Thickness of ventromedial prefrontal cortex in humans is correlated with extinction memory

The extinction of conditioned fear: structural and molecular basis and therapeutic use

OBJECTIVE: Through association, a large variety of stimuli acquire the property of signaling pleasant or aversive events. Pictures of a wedding or of a plane disaster may serve as cues to recall these events and/or others of a similar nature or emotional tone. Presentation of the cues unassociated with the events, particularly if repeated, reduces the tendency to retrieve the original learning based on that association. This attenuation of the expression of a learned response was discovered by Pavlov 100 years ago, who called it extinction. In this article we review some of the most recent findings about the behavioral and biochemical properties of extinction. RESULTS AND DISCUSSION: It has been shown that extinction is a new learning based on a new link formed by the cues and the absence of the original event(s) which originated the first association. Extinction does not consist of the erasure of the original memory, but of an inhibition of its retrieval: the original response reappears readily if the former association is reiterated, or if enough time is allowed to pass (spontaneous recovery). Extinction requires neural activity, signaling pathways, gene expression and protein synthesis in the ventromedial prefrontal cortex and/or basolateral amygdala, hippocampus, entorhinal cortex and eventually other areas. The site or sites of extinction vary with the task. CONCLUSIONS: Extinction was advocated by Freud in the 1920's for the treatment of phobias, and is used in cognitive therapy to treat diseases that rely on conditioned fear (phobias, panic, and particularly posttraumatic stress disorder). The treatment of learned fear disorders with medications is still unsatisfactory although some have been shown useful when used as adjuncts to behavioral therapy.

Prefrontal involvement in the regulation of emotion: convergence of rat and human studies

Emotion regulation is a process by which we control when and where emotions are expressed. Paradigms used to study the regulation of emotion in humans examine controlled responses to emotional stimuli and/or the inhibition of emotional influences on subsequent behavior. These processes of regulation of emotion trigger activation of the ventromedial prefrontal cortex and inhibition of the amygdala. A similar pattern of activation is seen in rodents during recall of fear extinction, an example of emotional regulation. The overlap in circuitry is consistent with a common mechanism, and points toward future experiments designed to bridge human and rodent models of emotion regulation.

Decision-making and the frontal lobes

PURPOSE OF REVIEW

This article reviews the most significant advances concerning the neural correlates of decision-making with emphasis on those imaging studies investigating the neural implementation of evaluative judgment processes. This is done against the background of current concepts from the field of judgment and decision-making.

RECENT FINDINGS

Actual neuroscientific findings suggest that subject to the extent of how deeply a decision-maker has to explore his/her value system in order to reach a decision, distinguishable orbital and medial prefrontal areas will be engaged. Decisions low in costs mapping the values onto the decision problem mainly rely on orbital and ventromedial prefrontal cortex, whereas decisions high in costs particularly draw on anterior-medial and dorsomedial prefrontal areas. This suggestion is related to the anatomic properties of the respective areas.

SUMMARY

Combining neuroimaging data with concepts from research in judgment and decision-making may facilitate advances in our understanding of the contrast between normative theories and descriptive theories of decision-making. Incorporating findings from research on decision-making behavior in patients with specific prefrontal lesions may have much to offer for an understanding of both the areas' functions and cognitive theories on decision-making.

Context-dependent human extinction memory is mediated by a ventromedial prefrontal and hippocampal network

In fear extinction, an animal learns that a conditioned stimulus (CS) no longer predicts a noxious stimulus [unconditioned stimulus (UCS)] to which it had previously been associated, leading to inhibition of the conditioned response (CR). Extinction creates a new CS-noUCS memory trace, competing with the initial fear (CS-UCS) memory. Recall of extinction memory and, hence, CR inhibition at later CS encounters is facilitated by contextual stimuli present during extinction training. In line with theoretical predictions derived from animal studies, we show that, after extinction, a CS-evoked engagement of human ventromedial prefrontal cortex (VMPFC) and hippocampus is context dependent, being expressed in an extinction, but not a conditioning, context. Likewise, a positive correlation between VMPFC and hippocampal activity is extinction context dependent. Thus, a VMPFC-hippocampal network provides for context-dependent recall of human extinction memory, consistent with a view that hippocampus confers context dependence on VMPFC.

