Early Psychosis: Interventions & Clinical-detection (EPIC) Lab, Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK.
Department of Neuroimaging, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK.
Neuropsychopharmacology. 2019 Jun;44(7):1300-1309. doi: 10.1038/s41386-018-0311-6. Epub 2019 Jan 9.
Preclinical and human studies suggest that hippocampal dysfunction is a key factor in the onset of psychosis. People at Clinical High Risk for psychosis (CHR-P) present with a clinical syndrome that can include social withdrawal and have a 20-35% risk of developing psychosis in the next 2 years. Recent research shows that resting hippocampal blood flow is altered in CHR-P individuals and predicts adverse clinical outcomes, such as non-remission/transition to frank psychosis. Previous work in healthy males indicates that a single dose of intranasal oxytocin has positive effects on social function and marked effects on resting hippocampal blood flow. The present study examined the effects of intranasal oxytocin on hippocampal blood flow in CHR-P individuals. In a double-blind, placebo-controlled, crossover design, 30 CHR-P males were studied using pseudo-continuous Arterial Spin Labelling on 2 occasions, once after 40IU intranasal oxytocin and once after placebo. The effects of oxytocin on left hippocampal blood flow were examined in a region-of-interest analysis of data acquired at 22-28 and at 30-36 minutes post-intranasal administration. Relative to placebo, administration of oxytocin was associated with increased hippocampal blood flow at both time points (p = .0056; p = .034), although the effect at the second did not survive adjustment for the effect of global blood flow. These data indicate that oxytocin can modulate hippocampal function in CHR-P individuals and therefore merits further investigation as a candidate novel treatment for this group.
临床前和人体研究表明,海马功能障碍是精神病发病的一个关键因素。处于精神病临床高风险(CHR-P)的人表现出一种临床综合征,可能包括社交退缩,并且在接下来的 2 年内有 20-35%的发展为精神病的风险。最近的研究表明,CHR-P 个体的静息海马血流发生改变,并预测不良的临床结局,例如无法缓解/向明显精神病转变。先前在健康男性中的工作表明,单次鼻腔内给予催产素对社会功能有积极影响,并对静息海马血流有明显影响。本研究检查了鼻腔内给予催产素对 CHR-P 个体海马血流的影响。在一项双盲、安慰剂对照、交叉设计中,30 名 CHR-P 男性在 2 次使用伪连续动脉自旋标记时进行了研究,一次在鼻腔内给予 40IU 催产素后,一次在安慰剂后。在鼻腔内给予催产素后 22-28 分钟和 30-36 分钟采集的数据的感兴趣区域分析中,检查了催产素对左侧海马血流的影响。与安慰剂相比,催产素给药在两个时间点都与海马血流增加相关(p=.0056;p=.034),尽管第二个时间点的效应在调整全局血流效应后没有存活。这些数据表明,催产素可以调节 CHR-P 个体的海马功能,因此值得进一步研究作为该人群的一种新型候选治疗方法。