Emotion-induced retrograde amnesia varies as a function of noradrenergic-glucocorticoid activity

Emotional salience modulates the forward-flow of memory

As we navigate our day-to-day lives, we regularly adapt our behaviour according to what we predict may happen next in a given context. When an unexpected event occurs, our predictions about the world are disrupted and must be updated. Unexpected, isolated events, particularly with high emotionality, are also better recalled. In the present work, we investigated how oddballs affect recall dynamics. Seventy young, healthy participants encoded word lists containing either emotional or perceptual oddballs at varying stimulus onset asynchronies followed by free recall. It is well established that after recalling an item, we have a higher probability of recalling items encoded nearby, particularly those that were encoded after the item was recalled, a phenomenon known as forward contiguity of recall. We tested how novelty (oddballs versus control words) modulated forward contiguity as a function of salience type (emotional versus perceptual). The present results provide empirical evidence of forward contiguity modulation selectively by emotional salience and suggest that recall patterns after presenting emotional and perceptual oddballs are mediated by different mechanisms.

A systematic review of the pharmacological modulation of autobiographical memory specificity

Background

Over-general autobiographical memory (AM) retrieval is proposed to have a causal role in the maintenance of psychological disorders like depression and PTSD. As such, the identification of drugs that modulate AM specificity may open up new avenues of research on pharmacological modeling and treatment of psychological disorders.

Aim

The current review summarizes randomized, placebo-controlled studies of acute pharmacological modulation of AM specificity.

Method

A systematic search was conducted of studies that examined the acute effects of pharmacological interventions on AM specificity in human volunteers (healthy and clinical participants) measured using the Autobiographical Memory Test.

Results

Seventeen studies were identified (986 total participants), of which 16 were judged to have low risk of bias. The presence and direction of effects varied across drugs and diagnostic status of participants (clinical vs. healthy volunteers). The most commonly studied drug-hydrocortisone-produced an overall impairment in AM specificity in healthy volunteers [g = -0.28, CI (-0.53, -0.03), p = 0.03], although improvements were reported in two studies of clinical participants. In general, studies of monoamine modulators reported no effect on specificity.

Conclusion

Pharmacological enhancement of AM specificity is inconsistent, although monaminergic modulators show little promise in this regard. Drugs that reduce AM specificity in healthy volunteers may be useful experimental-pharmacological tools that mimic an important transdiagnostic impairment in psychological disorders.

Systematic review registration

PROSPERO, identifier CRD42020199076, https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42020199076.

The limited reach of surprise: Evidence against effects of surprise on memory for preceding elements of an event

When reflecting on the past, some of our strongest memories are for experiences that took us by surprise. Extensive research has backed this intuition that we are more likely to remember surprising moments than mundane ones. But what about the moments leading up to the surprise? Are we more likely to remember those as well? While surprise is a well-established modulator of memory, it is unknown whether memory for the entire event will be enhanced, or only for the surprising occurrence itself. We developed a novel paradigm utilising stop-motion films, depicting of a sequence of narrative events, in which specific occurrences could be replaced with surprising ones, while keeping the rest of the film unaltered. Using this design, we tested whether surprise exerts retroactive effects on memory, and specifically whether any potential effect would be confined to elements in the same event as the surprising occurrence. In a large cohort of participants (n = 340), we found strong evidence that surprise did not retroactively modulate memory, neither when participants were tested immediately after study nor when they were tested 24 hours later. We suggest two possible accounts for these findings: (1) that the components of an event are encoded as independent episodic elements (not as a cohesive unit), or (2) that surprise segments experience, sectioning off the preceding elements as a separate event.

Effects of glucocorticoid and noradrenergic activity on spatial learning and spatial memory in healthy young adults

BACKGROUND

Acute stress leads to a rapid release of noradrenaline and glucocorticoids, which in turn influence cognitive functions such as spatial learning and memory. However, few studies have investigated noradrenergic and glucocorticoid effects on spatial learning and memory in humans. Therefore, we examined the separate and combined effects of noradrenergic and glucocorticoid stimulation on spatial learning and memory.

