Functional brain changes after alternative pharmacological interventions in posttraumatic stress disorder: A systematic review of clinical trials
Abstract Background Posttraumatic stress disorder (PTSD) is a complex and heterogeneous mental health condition that can develop after exposure to a traumatic event. Clinical trials have used alternative pharmacological agents to treat PTSD, but their associated neural correlates remain unclear. The...
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| Format: | Article |
| Language: | English |
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Wiley
2023-12-01
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| Series: | Brain and Behavior |
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| Online Access: | https://doi.org/10.1002/brb3.3292 |
| _version_ | 1797336367700639744 |
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| author | Shahab Lotfinia Amin Afshar Aram Yaseri Miranda Olff Yann Quidé |
| author_facet | Shahab Lotfinia Amin Afshar Aram Yaseri Miranda Olff Yann Quidé |
| author_sort | Shahab Lotfinia |
| collection | DOAJ |
| description | Abstract Background Posttraumatic stress disorder (PTSD) is a complex and heterogeneous mental health condition that can develop after exposure to a traumatic event. Clinical trials have used alternative pharmacological agents to treat PTSD, but their associated neural correlates remain unclear. The present systematic review aims to summarize the changes in brain function associated with the use of these alternative pharmacological agents in PTSD. Methods Clinical trials using functional magnetic resonance imaging, either at rest or during the performance of tasks, were included if they compared the effects of alternative pharmacological agents between PTSD patients and either trauma‐exposed controls or never‐exposed healthy controls. Results Sixteen studies were included, of which 11 used intranasal oxytocin, 2 used hydrocortisone, and 3 used delta‐9‐tetrahydrocannabinol (THC). Oxytocin administration was associated with the normalization of functional connectivity between the ventromedial prefrontal cortex and amygdala as well as enhanced the function of brain regions specifically involved in emotion processing (e.g., amygdala), working memory (e.g., dorsolateral prefrontal cortex), and reward (e.g., putamen). Hydrocortisone did not influence brain function at rest or during the performance of an autobiographical memory task, whereas THC was associated with the reduction of the amygdala and increased medial prefrontal cortex activation. Conclusions This systematic review identified preliminary evidence for normalizing brain function after the use of alternative pharmacological agents. Importantly, sex‐specific differences were noted, in particular when using oxytocin, that will require further investigation. |
| first_indexed | 2024-03-08T08:53:24Z |
| format | Article |
| id | doaj.art-703d87cbf32f40199b8d761c0b3b71b4 |
| institution | Directory Open Access Journal |
| issn | 2162-3279 |
| language | English |
| last_indexed | 2024-03-08T08:53:24Z |
| publishDate | 2023-12-01 |
| publisher | Wiley |
| record_format | Article |
| series | Brain and Behavior |
| spelling | doaj.art-703d87cbf32f40199b8d761c0b3b71b42024-02-01T07:45:36ZengWileyBrain and Behavior2162-32792023-12-011312n/an/a10.1002/brb3.3292Functional brain changes after alternative pharmacological interventions in posttraumatic stress disorder: A systematic review of clinical trialsShahab Lotfinia0Amin Afshar1Aram Yaseri2Miranda Olff3Yann Quidé4Department of Clinical Psychology, School of Medicine Shahid Beheshti University of Medical Science Tehran IranFaculty of Medicine Qazvin University of Medical Science Qazvin IranSchool of Medicine Shahid Beheshti University of Medical Science Tehran IranDepartment of Psychiatry Amsterdam University Medical Centers Location AMC, Amsterdam Public Health Amsterdam The NetherlandsNeuroRecovery Research Hub, School of Psychology The University of New South Wales (UNSW) Sydney Sydney New South Wales AustraliaAbstract Background Posttraumatic stress disorder (PTSD) is a complex and heterogeneous mental health condition that can develop after exposure to a traumatic event. Clinical trials have used alternative pharmacological agents to treat PTSD, but their associated neural correlates remain unclear. The present systematic review aims to summarize the changes in brain function associated with the use of these alternative pharmacological agents in PTSD. Methods Clinical trials using functional magnetic resonance imaging, either at rest or during the performance of tasks, were included if they compared the effects of alternative pharmacological agents between PTSD patients and either trauma‐exposed controls or never‐exposed healthy controls. Results Sixteen studies were included, of which 11 used intranasal oxytocin, 2 used hydrocortisone, and 3 used delta‐9‐tetrahydrocannabinol (THC). Oxytocin administration was associated with the normalization of functional connectivity between the ventromedial prefrontal cortex and amygdala as well as enhanced the function of brain regions specifically involved in emotion processing (e.g., amygdala), working memory (e.g., dorsolateral prefrontal cortex), and reward (e.g., putamen). Hydrocortisone did not influence brain function at rest or during the performance of an autobiographical memory task, whereas THC was associated with the reduction of the amygdala and increased medial prefrontal cortex activation. Conclusions This systematic review identified preliminary evidence for normalizing brain function after the use of alternative pharmacological agents. Importantly, sex‐specific differences were noted, in particular when using oxytocin, that will require further investigation.https://doi.org/10.1002/brb3.3292functional magnetic resonance imaginghydrocortisoneoxytocinposttraumatic stress disorder |
| spellingShingle | Shahab Lotfinia Amin Afshar Aram Yaseri Miranda Olff Yann Quidé Functional brain changes after alternative pharmacological interventions in posttraumatic stress disorder: A systematic review of clinical trials Brain and Behavior functional magnetic resonance imaging hydrocortisone oxytocin posttraumatic stress disorder |
| title | Functional brain changes after alternative pharmacological interventions in posttraumatic stress disorder: A systematic review of clinical trials |
| title_full | Functional brain changes after alternative pharmacological interventions in posttraumatic stress disorder: A systematic review of clinical trials |
| title_fullStr | Functional brain changes after alternative pharmacological interventions in posttraumatic stress disorder: A systematic review of clinical trials |
| title_full_unstemmed | Functional brain changes after alternative pharmacological interventions in posttraumatic stress disorder: A systematic review of clinical trials |
| title_short | Functional brain changes after alternative pharmacological interventions in posttraumatic stress disorder: A systematic review of clinical trials |
| title_sort | functional brain changes after alternative pharmacological interventions in posttraumatic stress disorder a systematic review of clinical trials |
| topic | functional magnetic resonance imaging hydrocortisone oxytocin posttraumatic stress disorder |
| url | https://doi.org/10.1002/brb3.3292 |
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