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Liu Y, Ye S, Li XN, Li WG. Memory Trace for Fear Extinction: Fragile yet Reinforceable. Neurosci Bull 2024; 40:777-794. [PMID: 37812300 PMCID: PMC11178705 DOI: 10.1007/s12264-023-01129-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2023] [Accepted: 06/08/2023] [Indexed: 10/10/2023] Open
Abstract
Fear extinction is a biological process in which learned fear behavior diminishes without anticipated reinforcement, allowing the organism to re-adapt to ever-changing situations. Based on the behavioral hypothesis that extinction is new learning and forms an extinction memory, this new memory is more readily forgettable than the original fear memory. The brain's cellular and synaptic traces underpinning this inherently fragile yet reinforceable extinction memory remain unclear. Intriguing questions are about the whereabouts of the engram neurons that emerged during extinction learning and how they constitute a dynamically evolving functional construct that works in concert to store and express the extinction memory. In this review, we discuss recent advances in the engram circuits and their neural connectivity plasticity for fear extinction, aiming to establish a conceptual framework for understanding the dynamic competition between fear and extinction memories in adaptive control of conditioned fear responses.
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Affiliation(s)
- Ying Liu
- Department of Rehabilitation Medicine, State Key Laboratory of Medical Neurobiology and Ministry of Education Frontiers Center for Brain Science, Huashan Hospital, Institute for Translational Brain Research, Fudan University, Shanghai, 200032, China
| | - Shuai Ye
- Department of Rehabilitation Medicine, State Key Laboratory of Medical Neurobiology and Ministry of Education Frontiers Center for Brain Science, Huashan Hospital, Institute for Translational Brain Research, Fudan University, Shanghai, 200032, China
| | - Xin-Ni Li
- Department of Rehabilitation Medicine, State Key Laboratory of Medical Neurobiology and Ministry of Education Frontiers Center for Brain Science, Huashan Hospital, Institute for Translational Brain Research, Fudan University, Shanghai, 200032, China
| | - Wei-Guang Li
- Department of Rehabilitation Medicine, State Key Laboratory of Medical Neurobiology and Ministry of Education Frontiers Center for Brain Science, Huashan Hospital, Institute for Translational Brain Research, Fudan University, Shanghai, 200032, China.
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Fremont R, Brown O, Feder A, Murrough J. Ketamine for Treatment of Posttraumatic Stress Disorder: State of the Field. FOCUS (AMERICAN PSYCHIATRIC PUBLISHING) 2023; 21:257-265. [PMID: 37404968 PMCID: PMC10316217 DOI: 10.1176/appi.focus.20230006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/06/2023]
Abstract
Posttraumatic stress disorder (PTSD) is a chronic and debilitating condition. Although several psychotherapeutic and pharmacological treatments are recommended for PTSD, many individuals do not respond to treatment or respond only partially, highlighting a critical need for additional treatments. Ketamine has the potential to address this therapeutic need. This review discusses how ketamine emerged as a rapid-acting antidepressant and has become a potential treatment for PTSD. A single dose of intravenous (IV) ketamine has been shown to facilitate rapid reduction of PTSD symptoms. Repeated IV ketamine administration significantly improved PTSD symptoms, compared with midazolam, in a predominantly civilian sample of individuals with PTSD. However, in a veteran and military population, repeated IV ketamine did not significantly reduce PTSD symptoms. Further study of ketamine as a treatment for PTSD is necessary, including which populations benefit most from this therapy and the potential benefits of combining psychotherapy and ketamine.
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Affiliation(s)
- Rachel Fremont
- Depression and Anxiety Center for Discovery and Treatment, Department of Psychiatry (all authors), and Nash Family Department of Neuroscience (Murrough), Icahn School of Medicine at Mount Sinai, New York
| | - Oneysha Brown
- Depression and Anxiety Center for Discovery and Treatment, Department of Psychiatry (all authors), and Nash Family Department of Neuroscience (Murrough), Icahn School of Medicine at Mount Sinai, New York
| | - Adriana Feder
- Depression and Anxiety Center for Discovery and Treatment, Department of Psychiatry (all authors), and Nash Family Department of Neuroscience (Murrough), Icahn School of Medicine at Mount Sinai, New York
| | - James Murrough
- Depression and Anxiety Center for Discovery and Treatment, Department of Psychiatry (all authors), and Nash Family Department of Neuroscience (Murrough), Icahn School of Medicine at Mount Sinai, New York
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Jauch I, Kamm J, Benn L, Rettig L, Friederich HC, Tesarz J, Kuner T, Wieland S. 2MDR, a Microcomputer-Controlled Visual Stimulation Device for Psychotherapy-Like Treatments of Mice. eNeuro 2023; 10:10/6/ENEURO.0394-22.2023. [PMID: 37268421 DOI: 10.1523/eneuro.0394-22.2023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2022] [Revised: 02/16/2023] [Accepted: 02/27/2023] [Indexed: 06/04/2023] Open
Abstract
Post-traumatic stress disorder and other mental disorders can be treated by an established psychotherapy called Eye Movement Desensitization and Reprocessing (EMDR). In EMDR, patients are confronted with traumatic memories while they are stimulated with alternating bilateral stimuli (ABS). How ABS affects the brain and whether ABS could be adapted to different patients or mental disorders is unknown. Interestingly, ABS reduced conditioned fear in mice. Yet, an approach to systematically test complex visual stimuli and compare respective differences in emotional processing based on semiautomated/automated behavioral analysis is lacking. We developed 2MDR (MultiModal Visual Stimulation to Desensitize Rodents), a novel, open-source, low-cost, customizable device that can be integrated in and transistor-transistor logic (TTL) controlled by commercial rodent behavioral setups. 2MDR allows the design and precise steering of multimodal visual stimuli in the head direction of freely moving mice. Optimized videography allows semiautomatic analysis of rodent behavior during visual stimulation. Detailed building, integration, and treatment instructions along with open-source software provide easy access for inexperienced users. Using 2MDR, we confirmed that EMDR-like ABS persistently improves fear extinction in mice and showed for the first time that ABS-mediated anxiolytic effects strongly depend on physical stimulus properties such as ABS brightness. 2MDR not only enables researchers to interfere with mouse behavior in an EMDR-like setting, but also demonstrates that visual stimuli can be used as a noninvasive brain stimulation to differentially alter emotional processing in mice.