METHODS

One hundred and four healthy men (mean age = 24.1 years ±SD 3.5) underwent the virtual Morris Water Maze (vMWM) task to test spatial learning and spatial memory retrieval after receiving either 10 mg hydrocortisone or 10 mg yohimbine (an alpha 2-adrenergic receptor antagonist that increases noradrenergic activity), 10 mg hydrocortisone and 10 mg yohimbine combined, or placebo. The vMWM task took place 90 min after yohimbine was administered and 75 min after hydrocortisone was administered. Placebo was given at the same times. Salivary cortisol and alpha amylase levels were measured to check pharmacological stimulation.

RESULTS

Hydrocortisone and yohimbine increased salivary cortisol and alpha amylase levels. Participants' task performance improved over time, suggesting successful spatial learning. However, separate and combined noradrenergic and glucocorticoid stimulation had no effect on spatial learning and spatial memory retrieval compared with placebo.

CONCLUSIONS

In healthy young men, hydrocortisone and/or yohimbine did not alter spatial learning or spatial memory retrieval. Importantly, pharmacological stimulation took place prior to learning. Further studies should examine the effects of glucocorticoid and noradrenergic stimulation during encoding, consolidation, and retrieval.

Noradrenergic mechanisms of arousal's bidirectional effects on episodic memory

Arousal's selective effects on cognition go beyond the simple enhancement of emotional stimuli, sometimes enhancing and other times impairing processing of proximal neutral information. Past work shows that arousal impairs encoding of subsequent neutral stimuli regardless of their top-down priority via the engagement of β-adrenoreceptors. In contrast, retrograde amnesia induced by emotional arousal can flip to enhancement when preceding neutral items are prioritized in top-down attention. Whether β-adrenoreceptors also contribute to this retrograde memory enhancement of goal-relevant neutral stimuli is unclear. In this pharmacological study, we administered 40mg of propranolol or 40mg of placebo to healthy young adults to examine whether emotional arousal's bidirectional effects on declarative memory relies on β-adrenoreceptor activation. Following pill intake, participants completed an emotional oddball task in which they were asked to prioritize a neutral object appearing just before an emotional or neutral oddball image within a sequence of 7 neutral objects. Under placebo, emotional oddballs impaired memory for lower priority oddball+1 objects but had no effect on memory for high priority oddball-1 objects. Propranolol blocked this anterograde amnesic effect of arousal. Emotional oddballs also enhanced selective memory trade-offs significantly more in the placebo than drug condition, such that high priority oddball-1 objects were more likely to be remembered at the cost of their corresponding lower priority oddball+1 objects under arousal. Lastly, those who recalled more high priority oddball-1 objects preceding an emotional versus neutral oddball image showed greater increases in salivary alpha-amylase, a biomarker of noradrenergic system activation, across the task. Together these findings suggest that different noradrenergic mechanisms contribute to the anterograde and retrograde mnemonic effects of arousal on proximal neutral memoranda.

Interactions of noradrenaline and cortisol and the induction of indelible memories

The glutamate amplifies noradrenergic effects (GANE) model emphasizes the role of focal glutamate–noradrenaline interactions in creating functional hotspots for prioritized processing of salient stimuli. Here, we briefly outline current evidence that synergistic action of noradrenaline and cortisol enables emotional stimuli to gain privileged access to amygdala–hippocampus circuits, eventually resulting in the formation of indelible memories and posttraumatic stress disorder (PTSD).

Enhanced Emotional Memory

Memory for emotional events is typically more vivid and accurate than memory for neutral ones. The modulation model focuses on the consolidation of memory traces to provide a partial account of enhanced emotional memory. Mediation theory focuses on encoding and retrieval to explain the selective enhancement of memory for emotional aspects of a complex event and why emotional memory also can be enhanced immediately after the experience, before consolidation has occurred. Mediation theory can therefore complement the modulation model, and together they may provide a more comprehensive account of human emotional memory.

