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Plas SL, Tuna T, Bayer H, Juliano VAL, Sweck SO, Arellano Perez AD, Hassell JE, Maren S. Neural circuits for the adaptive regulation of fear and extinction memory. Front Behav Neurosci 2024; 18:1352797. [PMID: 38370858 PMCID: PMC10869525 DOI: 10.3389/fnbeh.2024.1352797] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2023] [Accepted: 01/15/2024] [Indexed: 02/20/2024] Open
Abstract
The regulation of fear memories is critical for adaptive behaviors and dysregulation of these processes is implicated in trauma- and stress-related disorders. Treatments for these disorders include pharmacological interventions as well as exposure-based therapies, which rely upon extinction learning. Considerable attention has been directed toward elucidating the neural mechanisms underlying fear and extinction learning. In this review, we will discuss historic discoveries and emerging evidence on the neural mechanisms of the adaptive regulation of fear and extinction memories. We will focus on neural circuits regulating the acquisition and extinction of Pavlovian fear conditioning in rodent models, particularly the role of the medial prefrontal cortex and hippocampus in the contextual control of extinguished fear memories. We will also consider new work revealing an important role for the thalamic nucleus reuniens in the modulation of prefrontal-hippocampal interactions in extinction learning and memory. Finally, we will explore the effects of stress on this circuit and the clinical implications of these findings.
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Affiliation(s)
- Samantha L. Plas
- Department of Psychological and Brain Sciences, Texas A&M University, College Station, TX, United States
- Institute for Neuroscience, Texas A&M University, College Station, TX, United States
| | - Tuğçe Tuna
- Department of Psychological and Brain Sciences, Texas A&M University, College Station, TX, United States
- Institute for Neuroscience, Texas A&M University, College Station, TX, United States
| | - Hugo Bayer
- Department of Psychological and Brain Sciences, Texas A&M University, College Station, TX, United States
- Institute for Neuroscience, Texas A&M University, College Station, TX, United States
| | - Vitor A. L. Juliano
- Department of Pharmacology, Institute of Biomedical Sciences, University of São Paulo, São Paulo, Brazil
| | - Samantha O. Sweck
- Department of Psychological and Brain Sciences, Texas A&M University, College Station, TX, United States
- Institute for Neuroscience, Texas A&M University, College Station, TX, United States
| | - Angel D. Arellano Perez
- Department of Psychological and Brain Sciences, Texas A&M University, College Station, TX, United States
| | - James E. Hassell
- Department of Psychological and Brain Sciences, Texas A&M University, College Station, TX, United States
| | - Stephen Maren
- Department of Psychological and Brain Sciences, Texas A&M University, College Station, TX, United States
- Institute for Neuroscience, Texas A&M University, College Station, TX, United States
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Zaki Y, Pennington ZT, Morales-Rodriguez D, Francisco TR, LaBanca AR, Dong Z, Lamsifer S, Segura SC, Chen HT, Wick ZC, Silva AJ, van der Meer M, Shuman T, Fenton A, Rajan K, Cai DJ. Aversive experience drives offline ensemble reactivation to link memories across days. BIORXIV : THE PREPRINT SERVER FOR BIOLOGY 2023:2023.03.13.532469. [PMID: 36993254 PMCID: PMC10054942 DOI: 10.1101/2023.03.13.532469] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
Memories are encoded in neural ensembles during learning and stabilized by post-learning reactivation. Integrating recent experiences into existing memories ensures that memories contain the most recently available information, but how the brain accomplishes this critical process remains unknown. Here we show that in mice, a strong aversive experience drives the offline ensemble reactivation of not only the recent aversive memory but also a neutral memory formed two days prior, linking the fear from the recent aversive memory to the previous neutral memory. We find that fear specifically links retrospectively, but not prospectively, to neutral memories across days. Consistent with prior studies, we find reactivation of the recent aversive memory ensemble during the offline period following learning. However, a strong aversive experience also increases co-reactivation of the aversive and neutral memory ensembles during the offline period. Finally, the expression of fear in the neutral context is associated with reactivation of the shared ensemble between the aversive and neutral memories. Taken together, these results demonstrate that strong aversive experience can drive retrospective memory-linking through the offline co-reactivation of recent memory ensembles with memory ensembles formed days prior, providing a neural mechanism by which memories can be integrated across days.
