The effect of hydrocortisone on fear information processing
Research type
Research Study
Full title
The effect of hydrocortisone on fear information processing
IRAS ID
177371
Contact name
Andrea Reinecke
Contact email
Sponsor organisation
Clinical Trials and Research Governance, University of Oxford
Duration of Study in the UK
1 years, 0 months, 22 days
Research summary
The drug hydrocortisone (UK-licensed for 24 years) targets the glucocorticoid system and is usually prescribed to treat joint inflammation, allergies, or skin conditions. However, the drug also appears to increase synaptic plasticity in the brain, the key cellular mechanism underlying learning and memory. In line with such observations, the drug seems to improve cognition and memory for newly learned non-emotional and emotional information (e.g. Abercrombie et al., 2003; deQuervain et al., 1998). Animal research shows that acute cortisol administration prior to fear extinction – the equivalent to human cognitive-behaviour therapy for anxiety disorders - results in stronger fear reduction (Ninomiya et al., 2010). Similarly, in humans, a single dose of hydrocortisone given before cognitive-behaviour therapy for anxiety disorders significantly enhances the clinical effects of treatment (Soravia et al., 2006; deQuervain et al., 2011).
Such results suggest that the glucocorticoid system may be implicated in the development and extinction of anxiety. However, it remains to be clarified what the basic neuropsychological effects of this drug on emotional information processing in humans are to ultimately identify mechanisms by which it may improve psychological treatments. We hypothesise that hydrocortisone improves emotional information processing, such as attention and memory for fear stimuli, which is thought to be crucial for cognitive-behaviour therapy to work effectively.In this experimental medicine study, we will investigate the key neuropsychological effects of probing the glucocorticoid system on emotional information processing. We will use a single-dose of hydrocortisone as a probe of the glucocorticoid system to identify any effects of this manipulation on a battery of computerised tasks which measure emotional information processing and learning. Overall, the aim of this research is to consider the possible role of the glucocorticoid system in these types of processing and to develop a battery of tasks which form a model of neuroplastic drug action.
In a double-blind, randomised between-groups design, 40 healthy volunteers will be randomised to a group receiving a single dose of hydrocortisone (20mg) versus placebo. Participants will be showing high levels of spider fear, and we will be using spider-related and unrelated stimuli, so that emotional information processing can be measured particularly reliably. When peak plasma levels are reached, participants will work on a battery of behavioural, computerised measures of emotional information processing and learning, to assess attention and processing of emotional and non-emotional stimuli (e.g. spiders, butterflies) presented on a computer screen. Main outcome measures will be reaction time and accuracy scores in response to stimuli.
The results from this study will help us understand how the glucocorticoid system affects emotional information processing, and they will help us establish a battery of tasks that sensitively respond to such manipulations. Such information will ultimately lead to the development of hydrocortisone and similar agents for the more effective and more compact treatment of anxiety disorders.
REC name
South Central - Oxford C Research Ethics Committee
REC reference
15/SC/0270
Date of REC Opinion
2 Jul 2015
REC opinion
Favourable Opinion