Noradrenergic modulation of cognition: therapeutic implications

The noradrenaline (norepinephrine) system exerts profound influences on cognition via ascending projections to the forebrain, mostly originating from the locus coeruleus. This paper provides an overview of available infrahuman and healthy human studies, exploring the effects of specific noradrenergic manipulations on dissociable cognitive functions, including attention, working memory, cognitive flexibility, response inhibition and emotional memory. Remarkable parallels across species have been reported which may account for the mechanisms by which noradrenergic medications exert their beneficial effects in disorders such as depression and attention-deficit hyperactivity disorder (ADHD). The literature is discussed in relation to prevailing models of noradrenergic influences over cognition and novel therapeutic directions, including in relation to investigating the effects of noradrenergic manipulations on other disorders characterized by impulsivity, and dementias. Unanswered questions are also highlighted, along with key avenues for future research, both proof-of-concept and clinical.

Time-dependent effects of cortisol on selective attention and emotional interference: a functional MRI study

Acute stress is known to induce a state of hypervigilance, allowing optimal detection of threats. Although one may benefit from sensitive sensory processing, it comes at the cost of unselective attention and increased distraction by irrelevant information. Corticosteroids, released in response to stress, have been shown to profoundly influence brain function in a time-dependent manner, causing rapid non-genomic and slow genomic effects. Here, we investigated how these time-dependent effects influence the neural mechanisms underlying selective attention and the inhibition of emotional distracters in humans. Implementing a randomized, double-blind, placebo-controlled design, 65 young healthy men received 10 mg hydrocortisone either 60 min (rapid effects) or 270 min (slow effects), or placebo prior to an emotional distraction task, consisting of color-naming of either neutral or aversive words. Overall, participants responded slower to aversive compared to neutral words, indicating emotional interference with selective attention. Importantly, the rapid effects of corticosteroids increased emotional interference, which was associated with reduced amygdala inhibition to aversive words. Moreover, they induced enhanced amygdala connectivity with frontoparietal brain regions, which may reflect increased influence of the amygdala on an executive network. The slow effects of corticosteroids acted on the neural correlates of sustained attention. They decreased overall activity in the cuneus, possibly indicating reduced bottom-up attentional processing, and disrupted amygdala connectivity to the insula, potentially reducing emotional interference. Altogether, these data suggest a time-specific corticosteroid modulation of attentive processing. Whereas high circulating corticosteroid levels acutely increase emotional interference, possibly facilitating the detection of threats, a history of elevation might promote sustained attention and thereby contribute to stress-recovery of cognitive function.

Stimulus intensity-dependent modulations of hippocampal long-term potentiation by basolateral amygdala priming

There is growing realization that the relationship between memory and stress/emotionality is complicated, and may include both memory enhancing and memory impairing aspects. It has been suggested that the underlying mechanisms involve amygdala modulation of hippocampal synaptic plasticity, such as long-term potentiation (LTP). We recently reported that while in CA1 basolateral amygdala (BLA) priming impaired theta stimulation induced LTP, it enhanced LTP in the dentate gyrus (DG). However, emotional and stressfull experiences were found to activate synaptic plasticity within the BLA, raising the possibility that BLA modulation of other brain regions may be altered as well, as it may depend on the way the BLA is activated or is responding. In previous studies BLA priming stimulation was relatively weak (1 V, 50 μs pulse duration). In the present study we assessed the effects of two stronger levels of BLA priming stimulation (1 V or 2 V, 100 μs pulse duration) on LTP induction in hippocampal DG and CA1, in anesthetized rats. Results show that 1V-BLA priming stimulation enhanced but 2V-BLA priming stimulation impaired DG LTP; however, both levels of BLA priming stimulation impaired CA1 LTP, suggesting that modulation of hippocampal synaptic plasticity by amygdala is dependent on the degree of amygdala activation. These findings suggest that plasticity-induced within the amygdala, by stressful experiences induces a form of metaplasticity that would alter the way the amygdala may modulate memory-related processes in other brain areas, such as the hippocampus.

Noradrenergic-glucocorticoid modulation of emotional memory encoding in the human hippocampus

BACKGROUND

Current rodent models emphasize the joint action of the stress mediators noradrenaline (NE) and cortisol (CORT) in conferring a memory advantage of emotional over neutral stimuli.