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Affiliation(s)
- Yosif Zaki
- Nash Department of Neuroscience, Icahn School of Medicine at Mount Sinai, New York, NY, 10029
| | - Zachary T. Pennington
- Nash Department of Neuroscience, Icahn School of Medicine at Mount Sinai, New York, NY, 10029
| | | | - Taylor R. Francisco
- Nash Department of Neuroscience, Icahn School of Medicine at Mount Sinai, New York, NY, 10029
| | - Alexa R. LaBanca
- Nash Department of Neuroscience, Icahn School of Medicine at Mount Sinai, New York, NY, 10029
| | - Zhe Dong
- Nash Department of Neuroscience, Icahn School of Medicine at Mount Sinai, New York, NY, 10029
| | - Sophia Lamsifer
- Nash Department of Neuroscience, Icahn School of Medicine at Mount Sinai, New York, NY, 10029
| | - Simón Carrillo Segura
- Graduate Program in Mechanical and Aerospace Engineering, Tandon School of Engineering, New York University, Brooklyn, NY, 11201
| | - Hung-Tu Chen
- Department of Psychological & Brain Sciences, Dartmouth College, Hanover, NH, 03755
| | - Zoé Christenson Wick
- Nash Department of Neuroscience, Icahn School of Medicine at Mount Sinai, New York, NY, 10029
| | - Alcino J. Silva
- Department of Neurobiology, Psychiatry & Biobehavioral Sciences, and Psychology, Integrative Center for Learning and Memory, Brain Research Institute, UCLA, Los Angeles, CA 90095
| | | | - Tristan Shuman
- Nash Department of Neuroscience, Icahn School of Medicine at Mount Sinai, New York, NY, 10029
| | - André Fenton
- Center for Neural Science, New York University, New York, NY, 10003
- Neuroscience Institute at the NYU Langone Medical Center, New York, NY, 10016
| | - Kanaka Rajan
- Nash Department of Neuroscience, Icahn School of Medicine at Mount Sinai, New York, NY, 10029
| | - Denise J. Cai
- Nash Department of Neuroscience, Icahn School of Medicine at Mount Sinai, New York, NY, 10029
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van ’t Wout-Frank M, Garnaat SL, Faucher CR, Arulpragasam AR, Cole JE, Philip NS, Burwell RD. Transcranial direct current stimulation impairs updating of avoidance-based associative learning. Front Hum Neurosci 2023; 17:1104614. [PMID: 37169017 PMCID: PMC10164989 DOI: 10.3389/fnhum.2023.1104614] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2022] [Accepted: 04/03/2023] [Indexed: 05/13/2023] Open
Abstract
Introduction Exposure-based psychotherapies for the treatment of anxiety- and fear-based disorders rely on "corrective" associative learning. Namely the repeated confrontation with feared stimuli in the absence of negative outcomes allows the formation of new, corrected associations of safety, indicating that such stimuli no longer need to be avoided. Unfortunately, exposure-facilitated corrective learning tends to be bound by context and often poorly generalizes. One brain structure, the prefrontal cortex, is implicated in context-guided behavior and may be a relevant target for improving generalization of safety learning. Here, we tested whether inhibition of the left prefrontal cortex causally impaired updating of context-bound associations specifically or, alternatively, impaired updating of learned associations irrespective of contextual changes. Additionally, we tested whether prefrontal inhibition during corrective learning influenced subsequent generalization of associations to a novel context. Methods In two separate experiments, participants received either 10 min of 2 mA cathodal transcranial direct current stimulation (tDCS) over EEG coordinate F3 (Experiment 1 n = 9, Experiment 2 n = 22) or sham stimulation (Experiment 1 n = 10, Experiment 2 n = 22) while previously learned associations were reversed in the same or a different context from initial learning. Next, to assess generalization of learning, participants were asked to indicate which of the previously seen images they preferred in a novel, never seen before context. Results Results indicate that tDCS significantly impaired reversal irrespective of context in Experiment 2 only. When taking learning rate across trials into account, both experiments suggest that participants who received sham had the greatest learning rate when reversal occurred in a different context, as expected, whereas participants who received active tDCS in this condition had the lowest learning rate. However, active tDCS was associated with preferring the originally disadvantageous, but then neural stimulus after stimulus after reversal occurred in a different context in Experiment 1 only. Discussion These results support a causal role for the left prefrontal cortex in the updating of avoidance-based associations and encourage further inquiry investigating the use of non-invasive brain stimulation on flexible updating of learned associations.
