Examining Dose-Related Effects of Oxytocin on Social Cognition Across Populations

Conditions:Schizophrenia, Neurology, Psychiatric, Psychiatric, Bipolar Disorder, Autism
Therapuetic Areas:Neurology, Psychiatry / Psychology
Age Range:18 - 65
Start Date:September 2013
End Date:September 2019
Contact:Sarah B Rutter, MA

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Social cognition impairment is critical to the pathology and morbidity of a number of
psychiatric disorders, including the schizophrenia spectrum, the autism spectrum and the
personality disorders, thus representing a dimension consistent with RDoC. As such, this
study aims to a) further characterize the unique deficits in social cognition (recognition
and interpretation of social cues and representation of thoughts, intentions, and feelings of
others) across disorders, including the schizophrenia spectrum (which includes schizophrenia,
SCZ, schizoaffective disorder, SAD, bipolar disorder, BD, and schizotypal personality
disorder, SPD), the autism spectrum disorders (ASD), and borderline personality disorder
(BPD) compared to healthy controls (HC); b) assess the effect of intranasal oxytocin (OXT) as
a regulator and novel treatment of social cognition impairment in these disorders; and c)
enhance our understanding of the specificity and exact mechanisms of impairment to inform the
accurate dosing of OXT required to modulate social cognition in these disorders and identify
a model of optimum social cognitive function. Addressing these questions will further
catalyze research into a model of optimum social cognitive activity, and accelerate industry
development of agents suited to routine clinical administration.

Social cognitive impairments, particularly deficits and distortions in recognition and
interpretation of social cues and representations of thoughts, intentions, and feelings of
others—termed mentalization—are a key contributor to the pathology and morbidity of a number
of psychiatric disorders, including the schizophrenia spectrum, the autism spectrum and
personality disorders. Individuals with schizophrenia spectrum disorders have deficits in
social cognition (hypomentalization), while individuals with borderline personality disorder
seem to have exaggerated and distorted social cognition (hypermentalization). However, the
specificity and mechanisms of these impairments remain unclear. Therefore, a better
understanding of the modulation of social cognition is a priority for developing
interventions both pharmacologic and psychosocial. We propose here to examine the effects of
oxytocin, known to be a key regulator of social cognition through modulating frontolimbic
neural circuitry, on social cognition in schizotypal and borderline patients. In doing so, we
aim to characterize a model of optimum social cognitive activity to direct the development of
treatments, including dosing and target population-specific effects.

To this end, we propose to perform a 2-year study in which 105 patients, (45 with
schizophrenia spectrum disorders, 30 with borderline personality disorder, and 30 with autism
spectrum disorders) will perform 3 rounds of social cognition testing after three acute
single-dose treatment conditions (intranasal oxytocin dose of 24IU or 40IU or placebo)
separated by a washout period, in a repeated-measures, within-subjects, randomized,
placebo-controlled, double-blind, counterbalanced cross-over proof-of concept design. 30
healthy controls will not receive oxytocin/placebo and will perform 3 rounds of social
cognition tests separated by approximately 4 weeks, serving as a benchmark for normal
performance and a control for practice effects. Social cognitive testing will be performed 45
minutes after drug/placebo administration in an identical protocol each time. The social
cognitive test serving as primary outcome measure will be the Movie for the Assessment of
Social Cognition (MASC). We will also include other tests of social cognition and symptom
measures, to evaluate scope of effects. We will compare outcome measures at baseline (placebo
day) in schizotypal and borderline patients and healthy controls, and in schizotypal and
borderline patients across drug doses and placebo administration.

Furthermore, 60 subjects (15 HC, 15 with schizophrenia spectrum disorders, 15 BPD, and 15
with autism spectrum disorders, either new subjects or already enrolled subjects) will be
expected to complete an add-on MRI component of the study, after signing an additional
consent form. For the MRI portion of the study, these subjects will perform 2 more rounds of
social cognition testing after receiving double-blind intranasal oxytocin (40 IU) or placebo
in randomized order, in a cross-over, within-subjects design, separated by approximately a
1-week washout. The subjects will receive the study medication directly prior to beginning an
fMRI scan that will last approximately two hours. Oxytocin levels will be measured before
oxytocin administration and every 10-15 minutes until about 2 hours and 30 minutes
post-administration. The remainder of the protocol will remain the same.

Inclusion Criteria:

- 18 ≤ age ≤ 65

- Medically and neurologically healthy

- Willing and able to provide informed consent

- IQ≥80

Exclusion Criteria:

- Currently meets for a psychotic episode

- Clinically significant cardiovascular or neurological conditions, traumatic brain
injury, uncontrolled hypertension, clinically significant EKG abnormalities, or
serious general medical illness

- Clinical evidence of dehydration or significant hypotension; pregnant or lactating

- Currently meets DSM-IV-TR criteria for MDD

- Current substance abuse (last 6 months) or past dependence on stimulants, opioids or
other potentially neurotoxic drugs

- Currently taking psychotropic or other systemic medications

- Non-English speaking
We found this trial at
Bronx, New York 10468
Principal Investigator: Harold Koenigsberg, MD
Phone: 718-584-9000
Bronx, NY
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1428 Madison Ave
New York, New York 10029
(212) 241-6500
Principal Investigator: Maria de las Mercedes Perez Rodriguez, MD, PhD
Phone: 212-659-8738
Icahn School of Medicine at Mount Sinai Icahn School of Medicine at Mount Sinai is...
New York, NY
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