METHOD

Using a pharmacological strategy of tackling this stress-related mechanism to enhance human episodic (autobiographical) memory, we measured amygdala-hippocampal responses during encoding of emotional and neutral stimuli with functional magnetic resonance imaging in 51 healthy subjects under four pharmacological conditions in a double-blind parallel group design: (i) placebo; (ii) the NE-reuptake inhibitor reboxetine (4 mg); (iii) hydrocortisone (synthetic CORT) (30 mg); or (iv) both agents in combination.

RESULTS

Differential drug effects were found in the left hippocampus, whereas hydrocortisone alone selectively decreased hippocampal responses to emotional relative to neutral stimuli, reboxetine potentiated hippocampal responses to these stimuli. Importantly, the inhibitory influence of hydrocortisone was reversed by co-administration of reboxetine.

CONCLUSIONS

Our results imply that stress levels of CORT alone attenuate hippocampal responses to emotional stimuli, an effect possibly related to a regulatory negative feedback loop. However, when simultaneously elevated to stress levels, NE and CORT act together to synergistically enhance hippocampal activity during encoding of emotional stimuli, a mechanism that may turn maladaptive under circumstances of traumatic stress.

Pharmacological treatment of PTSD - established and new approaches

A large proportion of humans will experience a traumatic event at least once in their lifetime, with up to 10% then going on to developing posttraumatic stress disorder (PTSD). In this review we will discuss established pharmacological interventions for PTSD as well as highlight novel therapeutic strategies undergoing extensive pre-clinical research as well as ongoing clinical research. Such strategies include prophylactic treatments and use of pharmacotherapy as adjunctive treatment with established trauma-focused psychological therapies. These potential treatment approaches include modulation of stress effects on memory consolidation after trauma (e.g., glucocorticoid, corticotropin-releasing factor and norepinephrine signalling modulators), as well as putative cognitive enhancers that target mechanisms of conditioned fear extinction and reconsolidation (e.g., glucocorticoid receptor modulators and modulators of glutamate signalling such as positive allosteric modulators of glutamate receptors, glycine transporter inhibitors, or glycine agonists). We will discuss evidence for and against these potential novel treatment strategies and their limitations. This article is part of a Special Issue entitled 'Post-Traumatic Stress Disorder'.

Gravidade psicopatológica em mulheres vítimas de violência doméstica

OBJETIVO: Avaliar a presença de sintomas psicopatológicos em mulheres vítimas de violência doméstica (VD) que procuraram uma delegacia de defesa da mulher. MÉTODO: Foram avaliadas mulheres com idade entre 20 e 50 anos que deram entrada em uma delegacia da mulher com queixa de VD. Durante a entrevista, todas foram submetidas ao Relatório de Indicadores Sociais e preencheram os seguintes instrumentos de autoaplicação: Inventário de Depressão de Beck, Inventário de Ansiedade de Beck, Post-Traumatic Stress Disorder Checklist - Civilian Version e o Questionário de Experiências Dissociativas Peritraumáticas (todos em língua portuguesa). Foram usadas notas de corte a partir dos estudos de validação desses instrumentos para categorizar indivíduos com alta probabilidade de apresentar transtorno depressivo maior, transtorno de ansiedade, transtorno de estresse pós-traumático, ou alta/baixa dissociação peritraumática. RESULTADOS: Foram avaliadas 17 mulheres com idade média de 34,7±7,7 anos. O tempo médio de duração da violência foi de 9,1±8,7 anos. Do total de mulheres, 53% eram vítimas de agressão excessiva e 84% eram ameaçadas de morte pelo companheiro; em 71% dos casos, os companheiros eram usuários de drogas. Além disso, 53% das mulheres afirmaram ter sofrido VD na infância. Do total da amostra, 89% tiveram grande probabilidade de apresentar transtorno depressivo maior, 94% transtorno de ansiedade, 76% transtorno de estresse pós-traumático e 88% apresentaram elevados níveis de experiências dissociativas peritraumáticas. CONCLUSÃO: As vítimas de VD que dão entrada em delegacias de defesa da mulher têm alta probabilidade de apresentar morbidade psiquiátrica, assim como alterações cognitivas que as impossibilitam de sair do ciclo da violência.

