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Zuccolo PF, Hunziker MHL. A review of boundary conditions and variables involved in the prevention of return of fear after post-retrieval extinction. Behav Processes 2019; 162:39-54. [PMID: 30708059 DOI: 10.1016/j.beproc.2019.01.011] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2018] [Revised: 12/26/2018] [Accepted: 01/25/2019] [Indexed: 11/28/2022]
Abstract
Experimental evidence suggests that the return of fear may be prevented by post-retrieval extinction (PRE), a procedure consisting of extinction training after the presentation of a retrieval cue. However, attempts to replicate these findings have yielded mixed results, with some studies showing diminished fear responses after PRE, whereas others show no effect on the return of fear following this procedure. The discrepancies across studies have been interpreted as evidence that there might be conditions under which PRE is not effective (boundary conditions), but these variables have yet to be fully described. We aimed to provide an overview of PRE in humans. We briefly present the theory and research that originated post-retrieval procedures with a focus on the experimental setup used in human studies. We continue with a compilation of possible experimental boundary conditions along with some questions for future research.
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52
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Cahill EN, Milton AL. Neurochemical and molecular mechanisms underlying the retrieval-extinction effect. Psychopharmacology (Berl) 2019; 236:111-132. [PMID: 30656364 PMCID: PMC6373198 DOI: 10.1007/s00213-018-5121-3] [Citation(s) in RCA: 33] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/28/2018] [Accepted: 11/12/2018] [Indexed: 12/26/2022]
Abstract
Extinction within the reconsolidation window, or 'retrieval-extinction', has received much research interest as a possible technique for targeting the reconsolidation of maladaptive memories with a behavioural intervention. However, it remains to be determined whether the retrieval-extinction effect-a long-term reduction in fear behaviour, which appears resistant to spontaneous recovery, renewal and reinstatement-depends specifically on destabilisation of the original memory (the 'reconsolidation-update' account) or represents facilitation of an extinction memory (the 'extinction-facilitation' account). We propose that comparing the neurotransmitter systems, receptors and intracellular signalling pathways recruited by reconsolidation, extinction and retrieval-extinction will provide a way of distinguishing between these accounts.
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Affiliation(s)
- Emma N Cahill
- Department of Physiology, Development and Neuroscience, University of Cambridge, Downing Site, Cambridge, CB2 3EG, UK
| | - Amy L Milton
- Department of Psychology, University of Cambridge, Downing Site, Cambridge, CB2 3EB, UK.
- Behavioural and Clinical Neuroscience Institute, Cambridge, CB2 3EB, UK.
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53
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Farrell MR, Schoch H, Mahler SV. Modeling cocaine relapse in rodents: Behavioral considerations and circuit mechanisms. Prog Neuropsychopharmacol Biol Psychiatry 2018; 87:33-47. [PMID: 29305936 PMCID: PMC6034989 DOI: 10.1016/j.pnpbp.2018.01.002] [Citation(s) in RCA: 57] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/28/2017] [Revised: 12/18/2017] [Accepted: 01/02/2018] [Indexed: 12/29/2022]
Abstract
Addiction is a chronic relapsing disorder, in that most addicted individuals who choose to quit taking drugs fail to maintain abstinence in the long-term. Relapse is especially likely when recovering addicts encounter risk factors like small "priming" doses of drug, stress, or drug-associated cues and locations. In rodents, these same factors reinstate cocaine seeking after a period of abstinence, and extensive preclinical work has used priming, stress, or cue reinstatement models to uncover brain circuits underlying cocaine reinstatement. Here, we review common rat models of cocaine relapse, and discuss how specific features of each model influence the neural circuits recruited during reinstated drug seeking. To illustrate this point, we highlight the surprisingly specific roles played by ventral pallidum subcircuits in cocaine seeking reinstated by either cocaine-associated cues, or cocaine itself. One goal of such studies is to identify, and eventually to reverse the specific circuit activity that underlies the inability of some humans to control their drug use. Based on preclinical findings, we posit that circuit activity in humans also differs based on the triggers that precipitate craving and relapse, and that associated neural responses could help predict the triggers most likely to elicit relapse in a given person. If so, examining circuit activity could facilitate diagnosis of subgroups of addicted people, allowing individualized treatment based on the most problematic risk factors.
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Affiliation(s)
- Mitchell R Farrell
- Department of Neurobiology & Behavior, University of California, 1203 McGaugh Hall, Irvine, United States
| | - Hannah Schoch
- Department of Neurobiology & Behavior, University of California, 1203 McGaugh Hall, Irvine, United States
| | - Stephen V Mahler
- Department of Neurobiology & Behavior, University of California, 1203 McGaugh Hall, Irvine, United States.
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54
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Monfils MH, Holmes EA. Memory boundaries: opening a window inspired by reconsolidation to treat anxiety, trauma-related, and addiction disorders. Lancet Psychiatry 2018; 5:1032-1042. [PMID: 30385214 DOI: 10.1016/s2215-0366(18)30270-0] [Citation(s) in RCA: 69] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/08/2018] [Revised: 07/06/2018] [Accepted: 07/09/2018] [Indexed: 01/12/2023]
Abstract
Pioneering research over the past two decades has shown that memories are far more malleable than we once thought, thereby highlighting the potential for new clinical avenues for treatment of psychopathology. We first briefly review the historical foundation of memory reconsolidation-a concept that refers to hypothetical processes that occur when a memory is retrieved and restored. Then, we provide an overview of the basic research on memory reconsolidation that has been done with humans and other animals, focusing on models of fear, anxiety-related disorders, and addiction, from the perspective that they all involve disorders of memory. This basic research has fuelled early stage developments of novel treatment techniques. More specifically, we consider behavioural interventions inspired by reconsolidation updating, namely retrieval-extinction techniques. We discuss the set of principles that would be needed for memory modifications within a putative reconsolidation time window, and review research that employs reconsolidation-based strategies with clinical populations. We conclude by highlighting current pitfalls and controversies surrounding the use of reconsolidation-based approaches, but end on an optimistic note for clinical research going forward. Despite the challenges, we believe that drawing on ideas from psychological science can help open up treatment innovation.
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Affiliation(s)
- Marie H Monfils
- Department of Psychology, Institute for Mental Health Research, University of Texas at Austin, Austin, TX, USA.
| | - Emily A Holmes
- Division of Psychology, Department for Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
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Abstract
Several studies have revealed that fear recovery is prevented when extinction training is conducted after retrieval of a fear memory. Postretrieval extinction training is related to modification of memory during reconsolidation. Providing new information during reconsolidation can modify the original memory. We propose that avoidance behavior is a relevant factor that prevents subjects from obtaining new safety information during reconsolidation. Postretrieval extinction training without avoidance behavior reduced the fear response to conditioned stimulus and prevented spontaneous recovery in the current study, which corresponded with previous studies. Under the condition of postretrieval extinction training with avoidance behavior, the fear response was not reduced as much as it was in the condition without avoidance. It is possible that avoidance behavior prevents receiving new safety information during postretrieval extinction training.
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56
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Walsh KH, Das RK, Saladin ME, Kamboj SK. Modulation of naturalistic maladaptive memories using behavioural and pharmacological reconsolidation-interfering strategies: a systematic review and meta-analysis of clinical and 'sub-clinical' studies. Psychopharmacology (Berl) 2018; 235:2507-2527. [PMID: 30091003 PMCID: PMC6132663 DOI: 10.1007/s00213-018-4983-8] [Citation(s) in RCA: 48] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/28/2018] [Accepted: 07/23/2018] [Indexed: 12/13/2022]
Abstract
BACKGROUND Consolidated memories can undergo enduring modification through retrieval-dependent treatments that modulate reconsolidation. This represents a potentially transformative strategy for weakening or overwriting the maladaptive memories that underlie substance use and anxiety/trauma-related disorders. However, modulation of naturalistic maladaptive memories may be limited by 'boundary conditions' imposed on the reconsolidation process by the nature of these memories. METHODS We conducted a systematic review and meta-analyses of behavioural and pharmacological studies examining retrieval-dependent modulation of reward- and threat-related memories in (sub) clinical substance use and anxiety/trauma, respectively. RESULTS Of 4938 publications assessed for eligibility, 8 studies of substance use and 10 of anxiety (phobia)- and trauma-related symptoms were included in the meta-analyses. Overall, the findings were in the predicted direction, with most studies favouring the 'retrieval + treatment' condition. However, the magnitude of effects was dependent upon the nature of treatment, with pharmacological interventions showing a medium-sized effect (g = 0.59, p = 0.03) and behavioural treatments, a relatively small effect (g = 0.32, p = 0.10) in studies of phobia/trauma. Among studies of substance use, post-retrieval behavioural interventions yielded a larger effect (g = 0.60, p < 0.001) relative to pharmacological treatments (g = - 0.03, p = 0.91), with treatment type being a statistically significant moderator (χ2(1) = 4.20, p = 0.04). CONCLUSION Modification of naturalistic maladaptive memories during reconsolidation appears to be a viable treatment strategy for substance use and phobias/trauma disorders. However, high levels of heterogeneity and methodological variation limit the strength of conclusions that can be drawn from the reviewed studies at this stage.
