Nawijn Laura, van Zuiden Mirjam, Koch Saskia B J, Frijling Jessie L, Veltman Dick J, Olff Miranda
Department of Psychiatry, Academic Medical Center, University of Amsterdam, PO Box 22660, 1100 DD Amsterdam, The Netherlands.
Department of Psychiatry, VU University Medical Center, PO Box 7057, 1007?MB Amsterdam, The Netherlands.
Soc Cogn Affect Neurosci. 2017 Feb 1;12(2):212-223. doi: 10.1093/scan/nsw123.
Therapeutic alliance and perceived social support are important predictors of treatment response for post-traumatic stress disorder (PTSD). Intranasal oxytocin administration may enhance treatment response by increasing sensitivity for social reward and thereby therapeutic alliance and perceived social support. As a first step to investigate this therapeutical potential, we investigated whether intranasal oxytocin enhances neural sensitivity to social reward in PTSD patients. Male and female police officers with (n = 35) and without PTSD (n = 37) were included in a double-blind, randomized, placebo-controlled cross-over fMRI study. After intranasal oxytocin (40 IU) and placebo administration, a social incentive delay task was conducted to investigate neural responses during social reward and punishment anticipation and feedback. Under placebo, PTSD patients showed reduced left anterior insula (AI) responses to social rewards (i.e. happy faces) compared with controls. Oxytocin administration increased left AI responses during social reward in PTSD patients, such that PTSD patients no longer differed from controls under placebo. Furthermore, in PTSD patients, oxytocin increased responses to social reward in the right putamen. By normalizing abberant insula responses and increasing putamen responses to social reward, oxytocin administration may enhance sensitivity for social support and therapeutic alliance in PTSD patients. Future studies are needed to investigate clinical effects of oxytocin.
治疗联盟和感知到的社会支持是创伤后应激障碍（PTSD）治疗反应的重要预测因素。鼻内给予催产素可能通过提高对社会奖励的敏感性，从而增强治疗联盟和感知到的社会支持，来提高治疗反应。作为研究这种治疗潜力的第一步，我们调查了鼻内催产素是否能增强PTSD患者对社会奖励的神经敏感性。患有PTSD（n = 35）和未患PTSD（n = 37）的男女警察参与了一项双盲、随机、安慰剂对照的交叉功能磁共振成像（fMRI）研究。在鼻内给予催产素（40 IU）和安慰剂后，进行了一项社会奖励延迟任务，以研究在社会奖励、惩罚预期和反馈过程中的神经反应。在安慰剂条件下，与对照组相比，PTSD患者左侧前脑岛（AI）对社会奖励（即笑脸）的反应降低。给予催产素后，PTSD患者在社会奖励期间左侧AI的反应增加，使得PTSD患者在催产素条件下与对照组不再有差异。此外，在PTSD患者中，催产素增加了右侧壳核对社会奖励的反应。通过使异常的脑岛反应正常化并增加壳核对社会奖励的反应，给予催产素可能会增强PTSD患者对社会支持和治疗联盟的敏感性。未来需要进行研究以调查催产素的临床效果。