Early post-stressor intervention with propranolol is ineffective in preventing posttraumatic stress responses in an animal model for PTSD

The therapeutic value of β-adrenoceptor blockage, using propranolol, in the aftermath of traumatic experience is uncertain. A prospective, controlled animal model of posttraumatic stress disorder (PTSD) was employed to assess the effects of propranolol on long-term behavioral responses to stress. Animals exposed to predator scent stress received a single bolus of propranolol (10 or 15mg/kg) or vehicle 1h post-exposure. Outcomes were assessed using the elevated plus-maze (EPM) and acoustic startle response (ASR) at 30days and freezing response to a trauma reminder (unsoiled litter) on Day 31. Individual animals were classified as having "extreme", "partial" and "minimal" behavioral responses, according to pre-set cut-off criteria for EPM and ASR response patterns. The physiological efficacy of the doses of propranolol was verified by collecting cardiovascular data telemetrically (from exposed or unexposed individuals given propranolol or vehicle). The effect of propranolol on long-term memory was verified using a non-spatial memory task. Both doses of propranolol effectively reduced mean heart rate and impaired the object-recognition task, as expected. No significant effect on prevalence rates of PTSD-like behavioral responses or on trauma reminder response was observed for either dose of propranolol as compared to vehicle. Despite adequate efficacy in terms of heart rate and disruption of memory, single-dose, post-stress β-blockage with propranolol was ineffective in reducing onset of PTSD-like behavioral disruption and trauma cue responses in the long term. Traumatic stress-related processes appear to be affected differently than the others.

A comparison of memory for homicide, non-homicidal violence, and positive life experiences

Defendants commonly claim amnesia for their criminal actions especially in cases involving extreme violence. While some claims are malingered or result from physiological factors, other cases may represent genuine partial or complete amnesia resulting from the psychological distress and/or extreme emotion associated with the perpetration of the crime. Fifty Canadian homicide offenders described their memories of their homicide, a non-homicide violent offense, and their most positive adulthood life experience. Self-reported and objective measures of memories for these events revealed that homicides were recalled with the greatest level of detail and sensory information. Although dissociative tendencies were associated with a self-reported memory loss, objective measures of memory quality did not reflect this perceived impairment, suggesting a failure of meta-memory. Recollections of positive life events were superior to those of non-homicidal violence, possibly due to greater impact and meaning attached to such experiences. Findings suggest that memory for homicide typically is enhanced by the powerful emotion associated with its perpetration.

Opposing influences of affective state valence on visual cortical encoding

Positive and negative emotional states are thought to have originated from fundamentally opposing approach and avoidance behaviors. Furthermore, affective valence has been hypothesized to exert opposing biases in cognitive control. Here we examined with functional magnetic resonance imaging whether the opposing influences of positive and negative states extend to perceptual encoding in the visual cortices. Based on prior behavioral research, we hypothesized that positive states would broaden and negative states would narrow visual field of view (FOV). Positive, neutral, and negative states were induced on alternating blocks. To index FOV, observers then viewed brief presentations (300 ms) of face/place concentric center/surround stimuli on interleaved blocks. Central faces were attended, rendering the place surrounds unattended. As face and place information was presented at different visual eccentricities, our physiological metric of FOV was a valence-dependent modulation of place processing in the parahippocampal place area (PPA). Consistent with our hypotheses, positive affective states increased and negative states decreased PPA response to novel places as well as adaptation to repeated places. Individual differences in self-reported positive and negative affect correlated inversely with PPA encoding of peripheral places, as well as with activation in the mesocortical prefrontal cortex and amygdala. Psychophysiological interaction analyses further demonstrated that valence-dependent responses in the PPA arose from opponent coupling with extrafoveal regions of the primary visual cortex during positive and negative states. These findings collectively suggest that affective valence differentially biases gating of early visual inputs, fundamentally altering the scope of perceptual encoding.

