Impact of Oxytocin on the neural correlates of fearful face processing in PTSD related to childhood Trauma

Abstract

Background : Posttraumatic stress disorder (PTSD) related to exposure to abuse and neglect during childhood is associated with particularly severe and persistent deleterious outcomes. Amygdala hyperreactivity has been observed in childhood trauma survivors and implicated in symptoms of PTSD. Objective : The neuropeptide oxytocin holds promise as a potential treatment for PTSD due to its ability to attenuate amygdala response to threat cues. However, the effect of oxytocin on amygdala reactivity in individuals with childhood trauma-related PTSD has not been investigated. Method : We employed a double-blind, randomized, placebo-controlled crossover design to examine the effects of intranasal oxytocin (24 IU) versus placebo on amygdala reactivity to fearful faces among childhood-trauma exposed individuals with PTSD ( n = 17) and without PTSD (control group; n = 16). Results : Region-of-interest based amygdala fMRI signal magnitude did not differ by group, drug, or group x drug interaction. Self-report of childhood trauma exposure severity was negatively associated with the oxytocin-related change in left amygdala response in the PTSD group, but not in the control group. Supplementary and exploratory whole-brain analyses conducted separately in each group revealed that left amygdala reactivity to fearful faces was absent on placebo but increased on oxytocin in the control group. The PTSD group showed right amygdala activation to fearful faces in both the oxytocin and placebo conditions, but the left amygdala response observed in the placebo condition was diminished on oxytocin. Conclusions : Findings extend the literature pertaining to the potential for oxytocin to attenuate neural correlates of PTSD to a childhood trauma-related PTSD sample.

A decennial review of psychotraumatology: what did we learn and where are we going?

“…An important focus of EJPT has also been the neural correlates underlying treatment interventions, including both novel pharmacotherapeutic (Flanagan et al, 2019;Kelmendi et al, 2016;Olff et al, 2015) and psychotherapeutic approaches (Lanius et al, 2015). Here, one study demonstrated altered electroencephalogram patterns before and after Eye Movement Desensitization and Reprocessing (EMDR) treatment in patients with breast cancer (Carletto et al, 2019).…”

“…The first studies on the bonding hormone oxytocin in our field began approximately a decade ago (Olff, 2012;Olff, Langeland, Witteveen, & Denys, 2010), with an exponential increase after that (e.g. Bui et al, 2019;Bradley, Davis, Wingo, Mercer, & Ressler, 2013;Flanagan et al, 2019;Frijling, 2017;Olff et al, 2015). The initial findings with regard to both prevention and treatment potential of intranasal oxytocin administration seem promising.…”

“…Further, recent efforts in the past 10 years have tried to leverage growing advances in our understanding of the cognitive neurobiological, and genetics bases of PTSD, with a number of pharmacological approaches moving away from the fear-based models of PTSD (and monoaminergic system) being proposed (Kelmendi et al, 2016). The oxytocin system implicated in pro-social behaviours (Flanagan et al, 2019) and resilience (Bradley et al, 2013) has been proposed as a potential new avenue for treating or preventing PTSD (Olff et al, 2014;. Similarly, recent data on the cannabinoid system suggest that inhibiting the fatty acid amide hydrolase (FAAH) might be efficacious in treating PTSD (Ney, Matthews, Bruno, & Felmingham, 2019).…”

Harnessing the Neurobiology of Resilience to Protect the Mental Well-Being of Healthcare Workers During the COVID-19 Pandemic

“…One of the most prominent of these peptides is oxytocin, which appears to exert a regulatory effect on the cortisol response to stress ( Li et al, 2019 ; Winter and Jurek, 2019 ). In addition, it has been shown to reduce depressive symptoms following loss of a partner in animal models ( Bosch and Young, 2018 ), to reduce brain responses to fear-provoking visual stimuli in human suffering already exposed to trauma ( Flanagan et al, 2019 ), and to potentially enhance the likelihood of engaging in altruistic or pro-social behaviors ( Hurlemann, 2017 ). These effects are all relevant to the COVID-19 pandemic, where healthcare workers often experience interpersonal separation, social isolation, and a heightened exposure to fear-generating cues.…”

Effects of Oxytocin Administration on Cue‐Induced Craving in Co‐occurring Alcohol Use Disorder and PTSD: A Within‐Participant Randomized Clinical Trial

“…Furthermore, severity of alcohol use and PTSD symptoms have been shown to impact self‐reported alcohol craving (Day et al, ; Kaczkurkin et al, ) and subjective alcohol cue–induced responses (Jasinska et al, ). While there is an emerging literature demonstrating a moderating effect of childhood trauma severity on oxytocin‐induced outcomes (Flanagan et al, ), the moderating effects of alcohol use and classic PTSD symptom severity on oxytocin response have not been explored. Therefore, we will test alcohol use and PTSD symptom severity scores as moderating predictors.…”