sciences and Humanities, University of São Paulo, São Paulo, Brazil.
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25
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Boll S, Almeida de Minas A, Raftogianni A, Herpertz S, Grinevich V. Oxytocin and Pain Perception: From Animal Models to Human Research. Neuroscience 2018; 387:149-161. [DOI: 10.1016/j.neuroscience.2017.09.041] [Citation(s) in RCA: 69] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2017] [Revised: 09/14/2017] [Accepted: 09/24/2017] [Indexed: 11/24/2022]
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26
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Kreuder AK, Wassermann L, Wollseifer M, Ditzen B, Eckstein M, Stoffel-Wagner B, Hennig J, Hurlemann R, Scheele D. Oxytocin enhances the pain-relieving effects of social support in romantic couples. Hum Brain Mapp 2018; 40:242-251. [PMID: 30152573 DOI: 10.1002/hbm.24368] [Citation(s) in RCA: 31] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2018] [Revised: 07/19/2018] [Accepted: 08/10/2018] [Indexed: 01/23/2023] Open
Abstract
Social support plays a vital role in physical and mental well-being. The neuropeptide hormone oxytocin (OXT) has been implicated in modulating pair-bonding and affiliative behaviors, but whether OXT contributes to the analgesic effects of a romantic partner's touch remains elusive. In the present randomized placebo-controlled, between-group, functional magnetic resonance imaging study involving 194 healthy volunteers (97 heterosexual couples), we tested the effects of intranasal OXT (24 IU) on handholding as a common mode of expressing emotional support in romantic couples. We scanned the subjects while brief electric shocks were administered. The subjects assumed that they received social support from either their romantic partner or an unfamiliar person. Unbeknown to the subject, in the partner and stranger support conditions, the same male experimenter always held the subject's left hand. Partner support was most effective in reducing the unpleasantness of electric shocks, and OXT further attenuated the unpleasantness across conditions. On the neural level, OXT significantly augmented the beneficial effects of partner support, as evidenced by a stronger decrease of neural responses to shocks in the anterior insula (AI), a stronger activity increase in the middle frontal gyrus (MFG), and a strengthened functional coupling between the AI and MFG. Our results support the notion that OXT specifically modulates the beneficial effects of social support in romantic couples by concomitantly reducing pain-associated activity and increasing activity linked to cognitive control and pain inhibition. We hypothesize that impaired OXT signaling may contribute to the experience of a lack of partner support.
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Affiliation(s)
| | - Lea Wassermann
- Division of Medical Psychology, University of Bonn, Bonn, Germany
| | | | - Beate Ditzen
- Center for Psychosocial Medicine, Institute of Medical Psychology, Heidelberg University, Heidelberg, Germany
| | - Monika Eckstein
- Center for Psychosocial Medicine, Institute of Medical Psychology, Heidelberg University, Heidelberg, Germany
| | - Birgit Stoffel-Wagner
- Department of Clinical Chemistry and Clinical Pharmacology, University of Bonn, Bonn, Germany
| | - Juergen Hennig
- Division of Personality Psychology and Individual Differences, University of Giessen, Giessen, Germany
| | - René Hurlemann
- Division of Medical Psychology, University of Bonn, Bonn, Germany.,Department of Psychiatry, University of Bonn, Bonn, Germany
| | - Dirk Scheele
- Division of Medical Psychology, University of Bonn, Bonn, Germany
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27
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Schuh-Hofer S, Eichhorn N, Grinevich V, Treede RD. Sleep Deprivation Related Changes of Plasma Oxytocin in Males and Female Contraceptive Users Depend on Sex and Correlate Differentially With Anxiety and Pain Hypersensitivity. Front Behav Neurosci 2018; 12:161. [PMID: 30116181 PMCID: PMC6082934 DOI: 10.3389/fnbeh.2018.00161] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2018] [Accepted: 07/09/2018] [Indexed: 02/05/2023] Open
Abstract
Disturbed sleep is known to substantially aggravate both the pain condition and the affective state of pain patients. The neurobiological mechanisms underlying these adverse effects are unknown. Oxytocin (OT), being largely involved in social and emotional behavior, is considered to also play a modulatory role in nociception. We hypothesized a pathophysiological role of OT for the hyperalgesic and anxiogenic effects of sleep loss. An established human model of one night of total sleep deprivation (TSD) was used to test this hypothesis. Twenty young healthy students (n = 10 male and n = 10 female) were investigated in a balanced cross-over design, contrasting TSD with a night of habitual sleep (HS). All females took monophasic oral contraceptives (OC) and were investigated during their ‘pill-free’ phase. Plasma OT concentrations were correlated with (1) pain thresholds, (2) descending pain inhibition, and (3) state-anxiety scores. Compared to the HS condition, the plasma OT concentration was significantly increased in sleep deprived females (p = 0.02) but not males (p = 0.69). TSD resulted in pain hypersensitivity to noxious cold (p = 0.05), noxious heat (p = 0.023), and pricking stimuli (p = 0.013) and significantly increased state-anxiety (p = 0.021). While, independent of sex, lower heat pain thresholds correlated with higher plasma OT (p = 0.036), no such associations were found for cold/mechanical pain. In sleep-deprived females, higher plasma OT showed a mild (but insignificant) association with lower pain inhibition (p = 0.093). We found a positive correlation between anxiety-scores and OT (p = 0.021), which was enhanced when respecting “sex” (p = 0.008) and “sleep” (p = 0.001) in a hierarchical regression analysis. Altogether, our study revealed a complex and partially sex-dependent correlation between plasma OT and TSD-induced changes of experimental pain and anxiety. The minor role of OT for TSD-induced changes of evoked pain, and its major involvement in anxiety, argues against a specific role of OT for linking the adverse effects of TSD on pain sensitivity and anxiety with each other. Future investigations are needed in order to dissect out the effect of OC on the sex-dependent effects of TSD observed in our study.