Noradrenergic enhancement of amygdala responses to fear

Multiple lines of evidence implicate the basolateral amygdala (BLA) and the noradrenergic (norepinephrine, NE) system in responding to stressful stimuli such as fear signals, suggesting hyperfunction of both in the development of stress-related pathologies including anxiety disorders. However, no causative link between elevated NE neurotransmission and BLA hyperresponsiveness to fear signals has been established to date in humans. To determine whether or not increased noradrenergic tone enhances BLA responses to fear signals, we used functional magnetic resonance imaging (fMRI) and a strategy of pharmacologically potentiating NE neurotransmission in healthy volunteers. 18 subjects were scanned two times on a facial emotion paradigm and given either a single-dose placebo or 4 mg of the selective NE reuptake inhibitor reboxetine 2 h prior to an fMRI session. We found that reboxetine induced an amygdala response bias towards fear signals that did not exist at placebo baseline. This pharmacological effect was probabilistically mapped to the BLA. Extrapolation of our data to conditions of traumatic stress suggests that disinhibited endogenous NE signaling could serve as a crucial etiological contributor to post-traumatic stress disorder (PTSD) by eliciting exaggerated BLA responses to fear signals.

Modeling a negative response bias in the human amygdala by noradrenergic-glucocorticoid interactions

An emerging theme in the neuroscience of emotion is the question of how acute stress shapes, and distorts, social-emotional behavior. The prevailing neurocircuitry models of social-emotional behavior emphasize the central role of the amygdala. Acute stress leads to increased central levels of norepinephrine (NE) and cortisol (CORT), and evidence suggests that these endogenous neuromodulators synergistically influence amygdala responses to social-emotional stimuli. We therefore hypothesized that amygdala responses to emotional facial expressions would be susceptible to pharmacologically induced increases in central NE and CORT levels. To specifically test this hypothesis, we measured amygdala activation to emotional faces using functional magnetic resonance imaging in 62 healthy subjects under four pharmacological conditions: (1) single oral dose of placebo, (2) 4 mg of the selective NE-reuptake inhibitor reboxetine (RBX), (3) 30 mg of hydrocortisone, or (4) both drugs in combination. We found that a decrease in amygdala activation to positive facial emotion was coupled with an increase in amygdala activation to negative facial emotion in the RBX-CORT combined challenge condition. In conclusion, a pharmacologically induced elevation of central NE and CORT levels in healthy subjects created a negative response bias in the amygdala that did not exist at baseline. Our results implicate a causative role of NE-CORT interactions in the emergence of a negative bias of cognitive and emotional functions which is germane in stress-related affective spectrum disorders.

The limits of arousal's memory-impairing effects on nearby information

Showing an arousing central stimulus in a scene often leads to enhanced memory for the arousing central information and impaired memory for peripheral details. However, it is not clear from previous work whether arousing stimuli impair memory for all nonarousing nearby information or just background information. In several experiments, we tested how emotionally arousing pictures affect memory for nearby pictures and for background information. We found that when 2 pictures were presented together, an arousing picture did not affect item and location memory for the other picture. In contrast, an arousing picture impaired memory for a background pattern. These findings suggest that arousal impairs memory for information that is the target of perceptual suppression, such as background information when there is a figure-ground distinction, but does not impair memory for other foreground information.

Noradrenergic-glucocorticoid mechanisms in emotion-induced amnesia: from adaptation to disease

DISCUSSIONS

The interaction of emotion and episodic encoding has costs and benefits. These costs and benefits have been characterized in oddball experiments, where a violation of prevailing neutral context through aversive oddballs is associated with subsequent hypermnesia for the aversive oddball and peri-emotional amnesia for the neutral context. Both hypermnesia and peri-emotional amnesia are amygdala-dependent and vary as a function of noradrenergic-glucocorticoid input to the amygdala during emotional episodic encoding. Pharmacological enhancement of this input allows to model the maladaptive effects of emotion on episodic encoding. Extrapolation of these findings to conditions of emotional trauma suggests that disinhibited noradrenergic-glucocorticoid signaling could serve as a crucial etiological contributor to the pathogenesis of peri-traumatic amnesia (PTA) and post-traumatic stress disorder (PTSD).

CONCLUSIONS

Immediate pharmacological blockade of noradrenergic-glucocorticoid signaling might prove effective in the secondary prevention of PTA and PTSD.