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Affiliation(s)
- Katie H Walsh
- Clinical Psychopharmacology Unit, Research Department of Clinical, Educational and Health Psychology, University College London, Gower Street, London, WC1E 6BT, UK
| | - Ravi K Das
- Clinical Psychopharmacology Unit, Research Department of Clinical, Educational and Health Psychology, University College London, Gower Street, London, WC1E 6BT, UK
| | - Michael E Saladin
- Department of Health Sciences and Research, College of Health Professions, Medical University of South Carolina, Charleston, USA
| | - Sunjeev K Kamboj
- Clinical Psychopharmacology Unit, Research Department of Clinical, Educational and Health Psychology, University College London, Gower Street, London, WC1E 6BT, UK.
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57
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Kredlow MA, Orr SP, Otto MW. Exploring the boundaries of post-retrieval extinction in healthy and anxious individuals. Behav Res Ther 2018; 108:45-57. [PMID: 29981938 DOI: 10.1016/j.brat.2018.06.010] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2018] [Revised: 06/14/2018] [Accepted: 06/25/2018] [Indexed: 01/07/2023]
Abstract
Over a dozen studies have examined the efficacy of post-retrieval extinction (PRE) in healthy adults in the fear conditioning laboratory, with a recent meta-analysis reporting an overall small-moderate effect on attenuating the return of fear compared to standard extinction. The current study was designed to extend PRE effects to a mixed sample of healthy and anxious individuals, explore potential moderators, and examine the benefit of PRE for a memory conditioned over multiple days. Healthy (n = 49) and anxious (n = 43) adults received either one day of acquisition followed by PRE, one day of acquisition followed by extinction, or three days of acquisition followed by PRE. Comparing participants who received one day of acquisition followed by PRE or extinction, no significant effect of PRE was observed on differential skin conductance response reinstatement or reactivity to the conditioned stimulus alone. Anxiety symptoms did not moderate outcomes. There was no difference in return of fear for anxious participants who received three days of acquisition followed by PRE versus one day of acquisition followed by PRE. These results further highlight the variability of findings in the PRE literature and need for further examination of individual difference factors that may moderate PRE effects.
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Affiliation(s)
- M Alexandra Kredlow
- Department of Psychological & Brain Sciences, Boston University, 648 Beacon Street, 5th Floor, Boston, MA 02215, United States.
| | - Scott P Orr
- Department of Psychiatry, Massachusetts General Hospital and Harvard Medical School, East Building 120 -2nd Avenue, Charlestown, MA 02129, United States.
| | - Michael W Otto
- Department of Psychological & Brain Sciences, Boston University, 648 Beacon Street, 5th Floor, Boston, MA 02215, United States.
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Hu J, Wang W, Homan P, Wang P, Zheng X, Schiller D. Reminder duration determines threat memory modification in humans. Sci Rep 2018; 8:8848. [PMID: 29891856 PMCID: PMC5995965 DOI: 10.1038/s41598-018-27252-0] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2018] [Accepted: 05/29/2018] [Indexed: 11/10/2022] Open
Abstract
Memory reminders can return a memory into an unstable state such that it will decay unless actively restabilized into long-term memory through reconsolidation. Exposure to a memory reminder, however, does not always lead to destabilization. The 'trace dominance' principle posits that the extent of exposure to memory reminders governs memory susceptibility to disruption. Here, we provide a first systematic investigation of reminder duration effects on threat memory modification in humans. Reminder duration was parametrically varied across 155 participants in a three-day protocol. We found that short reminders (1 s and 4 s) made the memory prone to interference from post-retrieval extinction, suggesting that the memory had been updated. In contrast, no reminder or long reminders (30 s and 3 min) made the memory resistant to such interference, and robustly return. Reminder duration therefore influences memory stability and may be a critical determinant of therapeutic efficacy.
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Affiliation(s)
- Jingchu Hu
- School of Psychology and Center for Studies of Psychological Application, South China Normal University, Guangzhou, China
- School of Life Sciences, South China Normal University, Guangzhou, China
| | - Wenqing Wang
- School of Psychology and Center for Studies of Psychological Application, South China Normal University, Guangzhou, China
| | - Philipp Homan
- Center for Psychiatric Neuroscience, The Feinstein Institute for Medical Research, Zucker School of Medicine at Northwell/Hofstra, Hempstead, NY, USA
| | - Penggui Wang
- School of Psychology and Center for Studies of Psychological Application, South China Normal University, Guangzhou, China
| | - Xifu Zheng
- School of Psychology and Center for Studies of Psychological Application, South China Normal University, Guangzhou, China.
| | - Daniela Schiller
- Department of Psychiatry, Department of Neuroscience, and Friedman Brain Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
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59
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Who is studied in de novo fear conditioning paradigms? An examination of demographic and stimulus characteristics predicting fear learning. Int J Psychophysiol 2018; 130:21-28. [PMID: 29800584 DOI: 10.1016/j.ijpsycho.2018.05.008] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2017] [Revised: 05/09/2018] [Accepted: 05/21/2018] [Indexed: 01/16/2023]
Abstract
A common challenge in fear conditioning studies is that a relatively large proportion of individuals fail to acquire a differential conditioned skin conductance response (SCR). Researchers have identified demographic factors associated with poorer fear learning and explored the use of different fear conditioning paradigms across various populations. However, few studies have strategically aimed to enhance acquisition by manipulating the unconditioned stimulus (UCS). In the current manuscript, we examined whether demographic factors predicted failure to condition (n = 274) and explored whether modifications to the UCS enhanced fear learning (n = 143). Results indicated that race, but not age, education, or gender, predicted failure to condition. Stepwise logistic regression demonstrated that race was the most influential of these predictors; African Americans were less likely to acquire a conditioned SCR, compared to non-African Americans. Also, use of a compound UCS (i.e., electric shock combined with a scream noise) led to nearly double the rate of acquisition of a conditioned SCR. Hence, use of a compound UCS may provide a way to reduce the number of excluded individuals in studies of fear-conditioned SCR and thereby improve the representativeness of research samples.
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60
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Yue J, Shi L, Lin X, Khan MZ, Shi J, Lu L. Behavioral interventions to eliminate fear responses. SCIENCE CHINA-LIFE SCIENCES 2018; 61:625-632. [PMID: 29744783 DOI: 10.1007/s11427-018-9294-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/22/2018] [Accepted: 02/26/2018] [Indexed: 02/07/2023]
Abstract
Fear memory underlies anxiety-related disorders, including posttraumatic stress disorder (PTSD). PTSD is a fear-based disorder, characterized by difficulties in extinguishing the learned fear response and maintaining extinction. Currently, the first-line treatment for PTSD is exposure therapy, which forms an extinction memory to compete with the original fear memory. However, the extinguished fear often returns under numerous circumstances, suggesting that novel methods are needed to eliminate fear memory or facilitate extinction memory. This review discusses research that targeted extinction and reconsolidation to manipulate fear memory. Recent studies indicate that sleep is an active state that can regulate memory processes. We also discuss the influence of sleep on fear memory. For each manipulation, we briefly summarize the neural mechanisms that have been identified in human studies. Finally, we highlight potential limitations and future directions in the field to better translate existing interventions to clinical settings.