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Affiliation(s)
- Sigrid Schuh-Hofer
- Department of Neurophysiology, Centre of Biomedicine and Medical Technology Mannheim, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany.,Clinic for Neurology, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Nicole Eichhorn
- Department of Neurophysiology, Centre of Biomedicine and Medical Technology Mannheim, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Valery Grinevich
- Schaller Research Group on Neuropeptides, German Cancer Research Center, Heidelberg and Central Institute of Mental Health, Mannheim, Germany
| | - Rolf-Detlef Treede
- Department of Neurophysiology, Centre of Biomedicine and Medical Technology Mannheim, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
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Abstract
OBJECTIVE Placebo effects relieve various somatic symptoms, but it is unclear how they can be enhanced to maximize positive treatment outcomes. Oxytocin administration may potentially enhance placebo effects, but few studies have been performed, and they have had conflicting findings. The study aim was to investigate the influence of positive verbal suggestions and oxytocin on treatment expectations and placebo effects for pain and itch. METHODS One hundred eight female participants were allocated to one of the following four groups: (1) oxytocin with positive verbal suggestions, (2) placebo with positive verbal suggestions, (3) oxytocin without suggestions, and (4) placebo without suggestions. The administration of 24 IU oxytocin or a placebo spray was preceded by positive verbal suggestions regarding the pain- and itch-relieving properties of the spray or no suggestions, depending on group allocation. Pain was assessed with a cold pressor test, and itch was assessed with histamine iontophoresis. RESULTS Positive verbal suggestions induced expectations of lower pain (F = 4.77, p = .031) and itch (F = 5.38, p = .022). Moreover, positive verbal suggestions elicited placebo analgesia (F = 5.48, p = .021) but did not decrease itch. No effect of oxytocin on the placebo effect or on expectations was found. CONCLUSIONS Positive suggestions induced placebo analgesia but oxytocin did not enhance the placebo effect. Study limitations are that we only included a female sample and a failure to induce placebo effect for itch. Future studies should focus on how oxytocin might influence placebo effects, taken into account the role of sex, dose-dependent effects, and various expectation manipulations. TRIAL REGISTRATION The study was registered as a clinical trial on www.trialregister.nl (number 6376).
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29
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Meguro Y, Miyano K, Hirayama S, Yoshida Y, Ishibashi N, Ogino T, Fujii Y, Manabe S, Eto M, Nonaka M, Fujii H, Ueta Y, Narita M, Sata N, Yada T, Uezono Y. Neuropeptide oxytocin enhances μ opioid receptor signaling as a positive allosteric modulator. J Pharmacol Sci 2018; 137:67-75. [PMID: 29716811 DOI: 10.1016/j.jphs.2018.04.002] [Citation(s) in RCA: 45] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2018] [Revised: 03/28/2018] [Accepted: 03/30/2018] [Indexed: 10/17/2022] Open
Abstract
Oxytocin (OT) is a 9-amine neuropeptide that plays an essential role in mammalian labor, lactation, maternal bonding, and social affiliation. OT has been reported to exert an analgesic effect in both humans and animals, and the results of certain animal experiments have shown that the analgesic effect of OT is partially blocked by opioid receptor antagonists. To investigate the relationship between OT and μ opioid receptor (MOR), we evaluated how OT affects MOR in vitro by performing an electrical impedance-based receptor biosensor assay (CellKey™ assay), an intracellular cAMP assay, and a competitive receptor-binding analysis by using cells stably expressing human MOR and OT receptor. In both the CellKey™ assay and the intracellular cAMP assay, OT alone exerted no direct agonistic effect on human MOR, but treatment with 10-6 M OT markedly enhanced the MOR signaling induced by 10-6 M endomorphin-1, β-endorphin, morphine, fentanyl, and DAMGO. Moreover, in the competitive receptor-binding assay, 10-6 M OT did not alter the affinity of endomorphin-1 or morphine for MOR. These results suggest that OT could function as a positive allosteric modulator that regulates the efficacy of MOR signaling, and thus OT might represent a previously unrecognized candidate analgesic agent.