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Affiliation(s)
- Isa Jauch
- Department of Functional Neuroanatomy, Institute for Anatomy and Cell Biology, Heidelberg University, 69120 Heidelberg, Germany
| | - Jan Kamm
- Department of Functional Neuroanatomy, Institute for Anatomy and Cell Biology, Heidelberg University, 69120 Heidelberg, Germany
| | - Luca Benn
- Department of Functional Neuroanatomy, Institute for Anatomy and Cell Biology, Heidelberg University, 69120 Heidelberg, Germany
| | - Lukas Rettig
- Department of Functional Neuroanatomy, Institute for Anatomy and Cell Biology, Heidelberg University, 69120 Heidelberg, Germany
| | - Hans-Christoph Friederich
- Department of General Internal and Psychosomatic Medicine, Heidelberg University and Heidelberg University Hospital, 69115 Heidelberg, Germany
| | - Jonas Tesarz
- Department of General Internal and Psychosomatic Medicine, Heidelberg University and Heidelberg University Hospital, 69115 Heidelberg, Germany
| | - Thomas Kuner
- Department of Functional Neuroanatomy, Institute for Anatomy and Cell Biology, Heidelberg University, 69120 Heidelberg, Germany
| | - Sebastian Wieland
- Department of Functional Neuroanatomy, Institute for Anatomy and Cell Biology, Heidelberg University, 69120 Heidelberg, Germany
- Department of General Internal and Psychosomatic Medicine, Heidelberg University and Heidelberg University Hospital, 69115 Heidelberg, Germany
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Kapteijn C, van der Borg J, Vinke C, Endenburg N. On the applicability of eye movement desensitization and reprocessing (EMDR) as an intervention in dogs with fear and anxiety disorders after a traumatic event. BEHAVIOUR 2021. [DOI: 10.1163/1568539x-bja10123] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Abstract
Fear and anxiety disorders are prevalent in dogs. These disorders are not adequately resolved by current interventions, which urges exploration of additional interventions. In humans, fear and anxiety disorders such as post-traumatic stress disorder (PTSD), are effectively treated by Eye Movement Desensitization and Reprocessing (EMDR). EMDR is a non-invasive and non-pharmacological intervention involving bilateral sensory stimulation while memorizing the traumatic event, resulting in decreased emotionality of the memory. We argue EMDR might be applied as an intervention for fear and anxiety disorders in dogs, adding to the currently available interventions for the field of Clinical Ethology. Particularly nonverbal EMDR protocols used in preverbal children can be applied and the setup can be adapted for dogs. Future research should focus on the development of nonverbal EMDR protocols including proper controls, and on clinical effectiveness of such EMDR protocols for dogs. Apart from behavioural measures, psychophysiological variables should be incorporated as well.
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Affiliation(s)
- C.M. Kapteijn
- Department of Animals in Science & Society, Faculty of Veterinary Medicine, Utrecht University, Yalelaan 2, 3584 CM Utrecht, The Netherlands
| | - J.A.M. van der Borg
- Department of Animals in Science & Society, Faculty of Veterinary Medicine, Utrecht University, Yalelaan 2, 3584 CM Utrecht, The Netherlands
| | - C.M. Vinke
- Department of Animals in Science & Society, Faculty of Veterinary Medicine, Utrecht University, Yalelaan 2, 3584 CM Utrecht, The Netherlands
| | - N. Endenburg
- Department of Animals in Science & Society, Faculty of Veterinary Medicine, Utrecht University, Yalelaan 2, 3584 CM Utrecht, The Netherlands
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The advent of fear conditioning as an animal model of post-traumatic stress disorder: Learning from the past to shape the future of PTSD research. Neuron 2021; 109:2380-2397. [PMID: 34146470 DOI: 10.1016/j.neuron.2021.05.017] [Citation(s) in RCA: 32] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2020] [Revised: 03/23/2021] [Accepted: 05/11/2021] [Indexed: 01/06/2023]
Abstract
Translational research on post-traumatic stress disorder (PTSD) has produced limited improvements in clinical practice. Fear conditioning (FC) is one of the dominant animal models of PTSD. In fact, FC is used in many different ways to model PTSD. The variety of FC-based models is ill defined, creating confusion and conceptual vagueness, which in turn impedes translation into the clinic. This article takes a historical and conceptual approach to provide a comprehensive picture of current research and help reorient the research focus. This work historically reviews the variety of models that have emerged from the initial association of PTSD with FC, highlighting conceptual pitfalls that have limited the translation of animal research into clinical advances. We then provide some guidance on how future translational research could benefit from conceptual and technological improvements to translate basic findings in patients. This objective will require transdisciplinary approaches and should involve physicians, engineers, philosophers, and neuroscientists.