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Affiliation(s)
- Mascha van ’t Wout-Frank
- Department of Psychiatry and Human Behavior, Warren Alpert Medical School, Brown University, Providence, RI, United States
- COBRE Center for Neuromodulation, Butler Hospital, Providence, RI, United States
- Center for Neurorestoration and Neurotechnology, VA Providence Healthcare System, Providence, RI, United States
| | - Sarah L. Garnaat
- Department of Psychiatry and Human Behavior, Warren Alpert Medical School, Brown University, Providence, RI, United States
- COBRE Center for Neuromodulation, Butler Hospital, Providence, RI, United States
| | - Christiana R. Faucher
- Center for Neurorestoration and Neurotechnology, VA Providence Healthcare System, Providence, RI, United States
| | - Amanda R. Arulpragasam
- Department of Psychiatry and Human Behavior, Warren Alpert Medical School, Brown University, Providence, RI, United States
- Center for Neurorestoration and Neurotechnology, VA Providence Healthcare System, Providence, RI, United States
- Department of Cognitive, Linguistic and Psychological Sciences, Brown University, Providence, RI, United States
| | - Julia E. Cole
- COBRE Center for Neuromodulation, Butler Hospital, Providence, RI, United States
| | - Noah S. Philip
- Department of Psychiatry and Human Behavior, Warren Alpert Medical School, Brown University, Providence, RI, United States
- COBRE Center for Neuromodulation, Butler Hospital, Providence, RI, United States
- Center for Neurorestoration and Neurotechnology, VA Providence Healthcare System, Providence, RI, United States
| | - Rebecca D. Burwell
- COBRE Center for Neuromodulation, Butler Hospital, Providence, RI, United States
- Department of Cognitive, Linguistic and Psychological Sciences, Brown University, Providence, RI, United States
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Sjouwerman R, Lonsdorf TB. Systematically investigating the role of context on effect replicability in reinstatement of fear in humans. Behav Res Ther 2023; 162:104256. [PMID: 36736196 DOI: 10.1016/j.brat.2023.104256] [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: 11/16/2021] [Revised: 12/08/2022] [Accepted: 01/17/2023] [Indexed: 01/22/2023]
Abstract
Context is crucial in guiding behavior in an ever-changing world and contextual information plays a crucial role in associative learning processes. For instance, the return of fear (RoF) after successful extinction, which is used to study the mechanisms underlying relapse phenomena in fear- and stress-related disorders in an experimental model, is known to be context dependent as evident from phenomena such as renewal (contextual change) and reinstatement (re-exposure to an aversive event). Human adaptions of reinstatement paradigms have resulted in mixed findings: CS specific as well as unspecific RoF or unexpected "reinstated" conditioned responding in no reinstatement US control groups. Here, we systematically investigate the role of context (i.e., cue-context compound) on reinstatement-induced RoF in a human differential fear conditioning paradigm using subjective and psychophysiological measures in a large sample (N = 212) including reinstatement and control groups. Overall, response patterns in reinstatement-groups mirrored results from single-cue rodent work. Yet, only generalized, not differential RoF was observed. Remarkably, depending on outcome measure RoF was also observed under identical experimental context conditions without US-re-exposure, underlining effects of contextual change beyond the reinstatement-US and challenging reinstatement research in human subjects and highlight that future reinstatement work should focus on the operationalization of context.
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Affiliation(s)
- R Sjouwerman
- University Medical Center Hamburg-Eppendorf, Department of Systems Neuroscience, Hamburg, Germany; Maastricht University, Research Group Experimental Health Psychology, Maastricht, the Netherlands
| | - T B Lonsdorf
- University Medical Center Hamburg-Eppendorf, Department of Systems Neuroscience, Hamburg, Germany.