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Affiliation(s)
- Yoshiyuki Meguro
- Division of Cancer Pathophysiology, National Cancer Center Research Institute, 5-1-1 Tsukiji, Chuo-ku, Tokyo, 104-0045, Japan; Department of Surgery, Jichi Medical University School of Medicine, 3311-1 Yakushiji, Shimotsuke, Tochigi, 329-0498, Japan
| | - Kanako Miyano
- Division of Cancer Pathophysiology, National Cancer Center Research Institute, 5-1-1 Tsukiji, Chuo-ku, Tokyo, 104-0045, Japan
| | - Shigeto Hirayama
- Department of Medicinal Chemistry, School of Pharmacy, Kitasato University, 5-9-1 Shirokane, Minato-ku, Tokyo, 108-8641, Japan
| | - Yuki Yoshida
- Division of Cancer Pathophysiology, National Cancer Center Research Institute, 5-1-1 Tsukiji, Chuo-ku, Tokyo, 104-0045, Japan; Department of Medicinal and Life Sciences, Faculty of Pharmaceutical Sciences, Tokyo University of Science, 2641 Yamazaki, Noda, Chiba, 278-8510, Japan
| | - Naoto Ishibashi
- Division of Cancer Pathophysiology, National Cancer Center Research Institute, 5-1-1 Tsukiji, Chuo-ku, Tokyo, 104-0045, Japan; Department of Medicinal Chemistry, School of Pharmacy, Kitasato University, 5-9-1 Shirokane, Minato-ku, Tokyo, 108-8641, Japan
| | - Takumi Ogino
- Division of Cancer Pathophysiology, National Cancer Center Research Institute, 5-1-1 Tsukiji, Chuo-ku, Tokyo, 104-0045, Japan; Department of Medicinal Chemistry, School of Pharmacy, Kitasato University, 5-9-1 Shirokane, Minato-ku, Tokyo, 108-8641, Japan
| | - Yuriko Fujii
- Division of Cancer Pathophysiology, National Cancer Center Research Institute, 5-1-1 Tsukiji, Chuo-ku, Tokyo, 104-0045, Japan
| | - Sei Manabe
- Division of Cancer Pathophysiology, National Cancer Center Research Institute, 5-1-1 Tsukiji, Chuo-ku, Tokyo, 104-0045, Japan; Department of Anesthesiology and Resuscitation, Okayama University Hospital, 2-5-1 Shikata-cho, Kita-ku, Okayama, Okayama, 700-8558, Japan
| | - Moeko Eto
- Division of Cancer Pathophysiology, National Cancer Center Research Institute, 5-1-1 Tsukiji, Chuo-ku, Tokyo, 104-0045, Japan; Department of Medicinal and Life Sciences, Faculty of Pharmaceutical Sciences, Tokyo University of Science, 2641 Yamazaki, Noda, Chiba, 278-8510, Japan
| | - Miki Nonaka
- Division of Cancer Pathophysiology, National Cancer Center Research Institute, 5-1-1 Tsukiji, Chuo-ku, Tokyo, 104-0045, Japan
| | - Hideaki Fujii
- Department of Medicinal Chemistry, School of Pharmacy, Kitasato University, 5-9-1 Shirokane, Minato-ku, Tokyo, 108-8641, Japan
| | - Yoichi Ueta
- Department of Physiology, School of Medicine, University of Occupational and Environmental Health, 1-1 Iseigaoka, Yahatanishi-ku Kitakyushu, Fukuoka, 807-8555, Japan
| | - Minoru Narita
- Department of Pharmacology, Hoshi University School of Pharmacy and Pharmaceutical Sciences, 2-4-41 Ebara, Shinagawa-ku, Tokyo, 142-8501, Japan; Life Science Tokyo Advanced Research Center (L-StaR), Hoshi University School of Pharmacy and Pharmaceutical Sciences, 2-4-41 Ebara, Shinagawa-ku, Tokyo, 142-8501, Japan
| | - Naohiro Sata
- Department of Surgery, Jichi Medical University School of Medicine, 3311-1 Yakushiji, Shimotsuke, Tochigi, 329-0498, Japan
| | - Toshihiko Yada
- Division of Integrative Physiology, Department of Physiology, Jichi Medical University School of Medicine, 3311-1 Yakushiji, Shimotsuke, Tochigi, 329-0498, Japan
| | - Yasuhito Uezono
- Division of Cancer Pathophysiology, National Cancer Center Research Institute, 5-1-1 Tsukiji, Chuo-ku, Tokyo, 104-0045, Japan; Division of Supportive Care Research, Exploratory Oncology Research & Clinical Trial Center, National Cancer Center, 5-1-1 Tsukiji, Chuo-ku, Tokyo, 104-0045, Japan; Innovation Center for Supportive, Palliative and Psychosocial Care, National Cancer Center Hospital, 5-1-1 Tsukiji, Chuo-ku, Tokyo, 104-0045, Japan; Department of Comprehensive Oncology, Nagasaki University Graduate School of Biomedical Sciences, 1-12-4 Sakamoto, Nagasaki, 852-8523, Japan.
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30
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Abstract
BACKGROUND Over the years the effect of the neuropeptide oxytocin and its possible utilization for pain management has been increasingly more investigated and discussed. Initial results emphasized the effects of oxytocin with respect to labor and breastfeeding. Diverse animals studies were also able to demonstrate the effectiveness of the peptide in attachment behavior and pain perception; however, it is still unclear how oxytocin affects pain perception in humans. The potential therapeutic effectiveness of oxytocin could be particularly important for primary and secondary treatment of pain patients because chronification of pain can occur more frequently in this area. METHODS For this review the databases PubMed, Medline und PsycINFO were searched using the terms oxytocin, pain, human and analgesic. The search resulted in a total of 89 original articles after excluding articles regarding labor pain, breastfeeding and animal studies. Only those studies were included which were carried out between 1994 and 2015. A total of 17 articles remained for inclusion in this review and included 13 studies on the exogenous application of oxytocin and 4 on measurement of oxytocin levels in plasma. CONCLUSION This review article gives a summary of the current state of research on oxytocin and its direct and indirect association with human pain perception and emphasizes its relevance for the multimodal management of pain.