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Affiliation(s)
- Jingli Yue
- Peking University Sixth Hospital, Peking University Institute of Mental Health, Key of Mental Health, Ministry of Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Beijing, 100191, China
| | - Le Shi
- Peking University Sixth Hospital, Peking University Institute of Mental Health, Key of Mental Health, Ministry of Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Beijing, 100191, China.,National Institute on Drug Dependence, Peking University, Beijing, 100191, China
| | - Xiao Lin
- Peking University Sixth Hospital, Peking University Institute of Mental Health, Key of Mental Health, Ministry of Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Beijing, 100191, China.,Peking-Tsinghua Center for Life Sciences and PKU-IDG/McGovern Institute for Brain Research, Peking University, Beijing, 100871, China
| | - Muhammad Zahid Khan
- National Institute on Drug Dependence, Peking University, Beijing, 100191, China
| | - Jie Shi
- National Institute on Drug Dependence, Peking University, Beijing, 100191, China
| | - Lin Lu
- Peking University Sixth Hospital, Peking University Institute of Mental Health, Key of Mental Health, Ministry of Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Beijing, 100191, China. .,National Institute on Drug Dependence, Peking University, Beijing, 100191, China. .,Peking-Tsinghua Center for Life Sciences and PKU-IDG/McGovern Institute for Brain Research, Peking University, Beijing, 100871, China.
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61
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Redondo J, Fernandez-Rey J, Gonzalez-Gonzalez D. Is it possible to modify fear memories in humans with extinction training within a single day? PSYCHOLOGICAL RESEARCH 2018; 83:1340-1348. [PMID: 29671052 DOI: 10.1007/s00426-018-1017-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2017] [Accepted: 04/12/2018] [Indexed: 10/17/2022]
Abstract
Extinction procedures have been used widely in the study of fear memories, and different positions have been adopted regarding the efficacy of such procedures and the mechanisms involved. It has been argued that extinction may interfere with the consolidation of the fear memory if the procedure is applied with the appropriate timing after acquisition. However, the opposite position is also held, that is, that the extinction does not achieve an elimination of the fear response. The aim of the present study is to test the short-term effects of immediate extinction in fear reduction when this extinction is preceded by a retrieval trial. For this, a procedure similar to that employed by Schiller et al. (Nature 463(7277): 49-53, 2010) was used, but in a single day and with white noise as an aversive unconditioned stimulus. The results indicate that a CS+ single retrieval trial before the extinction procedure after acquisition was more effective in fear reduction than standard immediate extinction.
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Affiliation(s)
- Jaime Redondo
- Cognitive Processes and Behavior Lab, Faculty of Psychology, University of Santiago de Compostela,, Santiago, Spain.
| | - Jose Fernandez-Rey
- Cognitive Processes and Behavior Lab, Faculty of Psychology, University of Santiago de Compostela,, Santiago, Spain
| | - Daniel Gonzalez-Gonzalez
- Cognitive Processes and Behavior Lab, Faculty of Psychology, University of Santiago de Compostela,, Santiago, Spain
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62
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Kredlow MA, Eichenbaum H, Otto MW. Memory creation and modification: Enhancing the treatment of psychological disorders. AMERICAN PSYCHOLOGIST 2018; 73:269-285. [PMID: 29494172 PMCID: PMC5897133 DOI: 10.1037/amp0000185] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Modification of the ongoing influence of maladaptive cognitive, emotional, and behavioral patterns is a fundamental feature of many psychological treatments. Accordingly, a clear understanding of the nature of memory adaptation and accommodation to therapeutic learning becomes an important issue for (1) understanding the impact of clinical interventions, and (2) considering innovations in treatment strategies. In this article, we consider advances in the conceptualization of memory processes and memory modification research relative to clinical treatment. We review basic research on the formation of memories, the way in which new learning is integrated within memory structures, and strategies to influence the nature and degree to which new learning is integrated. We then discuss cognitive/behavioral and pharmacological strategies for influencing memory formation in relation to disorder prevention or treatment. Our goal is to foster awareness of current strategies for enhancing therapeutic learning and to encourage research on potential new avenues for memory enhancement in service of the treatment of mental health disorders. (PsycINFO Database Record
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Affiliation(s)
| | | | - Michael W Otto
- Department of Psychological and Brain Sciences, Boston University
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63
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Visser RM, Lau-Zhu A, Henson RN, Holmes EA. Multiple memory systems, multiple time points: how science can inform treatment to control the expression of unwanted emotional memories. Philos Trans R Soc Lond B Biol Sci 2018; 373:20170209. [PMID: 29352036 PMCID: PMC5790835 DOI: 10.1098/rstb.2017.0209] [Citation(s) in RCA: 54] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/04/2017] [Indexed: 01/04/2023] Open
Abstract
Memories that have strong emotions associated with them are particularly resilient to forgetting. This is not necessarily problematic, however some aspects of memory can be. In particular, the involuntary expression of those memories, e.g. intrusive memories after trauma, are core to certain psychological disorders. Since the beginning of this century, research using animal models shows that it is possible to change the underlying memory, for example by interfering with its consolidation or reconsolidation. While the idea of targeting maladaptive memories is promising for the treatment of stress and anxiety disorders, a direct application of the procedures used in non-human animals to humans in clinical settings is not straightforward. In translational research, more attention needs to be paid to specifying what aspect of memory (i) can be modified and (ii) should be modified. This requires a clear conceptualization of what aspect of memory is being targeted, and how different memory expressions may map onto clinical symptoms. Furthermore, memory processes are dynamic, so procedural details concerning timing are crucial when implementing a treatment and when assessing its effectiveness. To target emotional memory in its full complexity, including its malleability, science cannot rely on a single method, species or paradigm. Rather, a constructive dialogue is needed between multiple levels of research, all the way 'from mice to mental health'.This article is part of a discussion meeting issue 'Of mice and mental health: facilitating dialogue between basic and clinical neuroscientists'.
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Affiliation(s)
- Renée M Visser
- Medical Research Council Cognition and Brain Sciences Unit, University of Cambridge, 15 Chaucer Road, Cambridge CB2 7EF, UK
| | - Alex Lau-Zhu
- Medical Research Council Cognition and Brain Sciences Unit, University of Cambridge, 15 Chaucer Road, Cambridge CB2 7EF, UK
- Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Richard N Henson
- Medical Research Council Cognition and Brain Sciences Unit, University of Cambridge, 15 Chaucer Road, Cambridge CB2 7EF, UK
| | - Emily A Holmes
- Medical Research Council Cognition and Brain Sciences Unit, University of Cambridge, 15 Chaucer Road, Cambridge CB2 7EF, UK
- Karolinska Institutet, Division of Psychology, Department of Clinical Neuroscience, Stockholm, Sweden
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64
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Craske MG. Honoring the Past, Envisioning the Future: ABCT's 50th Anniversary Presidential Address. Behav Ther 2018; 49:151-164. [PMID: 29530256 DOI: 10.1016/j.beth.2017.05.003] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/01/2017] [Revised: 05/11/2017] [Accepted: 05/12/2017] [Indexed: 12/17/2022]
Abstract
The theme of the Association for Behavioral and Cognitive Therapies (ABCT) 50th Anniversary was to honor the past and envision the future. From the wisdom, foresight, and determination of the pioneers of our organization, and the continuous upholding of the scientific method over the last 50 years, cognitive behavioral therapy (CBT) has become the most empirically supported psychological treatment for a wide array of mental health problems. Yet, we still have a long way to go. This address outlines a vision for the future of CBT, which involves greater collaborative science, with all minds working together on the same problem, and greater attention to the risk factors and critical processes that underlie psychopathology and explain treatment change. Such knowledge generation can inform the development of new, more efficient and more effective therapies that are tailored with more precision to the needs of each person. Latest technologies provide tools for a precision focus while at the same time increasing the reach of our treatments to the many for whom traditional therapies are unavailable. Our impact will be greatly enhanced by large samples with common methods and measures that inform a precision approach. We have come a long way since ABCT was founded in 1966, and we are poised to make even larger strides in our mission to enhance health and well-being by harnessing science, our major guiding principle.