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Extracellular zinc regulates contextual fear memory formation in male rats through MMP-BDNF-TrkB pathway in dorsal hippocampus and basolateral amygdala. Behav Brain Res 2023; 439:114230. [PMID: 36442645 DOI: 10.1016/j.bbr.2022.114230] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2022] [Revised: 11/24/2022] [Accepted: 11/25/2022] [Indexed: 11/26/2022]
Abstract
Large amount of zinc (100 µM even up to 300 µM) is released from the nerve terminals in response to high frequency neuronal stimulation in certain brain regions including hippocampus and amygdala. However, its precise pharmacological effect is poorly understood. Here, we investigated the role of extracellular zinc (endogenous zinc) and exogenous zinc in memory formation using contextual fear conditioning (CFC) model. Male Sprague Dawley rats were trained for fear conditioning followed by in vivo microdialysis for collection of microdialysate samples from CA1 and CA3 regions of hippocampus and basolateral amygdala (BLA). Extracellular zinc chelator CaEDTA, BDNF scavenger TrkB-Fc, exogenous 7,8-DHF and matrix metalloproteinases (MMP) inhibitor were infused into the CA1 and CA3 regions of hippocampus and BLA after CFC. Different doses of exogenous zinc hydroaspartate were administered intraperitoneally immediately after CFC. We found that CFC increased the level of extracellular zinc in the hippocampus and BLA. Infusing the CaEDTA, TrkB-Fc and MMP inhibitor into the CA1 and CA3 regions of hippocampus and BLA disrupted the fear memory formation. Furthermore, administration of TrKB agonist 7,8-DHF reversed the inhibitory effect of CaEDTA on fear memory formation, suggesting that extracellular zinc may regulate fear memory formation via the BDNF-TrKB pathway. We also found that high dose of exogenous zinc hydroaspartate supplementation increased extracellular zinc levels in brain and enhanced fear memory formation. Altogether, these findings indicate that extracellular zinc may participate in formation of contextual fear memory through MMP-BDNF-TrkB pathway in the hippocampus and BLA.
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HDAC1-mediated regulation of GABA signaling within the lateral septum facilitates long-lasting social fear extinction in male mice. Transl Psychiatry 2023; 13:10. [PMID: 36646675 PMCID: PMC9842607 DOI: 10.1038/s41398-023-02310-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/09/2022] [Revised: 12/31/2022] [Accepted: 01/06/2023] [Indexed: 01/18/2023] Open
Abstract
Social anxiety disorder (SAD) is caused by traumatic social experiences. It is characterized by intense fear and avoidance of social contexts, which can be robustly mimicked by the social fear conditioning (SFC) paradigm. The extinction phase of the SFC paradigm is akin to exposure therapy for SAD and requires learning to disassociate the trauma with the social context. Learning-induced acetylation of histones is critical for extinction memory formation and its endurance. Although class I histone deacetylases (HDACs) regulate the abovementioned learning process, there is a lack of clarity in isoforms and spatial specificity in HDAC function in social learning. Utilizing the SFC paradigm, we functionally characterized the role of HDAC1, specifically in the lateral septum (LS), in regulating the formation of long-term social fear extinction memory. We measured a local increase in activity-inducing HDAC1 phosphorylation at serine residues of social fear-conditioned (SFC+) mice in response to the extinction of social fear. We also found that LS-HDAC1 function negatively correlates with acute social fear extinction learning using pharmacological and viral approaches. Further, inhibition of LS-HDAC1 enhanced the expression of the GABA-A receptor β1 subunit (Gabrb1) in SFC+ mice, and activation of GABA-A receptors facilitated acute extinction learning. Finally, the facilitation of extinction learning by HDAC1 inhibition or GABA-A receptor activation within the LS led to the formation of long-lasting extinction memory, which persisted even 30 days after extinction. Our results show that HDAC1-mediated regulation of GABA signaling in the LS is crucial for the formation of long-lasting social fear extinction memory.
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Christian C, Levinson CA. An integrated review of fear and avoidance learning in anxiety disorders and application to eating disorders. NEW IDEAS IN PSYCHOLOGY 2022. [DOI: 10.1016/j.newideapsych.2022.100964] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Using expectation violation models to improve the outcome of psychological treatments. Clin Psychol Rev 2022; 98:102212. [PMID: 36371900 DOI: 10.1016/j.cpr.2022.102212] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2022] [Revised: 06/14/2022] [Accepted: 10/11/2022] [Indexed: 01/27/2023]
Abstract
Expectations are a central maintaining mechanism in mental disorders and most psychological treatments aim to directly or indirectly modify clinically relevant expectations. Therefore, it is crucial to examine why patients with mental disorders maintain dysfunctional expectations, even in light of disconfirming evidence, and how expectation-violating situations should be created in treatment settings to optimize treatment outcome and reduce the risk of treatment failures. The different psychological subdisciplines offer various approaches for understanding the underlying mechanisms of expectation development, persistence, and change. Here, we convey recommendations on how to improve psychological treatments by considering these different perspectives. Based on our expectation violation model, we argue that the outcome of expectation violation depends on several characteristics: features of the expectation-violating situation; the dynamics between the magnitude of expectation violation and cognitive immunization processes; dealing with uncertainties during and after expectation change; controlled and automatic attention processes; and the costs of expectation changes. Personality factors further add to predict outcomes and may offer a basis for personalized treatment planning. We conclude with a list of recommendations derived from basic psychology that could contribute to improved treatment outcome and to reduced risks of treatment failures.