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Affiliation(s)
- A-C Pfeifer
- Tagesklinik für Schmerztherapie, Konservative Orthopädie, Klinik für Orthopädie und Unfallchirurgie, Universitätsklinikum Heidelberg, Schlierbacher Landstr. 200a, 69118, Heidelberg, Deutschland.
| | - B Ditzen
- Institut für Medizinische Psychologie, Zentrum für Psychosoziale Medizin (ZPM), Universitätsklinikum Heidelberg, Heidelberg, Deutschland
| | - E Neubauer
- Tagesklinik für Schmerztherapie, Konservative Orthopädie, Klinik für Orthopädie und Unfallchirurgie, Universitätsklinikum Heidelberg, Schlierbacher Landstr. 200a, 69118, Heidelberg, Deutschland
| | - M Schiltenwolf
- Tagesklinik für Schmerztherapie, Konservative Orthopädie, Klinik für Orthopädie und Unfallchirurgie, Universitätsklinikum Heidelberg, Schlierbacher Landstr. 200a, 69118, Heidelberg, Deutschland
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31
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Tracy LM, Labuschagne I, Georgiou-Karistianis N, Gibson SJ, Giummarra MJ. Sex-specific effects of intranasal oxytocin on thermal pain perception: A randomised, double-blind, placebo-controlled cross-over study. Psychoneuroendocrinology 2017; 83:101-110. [PMID: 28601750 DOI: 10.1016/j.psyneuen.2017.05.028] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/10/2017] [Revised: 05/26/2017] [Accepted: 05/29/2017] [Indexed: 12/20/2022]
Abstract
UNLABELLED Chronic neck and shoulder pain (CNSP) is a common musculoskeletal disorder in adults, which is linked to hypersensitivity to noxious stimuli. The hormone oxytocin has been implicated as a potential therapeutic for the management of chronic pain disorders, and has been suggested to have sex-specific effects on the salience of threatening stimuli. This study investigated the influence of intranasal oxytocin on the perception of noxious thermal stimuli. Participants were 24 individuals with CNSP lasting >12months (eight women), and 24 age- and sex-matched healthy, pain-free controls. In a randomised double-blind, placebo-controlled, cross-over study, participants attended two sessions, self-administering intranasal oxytocin (24 IU) in one session, and placebo in another. Participants rated intensity and unpleasantness of thermal heat stimuli at three body sites: the cervical spine, deltoid, and tibialis anterior, on 11-point numerical rating scales. Compared with placebo, intranasal oxytocin increased the perceived intensity of noxious heat stimuli in women with CNSP (Cohen's d=0.71), but not in men with CNSP, or healthy, pain-free controls. Men and women displayed divergent sensitivity across target sites for ratings of pain intensity (partial eta squared=0.12) and pain unpleasantness (partial eta squared=0.24), irrespective of drug condition. Men were more sensitive at the cervical spine and deltoid, whereas women were more sensitive at the tibialis. These findings suggest that oxytocin and endogenous sex hormones may interact to influence the salience of noxious stimuli. The hyperalgesic effects of oxytocin in women suggest that caution should be taken when considering oxytocin in the management of chronic pain. TRIAL REGISTRATION CT-2016-CTN-01313-1; ACTRN12616000532404.
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Affiliation(s)
- Lincoln M Tracy
- School of Psychological Sciences and Monash Institute for Cognitive and Clinical Neurosciences, Monash University, Clayton, VIC, Australia; Caulfield Pain Management & Research Centre, Caulfield Hospital, Caulfield, VIC, Australia.