Neurocircuitry models of posttraumatic stress disorder and extinction: human neuroimaging research--past, present, and future

The prevailing neurocircuitry models of anxiety disorders have been amygdalocentric in form. The bases for such models have progressed from theoretical considerations, extrapolated from research in animals, to in vivo human imaging data. For example, one current model of posttraumatic stress disorder (PTSD) has been highly influenced by knowledge from rodent fear conditioning research. Given the phenomenological parallels between fear conditioning and the pathogenesis of PTSD, we have proposed that PTSD is characterized by exaggerated amygdala responses (subserving exaggerated acquisition of fear associations and expression of fear responses) and deficient frontal cortical function (mediating deficits in extinction and the capacity to suppress attention/response to trauma-related stimuli), as well as deficient hippocampal function (mediating deficits in appreciation of safe contexts and explicit learning/memory). Neuroimaging studies have yielded convergent findings in support of this model. However, to date, neuroimaging investigations of PTSD have not principally employed conditioning and extinction paradigms per se. The recent development of such imaging probes now sets the stage for directly testing hypotheses regarding the neural substrates of fear conditioning and extinction abnormalities in PTSD.

Prefrontal mechanisms in extinction of conditioned fear

Interest in the medial prefrontal cortex (mPFC) as a source of behavioral inhibition has increased with the mounting evidence for a functional role of the mPFC in extinction of conditioned fear. In fear extinction, a tone-conditioned stimulus (CS) previously paired with a footshock is presented repeatedly in the absence of footshock, causing fear responses to diminish. Here, we review converging evidence from different laboratories implicating the mPFC in memory circuits for fear extinction: (1) lesions of mPFC impair recall of extinction under various conditions, (2) extinction potentiates mPFC physiological responses to the CS, (3) mPFC potentiation is correlated with extinction behavior, and (4) stimulation of mPFC strengthens extinction memory. These findings support Pavlov's original notion that extinction is new learning, rather than erasure of conditioning. In people suffering from posttraumatic stress disorder (PTSD), homologous areas of ventral mPFC show morphological and functional abnormalities, suggesting that extinction circuits are compromised in PTSD. Strategies for augmenting prefrontal function for clinical benefit are discussed.

Brief uncontrollable stress causes dendritic retraction in infralimbic cortex and resistance to fear extinction in mice

Extinction of conditioned fear responses is an active learning process resulting from the repeated presentation of a conditioned stimulus in the absence of the unconditioned aversive stimulus. Recent research implicates the medial prefrontal cortex (mPFC) in the mediation of fear extinction in rodents and the pathophysiology of posttraumatic stress disorder. However, there is currently little understanding of precisely how stress can impact fear extinction and the neural circuitry subserving this behavior. The present study examined the effects of brief exposure to an uncontrollable stressor on (1) fear conditioning and fear extinction, and (2) dendritic morphology of pyramidal neurons in the infralimbic (IL) and prelimbic (PL) regions of the mPFC in mice. Exposure to three episodes of stress ending 24 h before fear conditioning significantly attenuated the rate of cued fear extinction relative to nonstressed controls, but did not affect fear conditioning or cue or context recall. Analysis of Golgi-stained neurons showed that one or three exposures to daily swim stress caused significant retraction of terminal branches of apical, but not basilar, dendrites of IL neurons. In contrast, PL neuronal morphology was unaltered by stress. These data demonstrate that IL, but not PL, neurons are highly sensitive to even brief exposure to stress, and that this same form of stress impairs fear extinction. Present findings suggest that trauma may compromise the functional integrity of the mPFC with implications for the pathophysiology of certain neuropsychiatric disorders.

