Intranasal Oxytocin: A Neuropharmacological Intervention for Maternal Neglect?

描述(由申请人提供)：忽视是最常见但研究最少的虐待儿童形式，对儿童发展具有一些最严重的长期后果。行为和心理社会干预往往是无效的，可能是由于忽视子女的母亲固有的生物差异。啮齿动物和最近的人类研究已经证明了神经肽，催产素，在促进社会和母性行为方面的重要性。首席调查员最近被证明，根据成人依恋访谈的确定，患有不安全/拒绝成人依恋模式的母亲，在与自己的婴儿接触时，大脑奖励系统激活减少，催产素产生受损。这项建议旨在确定鼻内催产素是否能增强母亲对婴儿暗示的大脑和行为反应，作为一种可能的针对母亲忽视的神经药物干预。120名首次怀孕的母亲和她们的足月婴儿将参加一项随机、安慰剂对照的鼻内催产素交叉研究。将测量婴儿对面部暗示的功能磁共振大脑反应，以及母亲在自由游戏互动和改进的静脸程序中的视频行为反应。眼睛跟踪技术也将被用于扫描仪，以确定当母亲观看婴儿面部图像时，催产素是否会改变眼睛凝视的模式。据推测，与安慰剂相比，鼻腔内注射催产素将导致大脑中皮质边缘多巴胺奖赏区域的激活增加，以回应自己和未知婴儿的面部暗示。这种反应也将与催产素治疗条件下婴儿眼睛凝视的增强有关。在自由游戏互动(CARE-Index)中，接受鼻内催产素注射的母亲在母亲敏感度的总体测量上也会获得更高的分数，并且在修改后的静脸程序中，与婴儿一起时会表现出更多情感上的偶发反应。将探索治疗条件、母亲的依恋分类和功能磁共振检查中婴儿脸部影响(高兴与悲伤)之间的交互作用。最后，假设大脑奖赏激活将与母亲情绪忽视的其他间接测量有关，包括母亲的敏感度，看到悲伤的婴儿面孔时的眼睛凝视，以及在修改的静脸程序中母亲对婴儿暗示的偶然性反应。我们期望这些结果将成为未来鼻腔内催产素治疗母性忽视的随机对照干预研究的基础。

DESCRIPTION (provided by applicant): Neglect is the most common but least studied form of child maltreatment, with some of the most serious long- term consequences for child development. Behavioral and psychosocial interventions are frequently ineffective, possibly due to inherent biological differences in mothers who neglect their offspring. Rodent and more recent human research has demonstrated the importance of the neuropeptide, oxytocin, in facilitating social and maternal behaviors. The Principal Investigator was recently demonstrated that mothers with an insecure/dismissing pattern of adult attachment, as determined from the Adult Attachment Interview, show reduced brain reward system activation and impaired oxytocin production when engaging with their own infant. This proposal aims to determine whether intranasal oxytocin enhances maternal brain and behavioral responses to infant cues, as a possible neuropharmacological intervention for maternal neglect. One hundred and twenty first time mothers and their term infants will be enrolled to participate in a randomized, placebo- controlled crossover study of intranasal oxytocin. Functional MRI brain responses to infant face cues will be measured, as well as videotaped behavioral responses of mothers during a free-play interaction and a modified still-face procedure. Eye tracking technology will also be utilized in the scanner to determine whether oxytocin alters patterns of eye gaze when mothers view infant face images. It is hypothesized that intranasal oxytocin, compared with placebo, will result in increased activation of mesocorticolimbic dopamine reward regions in the brain, in response to own vs. unknown infant face cues. This response will also be associated with enhanced infant eye gaze in the oxytocin treatment condition. Mothers who receive intranasal oxytocin will also score higher on an overall measure of maternal sensitivity during a free play interaction (the CARE-Index), and will display more emotionally contingent responses with their infant during a modified still-face procedure. Interaction effects will be explored between treatment condition, mother's attachment classification and, in fMRI sessions, infant face affect (happy vs. sad). Finally, it is hypothesized that brain reward activation will be associated with other indirect measures of emotional neglect in mothers, including maternal sensitivity, eye gaze when viewing sad infant faces, and the contingency of maternal responses to infant cues during the modified still-face procedure. We anticipate that these results will be the basis for future randomized, controlled intervention studies of intranasal oxytocin in maternal neglect.