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Memories are not written in stone: Re-writing fear memories by means of non-invasive brain stimulation and optogenetic manipulations. Neurosci Biobehav Rev 2021; 127:334-352. [PMID: 33964307 DOI: 10.1016/j.neubiorev.2021.04.036] [Citation(s) in RCA: 57] [Impact Index Per Article: 19.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2020] [Revised: 03/29/2021] [Accepted: 04/29/2021] [Indexed: 11/21/2022]
Abstract
The acquisition of fear associative memory requires brain processes of coordinated neural activity within the amygdala, prefrontal cortex (PFC), hippocampus, thalamus and brainstem. After fear consolidation, a suppression of fear memory in the absence of danger is crucial to permit adaptive coping behavior. Acquisition and maintenance of fear extinction critically depend on amygdala-PFC projections. The robust correspondence between the brain networks encompassed cortical and subcortical hubs involved into fear processing in humans and in other species underscores the potential utility of comparing the modulation of brain circuitry in humans and animals, as a crucial step to inform the comprehension of fear mechanisms and the development of treatments for fear-related disorders. The present review is aimed at providing a comprehensive description of the literature on recent clinical and experimental researches regarding the noninvasive brain stimulation and optogenetics. These innovative manipulations applied over specific hubs of fear matrix during fear acquisition, consolidation, reconsolidation and extinction allow an accurate characterization of specific brain circuits and their peculiar interaction within the specific fear processing.
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Kostelnik C, Lucki I, Choi KH, Browne CA. Translational relevance of fear conditioning in rodent models of mild traumatic brain injury. Neurosci Biobehav Rev 2021; 127:365-376. [PMID: 33961927 DOI: 10.1016/j.neubiorev.2021.04.037] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2020] [Revised: 04/12/2021] [Accepted: 04/29/2021] [Indexed: 01/19/2023]
Abstract
Mild traumatic brain injury (mTBI) increases the risk of posttraumatic stress disorder (PTSD) in military populations. Utilizing translationally relevant animal models is imperative for establishing a platform to delineate neurobehavioral deficits common to clinical PTSD that emerge in the months to years following mTBI. Such platforms are required to facilitate preclinical development of novel therapeutics. First, this mini review provides an overview of the incidence of PTSD following mTBI in military service members. Secondly, the translational relevance of fear conditioning paradigms used in conjunction with mTBI in preclinical studies is evaluated. Next, this review addresses an important gap in the current preclinical literature; while incubation of fear has been studied in other areas of research, there are relatively few studies pertaining to the enhancement of cued and contextual fear memory over time following mTBI. Incubation of fear paradigms in conjunction with mTBI are proposed as a novel behavioral approach to advance this critical area of research. Lastly, this review discusses potential neurobiological substrates implicated in altered fear memory post mTBI.
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Affiliation(s)
- Claire Kostelnik
- Neuroscience Program, Uniformed Services University, Bethesda MD 20814, United States
| | - Irwin Lucki
- Neuroscience Program, Uniformed Services University, Bethesda MD 20814, United States; Department of Pharmacology & Molecular Therapeutics, Uniformed Services University, Bethesda MD 20814, United States; Department of Psychiatry, Uniformed Services University, Bethesda MD 20814, United States
| | - Kwang H Choi
- Neuroscience Program, Uniformed Services University, Bethesda MD 20814, United States; Department of Psychiatry, Uniformed Services University, Bethesda MD 20814, United States.
| | - Caroline A Browne
- Neuroscience Program, Uniformed Services University, Bethesda MD 20814, United States; Department of Pharmacology & Molecular Therapeutics, Uniformed Services University, Bethesda MD 20814, United States.
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Jellestad L, Zeffiro T, Piccirelli M, Malamud J, Klimke BBM, Rauen K, Rufer M, Orr SP, Mueller-Pfeiffer C. Interfering with fear memories by eye movement desensitization and reprocessing. Int J Psychophysiol 2021; 166:9-18. [PMID: 33901511 DOI: 10.1016/j.ijpsycho.2021.04.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2020] [Revised: 04/16/2021] [Accepted: 04/19/2021] [Indexed: 10/21/2022]
Abstract
OBJECTIVE Pharmacologic and behavioral interventions that block reconsolidation of reactivated fear memory have demonstrated only limited success in modifying stronger and long-standing fear memories. Given the efficacy of Eye Movement Desensitization and Reprocessing (EMDR) in treating PTSD, pursuit eye movements are a promising and novel intervention for studies of human memory reconsolidation. Here, we examined the efficacy of pursuit eye movements in interfering with reconsolidation of conditioned fear memories. METHODS We conducted a 3-day differential Pavlovian fear conditioning procedure in healthy adults, using videos of biologically prepared stimuli (tarantulas), partly reinforced with electrical shocks while recording skin conductance response (SCR) as a measure of autonomic conditioned responses. Fear conditioning was performed on Day 1. On Day 2, 38 participants were randomized into groups performing pursuit eye movements either immediately after fear memory reactivation, when the fear memory was stable, or 10 min later, when the fear memory was assumed to be more labile. On Day 3, fear memory strength was assessed by SCR to both reactivated and nonreactivated fear memories. RESULTS Strong differential conditioning to the spider stimuli were observed during both fear acquisition and fear memory reactivation. Reactivated fear memory conditioned responses of participants performing pursuit eye movements after a 10-min delay were significantly smaller in the reinstatement phase (0.16 μS; 95% CI [0.02, 0.31]). CONCLUSIONS Pursuit eye movements were effective in reducing fear-conditioned SCR in reinstatement. This result supports the theoretical proposition that EMDR can interfere with reactivated fear memory reconsolidation.
