The effects of intranasal oxytocin after trauma

Abstract

Rationale: Oxytocin has been suggested as promising pharma-cological strategy for prevention and medication-enhanced psychotherapy (MEP) for posttraumatic stress disorder (PTSD), by influencing neural fear responses, peripheral stress responses and socio-emotional functioning [1].

Methods: We conducted a randomized double-blind placebo-controlled functional magnetic resonance imaging (fMRI) study on the effects of single intranasal oxytocin administration on fear-and reward-related neural processes in male and female police of ficers with (n = 37, 21 males) and without (n = 40, 20 males) PTSD. In a second RCT we investigated effects of repeated intranasal oxytocin administration early after trauma on subsequent (up to 6 months) PTSD symptoms in 120 emergency department patients randomized to 8 days intranasal oxytocin (40 IU twice daily) or placebo.

Results: In PTSD patients, oxytocin administration resulted in dampened subjective anxiety and nervousness, decreased amyg dala activity towards emotional stimuli, and normalized aberrant amygdala subregion functional connectivity with prefrontal areas In this lecture we discuss the hypothesis that oxytocin and serotonin signalling in concert critically modulate the encoding of social reward and thus affect social motivation.

Recent neuroimaging insights including fMRI, PET and pharmacological tool studies illuminating the role of serotonin and reward circuit architecture in oxytocin-promoted social cognition will be presented and discussed. Specifically, the interplay between oxytocin, serotonin brain architecture and reward circuit function in social processing has been investigated in a dataset of 20 healthy women by combining intranasal oxytocin challenges, neuro psychology (EMOTICOM), fMRI and PET brain imaging markers of serotonin signalling ([11C]SB207145-PET), which will be presented. Perspectives with regard to individuals at high-risk for disturbed social interaction, e.g. mothers with perinatal depression and their infants, will be discussed.