Specific phobia: a disorder of fear conditioning and extinction

Specific phobia is the most prevalent of the anxiety disorders. Although there have been relatively few studies of its psychobiology and pharmacotherapy, there is a rich laboratory of literature on fear conditioning and extinction and a clear evolutionary perspective. Advances in the cognitive-affective neuroscience of fear processing may ultimately lead to new approaches to the clinical management of phobias.

Opposing effects of amygdala and orbital prefrontal cortex lesions on the extinction of instrumental responding in macaque monkeys

Extinction is a well-known behavioural phenomenon that allows organisms to respond flexibly to a changing environment. Although recent work implicates the amygdala and orbital prefrontal cortex (PFo) in extinction of Pavlovian conditioned fear and aversion, much less is known about the neural bases of instrumental extinction. To explore the contribution of the macaque amygdala to flexible responding in the face of changing reward contingency, we tested the effects of selective, excitotoxic lesions of the amygdala on extinction of an instrumental response. For comparison, we evaluated the effects of ablation of PFo on the same task. Amygdala lesions facilitated the extinction of instrumental responses, whereas lesions of PFo had the opposite effect.

Fear extinction in rodents: basic insight to clinical promise

Fear extinction, the reduction of fear by repeated exposure to the object of fear, is a crucial paradigm of inhibitory learning and the acknowledged preclinical model for behavior therapy of human anxiety. Recent insights have clarified roles for infralimbic prefrontal cortex, hippocampus and periaqueductal gray in extinction learning, while maintaining a central role for the basolateral amygdaloid nucleus in the acquisition and storage of this learning. Simultaneously, molecular insights have implicated several neurotransmitter and second messenger systems in extinction learning, and revealed that extinction is surprisingly easy to improve, yielding the promise of a novel approach to improved psychiatric treatments for a variety of human anxiety disorders.

Orbitofrontal thickness, retention of fear extinction, and extraversion

People differ in their personality traits and in their ability to modulate fear. Does our personality determine how well we extinguish conditioned fear responses? Or is the opposite true? Herein, we examine the relationships between personality traits, memory for fear extinction, and cortical thickness as a measure of brain structure. We found that in healthy humans, extinction retention and thickness of the medial orbitofrontal cortex are positively correlated with extraversion. Path analysis indicates that extinction retention mediates the relationship between the medial orbitofrontal cortex thickness and extraversion, thereby illustrating one path through which brain structure influences personality.

Rising rates of depression in today's society: consideration of the roles of effort-based rewards and enhanced resilience in day-to-day functioning

Despite the existence of a vastly improved health care system and a multi-billion dollar antidepressant industry, the rates of depression in the US remain alarmingly high. An exploration of lifestyle changes over the past century suggests that the level of physical activity necessary to provide life's basic resources, referred to as effort-based rewards, has diminished in our industrialized, technologically advanced, service-oriented society. The evolution of the accumbens-striatal-cortical circuitry and its modulating neurochemicals in our ancestors played a significant role in sustaining the continued effort critical for the acquisition of resources such as food, water and shelter; consequently, vast reductions in the degree of physical activity required to obtain necessary resources in today's society likely lead to reduced activation of brain areas essential for reward/pleasure, motivation, problem-solving, and effective coping strategies (i.e. depressive symptomology). Comparative cultural and gender analyses reinforce the significant role of effort-based rewards in mood regulation, suggesting that minimal engagement in such endeavors leads to compromised resilience upon exposure to life's stressful challenges. If physical activity is indeed important in the maintenance of mental health, increased emphasis on behavioral and behavioral/cognitive preventative life strategies, as opposed to an emphasis on psychopharmacological strategies directed at very specific neurochemicals after the onset of depression, should be adopted as protective measures against the onset of depressive symptomology. Thus, strategies that include more global neurobiological activation in the relevant context of directed efforts provide a fresh perspective for depression research.