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  • The effect of intranasal oxytocin on the perception of affective touch and multisensory integration in anorexia nervosa: protocol for a double-blind placebo-controlled crossover study

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Mental health
Protocol
The effect of intranasal oxytocin on the perception of affective touch and multisensory integration in anorexia nervosa: protocol for a double-blind placebo-controlled crossover study
  1. Laura Crucianelli1,
  2. Lucy Serpell1,
  3. Yannis Paloyelis2,
  4. Lucia Ricciardi3,
  5. Paul Robinson4,5,
  6. Paul Jenkinson6,
  7. Aikaterini Fotopoulou1
  1. 1 Department of Clinical, Educational and Health Psychology, University College London, London, UK
  2. 2 Department of Neuroimaging Science, Institute of Psychiatry, Psychology & Neuroscience, King’s College London, London, UK
  3. 3 Cardiovascular Sciences Research Centre, St George’s Hospital, London, UK
  4. 4 Barnet Enfield and Haringey Mental Health Trust, London, UK
  5. 5 Faculty of Medical Sciences, University College London, London, UK
  6. 6 Department of Psychology and Sport Sciences, University of Hertfordshire, Hatfield, UK
  1. Correspondence to Dr Laura Crucianelli; l.crucianelli{at}ucl.ac.uk

Abstract

Introduction Anorexia nervosa (AN) is an eating disorder characterised by restriction of energy intake, fears of gaining weight and related body image disturbances. The oxytocinergic system has been proposed as a pathophysiological candidate for AN. Oxytocin is a neuropeptide involved in bodily processes (eg, breast feeding) and in the onset of social behaviours (eg, bonding). Studies investigating the effect of intranasal oxytocin (IN-OT) in AN showed that it can improve attentional bias for high-calorie food and fat bodies stimuli, and related stress. However, less is known about the effect of IN-OT on bodily awareness and body image distortions, key features of the disorder linked to its development, prognosis and maintenance. Here, we aim to investigate the effect of IN-OT on the perception of affective, C-tactile-optimal touch, known to be impaired in AN and on multisensory integration processes underlying a body ownership illusion (ie, rubber hand illusion). For exploratory purposes, we will also investigate the effect of IN-OT on another interoceptive modality, namely cardiac awareness and its relationship with affective touch.

Design, methods and analysis Forty women with AN and forty matched healthy controls will be recruited and tested in two separate sessions; self-administering IN-OT (40 IU) or placebo, intranasally, in a pseudo-randomised manner. The data from this double-blind, placebo-controlled, cross-over study will be analysed using linear mixed models that allow the use of both fixed (treatment levels) and random (subjects) effects in the same analysis. To address our main hypotheses, separate analyses will be run for the affective touch task, where the primary outcome dependent variable will be the pleasantness of the touch, and for the rubber hand illusion, where we will investigate multisensory integration quantified as subjective embodiment towards the rubber hand. In the latter, we will manipulate the synchronicity of touch and the size of the hand.

Ethics and dissemination Ethics approval has been obtained by National Research Ethics Service NRES Committee London (Queen’s Square Committee, ref number 14/LO/1593). The results will be disseminated through conference presentations and publication in peer-reviewed journals.

  • intranasal oxytocin
  • Anorexia Nervosa
  • affective touch
  • multisensory integration
  • interoception

This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/.

http://dx.doi.org/10.1136/bmjopen-2018-024913

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    Footnotes

    • Contributors The study was designed with contributions from LC, YP, PJ and AF. LC, PJ and AF developed the materials and tasks for the study. LR provided medical supervision to the study. LS and PR provided support with recruitment. LC drafted the paper; YP, PJ and AF contributed to refinement of the paper. All authors approved the final manuscript.

    • Funding This work is supported by a European Research Council (ERC) Starting Investigator Award for the project ‘The Bodily Self’ N313755 to A.F. Funding for the time of AK and LC has been partially provided by the Fund for Psychoanalytic Research through the American Psychoanalytic Association. LC is supported by a Neuropsychoanalysis Foundation grant.

    • Competing interests None declared.

    • Ethics approval Ethical approval has been obtained by University College London and the National Research Ethics Service NRES Committee London (Queen’s Square Committee, ref number 14/LO/1593).

    • Provenance and peer review Not commissioned; externally peer reviewed.

    • Patient consent for publication Obtained.