Effects of acute yohimbine administration on interoception in major depression and childhood adversity

in Psychoneuroendocrinology (2019), 107(Supplement 1), 4

Acute stress, release of stress hormones and chronic stress can affect the processing of visceral-afferent neural signals at different brain levels, which are important for interoception. However, it ... [more ▼]

Acute stress, release of stress hormones and chronic stress can affect the processing of visceral-afferent neural signals at different brain levels, which are important for interoception. However, it remains unclear if these effects are due to activation of the sympatho-adreno-medullary (SAM) axis or hypothalamicpituitary adrenocortical (HPA) axis. With this study, we aimed to investigate the selective effect of SAM axis activation on interoceptive accuracy. Central alpha2-adrenergic receptors represent a negative feedback mechanism of the SAM axis. For major depressive disorder (MDD) and adverse childhood experiences (ACE), alterations in the biological stress systems, including density and sensitivity of central alpha2-adrenergic receptors, have been shown. Healthy individuals without ACE (n = 46), healthy individuals with ACE (n = 23), patients with MDD and without ACE (n = 26) and patients with MDD with ACE (n = 22, all without antidepressant medication) were tested after oral administration of 10mg of yohimbine (alpha2-adrenergic receptors antagonist) and placebo administration in a repeated measures design. Interoceptive accuracy and sensibility were assessed in a heartbeat tracking task. Increases in systolic and diastolic blood pressure after yohimbine administration in all groups confirmed successful activation of the SAM axis. Interoceptive accuracy decreased after yohimbine intake only in the healthy group with ACE, but remained unchanged in all other groups. This ‘group’בdrug’ interaction effect may be due to selective up-regulation of alpha2- adrenergic receptors after experience of childhood trauma, which reduces capacity for attention focus on heartbeats. Suppressed processing of physical sensations in stressful situations may represent an adaptive response in healthy individuals with childhood adversity. [less ▲]

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