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65
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Psychedelics and reconsolidation of traumatic and appetitive maladaptive memories: focus on cannabinoids and ketamine. Psychopharmacology (Berl) 2018; 235:433-445. [PMID: 29178010 DOI: 10.1007/s00213-017-4793-4] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/28/2017] [Accepted: 11/14/2017] [Indexed: 12/22/2022]
Abstract
RATIONALE Clinical data with 3,4-methylenedioxymethamphetamine (MDMA) in post-traumatic stress disorder (PTSD) patients recently stimulated interest on the potential therapeutic use of psychedelics in disorders characterized by maladaptive memories, including substance use disorders (SUD). The rationale for the use of MDMA in PTSD and SUD is being extended to a broader beneficial "psychedelic effect," which is supporting further clinical investigations, in spite of the lack of mechanistic hypothesis. Considering that the retrieval of emotional memories reactivates specific brain mechanisms vulnerable to inhibition, interference, or strengthening (i.e., the reconsolidation process), it was proposed that the ability to retrieve and change these maladaptive memories might be a novel intervention for PTSD and SUD. The mechanisms underlying MDMA effects indicate memory reconsolidation modulation as a hypothetical process underlying its efficacy. OBJECTIVE Mechanistic and clinical studies with other two classes of psychedelic substances, namely cannabinoids and ketamine, are providing data in support of a potential use in PTSD and SUD based on the modulation of traumatic and appetitive memory reconsolidation, respectively. Here, we review preclinical and clinical data on cannabinoids and ketamine effects on biobehavioral processes related to the reconsolidation of maladaptive memories. RESULTS We report the findings supporting (or not) the working hypothesis linking the potential therapeutic effect of these substances to the underlying reconsolidation process. We also proposed possible approaches for testing the use of these two classes of drugs within the current paradigm of reconsolidation memory inhibition. CONCLUSIONS Metaplasticity may be the process in common between cannabinoids and ketamine/ketamine-like substance effects on the mediation and potential manipulation of maladaptive memories.
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66
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Weisman JS, Rodebaugh TL. Exposure therapy augmentation: A review and extension of techniques informed by an inhibitory learning approach. Clin Psychol Rev 2018; 59:41-51. [DOI: 10.1016/j.cpr.2017.10.010] [Citation(s) in RCA: 59] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2017] [Revised: 09/30/2017] [Accepted: 10/25/2017] [Indexed: 12/11/2022]
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67
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Does exercise augment operant and Pavlovian extinction: A meta-analysis. J Psychiatr Res 2018; 96:73-93. [PMID: 28987515 DOI: 10.1016/j.jpsychires.2017.09.018] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/28/2017] [Revised: 08/17/2017] [Accepted: 09/14/2017] [Indexed: 12/16/2022]
Abstract
BACKGROUND Exposure therapy, a behavioral approach to reduce symptomology in fear, anxiety, and drug-related psychiatric disorders, is based on learning and memory principles of extinction, and is subject to relapse. As such, it is important to find ways to enhance outcomes. One such way is through exercise. OBJECTIVES Identify if exercise augments extinction behavior, and whether this depends on the experimental paradigm used (i.e. operant or Pavlovian) and/or stimulus (i.e. appetitive or aversive). Additionally, determine which moderating variables influence the effects of exercise on extinction learning. METHODS A literature search was conducted and a Hedges' g calculation was employed to conduct a meta-analysis (metaSEM) using a structural equation modeling approach. This approach was chosen because of its ability to account for dependencies in effect sizes. RESULTS We found a significant effect of exercise as an augmentation over extinction alone (g = 0.37, p < 0.001), with extinction paradigm (but not stimulus) producing a moderating effect (B = 0.43, p = 0.030). Data were then split by extinction paradigm, with operant extinction models having a significant effect (g = 0.55, p < 0.001), and number of extinction sessions moderating aggregate effects. Pavlovian models did not have significant overall effects (g = 0.11, p = 0.3976), but were moderated by the number of animals housed together and exercise after extinction. CONCLUSIONS The effects of exercise on extinction learning are differentially modulated by the type of paradigm used, the number of extinction sessions, the timing of when exercise treatment was applied (after extinction), and the housing conditions.
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Gray R, Budden-Potts D, Bourke F. Reconsolidation of Traumatic Memories for PTSD: A randomized controlled trial of 74 male veterans. Psychother Res 2017; 29:621-639. [PMID: 29241423 DOI: 10.1080/10503307.2017.1408973] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
Abstract
Design: A randomized waitlist-controlled design (n = 74) examined the efficacy of Reconsolidation of Traumatic Memories (RTM) among male veterans with current-month flashbacks and nightmares. Volunteers were randomly assigned to immediate treatment (three 120-minute sessions of RTM), or to a 3-week waiting condition before receiving the RTM treatment. Blinded psychometricians evaluated the symptoms at intake, 2 weeks, and 6 weeks post. Wait-listed participants were re-evaluated and then treated. Sixty-five volunteers completed the treatment. Results: Of those treated, 46 (71%) lost DSM diagnosis for post-traumatic stress disorder (PTSD) by one of the following definitions: 42 persons (65%) were in complete remission (PTSD Symptom Scale Interview (PSS-I) ≤ 20 and DSM criteria not met). Four others (6%) lost the DSM diagnosis or were otherwise sub-clinical by dichotomous criteria (PSS-I < 20 and absence of flashbacks and nightmares) but non-ambiguous on the PTSD Checklist Military Version measures. Within-group RTM effect sizes (Hedges' g) for PSS-I score changes ranged from 1.45 to 2.3. The between-group comparison between the treatment group and the untreated controls was significant (p < .001) with an effect size equivalent to two standard deviations (g = 2.13; 95% CI [1.56, 2.70]). Patient satisfaction with the intervention was high. Conclusions: RTM shows promise as a brief, cost-effective intervention for PTSD characterized primarily by intrusive symptoms. Clinical or methodological significance of this article: The article provides evidence to support a fast (5 hours or fewer) robust intervention for PTSD characterized by intrusive symptoms including current-month flashbacks, nightmares, and accompanied by sympathetic arousal in response to trauma narratives. The intervention is well tolerated and has demonstrated efficacy up to one year.
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Affiliation(s)
- Richard Gray
- a The Research and Recognition Project , Corning , NY , USA
| | | | - Frank Bourke
- a The Research and Recognition Project , Corning , NY , USA
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Fattore L, Piva A, Zanda MT, Fumagalli G, Chiamulera C. Psychedelics and reconsolidation of traumatic and appetitive maladaptive memories: focus on cannabinoids and ketamine. Psychopharmacology (Berl) 2017. [PMID: 29178010 DOI: 10.1007/s00213-017-4793-4.] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 09/29/2022]
Abstract
RATIONALE Clinical data with 3,4-methylenedioxymethamphetamine (MDMA) in post-traumatic stress disorder (PTSD) patients recently stimulated interest on the potential therapeutic use of psychedelics in disorders characterized by maladaptive memories, including substance use disorders (SUD). The rationale for the use of MDMA in PTSD and SUD is being extended to a broader beneficial "psychedelic effect," which is supporting further clinical investigations, in spite of the lack of mechanistic hypothesis. Considering that the retrieval of emotional memories reactivates specific brain mechanisms vulnerable to inhibition, interference, or strengthening (i.e., the reconsolidation process), it was proposed that the ability to retrieve and change these maladaptive memories might be a novel intervention for PTSD and SUD. The mechanisms underlying MDMA effects indicate memory reconsolidation modulation as a hypothetical process underlying its efficacy. OBJECTIVE Mechanistic and clinical studies with other two classes of psychedelic substances, namely cannabinoids and ketamine, are providing data in support of a potential use in PTSD and SUD based on the modulation of traumatic and appetitive memory reconsolidation, respectively. Here, we review preclinical and clinical data on cannabinoids and ketamine effects on biobehavioral processes related to the reconsolidation of maladaptive memories. RESULTS We report the findings supporting (or not) the working hypothesis linking the potential therapeutic effect of these substances to the underlying reconsolidation process. We also proposed possible approaches for testing the use of these two classes of drugs within the current paradigm of reconsolidation memory inhibition. CONCLUSIONS Metaplasticity may be the process in common between cannabinoids and ketamine/ketamine-like substance effects on the mediation and potential manipulation of maladaptive memories.
