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Oxytocin, Trauma Disclosure and Intrusions

1. februar 2018 opdateret af: Rene Hurlemann, University Hospital, Bonn

Effects of a Prolonged Oxytocin Treatment on Intrusions and Amygdala Reactivity in an Analogue Trauma Model

Severe traumatic experiences such as falling victim to assault, torture, or rape have deleterious effects. Clinical manifestations include intrusions, avoidance behavior, and hyperarousal, which are associated, at a circuit level, with hyperfunction of the amygdala and hypofunction of prefrontal cortex (PFC) subregions. In up to 50 % of the cases, resilience is not sufficient and trauma-exposed individuals develop posttraumatic stress disorder (PTSD). Oxytocin (OXT) is a hypothalamic peptide hormone that exerts anxiolytic effects. Recent clinical trials provide preliminary evidence that post-trauma administration of OXT could be effective as a preventive intervention for PTSD in a subsample of individuals exhibiting early PTSD symptoms prior to the onset of the disorder. However, the underlying neurobiological mechanisms are unclear. Therefore, the rationale of the present project is to expose a sample of healthy participants to experimental trauma in order to explore the circuit mechanisms by which OXT influences, and interferes with, traumatic experience. Functional magnetic resonance imaging (fMRI) will be employed in order to elucidate the long-term effects of intranasal OXT on trauma-induced intrusions, amygdala and PFC responses during an emotional face matching task and resting state functional connectivity.

Studieoversigt

Status

Afsluttet

Betingelser

Intervention / Behandling

Detaljeret beskrivelse

Participants will be exposed to an experimental trauma (i.e. a highly aversive movie) at days 1 and 4 of the study. After the first experimental trauma and after the first functional magnetic resonance imaging (fMRI) measurement, the participants will receive intranasal OXT or placebo in three different groups (1. OXT for six days, 2. OXT for three days and then placebo for three days, 3. placebo for six days). The same fMRI tasks will be used after the first and second trauma exposure (i.e. one measurement before the treatment and one measurement after three days of treatment).

Undersøgelsestype

Interventionel

Tilmelding (Faktiske)

70

Fase

  • Fase 1

Kontakter og lokationer

Dette afsnit indeholder kontaktoplysninger for dem, der udfører undersøgelsen, og oplysninger om, hvor denne undersøgelse udføres.

Studiesteder

      • Bonn, Tyskland, 53105
        • Department of Psychiatry, University of Bonn

Deltagelseskriterier

Forskere leder efter personer, der passer til en bestemt beskrivelse, kaldet berettigelseskriterier. Nogle eksempler på disse kriterier er en persons generelle helbredstilstand eller tidligere behandlinger.

Berettigelseskriterier

Aldre berettiget til at studere

18 år til 40 år (Voksen)

Tager imod sunde frivillige

Ja

Køn, der er berettiget til at studere

Kvinde

Beskrivelse

Inclusion Criteria:

  • Healthy female volunteers
  • Right-handed

Exclusion Criteria:

  • Current or past psychiatric disease
  • Current or past physical illness
  • Psychoactive medication
  • Hormonal contraception
  • MRI contraindication (e.g. metal in body, claustrophobia)

Studieplan

Dette afsnit indeholder detaljer om studieplanen, herunder hvordan undersøgelsen er designet, og hvad undersøgelsen måler.

Hvordan er undersøgelsen tilrettelagt?

Design detaljer

  • Primært formål: Grundvidenskab
  • Tildeling: Randomiseret
  • Interventionel model: Parallel tildeling
  • Maskning: Tredobbelt

Våben og indgreb

Deltagergruppe / Arm
Intervention / Behandling
Aktiv komparator: Oxytocin (6 days)
Intranasal administration, 24 international units (IU) oxytocin for three days after the first trauma movie exposure and three days after the second trauma movie exposure (24 IU per day)
Intranasal administration, 24 international units (IU) oxytocin.
Andre navne:
  • syntocinon
Aktiv komparator: Oxytocin (3 days)
Intranasal administration, 24 international units (IU) oxytocin for three days after the first trauma movie exposure (24 IU per day) and placebo nasal spray for three days after the second trauma movie exposure
Intranasal administration, 24 international units (IU) oxytocin.
Andre navne:
  • syntocinon
Placebo komparator: Placebo
Placebo nasal spray for six days
Placebo-næsesprayene indeholder identiske ingredienser bortset fra selve peptidet.

Hvad måler undersøgelsen?

