Neural Responses to Intranasal Oxytocin in Youths With Severe Irritability

OBJECTIVE: The authors investigated the neural impact of intranasal oxytocin on emotion processing areas in youths with severe irritability in the context of disruptive mood and behavior disorders.

METHODS: Fifty-two participants with severe irritability, as measured by a score ≥4 on the Affective Reactivity Index (ARI), with diagnoses of disruptive behavior disorders (DBDs) and/or disruptive mood dysregulation disorder (DMDD) were randomly assigned to treatment with intranasal oxytocin or placebo daily for 3 weeks. Assessments were conducted at baseline and at the end of the trial; the primary outcomes were measures of irritability on the ARI and ratings on the Clinical Global Impressions severity scale (CGI-S) focusing on DBD and DMDD symptoms, and secondary outcomes included the CGI improvement scale (CGI-I) and ratings of proactive and reactive aggressive behavior on the Reactive-Proactive Aggression Questionnaire. Forty-three participants (22 in the oxytocin group and 21 in the placebo group) completed pre- and posttreatment functional MRI (fMRI) scans with the affective Stroop task.

RESULTS: Youths who received oxytocin showed significant improvement in CGI-S and CGI-I ratings compared with those who received placebo. In the fMRI data, blood-oxygen-level-dependent (BOLD) responses to emotional stimuli in the dorsomedial prefrontal cortex and posterior cingulate cortex were significantly reduced after oxytocin compared with placebo. These BOLD response changes were correlated with improvement in clinical severity.

CONCLUSIONS: This study provides initial and preliminary evidence that intranasal oxytocin may induce neural-level changes in emotion processing in youths with irritability in the context of DBDs and DMDD. This may lead to symptom and severity changes in irritability.

Medienart:

E-Artikel

Erscheinungsjahr:

2024

Erschienen:

2024

Enthalten in:

Zur Gesamtaufnahme - volume:181

Enthalten in:

The American journal of psychiatry - 181(2024), 4 vom: 01. Apr., Seite 291-298

Sprache:

Englisch

Beteiligte Personen:

Hwang, Soonjo [VerfasserIn]
Suk, Ji-Woo [VerfasserIn]
Meffert, Harma [VerfasserIn]
Lerdahl, Arica [VerfasserIn]
Garvey, William F [VerfasserIn]
Edwards, Ryan [VerfasserIn]
Delizza, Alison [VerfasserIn]
Soltis-Vaughan, Brigette [VerfasserIn]
Cordts, Katrina [VerfasserIn]
Leibenluft, Ellen [VerfasserIn]
Blair, R J R [VerfasserIn]

Links:

Volltext

Themen:

50-56-6
Disruptive, Impulse-Control, and Conduct Disorders
Disruptive Behavior Disorder
Irritability
Journal Article
Neuroimaging
Oxytocin
Psychopharmacology
Randomized Controlled Trial

Anmerkungen:

Date Completed 03.04.2024

Date Revised 04.04.2024

published: Print-Electronic

Citation Status MEDLINE

doi:

10.1176/appi.ajp.20230174

funding:

Förderinstitution / Projekttitel:

PPN (Katalog-ID):

NLM369094077