催产素应激调节神经和心脏作用的头部和心脏:自闭症儿童的慢性给药随机对照试验。

IF 16.3 1区 医学 Q1 PSYCHIATRY Psychotherapy and Psychosomatics Pub Date : 2023-01-01 Epub Date: 2023-10-11 DOI:10.1159/000534114
Kaat Alaerts, Nicky Daniels, Matthijs Moerkerke, Margaux Evenepoel, Tiffany Tang, Stephanie Van der Donck, Viktoria Chubar, Stephan Claes, Jean Steyaert, Bart Boets, Jellina Prinsen
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引用次数: 0

摘要

引言:经鼻给予催产素是一种很有前途的新方法,可以减少与自闭症谱系障碍诊断相关的残疾。先前的研究强调杏仁核是催产素急性作用的神经基础。然而,为了充分了解催产素的治疗潜力,深入了解长期使用催产素引起的杏仁核回路的神经可塑性变化至关重要,尤其是在儿科人群中。目的:与安慰剂相比,我们旨在研究为期4周的鼻内催产素疗程对自闭症儿童杏仁核功能连接的影响。此外,我们还研究了催产素是否能改善心脏自主神经唤醒,这是以高频心率变异性为指标的。方法:57名8-12岁的自闭症儿童(45名男孩,12名女孩)参加了一项双盲、随机的药物神经成像试验,每天两次鼻内注射催产素或安慰剂。在鼻喷雾剂给药前、给药后立即和给药后4周获得静息状态fMRI扫描和同时的扫描内心率记录。结果:观察到杏仁核眶额固有连接显著降低,尤其是在4周的随访中。这些减少与社会症状的改善和心脏自主神经觉醒的降低有关。此外,催产素受体基因的表观遗传学修饰调节了催产素的神经和心脏自主作用。这种影响在表观遗传学甲基化减少的儿童中更为明显,这意味着催产素受体的表达增加。结论:这些发现强调了为期4周的催产素给药过程会降低杏仁核连接,改善心脏自主神经平衡。表观遗传学调节剂可能解释个体对催产素反应的差异。
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At the Head and Heart of Oxytocin's Stress-Regulatory Neural and Cardiac Effects: A Chronic Administration RCT in Children with Autism.

Introduction: Intranasal administration of oxytocin presents a promising new approach to reduce disability associated with an autism spectrum disorder diagnosis. Previous investigations have emphasized the amygdala as the neural foundation for oxytocin's acute effects. However, to fully understand oxytocin's therapeutic potential, it is crucial to gain insight into the neuroplastic changes in amygdala circuitry induced from chronic oxytocin administrations, particularly in pediatric populations.

Objective: We aimed to examine the impact of a 4-week course of intranasal oxytocin on amygdala functional connectivity in children with autism, compared to placebo. Additionally, we investigated whether oxytocin improves cardiac autonomic arousal, as indexed by high-frequency heart rate variability.

Methods: Fifty-seven children with autism aged 8-12 years (45 boys, 12 girls) participated in a double-blind, randomized pharmaco-neuroimaging trial involving twice-daily administrations of intranasal oxytocin or placebo. Resting-state fMRI scans and simultaneous, in-scanner heart rate recordings were obtained before, immediately after, and 4 weeks after the nasal spray administration period.

Results: Significant reductions in intrinsic amygdala-orbitofrontal connectivity were observed, particularly at the 4-week follow-up session. These reductions were correlated with improved social symptoms and lower cardiac autonomic arousal. Further, oxytocin's neural and cardiac autonomic effects were modulated by epigenetic modifications of the oxytocin receptor gene. The effects were more pronounced in children with reduced epigenetic methylation, signifying heightened expression of the oxytocin receptor.

Conclusion: These findings underscore that a 4-week oxytocin administration course decreases amygdala connectivity and improves cardiac autonomic balance. Epigenetic modulators may explain inter-individual variation in responses to oxytocin.

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来源期刊
Psychotherapy and Psychosomatics
Psychotherapy and Psychosomatics 医学-精神病学
CiteScore
29.40
自引率
6.10%
发文量
46
期刊介绍: Psychotherapy and Psychosomatics is a reputable journal that has been published since 1953. Over the years, it has gained recognition for its independence, originality, and methodological rigor. The journal has been at the forefront of research in psychosomatic medicine, psychotherapy research, and psychopharmacology, and has contributed to the development of new lines of research in these areas. It is now ranked among the world's most cited journals in the field. As the official journal of the International College of Psychosomatic Medicine and the World Federation for Psychotherapy, Psychotherapy and Psychosomatics serves as a platform for discussing current and controversial issues and showcasing innovations in assessment and treatment. It offers a unique forum for cutting-edge thinking at the intersection of medical and behavioral sciences, catering to both practicing clinicians and researchers. The journal is indexed in various databases and platforms such as PubMed, MEDLINE, Web of Science, Science Citation Index, Social Sciences Citation Index, Science Citation Index Expanded, BIOSIS Previews, Google Scholar, Academic Search, and Health Research Premium Collection, among others.
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