Primære resultatmål

Resultatmål
Foranstaltningsbeskrivelse
Tidsramme
Total number of intrusions following the first trauma movie exposure.
Tidsramme: Three days following the first trauma movie exposure.
The participants will be asked to complete intrusion diaries at home in the evening of the days 1 to 3. Intrusions will be defined as involuntary recollections relating to film events that appear, apparently spontaneously, in consciousness.
Three days following the first trauma movie exposure.
Total number of intrusions following the second trauma movie exposure.
Tidsramme: Three days following the second trauma movie exposure.
The participants will be asked to complete intrusion diaries at home in the evening of the days 4 to 6. Intrusions will be defined as involuntary recollections relating to film events that appear, apparently spontaneously, in consciousness.
Three days following the second trauma movie exposure.
Neural responses to emotional faces in the amygdala.
Tidsramme: Neural activations will be measured with fMRI in an emotional face matching task that lasts 20 min.
Functional magnetic resonance imaging (fMRI) will be performed to measure blood-oxygen-level dependent signal in response to emotional face stimuli. The investigators specifically plan to investigate amygdala responses to emotional faces, because pilot data indicate that neural responses to emotional faces in these regions are associated with the total number of intrusions.
Neural activations will be measured with fMRI in an emotional face matching task that lasts 20 min.
Neural responses to emotional faces in the prefrontal cortex.
Tidsramme: Neural activations will be measured with fMRI in an emotional face matching task that lasts 20 min.
Functional magnetic resonance imaging (fMRI) will be performed to measure blood-oxygen-level dependent signal in response to emotional face stimuli. The investigators specifically plan to investigate prefrontal cortex responses to emotional faces, because pilot data indicate that neural responses to emotional faces in these regions are associated with the total number of intrusions.
Neural activations will be measured with fMRI in an emotional face matching task that lasts 20 min.
fMRI resting state data
Tidsramme: Functional data will be acquired for 6 min.
Participants will be instructed to lie still with open eyes during the resting state measurement and not think of anything in particular.
Functional data will be acquired for 6 min.
Trauma disclosure (time spend discussing the movie)
Tidsramme: Six days following the first trauma movie exposure.
The intrusion diaries will contain a question for how long participants discussed the trauma movie.
Six days following the first trauma movie exposure.

Sekundære resultatmål

Resultatmål
Foranstaltningsbeskrivelse
Tidsramme
Changes in pupil diameter in response to the trauma movie
Tidsramme: 2 min baseline before the trauma movie and during 15 min of the trauma movie.
Changes in pupil diameter will be measured.
2 min baseline before the trauma movie and during 15 min of the trauma movie.
Changes in skin conductance level in response to the trauma movie
Tidsramme: 2 min baseline before the trauma movie and during 15 min of the trauma movie.
Changes in skin conductance level will be measured.
2 min baseline before the trauma movie and during 15 min of the trauma movie.
Changes in respiration rate in response to the trauma movie
Tidsramme: 2 min baseline before the trauma movie and during 15 min of the trauma movie.
Changes in respiration rate will be measured.
2 min baseline before the trauma movie and during 15 min of the trauma movie.
Salivary oxytocin concentrations
Tidsramme: Immediately before the trauma movie, immediately after the trauma movie and 40 min after the trauma movie.
Saliva samples will be collected before and after the trauma movie to assess changes in oxytocin concentrations.
Immediately before the trauma movie, immediately after the trauma movie and 40 min after the trauma movie.
Salivary cortisol concentrations
Tidsramme: Immediately before the trauma movie, immediately after the trauma movie and 40 min after the trauma movie.
Saliva samples will be collected before and after the trauma movie to assess changes in cortisol concentrations.
Immediately before the trauma movie, immediately after the trauma movie and 40 min after the trauma movie.
Questionnaire measurement of mood (PANAS)
Tidsramme: 10 min before and 10 min after the trauma movie.
Positive and negative affect will be assessed via self-rating questionnaire 'The Positive and Negative Affect Schedule' using a categorical 5 point scale.
10 min before and 10 min after the trauma movie.

Samarbejdspartnere og efterforskere

Det er her, du vil finde personer og organisationer, der er involveret i denne undersøgelse.

Sponsor

Efterforskere

  • Ledende efterforsker: René Hurlemann, MD, PhD, University of Bonn

Publikationer og nyttige links

Den person, der er ansvarlig for at indtaste oplysninger om undersøgelsen, leverer frivilligt disse publikationer. Disse kan handle om alt relateret til undersøgelsen.

Datoer for undersøgelser

Disse datoer sporer fremskridtene for indsendelser af undersøgelsesrekord og resumeresultater til ClinicalTrials.gov. Studieregistreringer og rapporterede resultater gennemgås af National Library of Medicine (NLM) for at sikre, at de opfylder specifikke kvalitetskontrolstandarder, før de offentliggøres på den offentlige hjemmeside.

Studer store datoer

Studiestart (Faktiske)

1. juni 2016

Primær færdiggørelse (Faktiske)

18. marts 2017

Studieafslutning (Faktiske)

18. marts 2017

Datoer for studieregistrering

Først indsendt

28. januar 2018

Først indsendt, der opfyldte QC-kriterier

1. februar 2018

Først opslået (Faktiske)

8. februar 2018

Opdateringer af undersøgelsesjournaler

Sidste opdatering sendt (Faktiske)

8. februar 2018

Sidste opdatering indsendt, der opfyldte kvalitetskontrolkriterier

1. februar 2018

Sidst verificeret

1. februar 2018

Mere information

Begreber relateret til denne undersøgelse

Andre undersøgelses-id-numre

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