Objective:

The authors investigated the neural impact of intranasal oxytocin on emotion processing areas in youths with severe irritability in the context of disruptive mood and behavior disorders.

Methods:

Fifty-two participants with severe irritability, as measured by a score ≥4 on the Affective Reactivity Index (ARI), with diagnoses of disruptive behavior disorders (DBDs) and/or disruptive mood dysregulation disorder (DMDD) were randomly assigned to treatment with intranasal oxytocin or placebo daily for 3 weeks. Assessments were conducted at baseline and at the end of the trial; the primary outcomes were measures of irritability on the ARI and ratings on the Clinical Global Impressions severity scale (CGI-S) focusing on DBD and DMDD symptoms, and secondary outcomes included the CGI improvement scale (CGI-I) and ratings of proactive and reactive aggressive behavior on the Reactive-Proactive Aggression Questionnaire. Forty-three participants (22 in the oxytocin group and 21 in the placebo group) completed pre- and posttreatment functional MRI (fMRI) scans with the affective Stroop task.

Results:

Youths who received oxytocin showed significant improvement in CGI-S and CGI-I ratings compared with those who received placebo. In the fMRI data, blood-oxygen-level-dependent (BOLD) responses to emotional stimuli in the dorsomedial prefrontal cortex and posterior cingulate cortex were significantly reduced after oxytocin compared with placebo. These BOLD response changes were correlated with improvement in clinical severity.

Conclusions:

This study provides initial and preliminary evidence that intranasal oxytocin may induce neural-level changes in emotion processing in youths with irritability in the context of DBDs and DMDD. This may lead to symptom and severity changes in irritability.

中文翻译：

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严重烦躁青少年对鼻内催产素的神经反应

客观的：

作者研究了鼻内催产素对在破坏性情绪和行为障碍的情况下严重易怒的青少年情绪处理区域的神经影响。

方法：

52 名患有严重烦躁的参与者（根据情感反应指数 (ARI) 评分≥4，诊断为破坏性行为障碍 (DBD) 和/或破坏性情绪失调障碍 (DMDD)）被随机分配接受鼻内给药治疗每天服用催产素或安慰剂，持续 3 周。在基线和试验结束时进行评估；主要结局是 ARI 的烦躁性测量以及针对 DBD 和 DMDD 症状的临床总体印象严重程度量表 (CGI-S) 的评级，次要结局包括 CGI 改善量表 (CGI-I) 以及主动和反应性评级反应-主动攻击行为问卷中的攻击行为。43 名参与者（催产素组 22 名，安慰剂组 21 名）通过情感 Stroop 任务完成了治疗前和治疗后的功能性 MRI (fMRI) 扫描。

结果：

与接受安慰剂的青少年相比，接受催产素的青少年的 CGI-S 和 CGI​​-I 评级显着改善。在功能磁共振成像数据中，与安慰剂相比，使用催产素后，背内侧前额叶皮层和后扣带皮层对情绪刺激的血氧水平依赖性（BOLD）反应显着降低。这些 BOLD 反应变化与临床严重程度的改善相关。

结论：

这项研究提供了初步证据，表明鼻内催产素可能会引起 DBD 和 DMDD 背景下易激惹青少年情绪处理的神经水平变化。这可能会导致烦躁的症状和严重程度发生变化。