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Affiliation(s)
- Lena Jellestad
- Department of Consultation- Liaison Psychiatry and Psychosomatic Medicine, University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Thomas Zeffiro
- Department of Consultation- Liaison Psychiatry and Psychosomatic Medicine, University Hospital Zurich, University of Zurich, Zurich, Switzerland; Neurometrika, Potomac, MD, USA; University of Maryland School of Medicine, Baltimore, MD, USA
| | - Marco Piccirelli
- Department of Neuroradiology, Clinical Neuroscience Center, University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Jolanda Malamud
- Department of Consultation- Liaison Psychiatry and Psychosomatic Medicine, University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Benedikt B M Klimke
- Department of Consultation- Liaison Psychiatry and Psychosomatic Medicine, University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Katrin Rauen
- Department of Geriatric Psychiatry, Psychiatric Hospital Zurich & Institute for Regenerative Medicine, University of Zurich, Switzerland
| | - Michael Rufer
- Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric Hospital, University of Zurich, Zurich, Switzerland
| | - Scott P Orr
- Department of Psychiatry, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA
| | - Christoph Mueller-Pfeiffer
- Department of Consultation- Liaison Psychiatry and Psychosomatic Medicine, University Hospital Zurich, University of Zurich, Zurich, Switzerland.
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Khalfa S, Poupard G. MOSAIC: A New Pain-Free Psychotherapy for Psychological Trauma. Am J Psychother 2021; 74:40-43. [PMID: 33302705 DOI: 10.1176/appi.psychotherapy.202020200018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Eye movements and alternating stimuli for brain integration (MOSAIC) is a promising but untested new therapy. Its four-step protocol is based on the effects of bilateral alternating stimulation (BAS) (as in eye movement desensitization and reprocessing therapy) on the brain. This solution-oriented therapy promotes experiencing solutions through bodily sensations. Through BAS and bodily sensations, MOSAIC therapy aims to enrich the traumatic memory neuronal network with new information so that the client's psychological trauma is no longer distressing. Thus, MOSAIC can be used to treat psychological trauma without the pain associated with reliving the traumatic situation. This method may be particularly adaptive for patients who have experienced complex trauma and who have dissociative experiences.
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Affiliation(s)
- Stéphanie Khalfa
- Laboratory of Cognitive and Sensory Neuroscience, Aix Marseille University, Marseille, France (Khalfa); Way Inside, Monteux, France (Poupard)
| | - Guillaume Poupard
- Laboratory of Cognitive and Sensory Neuroscience, Aix Marseille University, Marseille, France (Khalfa); Way Inside, Monteux, France (Poupard)
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Carr P. The value of visioning: Augmenting EMDR with alpha-band alternating bilateral photic stimulation for trauma treatment in schizophrenia. Med Hypotheses 2020; 144:110184. [DOI: 10.1016/j.mehy.2020.110184] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2020] [Revised: 07/27/2020] [Accepted: 08/13/2020] [Indexed: 11/28/2022]
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Rousseau PF, Boukezzi S, Garcia R, Chaminade T, Khalfa S. Cracking the EMDR code: Recruitment of sensory, memory and emotional networks during bilateral alternating auditory stimulation. Aust N Z J Psychiatry 2020; 54:818-831. [PMID: 32271126 DOI: 10.1177/0004867420913623] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
INTRODUCTION The inability to extinguish a conditioned fear is thought to be at the core of post-traumatic stress disorder. Eye movement desensitization and reprocessing therapy has been efficacious for post-traumatic stress disorder, but the brain mechanisms underlying the effect are still unknown. The core effect of eye movement desensitization and reprocessing therapy seems to rely on the simultaneous association of bilateral alternating stimulation and the recall of the traumatic memory. To shed light on how eye movement desensitization and reprocessing therapy functions, we aimed to highlight the structures activated by bilateral alternating stimulation during fear extinction and its recall. METHODS We included 38 healthy participants in this study. Participants were examined twice in functional magnetic resonance imaging, over 2 consecutive days. On the first day, they performed two fear conditioning and extinction procedures, one with and one without the bilateral alternating stimulation during the fear extinction learning phase in a counter-balanced order across the participants. On the second day, participants completed the fear extinction recall procedure, in the same order as the previous day. Statistical significance of maps was set at p < 0.05 after correction for family-wise error at the cluster level. RESULTS The analysis revealed significant activation with versus without bilateral alternating stimulation at the early extinction in the bilateral auditory areas, the right precuneus, and the left medial frontal gyrus. The same pattern was found in the early recall on the second day. The connectivity analysis found a significant increase in connectivity during bilateral alternating stimulation versus without bilateral alternating stimulation in the early extinction and recall between the two superior temporal gyri, the precuneus, the middle frontal gyrus and a set of structures involved in multisensory integration, executive control, emotional processing, salience and memory. CONCLUSION We show for the first time that in the eye movement desensitization and reprocessing therapy the bilateral alternating stimulation is not a simple sensory signal and can activate large emotional neural networks.
