The effects of the angiotensin II receptor antagonist losartan on appetitive versus aversive learning: A randomized controlled trial
<p><strong>Background</strong><br/> Exposure therapy is a first-line treatment for anxiety disorders but remains ineffective in a large proportion of patients. A proposed mechanism of exposure involves inhibitory learning whereby the association between a stimulus and an aver...
| Main Authors: | , , , , , , |
|---|---|
| Format: | Journal article |
| Language: | English |
| Published: |
Elsevier
2019
|
| _version_ | 1797080678767001600 |
|---|---|
| author | Pulcu, E Shkreli, L Guzman-Holst, C Woud, ML Craske, MG Browning, M Reinecke, A |
| author_facet | Pulcu, E Shkreli, L Guzman-Holst, C Woud, ML Craske, MG Browning, M Reinecke, A |
| author_sort | Pulcu, E |
| collection | OXFORD |
| description | <p><strong>Background</strong><br/> Exposure therapy is a first-line treatment for anxiety disorders but remains ineffective in a large proportion of patients. A proposed mechanism of exposure involves inhibitory learning whereby the association between a stimulus and an aversive outcome is suppressed by a new association with an appetitive or neutral outcome. The blood pressure medication losartan augments fear extinction in rodents and may have similar synergistic effects on human exposure therapy, but the exact cognitive mechanisms underlying these effects remain unknown.</p><br/> <p><strong>Methods</strong><br/> We used a reinforcement learning paradigm with compound rewards and punishments to test the prediction that losartan augments learning from appetitive relative to aversive outcomes. In a double-blind parallel design, healthy volunteers were randomly assigned to single-dose losartan (50 mg) (n = 28) versus placebo (n = 25). Participants then performed a reinforcement learning task, which simultaneously probes appetitive and aversive learning. Participant choice behavior was analyzed using both a standard reinforcement learning model and analysis of choice switching behavior.</p><br/> <p><strong>Results</strong><br/> Losartan significantly reduced learning rates from aversive events (losses) when participants were first exposed to the novel task environment, while preserving learning from positive outcomes. The same effect was seen in choice switching behavior.</p><br/> <p><strong>Conclusions</strong><br/> This study shows that losartan enhances learning from positive relative to negative events. This effect may represent a computationally defined neurocognitive mechanism by which the drug could enhance the effect of exposure in clinical populations.</p><br/> |
| first_indexed | 2024-03-07T01:03:33Z |
| format | Journal article |
| id | oxford-uuid:8a8abd41-31fe-48ae-8959-766a57bb3755 |
| institution | University of Oxford |
| language | English |
| last_indexed | 2024-03-07T01:03:33Z |
| publishDate | 2019 |
| publisher | Elsevier |
| record_format | dspace |
| spelling | oxford-uuid:8a8abd41-31fe-48ae-8959-766a57bb37552022-03-26T22:32:17ZThe effects of the angiotensin II receptor antagonist losartan on appetitive versus aversive learning: A randomized controlled trialJournal articlehttp://purl.org/coar/resource_type/c_dcae04bcuuid:8a8abd41-31fe-48ae-8959-766a57bb3755EnglishSymplectic Elements at OxfordElsevier2019Pulcu, EShkreli, LGuzman-Holst, CWoud, MLCraske, MGBrowning, MReinecke, A<p><strong>Background</strong><br/> Exposure therapy is a first-line treatment for anxiety disorders but remains ineffective in a large proportion of patients. A proposed mechanism of exposure involves inhibitory learning whereby the association between a stimulus and an aversive outcome is suppressed by a new association with an appetitive or neutral outcome. The blood pressure medication losartan augments fear extinction in rodents and may have similar synergistic effects on human exposure therapy, but the exact cognitive mechanisms underlying these effects remain unknown.