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Affiliation(s)
- Liana Fattore
- National Research Council of Italy, Institute of Neuroscience-Cagliari, Cagliari, Italy
| | - Alessandro Piva
- Sezione Farmacologia, Dipt. Diagnostica e Sanità Pubblica, Università degli Studi di Verona, Policlinico Borgo Roma, P.le Scuro 10, 37134, Verona, Italy
| | - Mary Tresa Zanda
- Department of Biomedical Sciences, Division of Neuroscience and Clinical Pharmacology, University of Cagliari, Cittadella Universitaria di Monserrato, SP 8, Km 0.700, 09042, Monserrato, Italy
| | - Guido Fumagalli
- Sezione Farmacologia, Dipt. Diagnostica e Sanità Pubblica, Università degli Studi di Verona, Policlinico Borgo Roma, P.le Scuro 10, 37134, Verona, Italy
| | - Cristiano Chiamulera
- Sezione Farmacologia, Dipt. Diagnostica e Sanità Pubblica, Università degli Studi di Verona, Policlinico Borgo Roma, P.le Scuro 10, 37134, Verona, Italy.
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The Effects of β-Adrenergic Blockade on the Degrading Effects of Eye Movements on Negative Autobiographical Memories. Biol Psychiatry 2017; 82:587-593. [PMID: 28456330 DOI: 10.1016/j.biopsych.2017.03.012] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/04/2016] [Revised: 03/06/2017] [Accepted: 03/10/2017] [Indexed: 12/11/2022]
Abstract
BACKGROUND Eye movement desensitization and reprocessing (EMDR) is an effective treatment for posttraumatic stress disorder. During EMDR, patients make horizontal eye movements (EMs) while simultaneously recalling a traumatic memory, which renders the memory less vivid and emotional when it is later recalled again. Recalling highly emotional autobiographical memories enhances noradrenergic neurotransmission. Noradrenaline (NA) strengthens memory (re)consolidation. However, memories become less vivid after recall+EMs. Therefore, NA might either play no significant role or serve to strengthen memories that are degraded by EMs. The present study was designed to test the latter hypothesis. We predicted that blocking NA would abolish the memory degrading effects of EMs. METHODS Fifty-six healthy participants selected three negative autobiographical memories. One was then recalled while making EMs, one was recalled without EMs, and one was not recalled. Vividness and emotionality of the memories as well as heart rate and skin conductance level during memory retrieval were measured before, directly after, and 24 hours after the EM task. Before the task, participants received a placebo or the noradrenergic β-receptor blocker propranolol (40 mg). RESULTS There were no effects of EMs on memory emotionality or psychophysiological measures in the propranolol and placebo groups. However, in the placebo group, but not in the propranolol group, memory vividness significantly decreased from pretest to posttest and follow-up after recall+EMs relative to the control conditions. CONCLUSIONS Blocking NA abolished the effects of EMs on the vividness of emotional memories, indicating that NA is crucial for EMDR effectiveness and possibly strengthens the reconsolidation of the degraded memory.
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Luyten L, Beckers T. A preregistered, direct replication attempt of the retrieval-extinction effect in cued fear conditioning in rats. Neurobiol Learn Mem 2017; 144:208-215. [PMID: 28765085 PMCID: PMC5931313 DOI: 10.1016/j.nlm.2017.07.014] [Citation(s) in RCA: 42] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2017] [Revised: 07/11/2017] [Accepted: 07/28/2017] [Indexed: 11/19/2022]
Abstract
In 2009, Monfils and colleagues proposed a behavioral procedure that was said to result in a permanent attenuation of a previously established fear memory, thereby precluding a possible return of fear after extinction (Monfils, Cowansage, Klann, & LeDoux, 2009). By presenting a single retrieval trial one hour before standard extinction training, they found an enduring reduction of fear. The retrieval-extinction procedure holds great clinical potential, particularly for anxiety patients, but the findings are not undisputed, and several conceptual replications have failed to reproduce the effect. These failures have largely been attributed to small procedural differences. This preregistered study is the first endeavor to exactly replicate three key experiments of the original report by Monfils et al. (2009), thereby gauging the robustness of their seminal findings. Despite adhering to the original procedures as closely as possible, we did not find any evidence for reduced return of fear with the retrieval-extinction procedure relative to regular extinction training, as assessed through spontaneous recovery, reinstatement and renewal. Behavior of animals in the control condition (extinction only) was comparable to that in the original studies and provided an adequate baseline to reveal differences with the retrieval-extinction condition. Our null findings indicate that the effect sizes in the original paper may have been inflated and question the legitimacy of previously proposed moderators of the retrieval-extinction effect. We argue that direct experimental evaluation of purported moderators of the retrieval-extinction effect will be key to shed more light on its nature and prerequisites.
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Affiliation(s)
- Laura Luyten
- Centre for the Psychology of Learning and Experimental Psychopathology, KU Leuven, Belgium.
| | - Tom Beckers
- Centre for the Psychology of Learning and Experimental Psychopathology, KU Leuven, Belgium
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Jacquart J, Roquet RF, Papini S, Powers MB, Rosenfield D, Smits JAJ, Monfils MH. Effects of acute exercise on fear extinction in rats and exposure therapy in humans: Null findings from five experiments. J Anxiety Disord 2017; 50:76-86. [PMID: 28618306 DOI: 10.1016/j.janxdis.2017.05.010] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/02/2017] [Revised: 05/25/2017] [Accepted: 05/25/2017] [Indexed: 11/18/2022]
Abstract
BACKGROUND Exposure therapy is an established learning-based intervention for the treatment of anxiety disorders with an average response rate of nearly 50%, leaving room for improvement. Emerging strategies to enhance exposure therapy in humans and fear extinction retention in animal models are primarily pharmacological. These approaches are limited as many patients report preferring non-pharmacological approaches in therapy. With general cognitive enhancement effects, exercise has emerged as a plausible non-pharmacological augmentation strategy. The present study tested the hypothesis that fear extinction and exposure therapy would be enhanced by a pre-training bout of exercise. METHODS We conducted four experiments with rats that involved a standardized conditioning and extinction paradigm and a manipulation of exercise. In a fifth experiment, we manipulated vigorous-intensity exercise prior to a standardized virtual reality exposure therapy session among adults with fear of heights. RESULTS In experiments 1-4, exercise did not facilitate fear extinction, long-term memory, or fear relapse tests. In experiment 5, human participants showed an overall reduction in fear of heights but exercise did not enhance symptom improvement. CONCLUSIONS Although acute exercise prior to fear extinction or exposure therapy, as operationalized in the present 5 studies, did not enhance outcomes, these results must be interpreted within the context of a broader literature that includes positive findings. Taken all together, this suggests that more research is necessary to identify optimal parameters and key individual differences so that exercise can be implemented successfully to treat anxiety disorders.
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Affiliation(s)
- Jolene Jacquart
- Department of Psychology, University of Texas at Austin, 108 E. Dean Keaton St., Austin, TX, 78712, USA; Institute for Mental Health Research, University of Texas at Austin, 305 E. 23rd St. Stop E9000, Austin, TX, 78712, USA
| | - Rheall F Roquet
- Department of Psychology, University of Texas at Austin, 108 E. Dean Keaton St., Austin, TX, 78712, USA
| | - Santiago Papini
- Department of Psychology, University of Texas at Austin, 108 E. Dean Keaton St., Austin, TX, 78712, USA; Institute for Mental Health Research, University of Texas at Austin, 305 E. 23rd St. Stop E9000, Austin, TX, 78712, USA
| | - Mark B Powers
- Department of Psychology, University of Texas at Austin, 108 E. Dean Keaton St., Austin, TX, 78712, USA; Institute for Mental Health Research, University of Texas at Austin, 305 E. 23rd St. Stop E9000, Austin, TX, 78712, USA; Baylor University Medical Center, 3500 Gaston Ave, Dallas, TX, 75246, USA
| | - David Rosenfield
- Department of Psychology, Southern Methodist University, PO Box 750442, Dallas, TX, 75275-0442, USA
| | - Jasper A J Smits
- Department of Psychology, University of Texas at Austin, 108 E. Dean Keaton St., Austin, TX, 78712, USA; Institute for Mental Health Research, University of Texas at Austin, 305 E. 23rd St. Stop E9000, Austin, TX, 78712, USA
| | - Marie-H Monfils
- Department of Psychology, University of Texas at Austin, 108 E. Dean Keaton St., Austin, TX, 78712, USA; Institute for Mental Health Research, University of Texas at Austin, 305 E. 23rd St. Stop E9000, Austin, TX, 78712, USA.