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Affiliation(s)
- Pierre-François Rousseau
- Laboratoire de Neurosciences Sensorielles et Cognitives, UMR 7260, Aix-Marseille Université, CNRS, Marseille, France
| | - Sarah Boukezzi
- Connors Center for Women's Health & Gender Biology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - René Garcia
- Institut de Neurosciences de la Timone, Aix-Marseille Université, CNRS, Marseille, France
| | - Thierry Chaminade
- Institut de Neurosciences de la Timone, Aix-Marseille Université, CNRS, Marseille, France
| | - Stéphanie Khalfa
- Laboratoire de Neurosciences Sensorielles et Cognitives, UMR 7260, Aix-Marseille Université, CNRS, Marseille, France
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Brandão ML, Lovick TA. Role of the dorsal periaqueductal gray in posttraumatic stress disorder: mediation by dopamine and neurokinin. Transl Psychiatry 2019; 9:232. [PMID: 31530797 PMCID: PMC6748916 DOI: 10.1038/s41398-019-0565-8] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/25/2019] [Revised: 07/09/2019] [Accepted: 07/30/2019] [Indexed: 12/21/2022] Open
Abstract
In susceptible individuals, exposure to intensely traumatic life events can lead to the development of posttraumatic stress disorder (PTSD), including long-term dysregulation of the contextual processing of aversive stimuli, the overgeneralization of learned fear, and impairments in the ability to learn or respond to safety signals. The neuropathophysiological changes that underlie PTSD remain incompletely understood. Attention has focused on forebrain structures associated with fear processing. Here we consider evidence from human and animal studies that long-lasting changes in functional connectivity between the midbrain periaqueductal gray (dPAG) and amygdala may be one of the precipitating events that contribute to PTSD. Long-lasting neuroplastic changes in the dPAG can persist after a single aversive stimulation and are pharmacologically labile. The early stage (at least up to 24 h post-stimulation) involves neurokinin-1 receptor-mediated events in the PAG and amygdala and is also regulated by dopamine, both of which are mainly involved in transferring ascending aversive information from the dPAG to higher brain structures, mainly the amygdala. Changes in the functional connectivity within the dPAG-amygdala circuit have been reported in PTSD patients. We suggest that further investigations of plasticity and pharmacology of the PAG-amygdala network provide a promising target for understanding pathophysiological circuitry that underlies PTSD in humans and that dopaminergic and neurokininergic drugs may have a potential for the treatment of psychiatric disorders that are associated with a dysfunctional dPAG.
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Affiliation(s)
- M. L. Brandão
- grid.456657.3Instituto de Neurociências e Comportamento, Avenida do Café, 2450, 14050-220 Ribeirão Preto, SP Brazil ,0000 0004 1937 0722grid.11899.38NAP-USP-Neurobiology of Emotions Research Centre (NuPNE), Ribeirão Preto Medical School of the University of São Paulo (FMRP-USP), Av. Bandeirantes, 3900, Ribeirão Preto, São Paulo 14049-900 Brazil
| | - T. A. Lovick
- 0000 0004 1937 0722grid.11899.38NAP-USP-Neurobiology of Emotions Research Centre (NuPNE), Ribeirão Preto Medical School of the University of São Paulo (FMRP-USP), Av. Bandeirantes, 3900, Ribeirão Preto, São Paulo 14049-900 Brazil ,0000 0004 1936 7603grid.5337.2School of Physiology, Pharmacology and Neuroscience, University of Bristol, Bristol, B15 2TT UK
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Rousseau P, El Khoury-Malhame M, Reynaud E, Zendjidjian X, Samuelian J, Khalfa S. Neurobiological correlates of EMDR therapy effect in PTSD. EUROPEAN JOURNAL OF TRAUMA & DISSOCIATION 2019. [DOI: 10.1016/j.ejtd.2018.07.001] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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14
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Neural circuits underlying a psychotherapeutic regimen for fear disorders. Nature 2019; 566:339-343. [DOI: 10.1038/s41586-019-0931-y] [Citation(s) in RCA: 56] [Impact Index Per Article: 11.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2018] [Accepted: 01/07/2019] [Indexed: 11/08/2022]
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15
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Rousseau PF, El Khoury-Malhame M, Reynaud E, Boukezzi S, Cancel A, Zendjidjian X, Guyon V, Samuelian JC, Guedj E, Chaminade T, Khalfa S. Fear extinction learning improvement in PTSD after EMDR therapy: an fMRI study. Eur J Psychotraumatol 2019; 10:1568132. [PMID: 33235664 PMCID: PMC7671715 DOI: 10.1080/20008198.2019.1568132] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
Objective: Neurobiological models of Posttraumatic Stress Disorder (PTSD) implicate fear processing impairments in the maintenance of the disorder. Eye Movement Desensitization and Reprocessing (EMDR) is one of the most efficient psychotherapies to treat PTSD. We aimed at exploring the brain mechanisms of the fear circuitry involved in PTSD patients' symptom remission after EMDR therapy. Method: Thirty-six PTSD participants were randomly assigned to either EMDR group receiving EMDR therapy or Wait-List (WL) group receiving supportive therapy. Participants underwent a behavioural fear conditioning and extinction paradigm during functional magnetic resonance (fMRI). In the EMDR group, patients were scanned at baseline, before EMDR and one week after remission. In the WL group, patients were scanned at baseline and within the same time interval as the EMDR group. Results: In the EMDR group after treatment, fear responses in the late extinction were significantly lower than before therapy. In parallel, significant functional activity and connectivity changes were found in the EMDR group versus the WL during the late extinction. These changes involve the fear circuit (amygdalae, left hippocampus), the right inferior frontal gyrus, the right frontal eye field and insula (pFWE < .05). Conclusion: These functional modifications underlie a significant improvement of fear extinction learning in PTSD patients after EMDR therapy.