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Szadzinska W, Danielewski K, Kondrakiewicz K, Andraka K, Nikolaev E, Mikosz M, Knapska E. Hippocampal Inputs in the Prelimbic Cortex Curb Fear after Extinction. J Neurosci 2021; 41:9129-9140. [PMID: 34518304 PMCID: PMC8570826 DOI: 10.1523/jneurosci.0764-20.2021] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2020] [Revised: 07/23/2021] [Accepted: 07/29/2021] [Indexed: 11/21/2022] Open
Abstract
In contrast to easily formed fear memories, fear extinction requires prolonged training. The prelimbic cortex (PL), which integrates signals from brain structures involved in fear conditioning and extinction such as the ventral hippocampus (vHIP) and the basolateral amygdala (BL), is necessary for fear memory retrieval. Little is known, however, about how the vHIP and BL inputs to the PL regulate the display of fear after fear extinction. Using functional anatomy tracing in male rats, we found two distinct subpopulations of neurons in the PL activated by either the successful extinction or the relapse of fear. During the retrieval of fear extinction memory, the dominant input to active neurons in the PL was from the vHIP, whereas the retrieval of fear memory, regardless of the age of a memory and testing context, was associated with greater BL input. Optogenetic stimulation of the vHIP-PL pathway after one session of fear extinction increased conditioned fear, whereas stimulation of the vHIP inputs after several sessions of extinction decreased the conditioned fear response. This latter effect was, however, transient, as stimulation of this pathway 28 d after extinction increased conditioned fear response again. The results show that repeated fear extinction training gradually changes vHIP-PL connectivity, making fear suppression possible, whereas in the absence of fear suppression from the vHIP, signals from the BL can play a dominant role, resulting in high levels of fear.SIGNIFICANCE STATEMENT Behavioral therapies of fear are based on extinction learning. As extinction memories fade over time, such therapies produce only a temporary suppression of fear, which constitutes a clinical and societal challenge. In our study, we provide a framework for understating the underlying mechanism by which extinction of fear memories fade by demonstrating the existence of two subpopulations of neurons in the prelimbic cortex associated with low and high levels of fear. Insufficient extinction and exposure to the context in which fear memory was formed promoted high fear neuronal activity in the prelimbic cortex, leading to fear retrieval. Extensive extinction training, on the other hand, boosted low fear neuronal activity and, as a result, extinction memory retrieval. This effect was, however, transient and disappeared with time.
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Affiliation(s)
- Weronika Szadzinska
- Laboratory of Emotions Neurobiology, Nencki-European Molecular Biology Laboratory Partnership for Neural Plasticity and Brain Disorders BRAINCITY, Nencki Institute of Experimental Biology, Pasteur 3 Str., 02-093 Warsaw, Poland
| | - Konrad Danielewski
- Laboratory of Emotions Neurobiology, Nencki-European Molecular Biology Laboratory Partnership for Neural Plasticity and Brain Disorders BRAINCITY, Nencki Institute of Experimental Biology, Pasteur 3 Str., 02-093 Warsaw, Poland
| | - Kacper Kondrakiewicz
- Laboratory of Emotions Neurobiology, Nencki-European Molecular Biology Laboratory Partnership for Neural Plasticity and Brain Disorders BRAINCITY, Nencki Institute of Experimental Biology, Pasteur 3 Str., 02-093 Warsaw, Poland
| | - Karolina Andraka
- Laboratory of Emotions Neurobiology, Nencki-European Molecular Biology Laboratory Partnership for Neural Plasticity and Brain Disorders BRAINCITY, Nencki Institute of Experimental Biology, Pasteur 3 Str., 02-093 Warsaw, Poland
| | - Evgeni Nikolaev
- Laboratory of Emotions Neurobiology, Nencki-European Molecular Biology Laboratory Partnership for Neural Plasticity and Brain Disorders BRAINCITY, Nencki Institute of Experimental Biology, Pasteur 3 Str., 02-093 Warsaw, Poland
| | - Marta Mikosz
- Laboratory of Emotions Neurobiology, Nencki-European Molecular Biology Laboratory Partnership for Neural Plasticity and Brain Disorders BRAINCITY, Nencki Institute of Experimental Biology, Pasteur 3 Str., 02-093 Warsaw, Poland
| | - Ewelina Knapska
