title: Classical conditioning and conditionability of insulin and glucose effects in healthy humans.
abstract: We examined whether the effects of intravenously injected insulin and glucose (the physiological endogenous insulin production stimulus) could be classically conditioned in healthy humans. We expected a conditioned blood glucose decrease to a conditioned stimulus (CS) previously paired with insulin and an, albeit lower, blood glucose decrease to a CS paired with glucose injection. In addition, we analyzed glucoregulatory hormone and symptom conditionability. Thirty healthy males were divided into three groups and were given the CS and an intravenous injection of either insulin (0.05 IU/kg) in Group 1, glucose (15%, 0.5 g/kg) in Group 2, or placebo [physiological saline (0.9%)] in Group 3 during the acquisition phase on 4 days. All participants were given the olfactory CS (rosewood-peppermint smell) and placebo injection on Day 5 (test). On Day 5, the total blood glucose decrease tended to be higher in Group 1 than in Group 3 (P<.10), especially at CS presentation (P<.10) and previous unconditioned hypoglycemia time-point (P<.05). The conditioned blood glucose decrease was statistically nonsignificant in Group 2, but shortly after CS presentation, insulin level and blood glucose changes were negatively correlated in Groups 1 and 2 in contrast to positive correlation in Group 3. Furthermore, Group 1 showed an increase in noradrenaline (P<.05), a temporarily delayed increase in growth hormone (GH; P<.05), and an increase of autonomic and neuroglycopenic symptoms, reaching a medium and small effect size, respectively. Group 2 responded with an increase in cortisol (P<.01) and neuroglycopenic symptoms (P<.05) at the time-point of the previous unconditioned blood glucose minimum. To conclude, the effects of exogenously applied insulin can be conditioned in a reliable way. In correspondence with the lower intensity of the unconditioned stimulus (US), conditioning effects with glucose-and, thus, endogenously produced insulin-are weaker but also reflect the actions of central insulin. Future studies will examine the diverse actions of insulin within the brain further.
authors.affiliation: Institute of Medical Psychology, Heinrich-Heine-University Duesseldorf, P.O. Box 101007, D-40001 Duesseldorf, Germany. ursula.stockhorst@uni-duesseldorf.de
authors.forename: Ursula
authors.initials: U
authors.lastname: Stockhorst
authors.forename: Nicola
authors.initials: N
authors.lastname: Mahl
authors.forename: Maren
authors.initials: M
authors.lastname: Krueger
authors.forename: Anja
authors.initials: A
authors.lastname: Huenig
authors.forename: Yolanda
authors.initials: Y
authors.lastname: Schottenfeld-Naor
authors.forename: Achim
authors.initials: A
authors.lastname: Huebinger
authors.forename: Hans-Walter
authors.initials: HW
authors.lastname: Berresheim
authors.forename: Hans-Joachim
authors.initials: HJ
authors.lastname: Steingrueber
authors.forename: Werner A
authors.initials: WA
authors.lastname: Scherbaum
mesh_terms: D000328:Adult; D001786:Blood Glucose / Q000378:metabolism; D002395:Catecholamines / Q000097:blood; D003214:Conditioning, Classical / Q000187:drug effects*; D004311:Double-Blind Method; D005934:Glucagon / Q000097:blood; D005947:Glucose / Q000378:metabolism* / Q000494:pharmacology*; D019382:Human Growth Hormone / Q000097:blood; D006801:Humans; D006854:Hydrocortisone / Q000097:blood; D007004:Hypoglycemic Agents / Q000008:administration & dosage / Q000097:blood / Q000494:pharmacology*; D007275:Injections, Intravenous; D007328:Insulin / Q000008:administration & dosage / Q000097:blood / Q000494:pharmacology*; D008297:Male; D012054:Reinforcement, Psychology
chemical_list: D001786:Blood Glucose; D002395:Catecholamines; D007004:Hypoglycemic Agents; D007328:Insulin; D019382:Human Growth Hormone; D005934:Glucagon; D005947:Glucose; D006854:Hydrocortisone