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Affiliation(s)
- Simon Nørby
- Danish School of Education, Aarhus University, Copenhagen, Denmark
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Goode TD, Holloway-Erickson CM, Maren S. Extinction after fear memory reactivation fails to eliminate renewal in rats. Neurobiol Learn Mem 2017; 142:41-47. [PMID: 28274824 PMCID: PMC5457330 DOI: 10.1016/j.nlm.2017.03.001] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2017] [Revised: 03/01/2017] [Accepted: 03/02/2017] [Indexed: 11/20/2022]
Abstract
Retrieving fear memories just prior to extinction has been reported to effectively erase fear memories and prevent fear relapse. The current study examined whether the type of retrieval procedure influences the ability of extinction to impair fear renewal, a form of relapse in which responding to a conditional stimulus (CS) returns outside of the extinction context. Rats first underwent Pavlovian fear conditioning with an auditory CS and footshock unconditional stimulus (US); freezing behavior served as the index of conditioned fear. Twenty-four hours later, the rats underwent a retrieval-extinction procedure. Specifically, 1h prior to extinction (45 CS-alone trials; 44 for rats receiving a CS reminder), fear memory was retrieved by either a single exposure to the CS alone, the US alone, a CS paired with the US, or exposure to the conditioning context itself. Over the next few days, conditional freezing to the extinguished CS was tested in the extinction and conditioning context in that order (i.e., an ABBA design). In the extinction context, rats that received a CS+US trial before extinction exhibited higher levels of conditional freezing than animals in all other groups, which did not differ from one another. In the renewal context, all groups showed renewal, and none of the reactivation procedures reduced renewal relative to a control group that did not receive a reactivation procedure prior to extinction. These data suggest retrieval-extinction procedures may have limited efficacy in preventing fear renewal.
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Affiliation(s)
- Travis D Goode
- Institute for Neuroscience, Texas A&M University, College Station, TX 77843-3474, United States
| | | | - Stephen Maren
- Institute for Neuroscience, Texas A&M University, College Station, TX 77843-3474, United States; Department of Psychology, Texas A&M University, College Station, TX 77843-3474, United States.
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Lee JLC, Nader K, Schiller D. An Update on Memory Reconsolidation Updating. Trends Cogn Sci 2017; 21:531-545. [PMID: 28495311 DOI: 10.1016/j.tics.2017.04.006] [Citation(s) in RCA: 292] [Impact Index Per Article: 41.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2017] [Revised: 04/12/2017] [Accepted: 04/13/2017] [Indexed: 10/19/2022]
Abstract
The reactivation of a stored memory in the brain can make the memory transiently labile. During the time it takes for the memory to restabilize (reconsolidate) the memory can either be reduced by an amnesic agent or enhanced by memory enhancers. The change in memory expression is related to changes in the brain correlates of long-term memory. Many have suggested that such retrieval-induced plasticity is ideally placed to enable memories to be updated with new information. This hypothesis has been tested experimentally, with a translational perspective, by attempts to update maladaptive memories to reduce their problematic impact. We review here progress on reconsolidation updating studies, highlighting their translational exploitation and addressing recent challenges to the reconsolidation field.
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Affiliation(s)
- Jonathan L C Lee
- School of Psychology, University of Birmingham, Edgbaston, Birmingham B15 2TT, UK.
| | - Karim Nader
- Department of Psychology, McGill University, Department of Psychology,1205 Dr Penfield Avenue, Montreal, QC H3A 1B1, Canada.
| | - Daniela Schiller
- Departments of Psychiatry and Neuroscience, Icahn School of Medicine at Mount Sinai and Friedman Brain Institute, New York, NY 10029, USA.
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Abstract
Anxiety disorders constitute the largest group of mental disorders in most western societies and are a leading cause of disability. The essential features of anxiety disorders are excessive and enduring fear, anxiety or avoidance of perceived threats, and can also include panic attacks. Although the neurobiology of individual anxiety disorders is largely unknown, some generalizations have been identified for most disorders, such as alterations in the limbic system, dysfunction of the hypothalamic-pituitary-adrenal axis and genetic factors. In addition, general risk factors for anxiety disorders include female sex and a family history of anxiety, although disorder-specific risk factors have also been identified. The diagnostic criteria for anxiety disorders varies for the individual disorders, but are generally similar across the two most common classification systems: the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) and the International Classification of Diseases, Tenth Edition (ICD-10). Despite their public health significance, the vast majority of anxiety disorders remain undetected and untreated by health care systems, even in economically advanced countries. If untreated, these disorders are usually chronic with waxing and waning symptoms. Impairments associated with anxiety disorders range from limitations in role functioning to severe disabilities, such as the patient being unable to leave their home.
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Affiliation(s)
- Michelle G Craske
- Department of Psychology, University of California Los Angeles, 405 Hilgard Avenue, Los Angeles, California 90095, USA
| | - Murray B Stein
- Department of Psychiatry, University of California San Diego, La Jolla, California, USA
- Department of Family Medicine and Public Health, University of California San Diego, La Jolla, California, USA
| | - Thalia C Eley
- King's College London, MRC Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, London, UK
| | - Mohammed R Milad
- Department of Psychiatry, Harvard Medical School, Harvard University, Boston, Massachusetts, USA
- Department of Psychiatry, Massachusetts General Hospital, Charleston, Massachusetts, USA
| | - Andrew Holmes
- Laboratory of Behavioral and Genomic Neuroscience, National Institute on Alcohol Abuse and Alcoholism, Rockville, Maryland, USA
| | - Ronald M Rapee
- Department of Psychology, Centre for Emotional Health, Macquarie University, Sydney, New South Wales, Australia
| | - Hans-Ulrich Wittchen
- Institute of Clinical Psychology and Psychotherapy, Faculty of Science, Technische Universitaet Dresden, Dresden, Germany
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Think twice, it’s all right: Long lasting effects of disrupted reconsolidation on brain and behavior in human long-term fear. Behav Brain Res 2017; 324:125-129. [DOI: 10.1016/j.bbr.2017.02.016] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2017] [Accepted: 02/11/2017] [Indexed: 11/19/2022]
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Schroyens N, Beckers T, Kindt M. In Search for Boundary Conditions of Reconsolidation: A Failure of Fear Memory Interference. Front Behav Neurosci 2017; 11:65. [PMID: 28469565 PMCID: PMC5395559 DOI: 10.3389/fnbeh.2017.00065] [Citation(s) in RCA: 42] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2017] [Accepted: 03/29/2017] [Indexed: 11/24/2022] Open
Abstract
The presentation of a fear memory cue can result in mere memory retrieval, destabilization of the reactivated memory trace, or the formation of an extinction memory. The interaction between the degree of novelty during reactivation and previous learning conditions is thought to determine the outcome of a reactivation session. This study aimed to evaluate whether contextual novelty can prevent cue-induced destabilization and disruption of a fear memory acquired by non-asymptotic learning. To this end, fear memory was reactivated in a novel context or in the original context of learning, and fear memory reactivation was followed by the administration of propranolol, an amnestic drug. Remarkably, fear memory was not impaired by post-reactivation propranolol administration or extinction training under the usual conditions used in our lab, irrespective of the reactivation context. These unexpected findings are discussed in the light of our current experimental parameters and alleged boundary conditions on memory destabilization.