| | - Izelle Labuschagne
- School of Psychology, Australian Catholic University, Fitzroy, VIC, Australia
| | - Nellie Georgiou-Karistianis
- School of Psychological Sciences and Monash Institute for Cognitive and Clinical Neurosciences, Monash University, Clayton, VIC, Australia
| | - Stephen J Gibson
- Caulfield Pain Management & Research Centre, Caulfield Hospital, Caulfield, VIC, Australia; National Aging Research Institute, Parkville, VIC, Australia
| | - Melita J Giummarra
- Caulfield Pain Management & Research Centre, Caulfield Hospital, Caulfield, VIC, Australia; School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia; Institute for Safety, Compensation & Recovery Research, Melbourne, VIC, Australia
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32
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Walker SC, Trotter PD, Swaney WT, Marshall A, Mcglone FP. C-tactile afferents: Cutaneous mediators of oxytocin release during affiliative tactile interactions? Neuropeptides 2017; 64:27-38. [PMID: 28162847 DOI: 10.1016/j.npep.2017.01.001] [Citation(s) in RCA: 86] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/17/2017] [Accepted: 01/18/2017] [Indexed: 11/24/2022]
Abstract
Low intensity, non-noxious, stimulation of cutaneous somatosensory nerves has been shown to trigger oxytocin release and is associated with increased social motivation, plus reduced physiological and behavioural reactivity to stressors. However, to date, little attention has been paid to the specific nature of the mechanosensory nerves which mediate these effects. In recent years, the neuroscientific study of human skin nerves (microneurography studies on single peripheral nerve fibres) has led to the identification and characterisation of a class of touch sensitive nerve fibres named C-tactile afferents. Neither itch nor pain receptive, these unmyelinated, low threshold mechanoreceptors, found only in hairy skin, respond optimally to low force/velocity stroking touch. Notably, the speed of stroking which C-tactile afferents fire most strongly to is also that which people perceive to be most pleasant. The social touch hypothesis posits that this system of nerves has evolved in mammals to signal the rewarding value of physical contact in nurturing and social interactions. In support of this hypothesis, we review the evidence that cutaneous stimulation directly targeted to optimally activate C-tactile afferents reduces physiological arousal, carries a positive affective value and, under healthy conditions, inhibits responses to painful stimuli. These effects mirror those, we also review, which have been reported following endogenous release and exogenous administration of oxytocin. Taken together this suggests C-tactile afferent stimulation may mediate oxytocin release during affiliative tactile interactions.
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Affiliation(s)
- Susannah C Walker
- Research Centre for Brain & Behaviour, School of Natural Sciences & Psychology, Liverpool John Moores University, Liverpool L3 3AF, UK..
| | - Paula D Trotter
- Research Centre for Brain & Behaviour, School of Natural Sciences & Psychology, Liverpool John Moores University, Liverpool L3 3AF, UK
| | - William T Swaney
- Research Centre for Brain & Behaviour, School of Natural Sciences & Psychology, Liverpool John Moores University, Liverpool L3 3AF, UK
| | - Andrew Marshall
- Research Centre for Brain & Behaviour, School of Natural Sciences & Psychology, Liverpool John Moores University, Liverpool L3 3AF, UK.; Department of Clinical Neurophysiology, Salford Royal NHS Foundation Trust, Salford M6 8HD, UK
| | - Francis P Mcglone
- Research Centre for Brain & Behaviour, School of Natural Sciences & Psychology, Liverpool John Moores University, Liverpool L3 3AF, UK.; Institute of Psychology, Health and Society, University of Liverpool, UK
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33
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Rash JA, Toivonen K, Robert M, Nasr-Esfahani M, Jarrell JF, Campbell TS. Protocol for a placebo-controlled, within-participants crossover trial evaluating the efficacy of intranasal oxytocin to improve pain and function among women with chronic pelvic musculoskeletal pain. BMJ Open 2017; 7:e014909. [PMID: 28416501 PMCID: PMC5775465 DOI: 10.1136/bmjopen-2016-014909] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023] Open
Abstract
INTRODUCTION This protocol presents the rationale and design for a trial evaluating the efficacy of intranasal oxytocin in improving pain and function among women with chronic pelvic musculoskeletal pain. Oxytocin is a neuropeptide traditionally recognised for involvement in labour, delivery and lactation. Novel evidence suggests that oxytocin decreases pain sensitivity in humans. While oxytocin administration has been reported to lower pain sensitivity among patients experiencing chronic back pain, headache, constipation and colon pain, no research has evaluated the association between intranasal oxytocin and chronic pelvic musculoskeletal pain. The association between oxytocin and pain may differ in women with chronic pelvic musculoskeletal pain relative to other chronic pain conditions because of the abundance of oxytocin receptors in the uterus. METHODS AND ANALYSIS This is a prospective, randomised, placebo-controlled, double-blind, within-participants crossover trial. 50 women with chronic pelvic musculoskeletal pain will be recruited through a local chronic pain centre and gynaecology clinics. Women will complete baseline measures and be randomised to an experimental or control condition that involve 2 weeks of self-administering twice-daily doses of 24 IU intranasal oxytocin or placebo, respectively. Women will then undergo a 2-week washout period before crossing over to receive the condition that they had not yet received. The primary outcome will be pain and function measured using the Brief Pain Inventory-Short Form. Secondary outcomes include emotional function, sleep disturbance and global impression of change. This trial will provide data on the 14-day safety and side-effect profile of intranasal oxytocin self-administered as an adjuvant treatment for chronic pelvic musculoskeletal pain. ETHICS AND DISSEMINATION This trial was granted approval from Health Canada and the University of Calgary Conjoint Health Research Ethics Board, and is registered online at ClinicalTrials.gov (#NCT02888574). Results will be disseminated to healthcare professionals through peer-reviewed publications and to the general public through press releases. TRIAL REGISTRATION NUMBER NCT02888574; Pre-results.