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Affiliation(s)
| | - Myriam El Khoury-Malhame
- School of Arts and Sciences, Neurosciences, Neuropsychology, Lebanese American University, Beirut, Lebanon
| | | | - Sarah Boukezzi
- Timone Institute of Neuroscience, UMR 7289 CNRS, Marseille, France
| | - Aïda Cancel
- Timone Institute of Neuroscience, UMR 7289 CNRS, Marseille, France
| | - Xavier Zendjidjian
- Department of Psychiatry, La Conception University Hospital, Marseille, France
| | - Valérie Guyon
- Department of Psychiatry, La Conception University Hospital, Marseille, France
| | | | - Eric Guedj
- Biophysics and Nuclear Medicine Department, Timone Hospital, Marseille, France
| | | | - Stephanie Khalfa
- Laboratoire de Neurosciences Sensorielles et Cognitives, UMR 7260 CNRS, Marseille, France
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Corne R, Leconte C, Ouradou M, Fassina V, Zhu Y, Déou E, Besson V, Plotkine M, Marchand-Leroux C, Mongeau R. Spontaneous resurgence of conditioned fear weeks after successful extinction in brain injured mice. Prog Neuropsychopharmacol Biol Psychiatry 2019; 88:276-286. [PMID: 30096331 DOI: 10.1016/j.pnpbp.2018.07.023] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/23/2018] [Revised: 06/28/2018] [Accepted: 07/29/2018] [Indexed: 12/25/2022]
Abstract
Mild traumatic brain injury (TBI) is a major risk factor for post-traumatic stress disorder (PTSD), and both disorders share common symptoms and neurobiological defects. Relapse after successful treatment, known as long-term fear resurgence, is common in PTSD patients and a major therapeutic hurdle. We induced a mild focal TBI by controlled cortical impact (CCI) in male C57BL/6 J mice and used fear conditioning to assess PTSD-like behaviors and concomitant alterations in the fear circuitry. We found for the first time that mild TBI, and to a lesser extent sham (craniotomy), mice displayed a spontaneous resurgence of conditioned fear when tested for fear extinction memory recall, despite having effectively acquired and extinguished conditioned fear 6 weeks earlier in the same context. Other characteristic symptoms of PTSD are risk-taking behaviors and cognitive deficits. CCI mice displayed risk-taking behaviors, behavioral inflexibility and reductions in processing speed compared to naïve mice. In conjunction with these changes there were alterations in amygdala morphology 3 months post-trauma, and decreased myelin basic protein density at the primary lesion site and in distant secondary sites such as the hippocampus, thalamus, and amygdala, compared to sham mice. Furthermore, activity-dependent brain-derived neurotrophic factor (BDNF) transcripts were decreased in the prefrontal cortex, a key region for fear extinction consolidation, following fear extinction training in both TBI and, to a lesser extent, sham mice. This study shows for the first time that a mild brain injury can generate a spontaneous resurgence of conditioned fear associated with defective BDNF signalling in the prefrontal cortex, PTSD-like behaviors, and have enduring effects on the brain.
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Affiliation(s)
- R Corne
- EA4475 - Pharmacologie de la Circulation Cérébrale, Faculté de Pharmacie de Paris, Université Paris Descartes, Paris, France
| | - C Leconte
- EA4475 - Pharmacologie de la Circulation Cérébrale, Faculté de Pharmacie de Paris, Université Paris Descartes, Paris, France
| | - M Ouradou
- EA4475 - Pharmacologie de la Circulation Cérébrale, Faculté de Pharmacie de Paris, Université Paris Descartes, Paris, France
| | - V Fassina
- EA4475 - Pharmacologie de la Circulation Cérébrale, Faculté de Pharmacie de Paris, Université Paris Descartes, Paris, France
| | - Y Zhu
- EA4475 - Pharmacologie de la Circulation Cérébrale, Faculté de Pharmacie de Paris, Université Paris Descartes, Paris, France
| | - E Déou
- EA4475 - Pharmacologie de la Circulation Cérébrale, Faculté de Pharmacie de Paris, Université Paris Descartes, Paris, France
| | - V Besson
- EA4475 - Pharmacologie de la Circulation Cérébrale, Faculté de Pharmacie de Paris, Université Paris Descartes, Paris, France
| | - M Plotkine
- EA4475 - Pharmacologie de la Circulation Cérébrale, Faculté de Pharmacie de Paris, Université Paris Descartes, Paris, France
| | - C Marchand-Leroux
- EA4475 - Pharmacologie de la Circulation Cérébrale, Faculté de Pharmacie de Paris, Université Paris Descartes, Paris, France
| | - R Mongeau
- EA4475 - Pharmacologie de la Circulation Cérébrale, Faculté de Pharmacie de Paris, Université Paris Descartes, Paris, France.