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Affiliation(s)
- Natalie Schroyens
- Department of Psychology, KU LeuvenLeuven, Belgium.,Department of Clinical Psychology, University of AmsterdamAmsterdam, Netherlands
| | - Tom Beckers
- Department of Psychology, KU LeuvenLeuven, Belgium.,Department of Clinical Psychology, University of AmsterdamAmsterdam, Netherlands
| | - Merel Kindt
- Department of Clinical Psychology, University of AmsterdamAmsterdam, Netherlands
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Auchter AM, Shumake J, Gonzalez-Lima F, Monfils MH. Preventing the return of fear using reconsolidation updating and methylene blue is differentially dependent on extinction learning. Sci Rep 2017; 7:46071. [PMID: 28397861 PMCID: PMC5387397 DOI: 10.1038/srep46071] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2016] [Accepted: 03/08/2017] [Indexed: 12/23/2022] Open
Abstract
Many factors account for how well individuals extinguish conditioned fears, such as genetic variability, learning capacity and conditions under which extinction training is administered. We predicted that memory-based interventions would be more effective to reduce the reinstatement of fear in subjects genetically predisposed to display more extinction learning. We tested this hypothesis in rats genetically selected for differences in fear extinction using two strategies: (1) attenuation of fear memory using post-retrieval extinction training, and (2) pharmacological enhancement of the extinction memory after extinction training by low-dose USP methylene blue (MB). Subjects selectively bred for divergent extinction phenotypes were fear conditioned to a tone stimulus and administered either standard extinction training or retrieval + extinction. Following extinction, subjects received injections of saline or MB. Both reconsolidation updating and MB administration showed beneficial effects in preventing fear reinstatement, but differed in the groups they targeted. Reconsolidation updating showed an overall effect in reducing fear reinstatement, whereas pharmacological memory enhancement using MB was an effective strategy, but only for individuals who were responsive to extinction.
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Affiliation(s)
- Allison M Auchter
- The University of Texas at Austin, Department of Psychology, Austin, TX 78712, USA
| | - Jason Shumake
- The University of Texas at Austin, Department of Psychology, Austin, TX 78712, USA.,Institute for Mental Health Research, The University of Texas at Austin, USA
| | | | - Marie H Monfils
- The University of Texas at Austin, Department of Psychology, Austin, TX 78712, USA.,Institute for Mental Health Research, The University of Texas at Austin, USA
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Tylee DS, Gray R, Glatt SJ, Bourke F. Evaluation of the reconsolidation of traumatic memories protocol for the treatment of PTSD: a randomized, wait-list-controlled trial. JOURNAL OF MILITARY VETERAN AND FAMILY HEALTH 2017. [DOI: 10.3138/jmvfh.4120] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Affiliation(s)
| | - Richard Gray
- Research and Recognition Project, Corning, New York, USA
| | | | - Frank Bourke
- Research and Recognition Project, Corning, New York, USA
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Beckers T, Kindt M. Memory Reconsolidation Interference as an Emerging Treatment for Emotional Disorders: Strengths, Limitations, Challenges, and Opportunities. Annu Rev Clin Psychol 2017; 13:99-121. [PMID: 28375725 DOI: 10.1146/annurev-clinpsy-032816-045209] [Citation(s) in RCA: 92] [Impact Index Per Article: 13.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Experimental research on emotional memory reconsolidation interference, or the induction of amnesia for previously established emotional memory, has a long tradition, but the potential of that research for the development of novel interventions to treat psychological disorders has been recognized only recently. Here we provide an overview of basic research and clinical studies on emotional memory reconsolidation interference. We point out specific advantages of interventions based on memory reconsolidation interference over traditional treatment for emotional disorders. We also explain how findings from basic research suggest limitations and challenges to clinical translation that may help to understand why clinical trials have met with mixed success so far and how their success can be increased. In closing, we preview new intervention approaches beyond the induction of amnesia that the phenomenon of memory reconsolidation may afford for alleviating the burden imposed by emotional memories and comment on theoretical controversies regarding the nature of memory reconsolidation.
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Affiliation(s)
- Tom Beckers
- Department of Psychology, KU Leuven, Leuven, Belgium 3000;
| | - Merel Kindt
- Department of Clinical Psychology, University of Amsterdam, Amsterdam, Netherlands 1018WT;
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Gershman SJ, Monfils MH, Norman KA, Niv Y. The computational nature of memory modification. eLife 2017; 6:e23763. [PMID: 28294944 PMCID: PMC5391211 DOI: 10.7554/elife.23763] [Citation(s) in RCA: 61] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2016] [Accepted: 03/13/2017] [Indexed: 11/25/2022] Open
Abstract
Retrieving a memory can modify its influence on subsequent behavior. We develop a computational theory of memory modification, according to which modification of a memory trace occurs through classical associative learning, but which memory trace is eligible for modification depends on a structure learning mechanism that discovers the units of association by segmenting the stream of experience into statistically distinct clusters (latent causes). New memories are formed when the structure learning mechanism infers that a new latent cause underlies current sensory observations. By the same token, old memories are modified when old and new sensory observations are inferred to have been generated by the same latent cause. We derive this framework from probabilistic principles, and present a computational implementation. Simulations demonstrate that our model can reproduce the major experimental findings from studies of memory modification in the Pavlovian conditioning literature.
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Affiliation(s)
- Samuel J Gershman
- Department of Psychology and Center for Brain Science, Harvard University, Cambridge, United States
| | - Marie-H Monfils
- Department of Psychology, University of Texas, Austin, United States
| | - Kenneth A Norman
- Princeton Neuroscience Institute and Department of Psychology, Princeton University, Princeton, United States
| | - Yael Niv
- Princeton Neuroscience Institute and Department of Psychology, Princeton University, Princeton, United States
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83
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Telch MJ, York J, Lancaster CL, Monfils MH. Use of a Brief Fear Memory Reactivation Procedure for Enhancing Exposure Therapy. Clin Psychol Sci 2017; 5:367-378. [DOI: 10.1177/2167702617690151] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 08/30/2023]
Abstract
We tested postretrieval extinction as an augmentation strategy for enhancing in vivo exposure therapy for naturally acquired pathological fear. Participants displaying marked phobic responding to either spiders or snakes were randomized to receive a standard one session in vivo exposure therapy protocol under one of two conditions. The experimental group (RFM-EXP) completed a 10-s fear reactivation procedure 30 min prior to initiating exposure therapy. Controls (EXP-RFM) completed the reactivation procedure after completing exposure therapy. Expected and peak fear during confrontation with live spiders or snakes were collected at pretreatment, posttreatment, and 1-month follow-up. RFM-EXP participants displayed significantly lower phobic responding at the 1-month follow-up relative to EXP-RFM controls. Unexpectedly, RFM-EXP participants showed more rapid fear attenuation during exposure relative to controls. Results provide preliminary support for further investigation of this exposure augmentation strategy across a wider range of anxiety-related disorders.
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Affiliation(s)
| | - Jamie York
- Department of Psychology, University of Texas at Austin
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Cofresí RU, Lewis SM, Chaudhri N, Lee HJ, Monfils MH, Gonzales RA. Postretrieval Extinction Attenuates Alcohol Cue Reactivity in Rats. Alcohol Clin Exp Res 2017; 41:608-617. [PMID: 28169439 DOI: 10.1111/acer.13323] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2016] [Accepted: 12/22/2016] [Indexed: 12/11/2022]
Abstract
BACKGROUND Conditioned responses to alcohol-associated cues can hinder recovery from alcohol use disorder (AUD). Cue exposure (extinction) therapy (CET) can reduce reactivity to alcohol cues, but its efficacy is limited by phenomena such as spontaneous recovery and reinstatement that can cause a return of conditioned responding after extinction. Using a preclinical model of alcohol cue reactivity in rats, we evaluated whether the efficacy of alcohol CET could be improved by conducting CET during the memory reconsolidation window after retrieval of cue-alcohol associations. METHODS Rats were provided with intermittent access to unsweetened alcohol. Rats were then trained to predict alcohol access based on a visual cue. Next, rats were treated with either standard extinction (n = 14) or postretrieval extinction (n = 13). Rats were then tested for long-term memory of extinction and susceptibility to spontaneous recovery and reinstatement. RESULTS Despite equivalent extinction, rats treated with postretrieval extinction exhibited reduced spontaneous recovery and reinstatement relative to rats treated with standard extinction. CONCLUSIONS Postretrieval CET shows promise for persistently attenuating the risk to relapse posed by alcohol cues in individuals with AUD.