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Affiliation(s)
- Joshua A Rash
- Department of Psychology, University of Calgary, Calgary, Alberta, Canada
- Department of Psychology, Memorial University of Newfoundland, St. John's, Newfoundland, Canada
| | - Kirsti Toivonen
- Department of Psychology, University of Calgary, Calgary, Alberta, Canada
| | - Magali Robert
- Department of Obstetrics and Gynecology, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Maryam Nasr-Esfahani
- Department of Obstetrics and Gynecology, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - John F Jarrell
- Department of Obstetrics and Gynecology, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Tavis S Campbell
- Department of Psychology, University of Calgary, Calgary, Alberta, Canada
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The analgesic effects of oxytocin in the peripheral and central nervous system. Neurochem Int 2017; 103:57-64. [DOI: 10.1016/j.neuint.2016.12.021] [Citation(s) in RCA: 44] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2016] [Revised: 12/01/2016] [Accepted: 12/28/2016] [Indexed: 02/07/2023]
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Zunhammer M, Geis S, Busch V, Eichhammer P, Greenlee MW. Pain modulation by intranasal oxytocin and emotional picture viewing - a randomized double-blind fMRI study. Sci Rep 2016; 6:31606. [PMID: 27546446 PMCID: PMC4992880 DOI: 10.1038/srep31606] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2016] [Accepted: 07/25/2016] [Indexed: 02/01/2023] Open
Abstract
The hormone oxytocin has been hypothesized to influence the emotional dimension of pain. This randomized, placebo-controlled, double-blind, crossover study explored whether intranasal oxytocin and emotional context can affect heat pain perception in 30 healthy male volunteers. After receiving 36 IU oxytocin or placebo, participants underwent functional Magnetic Resonance Imaging (fMRI) during which noxious and non-noxious thermode heat stimuli were applied. Simultaneously, scenes from the International Affective Pictures System (IAPS) with positive, neutral, and negative emotional valence were shown. Heat intensity and unpleasantness ratings were obtained. The activity of whole-brain correlates of heat processing was quantified via multi-voxel pattern analysis. We observed no appreciable main effects of oxytocin on ratings or neural pain correlates. Effects of emotional picture valence on ratings were smaller than reported in previous studies. Nevertheless, oxytocin was found to significantly enhance the influence of picture valence on unpleasantness ratings at noxious heat levels. No corresponding changes in whole-brain correlates of heat intensity processing were found. Our study provides evidence that intranasal oxytocin increases the effects of emotional context on the subjective unpleasantness of experimental heat pain. Future studies are needed to determine whether this effect can be utilized in clinical settings.
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Affiliation(s)
- Matthias Zunhammer
- Klinik für Neurologie, Universitätsklinikum Essen, Hufelandstraße 55, 45147 Essen, Germany
| | - Sandra Geis
- Lehrstuhl für Experimentelle Psychologie, Universität Regensburg, Universitätsstrasse 31, 93053 Regensburg, Germany
| | - Volker Busch
- Klinik für Psychiatrie und Psychotherapie, Universität Regensburg, Universitätsstraße 84, 93053 Regensburg, Germany
| | - Peter Eichhammer
- Klinik für Psychiatrie und Psychotherapie, Universität Regensburg, Universitätsstraße 84, 93053 Regensburg, Germany
| | - Mark W. Greenlee
- Lehrstuhl für Experimentelle Psychologie, Universität Regensburg, Universitätsstrasse 31, 93053 Regensburg, Germany
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Thwala LN, Préat V, Csaba NS. Emerging delivery platforms for mucosal administration of biopharmaceuticals: a critical update on nasal, pulmonary and oral routes. Expert Opin Drug Deliv 2016; 14:23-36. [PMID: 27351299 DOI: 10.1080/17425247.2016.1206074] [Citation(s) in RCA: 53] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
INTRODUCTION Protein and peptide-based drugs are preferred therapeutics due to their specificity but are mainly administered by injection. Alternative routes for peptide delivery are preferred because of their ease of administration and increased patient compliance. Areas covered: This review provides a critical overview of current strategies for non-invasive mucosal delivery routes of therapeutic proteins and peptides, with emphasis on their advantages and limitations. Selected new trends and interesting novel formulations in advanced preclinical and clinical development stages for the pulmonary, nasal and the oral route are discussed for the most relevant peptide and protein drugs in terms of their specific requirements and intended therapeutic applications. Expert opinion: Despite the low frequency of clinical breakthroughs with non-invasive routes, these remain an active research area not only due to their improved therapeutic potential, but also due to the attractive commercial outcomes they offer. Currently, a number of technologies are adopted, including combinations of penetration enhancers with protease inhibitors and/or nanotechnology-based products and a few candidates are anticipated to be approved in the near future.
