TY - JOUR

T1 - Potential shortcomings in current studies on the effect of intranasal oxytocin in Anorexia Nervosa and healthy controls

T2 - A systematic review and meta-analysis

AU - Hasselbalch, Katharina Collin

AU - Lanng, Klara Rasmussen

AU - Birkeland, Margrete

AU - Sjögren, Magnus

PY - 2020

Y1 - 2020

N2 - Rationale: The psychopathology of anorexia nervosa (AN) includes altered social cognition and information processing of fear and anxiety. Oxytocin, a neuromodulating hormone, may influence these functions and could be valuable for the treatment of AN. Objective: The current study aimed at reviewing the effect of intranasal oxytocin (IN-OT) on attentional bias (AB) and emotion recognition (ER) in AN. Methods: A systematic literature review was done for free-text and the MeSH-terms: anorexia nervosa, feeding and eating disorders, and oxytocin. Six publications, reporting from 4 unique clinical trials, were included in this review. A meta-analysis was conducted to examine the effects of IN-OT on AB towards food images and ER on healthy controls (HC) and patients with AN. Results: Overall, IN-OT did not influence AB towards food images (effect size = 0.20 [− 0.16, 0.57], p = 0.28) and had no effect on ER (effect size = − 0.01 [− 0.27, 0.26], p = 0.97) in patients with AN and healthy control (HC) subjects collectively. Assessing HC and AN separately in subgroup analyses did not show any significant effect on AB and ER in neither of the subgroups. All tests were done between 15 and 55 min post-administration of IN-OT, while peak concentration in the cerebrospinal fluid has been determined to be at 75 min. Conclusion: The current level of evidence is moderate showing no effect of IN-OT on AB or ER in AN. However, brain exposure may not have been sufficient which future studies with IN-OT need to ensure by considering dose and dose-to-task interval.

AB - Rationale: The psychopathology of anorexia nervosa (AN) includes altered social cognition and information processing of fear and anxiety. Oxytocin, a neuromodulating hormone, may influence these functions and could be valuable for the treatment of AN. Objective: The current study aimed at reviewing the effect of intranasal oxytocin (IN-OT) on attentional bias (AB) and emotion recognition (ER) in AN. Methods: A systematic literature review was done for free-text and the MeSH-terms: anorexia nervosa, feeding and eating disorders, and oxytocin. Six publications, reporting from 4 unique clinical trials, were included in this review. A meta-analysis was conducted to examine the effects of IN-OT on AB towards food images and ER on healthy controls (HC) and patients with AN. Results: Overall, IN-OT did not influence AB towards food images (effect size = 0.20 [− 0.16, 0.57], p = 0.28) and had no effect on ER (effect size = − 0.01 [− 0.27, 0.26], p = 0.97) in patients with AN and healthy control (HC) subjects collectively. Assessing HC and AN separately in subgroup analyses did not show any significant effect on AB and ER in neither of the subgroups. All tests were done between 15 and 55 min post-administration of IN-OT, while peak concentration in the cerebrospinal fluid has been determined to be at 75 min. Conclusion: The current level of evidence is moderate showing no effect of IN-OT on AB or ER in AN. However, brain exposure may not have been sufficient which future studies with IN-OT need to ensure by considering dose and dose-to-task interval.

KW - Anorexia Nervosa

KW - Attentional bias

KW - Eating disorders

KW - Emotion recognition

KW - Oxytocin

U2 - 10.1007/s00213-020-05626-5

DO - 10.1007/s00213-020-05626-5

M3 - Review

C2 - 32809046

AN - SCOPUS:85089474416

VL - 237

SP - 2891

EP - 2903

JO - Psychopharmacology

JF - Psychopharmacology

SN - 0033-3158

IS - 10

ER -