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17
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Schäfer SK, Ihmig FR, Lara H KA, Neurohr F, Kiefer S, Staginnus M, Lass-Hennemann J, Michael T. Effects of heart rate variability biofeedback during exposure to fear-provoking stimuli within spider-fearful individuals: study protocol for a randomized controlled trial. Trials 2018; 19:184. [PMID: 29548298 PMCID: PMC5857097 DOI: 10.1186/s13063-018-2554-2] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2017] [Accepted: 02/15/2018] [Indexed: 02/24/2023] Open
Abstract
Background Specific phobias are among the most common anxiety disorders. Exposure therapy is the treatment of choice for specific phobias. However, not all patients respond equally well to it. Hence, current research focuses on therapeutic add-ons to increase and consolidate the effects of exposure therapy. One potential therapeutic add-on is biofeedback to increase heart rate variability (HRV). A recent meta-analysis shows beneficial effects of HRV biofeedback interventions on stress and anxiety symptoms. Therefore, the purpose of the current trial is to evaluate the effects of HRV biofeedback, which is practiced before and utilized during exposure, in spider-fearful individuals. Further, this trial is the first to differentiate between the effects of a HRV biofeedback intervention and those of a low-load working memory (WM) task. Methods Eighty spider-fearful individuals participate in the study. All participants receive a training session in which they practice two tasks (HRV biofeedback and a motor pseudo-biofeedback task or two motor pseudo-biofeedback tasks). Afterwards, they train both tasks at home for 6 days. One week later, during the exposure session, they watch 16 1-min spider video clips. Participants are divided into four groups: group 1 practices the HRV biofeedback and one motor pseudo-task before exposure and utilizes HRV biofeedback during exposure. Group 2 receives the same training, but continues the pseudo-biofeedback task during exposure. Group 3 practices two pseudo-biofeedback tasks and continues one of them during exposure. Group 4 trains in two pseudo-biofeedback tasks and has no additional task during exposure. The primary outcome is fear of spiders (measured by the Fear of Spiders Questionnaire and the Behavioral Approach Test). Secondary outcomes are physiological measures based on electrodermal activity, electrocardiogram and respiration. Discussion This RCT is the first one to investigate the effects of using a pre-trained HRV biofeedback during exposure in spider-fearful individuals. The study critically contrasts the effects of the biofeedback intervention with those of pseudo-tasks, which also require WM capacity, but which do not have a physiological base. If HRV biofeedback is effective in reducing fear of spiders, it would represent an easy-to-use tool to improve exposure-therapy outcomes. Trial registration Deutsches Register Klinischer Studien, DRKS00012278. Registered on 23 May 2017, amendment on 5 October 2017. Electronic supplementary material The online version of this article (10.1186/s13063-018-2554-2) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Sarah K Schäfer
- Division of Clinical Psychology and Psychotherapy, Department of Psychology, Saarland University, Building A 1.3, 66123, Saarbrücken, Germany
| | - Frank R Ihmig
- Department of Biomedical Microsystems, Fraunhofer-Institut fuer Biomedizinische Technik (IBMT), Sulzbach, Saar, Germany
| | - Karen A Lara H
- Department of Biomedical Microsystems, Fraunhofer-Institut fuer Biomedizinische Technik (IBMT), Sulzbach, Saar, Germany
| | - Frank Neurohr
- Department of Biomedical Microsystems, Fraunhofer-Institut fuer Biomedizinische Technik (IBMT), Sulzbach, Saar, Germany
| | - Stephan Kiefer
- Department of Biomedical Microsystems, Fraunhofer-Institut fuer Biomedizinische Technik (IBMT), Sulzbach, Saar, Germany
| | - Marlene Staginnus
- Division of Clinical Psychology and Psychotherapy, Department of Psychology, Saarland University, Building A 1.3, 66123, Saarbrücken, Germany
| | - Johanna Lass-Hennemann
- Division of Clinical Psychology and Psychotherapy, Department of Psychology, Saarland University, Building A 1.3, 66123, Saarbrücken, Germany
| | - Tanja Michael
- Division of Clinical Psychology and Psychotherapy, Department of Psychology, Saarland University, Building A 1.3, 66123, Saarbrücken, Germany.
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18
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Hurtado-Parrado C, González-León C, Arias-Higuera MA, Cardona A, Medina LG, García-Muñoz L, Sánchez C, Cifuentes J, Forigua JC, Ortiz A, Acevedo-Triana CA, Rico JL. Assessing Mongolian gerbil emotional behavior: effects of two shock intensities and response-independent shocks during an extended inhibitory-avoidance task. PeerJ 2017; 5:e4009. [PMID: 29152417 PMCID: PMC5689020 DOI: 10.7717/peerj.4009] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2017] [Accepted: 10/18/2017] [Indexed: 12/28/2022] Open
Abstract
Despite step-down inhibitory avoidance procedures that have been widely implemented in rats and mice to study learning and emotion phenomena, performance of other species in these tasks has received less attention. The case of the Mongolian gerbil is of relevance considering the discrepancies in the parameters of the step-down protocols implemented, especially the wide range of foot-shock intensities (i.e., 0.4–4.0 mA), and the lack of information on long-term performance, extinction effects, and behavioral patterning during these tasks. Experiment 1 aimed to (a) characterize gerbils’ acquisition, extinction, and steady-state performance during a multisession (i.e., extended) step-down protocol adapted for implementation in a commercially-available behavioral package (Video Fear Conditioning System—MED Associates Fairfax, VT, USA), and (b) compare gerbils’ performance in this task with two shock intensities – 0.5 vs. 1.0 mA—considered in the low-to-mid range. Results indicated that the 1.0 mA protocol produced more reliable and clear evidence of avoidance learning, extinction, and reacquisition in terms of increments in freezing and on-platform time as well as suppression of platform descent. Experiment 2 aimed to (a) assess whether an alternate protocol consisting of a random delivery of foot shocks could replicate the effects of Experiment 1 and (b) characterize gerbils’ exploratory behavior during the step-down task (jumping, digging, rearing, and probing). Random shocks did not reproduce the effects observed with the first protocol. The data also indicated that a change from random to response-dependent shocks affects (a) the length of each visit to the platform, but not the frequency of platform descends or freezing time, and (b) the patterns of exploratory behavior, namely, suppression of digging and rearing, as well as increments in probing and jumping. Overall, the study demonstrated the feasibility of the extended step-down protocol for studying steady performance, extinction, and reacquisition of avoidance behavior in gerbils, which could be easily implemented in a commercially available system. The observation that 1.0 mA shocks produced a clear and consistent avoidance behavior suggests that implementation of higher intensities is unnecessary for reproducing aversive-conditioning effects in this species. The observed patterning of freezing, platform descents, and exploratory responses produced by the change from random to periodic shocks may relate to the active defensive system of the gerbil. Of special interest is the probing behavior, which could be interpreted as risk assessment and has not been reported in other rodent species exposed to step-down and similar tasks.