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Affiliation(s)
- Lungile Nomcebo Thwala
- a Center for Research in Molecular Medicine and Chronic Diseases (CIMUS), Health Research Institute of Santiago de Compostela (IDIS), Department of Pharmacy and Pharmaceutical Technology, School of Pharmacy , University of Santiago de Compostela , Santiago de Compostela , Spain.,b Louvain Drug Research Institute, Advanced Drug Delivery and Biomaterials , Université Catholique de Louvain , Brussels , Belgium
| | - Veronique Préat
- b Louvain Drug Research Institute, Advanced Drug Delivery and Biomaterials , Université Catholique de Louvain , Brussels , Belgium
| | - Noémi Stefania Csaba
- a Center for Research in Molecular Medicine and Chronic Diseases (CIMUS), Health Research Institute of Santiago de Compostela (IDIS), Department of Pharmacy and Pharmaceutical Technology, School of Pharmacy , University of Santiago de Compostela , Santiago de Compostela , Spain
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Paloyelis Y, Krahé C, Maltezos S, Williams SC, Howard MA, Fotopoulou A. The Analgesic Effect of Oxytocin in Humans: A Double-Blind, Placebo-Controlled Cross-Over Study Using Laser-Evoked Potentials. J Neuroendocrinol 2016; 28:10.1111/jne.12347. [PMID: 26660859 PMCID: PMC5103211 DOI: 10.1111/jne.12347] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/07/2015] [Revised: 12/04/2015] [Accepted: 12/05/2015] [Indexed: 12/29/2022]
Abstract
Oxytocin is a neuropeptide regulating social-affiliative and reproductive behaviour in mammals. Despite robust preclinical evidence for the antinociceptive effects and mechanisms of action of exogenous oxytocin, human studies have produced mixed results regarding the analgesic role of oxytocin and are yet to show a specific modulation of neural processes involved in pain perception. In the present study, we investigated the analgesic effects of 40 IU of intranasal oxytocin in 13 healthy male volunteers using a double-blind, placebo-controlled, cross-over design and brief radiant heat pulses generated by an infrared laser that selectively activate Aδ- and C-fibre nerve endings in the epidermis, at the same time as recording the ensuing laser-evoked potentials (LEPs). We predicted that oxytocin would reduce subjective pain ratings and attenuate the amplitude of the N1, N2 and P2 components. We observed that oxytocin attenuated perceived pain intensity and the local peak amplitude of the N1 and N2 (but not of P2) LEPs, and increased the latency of the N2 component. Importantly, for the first time, the present study reports an association between the analgesic effect of oxytocin (reduction in subjective pain ratings) and the oxytocin-induced modulation of cortical activity after noxious stimulation (attenuation of the N2 LEP). These effects indicate that oxytocin modulates neural processes contributing to pain perception. The present study reports preliminary evidence that is consistent with electrophysiological studies in rodents showing that oxytocin specifically modulates Aδ/C-fibre nociceptive afferent signalling at the spinal level and provides further specificity to evidence obtained in humans indicating that oxytocin may be modulating pain experience by modulating activity in the cortical areas involved in pain processing.
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Affiliation(s)
- Y Paloyelis
- Department of Neuroimaging, Institute of Psychiatry Psychology and Neuroscience, King's College London, London, UK
| | - C Krahé
- Department of Neuroimaging, Institute of Psychiatry Psychology and Neuroscience, King's College London, London, UK
| | - S Maltezos
- Department of Forensic and Neurodevelopmental Science, Institute of Psychiatry, King's College London, London, UK
| | - S C Williams
- Department of Neuroimaging, Institute of Psychiatry Psychology and Neuroscience, King's College London, London, UK
| | - M A Howard
- Department of Neuroimaging, Institute of Psychiatry Psychology and Neuroscience, King's College London, London, UK
| | - A Fotopoulou
- Research Department of Clinical, Educational and Health Psychology, University College London, London, UK
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Goodin BR, Anderson AJB, Freeman EL, Bulls HW, Robbins MT, Ness TJ. Intranasal Oxytocin Administration is Associated With Enhanced Endogenous Pain Inhibition and Reduced Negative Mood States. Clin J Pain 2015; 31:757-767. [PMID: 25370147 DOI: 10.1097/ajp.0000000000000166] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
OBJECTIVES This study examined whether the administration of intranasal oxytocin was associated with pain sensitivity, endogenous pain inhibitory capacity, and negative mood states. MATERIALS AND METHODS A total of 30 pain-free, young adults each completed 3 laboratory sessions on consecutive days. The first session (baseline) assessed ischemic pain sensitivity, endogenous pain inhibition via conditioned pain modulation (CPM), and negative mood using the Profile of Mood States. CPM was tested on the dominant forearm and ipsilateral masseter muscle using algometry (test stimulus) and the cold pressor task (conditioning stimulus; nondominant hand). For the second and third sessions, participants initially completed the State-Trait Anxiety Inventory and then self-administered a single (40 IU/1 mL) dose of intranasal oxytocin or placebo in a randomized counterbalanced order. Thirty minutes postadministration, participants again completed the State-Trait Anxiety Inventory and repeated assessments of ischemic pain sensitivity and CPM followed by the Profile of Mood States. RESULTS Findings demonstrated that ischemic pain sensitivity did not significantly differ across the 3 study sessions. CPM at the masseter, but not the forearm, was significantly greater following administration of oxytocin compared to placebo. Negative mood was also significantly lower following administration of oxytocin compared to placebo. Similarly, anxiety significantly decreased following administration of oxytocin but not placebo. DISCUSSION This study incorporated a placebo-controlled, double-blind, within-subjects crossover design with randomized administration of intranasal oxytocin and placebo. The data suggest that the administration of intranasal oxytocin may augment endogenous pain inhibitory capacity and reduce negative mood states including anxiety.