</p><br/> <p><strong>Methods</strong><br/> We used a reinforcement learning paradigm with compound rewards and punishments to test the prediction that losartan augments learning from appetitive relative to aversive outcomes. In a double-blind parallel design, healthy volunteers were randomly assigned to single-dose losartan (50 mg) (n = 28) versus placebo (n = 25). Participants then performed a reinforcement learning task, which simultaneously probes appetitive and aversive learning. Participant choice behavior was analyzed using both a standard reinforcement learning model and analysis of choice switching behavior.</p><br/> <p><strong>Results</strong><br/> Losartan significantly reduced learning rates from aversive events (losses) when participants were first exposed to the novel task environment, while preserving learning from positive outcomes. The same effect was seen in choice switching behavior.</p><br/> <p><strong>Conclusions</strong><br/> This study shows that losartan enhances learning from positive relative to negative events. This effect may represent a computationally defined neurocognitive mechanism by which the drug could enhance the effect of exposure in clinical populations.</p><br/> |
| spellingShingle | Pulcu, E Shkreli, L Guzman-Holst, C Woud, ML Craske, MG Browning, M Reinecke, A The effects of the angiotensin II receptor antagonist losartan on appetitive versus aversive learning: A randomized controlled trial |
| title | The effects of the angiotensin II receptor antagonist losartan on appetitive versus aversive learning: A randomized controlled trial |
| title_full | The effects of the angiotensin II receptor antagonist losartan on appetitive versus aversive learning: A randomized controlled trial |
| title_fullStr | The effects of the angiotensin II receptor antagonist losartan on appetitive versus aversive learning: A randomized controlled trial |
| title_full_unstemmed | The effects of the angiotensin II receptor antagonist losartan on appetitive versus aversive learning: A randomized controlled trial |
| title_short | The effects of the angiotensin II receptor antagonist losartan on appetitive versus aversive learning: A randomized controlled trial |
| title_sort | effects of the angiotensin ii receptor antagonist losartan on appetitive versus aversive learning a randomized controlled trial |
| work_keys_str_mv | AT pulcue theeffectsoftheangiotensiniireceptorantagonistlosartanonappetitiveversusaversivelearningarandomizedcontrolledtrial AT shkrelil theeffectsoftheangiotensiniireceptorantagonistlosartanonappetitiveversusaversivelearningarandomizedcontrolledtrial AT guzmanholstc theeffectsoftheangiotensiniireceptorantagonistlosartanonappetitiveversusaversivelearningarandomizedcontrolledtrial AT woudml theeffectsoftheangiotensiniireceptorantagonistlosartanonappetitiveversusaversivelearningarandomizedcontrolledtrial AT craskemg theeffectsoftheangiotensiniireceptorantagonistlosartanonappetitiveversusaversivelearningarandomizedcontrolledtrial AT browningm theeffectsoftheangiotensiniireceptorantagonistlosartanonappetitiveversusaversivelearningarandomizedcontrolledtrial AT reineckea theeffectsoftheangiotensiniireceptorantagonistlosartanonappetitiveversusaversivelearningarandomizedcontrolledtrial AT pulcue effectsoftheangiotensiniireceptorantagonistlosartanonappetitiveversusaversivelearningarandomizedcontrolledtrial AT shkrelil effectsoftheangiotensiniireceptorantagonistlosartanonappetitiveversusaversivelearningarandomizedcontrolledtrial AT guzmanholstc effectsoftheangiotensiniireceptorantagonistlosartanonappetitiveversusaversivelearningarandomizedcontrolledtrial AT woudml effectsoftheangiotensiniireceptorantagonistlosartanonappetitiveversusaversivelearningarandomizedcontrolledtrial AT craskemg effectsoftheangiotensiniireceptorantagonistlosartanonappetitiveversusaversivelearningarandomizedcontrolledtrial AT browningm effectsoftheangiotensiniireceptorantagonistlosartanonappetitiveversusaversivelearningarandomizedcontrolledtrial AT reineckea effectsoftheangiotensiniireceptorantagonistlosartanonappetitiveversusaversivelearningarandomizedcontrolledtrial |