Intranasal oxytocin administration impacts the acquisition and consolidation of trauma-associated memories: a double-blind randomized placebo-controlled experimental study in healthy women

Katharina Schultebraucks, Tolou Maslahati, Katja Wingenfeld, Julian Hellmann-Regen, Julia Kraft, Maureen Kownatzki, Behnoush Behnia, Stephan Ripke, Christian Otte, Stefan Roepke, Katharina Schultebraucks, Tolou Maslahati, Katja Wingenfeld, Julian Hellmann-Regen, Julia Kraft, Maureen Kownatzki, Behnoush Behnia, Stephan Ripke, Christian Otte, Stefan Roepke

Abstract

Intrusive memories are a hallmark symptom of post-traumatic stress disorder (PTSD) and oxytocin has been implicated in the formation of intrusive memories. This study investigates how oxytocin influences the acquisition and consolidation of trauma-associated memories and whether these effects are influenced by individual neurobiological and genetic differences. In this randomized, double-blind, placebo-controlled study, 220 healthy women received either a single dose of intranasal 24IU oxytocin or a placebo before exposure to a trauma film paradigm that solicits intrusive memories. We used a "general random forest" machine learning approach to examine whether differences in the noradrenergic and hypothalamic-pituitary-adrenal axis activity, polygenic risk for psychiatric disorders, and genetic polymorphism of the oxytocin receptor influence the effect of oxytocin on the acquisition and consolidation of intrusive memories. Oxytocin induced significantly more intrusive memories than placebo did (t(188.33) = 2.12, p = 0.035, Cohen's d = 0.30, 95% CI 0.16-0.44). As hypothesized, we found that the effect of oxytocin on intrusive memories was influenced by biological covariates, such as salivary cortisol, heart rate variability, and PTSD polygenic risk scores. The five factors that were most relevant to the oxytocin effect on intrusive memories were included in a Poisson regression, which showed that, besides oxytocin administration, higher polygenic loadings for PTSD and major depressive disorder were directly associated with a higher number of reported intrusions after exposure to the trauma film stressor. These results suggest that intranasal oxytocin amplifies the acquisition and consolidation of intrusive memories and that this effect is modulated by neurobiological and genetic factors. Trial registration: NCT03031405.

© 2021. The Author(s).

Figures

Fig. 1. Flow Diagram.
Fig. 1. Flow Diagram.
Flow chart showing the inclusion and exclusion of participants during the course of the study.
Fig. 2. Number of intrusive memories in…
Fig. 2. Number of intrusive memories in the oxytocin and placebo group over 4 days.
Points are means, with standard errors represented by vertical bars.
Fig. 3. Variable importance ranking of the…
Fig. 3. Variable importance ranking of the covariates that are most informative in the random forest model at predicting differences in the treatment effect, i.e., to determine factors associated with differences in how the administration of oxytocin affects self-reported intrusive memories after exposure to a trauma film.
RMSSD root mean square of successive differences, PTSD PRS post-traumatic stress disorder polygenic risk score, MDD PRS major depressive disorder polygenic risk score, sAA salivary α-amylase activity, CRD PRS cross-disorder polygenic risk score.

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