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Affiliation(s)
- Burel R Goodin
- Departments of Psychology.,Anesthesiology, University of Alabama at Birmingham
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Tracy LM, Georgiou-Karistianis N, Gibson SJ, Giummarra MJ. Oxytocin and the modulation of pain experience: Implications for chronic pain management. Neurosci Biobehav Rev 2015; 55:53-67. [DOI: 10.1016/j.neubiorev.2015.04.013] [Citation(s) in RCA: 50] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2014] [Revised: 04/10/2015] [Accepted: 04/25/2015] [Indexed: 12/21/2022]
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40
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Oxytocin reduces neural activity in the pain circuitry when seeing pain in others. Neuroimage 2015; 113:217-224. [PMID: 25818690 DOI: 10.1016/j.neuroimage.2015.03.049] [Citation(s) in RCA: 51] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2015] [Revised: 03/13/2015] [Accepted: 03/18/2015] [Indexed: 12/30/2022] Open
Abstract
Our empathetic abilities allow us to feel the pain of others. This phenomenon of vicarious feeling arises because the neural circuitry of feeling pain and seeing pain in others is shared. The neuropeptide oxytocin (OXT) is considered a robust facilitator of empathy, as intranasal OXT studies have repeatedly been shown to improve cognitive empathy (e.g. mind reading and emotion recognition). However, OXT has not yet been shown to increase neural empathic responses to pain in others, a core aspect of affective empathy. Effects of OXT on empathy for pain are difficult to predict, because OXT evidently has pain-reducing properties. Accordingly, OXT might paradoxically decrease empathy for pain. Here, using functional neuroimaging we show robust activation in the neural circuitry of pain (insula and sensorimotor regions) when subjects observe pain in others. Crucially, this empathy-related activation in the neural circuitry of pain is strongly reduced after intranasal OXT, specifically in the left insula. OXT on the basis of our neuroimaging data thus remarkably decreases empathy for pain, but further research including behavioral measures is necessary to draw definite conclusions.
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Effects of intranasal oxytocin on thermal pain in healthy men: a randomized functional magnetic resonance imaging study. Psychosom Med 2015; 77:156-66. [PMID: 25647754 DOI: 10.1097/psy.0000000000000142] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
Abstract
OBJECTIVE Intranasal oxytocin has been shown to affect human social and emotional processing, but its potential to affect pain remains elusive. This randomized, placebo-controlled, double-blind, crossover trial investigated the effect of intranasal oxytocin on the perception and processing of noxious experimental heat in 36 healthy male volunteers. METHODS Thermal thresholds were determined according to the Quantitative Sensory Testing protocol. A functional magnetic resonance imaging experiment including intensity and unpleasantness ratings of tonic heat was used to investigate the effects of oxytocin within the brain. RESULTS Thirty men (aged 18-50 years) were included in the study. Intranasal oxytocin had no significant effect on thermal thresholds, but significantly (t = -2.06, p = .046) reduced heat intensity ratings during functional magnetic resonance imaging. The effect on intensity ratings was small (-3.46 points on a 100-point visual analog scale [95% confidence interval {CI} = -6.86 to -0.07] and independent of temperature. No effects of oxytocin on stimulus- or temperature-related processing were found at the whole-brain level at a robust statistical threshold. A region of interest analysis indicated that oxytocin caused small but significant decreases in left (-0.045%, 95% CI = -0.087 to -0.003, t = -2.19, p = .037) and right (-0.051%, 95% CI = -0.088 to -0.014], t = -2.82, p = .008) amygdala activity across all temperatures. CONCLUSIONS The present study provides evidence for a significant but subtle inhibitory effect of oxytocin on thermal stimulus ratings and concurrent amygdala activity. Neither of the two effects significantly depended of temperature; therefore, the hypothesis of a pain-specific effect of oxytocin could not be confirmed. TRIAL REGISTRATION EUDRA-CT 2009-015115-40.
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Kwong KK, Chan ST. Intranasal oxytocin and NSAIDs : Comment on: Oxytocin nasal spray in fibromyalgic patients (Rheumatol Int. 2014 Aug;34(8):1047-52.). Rheumatol Int 2014; 35:941-2. [PMID: 25354464 DOI: 10.1007/s00296-014-3163-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2014] [Accepted: 10/20/2014] [Indexed: 02/04/2023]
Affiliation(s)
- Kenneth K Kwong
- MGH/MIT/HMS Athinoula A. Martinos Center for Biomedical Imaging, Department of Radiology, Massaschusetts General Hospital, Building 149, Thirteenth Street, Mail Code 149-2301, Charlestown, MA, 02129, USA,
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Agabio R, Mameli S, Sardo S, Minerba L, Melis MR. Oxytocin nasal spray in fibromyalgic patients: additional information. Rheumatol Int 2014; 34:1335-6. [DOI: 10.1007/s00296-014-3101-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2014] [Accepted: 07/17/2014] [Indexed: 10/25/2022]
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Rash JA, Campbell TS. Future directions for the investigation of intranasal oxytocin and pain: Comment on: Oxytocin nasal spray in fibromyalgic patients (Rheumatol Int. E-pub ahead of print. doi: 10.1007/s00296-014-2953-y). Rheumatol Int 2014; 34:1177-8. [PMID: 24939559 DOI: 10.1007/s00296-014-3070-7] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2014] [Accepted: 06/05/2014] [Indexed: 12/25/2022]
Affiliation(s)
- Joshua A Rash
- Department of Psychology, University of Calgary, 2500 University Drive NW, Calgary, AB, T2N 1N4, Canada,
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