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Affiliation(s)
- Roberto U Cofresí
- Institute for Neuroscience, The University of Texas at Austin, Austin, Texas
| | - Suzanne M Lewis
- Department of Psychology, The University of Washington, Seattle, Washington
| | - Nadia Chaudhri
- Department of Psychology, Center for Studies in Behavioral Neurobiology, Concordia University, Montreal, Quebec, Canada
| | - Hongjoo J Lee
- Department of Psychology, Institute for Neuroscience, The University of Texas at Austin, Austin, Texas
| | - Marie-H Monfils
- Department of Psychology, Institute for Neuroscience, The University of Texas at Austin, Austin, Texas
| | - Rueben A Gonzales
- Division of Pharmacology & Toxicology, Institute for Neuroscience, The University of Texas at Austin, Austin, Texas
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85
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Thompson A, Lipp OV. Extinction during reconsolidation eliminates recovery of fear conditioned to fear-irrelevant and fear-relevant stimuli. Behav Res Ther 2017; 92:1-10. [PMID: 28171767 DOI: 10.1016/j.brat.2017.01.017] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2016] [Revised: 01/25/2017] [Accepted: 01/30/2017] [Indexed: 12/11/2022]
Abstract
Extant literature suggests that extinction training delivered during the memory reconsolidation period is superior to traditional extinction training in the reduction of fear recovery, as it targets the original fear memory trace. At present it is debated whether different types of fear memories are differentially sensitive to behavioral manipulations of reconsolidation. Here, we examined post-reconsolidation recovery of fear as a function of conditioned stimulus (CS) fear-relevance, using the unconditioned stimulus (US) to reactivate and destabilize conditioned fear memories. Participants (N = 56; 25 male; M = 24.39 years, SD = 7.71) in the US-reactivation and control group underwent differential fear conditioning to fear-relevant (spiders/snakes) and fear-irrelevant (geometric shapes) CSs on Day 1. On Day 2, participants received either reminded (US-reactivation) or non-reminded extinction training. Tests of fear recovery, conducted 24 h later, revealed recovery of differential electrodermal responding to both classes of CSs in the control group, but not in the US-reactivation group. These findings indicate that the US reactivation-extinction procedure eliminated recovery of extinguished responding not only to fear-irrelevant, but also to fear-relevant CSs. Contrasting previous reports, our findings show that post-reconsolidation recovery of conditioned responding is not a function of CS fear-relevance and that persistent reduction of fear, conditioned to fear-relevant CSs, can be achieved through behavioral manipulations of reconsolidation.
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Affiliation(s)
- Alina Thompson
- School of Psychology and Speech Pathology, Curtin University, Australia.
| | - Ottmar V Lipp
- School of Psychology and Speech Pathology, Curtin University, Australia; ARC-SRI: Science of Learning Research Centre, Australia
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86
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Disruption of human fear reconsolidation using imaginal and in vivo extinction. Behav Brain Res 2016; 319:9-15. [PMID: 27840245 DOI: 10.1016/j.bbr.2016.11.014] [Citation(s) in RCA: 41] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2016] [Revised: 10/11/2016] [Accepted: 11/08/2016] [Indexed: 11/24/2022]
Abstract
Memories are not set forever, but can be altered following reactivation, which renders memories malleable, before they are again stabilized through reconsolidation. Fear memories can be attenuated by using extinction during the malleable period. The present study adopts a novel form of extinction, using verbal instructions, in order to examine whether fear memory reconsolidation can be affected by an imaginal exposure. The extinction using verbal instructions, called imaginal extinction, consists of a recorded voice encouraging participants to imagine the scene in which fear was acquired, and to envision the stimuli before their inner eye. The voice signals stimuli appearance, and identical to standard (in vivo) extinction, participants discover that the conditioned stimulus no longer is followed by unconditioned stimulus (UCS). In this way, imaginal extinction translates clinically used imaginal exposure into the standard experimental fear conditioning paradigm. Fear was acquired by pairing pictorial stimuli with an electric shock UCS. Then, both standard and imaginal extinction were given following fear memory reactivation, either after 10min, within the reconsolidation interval, or after 6h, outside of the reconsolidation interval. In vivo and imaginal extinction produced comparable reductions in conditioned responses during extinction and importantly, both disrupted reconsolidation of conditioned fear and abolished stimulus discrimination between reinforced and non-reinforced cues. Thus, disrupted reconsolidation of fear conditioning can be achieved without in vivo stimulus presentation, through purely cognitive means, suggesting possible therapeutic applications.
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87
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Using model systems to understand errant plasticity mechanisms in psychiatric disorders. Nat Neurosci 2016; 19:1418-1425. [PMID: 27786180 DOI: 10.1038/nn.4413] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2016] [Accepted: 09/13/2016] [Indexed: 02/08/2023]
Abstract
In vivo model systems are a critical tool for gaining insight into the pathology underlying psychiatric disorders. Although modern functional imaging tools allow study of brain correlates of behavior in clinical groups and genome-wide association studies are beginning to uncover the complex genetic architecture of psychiatric disorders, there is less understanding of pathology at intervening levels of organization. Several psychiatric disorders derive from pathological neural plasticity, and studying the mechanisms that underlie these processes, including reinforcement learning and spike-timing-dependent plasticity, requires the use of animals. It will be particularly important to understand how individual differences in plasticity mechanisms at a cellular level confer resilience on some but lead to disease in others.
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88
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Jones CE, Monfils MH. Post-retrieval extinction in adolescence prevents return of juvenile fear. ACTA ACUST UNITED AC 2016; 23:567-75. [PMID: 27634147 PMCID: PMC5026207 DOI: 10.1101/lm.043281.116] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2016] [Accepted: 07/13/2016] [Indexed: 11/24/2022]
Abstract
Traumatic experiences early in life can contribute to the development of mood and anxiety disorders that manifest during adolescence and young adulthood. In young rats exposed to acute fear or stress, alterations in neural development can lead to enduring behavioral abnormalities. Here, we used a modified extinction intervention (retrieval+extinction) during late adolescence (post-natal day 45 [p45]), in rats, to target auditory Pavlovian fear associations acquired as juveniles (p17 and p25). The effects of adolescent intervention were examined by assessing freezing as adults during both fear reacquisition and social transmission of fear from a cagemate. Rats underwent testing or training at three time points across development: juvenile (p17 or p25), adolescent (p45), and adult (p100). Retrieval+extinction during late adolescence prevented social reinstatement and recovery over time of fears initially acquired as juveniles (p17 and p25, respectively). Adolescence was the only time point tested here where retrieval+extinction prevented fear recall of associations acquired 20+ days earlier.
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Affiliation(s)
- Carolyn E Jones
- Department of Psychology, The University of Texas at Austin, Austin, Texas 78712-1043, USA
| | - Marie-H Monfils
- Department of Psychology, The University of Texas at Austin, Austin, Texas 78712-1043, USA
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89
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Clem RL, Schiller D. New Learning and Unlearning: Strangers or Accomplices in Threat Memory Attenuation? Trends Neurosci 2016; 39:340-351. [PMID: 27079843 DOI: 10.1016/j.tins.2016.03.003] [Citation(s) in RCA: 53] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2015] [Revised: 03/04/2016] [Accepted: 03/07/2016] [Indexed: 10/21/2022]
Abstract
To achieve greatest efficacy, therapies for attenuating fear and anxiety should preclude the re-emergence of emotional responses. Of relevance to this aim, preclinical models of threat memory reduction are considered to engage one of two discrete neural processes: either establishment of a new behavioral response that competes with, and thereby temporarily interferes with the expression of, threat memory (new learning) or one that modifies and thereby disrupts threat memory (unlearning). We contend that a strict dichotomy of new learning and unlearning does not provide a compelling explanation for current data. Instead, we suggest that the evidence warrants consideration of alternative models that assume cooperation rather than competition between formation of new cellular traces and the modification of preexisting ones.
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Affiliation(s)
- Roger L Clem
- Department of Neuroscience, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
| | - Daniela Schiller
- Department of Neuroscience, Icahn School of Medicine at Mount Sinai, New York, NY, USA; Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA
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