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Affiliation(s)
- Camilo Hurtado-Parrado
- Animal Behavior Laboratory, Faculty of Psychology, Fundación Universitaria Konrad Lorenz, Bogota, D.C., Colombia
| | - Camilo González-León
- Animal Behavior Laboratory, Faculty of Psychology, Fundación Universitaria Konrad Lorenz, Bogota, D.C., Colombia
| | - Mónica A Arias-Higuera
- Animal Behavior Laboratory, Faculty of Psychology, Fundación Universitaria Konrad Lorenz, Bogota, D.C., Colombia
| | - Angelo Cardona
- Animal Behavior Laboratory, Faculty of Psychology, Fundación Universitaria Konrad Lorenz, Bogota, D.C., Colombia
| | - Lucia G Medina
- Animal Behavior Laboratory, Faculty of Psychology, Fundación Universitaria Konrad Lorenz, Bogota, D.C., Colombia
| | - Laura García-Muñoz
- Animal Behavior Laboratory, Faculty of Psychology, Fundación Universitaria Konrad Lorenz, Bogota, D.C., Colombia
| | - Christian Sánchez
- Animal Behavior Laboratory, Faculty of Psychology, Fundación Universitaria Konrad Lorenz, Bogota, D.C., Colombia
| | - Julián Cifuentes
- Animal Behavior Laboratory, Faculty of Psychology, Fundación Universitaria Konrad Lorenz, Bogota, D.C., Colombia
| | - Juan Carlos Forigua
- Animal Behavior Laboratory, Faculty of Psychology, Fundación Universitaria Konrad Lorenz, Bogota, D.C., Colombia
| | - Andrea Ortiz
- Animal Behavior Laboratory, Faculty of Psychology, Fundación Universitaria Konrad Lorenz, Bogota, D.C., Colombia
| | | | - Javier L Rico
- Animal Behavior Laboratory, Faculty of Psychology, Fundación Universitaria Konrad Lorenz, Bogota, D.C., Colombia
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Boukezzi S, Silva C, Nazarian B, Rousseau PF, Guedj E, Valenzuela-Moguillansky C, Khalfa S. Bilateral Alternating Auditory Stimulations Facilitate Fear Extinction and Retrieval. Front Psychol 2017; 8:990. [PMID: 28659851 PMCID: PMC5470101 DOI: 10.3389/fpsyg.2017.00990] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2017] [Accepted: 05/29/2017] [Indexed: 11/13/2022] Open
Abstract
Disruption of fear conditioning, its extinction and its retrieval are at the core of posttraumatic stress disorder (PTSD). Such deficits, especially fear extinction delay, disappear after alternating bilateral stimulations (BLS) during eye movement desensitization and reprocessing (EMDR) therapy. An animal model of fear recovery, based on auditory cued fear conditioning and extinction learning, recently showed that BLS facilitate fear extinction and fear extinction retrieval. Our goal was to determine if these previous results found in animals can be reproduced in humans. Twenty-two healthy participants took part in a classical fear conditioning, extinction, and extinction recall paradigm. Behavioral responses (fear expectations) as well as psychophysiological measures (skin conductance responses, SCRs) were recorded. The results showed a significant fear expectation decrease during fear extinction with BLS. Additionally, SCR for fear extinction retrieval were significantly lower with BLS. Our results demonstrate the importance of BLS to reduce negative emotions, and provide a successful model to further explore the neural mechanisms underlying the sole BLS effect in the EMDR.
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Affiliation(s)
- Sarah Boukezzi
- Institut de Neurosciences de la Timone, UMR 7289, Aix Marseille Université and CNRSMarseille, France
| | - Catarina Silva
- Institut de Neurosciences de la Timone, UMR 7289, Aix Marseille Université and CNRSMarseille, France.,Instituto Universitário de Lisboa (ISCTE-IUL)Lisboa, Portugal
| | - Bruno Nazarian
- Institut de Neurosciences de la Timone, UMR 7289, Aix Marseille Université and CNRSMarseille, France
| | - Pierre-François Rousseau
- Institut de Neurosciences de la Timone, UMR 7289, Aix Marseille Université and CNRSMarseille, France.,Service de Psychiatrie, Hôpital d'Instruction des Armées Sainte-AnneToulon, France
| | - Eric Guedj
- Institut de Neurosciences de la Timone, UMR 7289, Aix Marseille Université and CNRSMarseille, France.,Centre Européen de Recherche en Imagerie MédicaleMarseille, France.,Assistance Publiques des Hôpitaux de Marseille, Service Central de Biophysique et Médecine NucléaireMarseille, France
| | | | - Stéphanie Khalfa
- Institut de Neurosciences de la Timone, UMR 7289, Aix Marseille Université and CNRSMarseille, France
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20
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Affiliation(s)
- Joshua A Gordon
- Department of Psychiatry, Columbia University, New York, NY 10032, United States.
| | - Kafui Dzirasa
- Department of Psychiatry and Behavioral Sciences, Duke University, Durham, NC 27710, United States; Department of Neurobiology, Duke University, Durham, NC 27710, United States; Department of Biomedical Engineering, Duke University, Durham, NC 27710, United States
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