- Laboratory of Emotions Neurobiology, Nencki-European Molecular Biology Laboratory Partnership for Neural Plasticity and Brain Disorders BRAINCITY, Nencki Institute of Experimental Biology, Pasteur 3 Str., 02-093 Warsaw, Poland
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Pittig A, Heinig I, Goerigk S, Thiel F, Hummel K, Scholl L, Deckert J, Pauli P, Domschke K, Lueken U, Fydrich T, Fehm L, Plag J, Ströhle A, Kircher T, Straube B, Rief W, Koelkebeck K, Arolt V, Dannlowski U, Margraf J, Totzeck C, Schneider S, Neudeck P, Craske MG, Hollandt M, Richter J, Hamm A, Wittchen HU. Efficacy of temporally intensified exposure for anxiety disorders: A multicenter randomized clinical trial. Depress Anxiety 2021; 38:1169-1181. [PMID: 34293223 DOI: 10.1002/da.23204] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/30/2021] [Revised: 06/25/2021] [Accepted: 07/12/2021] [Indexed: 11/09/2022] Open
Abstract
BACKGROUND The need to optimize exposure treatments for anxiety disorders may be addressed by temporally intensified exposure sessions. Effects on symptom reduction and public health benefits should be examined across different anxiety disorders with comorbid conditions. METHODS This multicenter randomized controlled trial compared two variants of prediction error-based exposure therapy (PeEx) in various anxiety disorders (both 12 sessions + 2 booster sessions, 100 min/session): temporally intensified exposure (PeEx-I) with exposure sessions condensed to 2 weeks (n = 358) and standard nonintensified exposure (PeEx-S) with weekly exposure sessions (n = 368). Primary outcomes were anxiety symptoms (pre, post, and 6-months follow-up). Secondary outcomes were global severity (across sessions), quality of life, disability days, and comorbid depression. RESULTS Both treatments resulted in substantial improvements at post (PeEx-I: dwithin = 1.50, PeEx-S: dwithin = 1.78) and follow-up (PeEx-I: dwithin = 2.34; PeEx-S: dwithin = 2.03). Both groups showed formally equivalent symptom reduction at post and follow-up. However, time until response during treatment was 32% shorter in PeEx-I (median = 68 days) than PeEx-S (108 days; TRPeEx-I = 0.68). Interestingly, drop-out rates were lower during intensified exposure. PeEx-I was also superior in reducing disability days and improving quality of life at follow-up without increasing relapse. CONCLUSIONS Both treatment variants focusing on the transdiagnostic exposure-based violation of threat beliefs were effective in reducing symptom severity and disability in severe anxiety disorders. Temporally intensified exposure resulted in faster treatment response with substantial public health benefits and lower drop-out during the exposure phase, without higher relapse. Clinicians can expect better or at least comparable outcomes when delivering exposure in a temporally intensified manner.
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Affiliation(s)
- Andre Pittig
- Department of Psychology (Biological Psychology Clinical Psychology, and Psychotherapy), Center of Mental Health, University of Würzburg, Würzburg, Germany.,Institute of Clinical Psychology & Psychotherapy, Technische Universität Dresden, Dresden, Germany
| | - Ingmar Heinig
- Institute of Clinical Psychology & Psychotherapy, Technische Universität Dresden, Dresden, Germany
| | - Stephan Goerigk
- Institute of Clinical Psychology & Psychotherapy, Technische Universität Dresden, Dresden, Germany.,Department of Psychiatry and Psychotherapy, University Hospital, Ludwig Maximilians University, Munich, Germany
| | - Freya Thiel
- Institute of Clinical Psychology & Psychotherapy, Technische Universität Dresden, Dresden, Germany
| | - Katrin Hummel
- Institute of Clinical Psychology & Psychotherapy, Technische Universität Dresden, Dresden, Germany
| | - Lucie Scholl
- Institute of Clinical Psychology & Psychotherapy, Technische Universität Dresden, Dresden, Germany
| | - Jürgen Deckert
- Department of Psychiatry, Psychosomatics, and Psychotherapy, Center of Mental Health, University Hospital of Würzburg, Würzburg, Germany
| | - Paul Pauli
- Department of Psychology (Biological Psychology Clinical Psychology, and Psychotherapy), Center of Mental Health, University of Würzburg, Würzburg, Germany
| | - Katharina Domschke
- Department of Psychiatry, Psychosomatics, and Psychotherapy, Center of Mental Health, University Hospital of Würzburg, Würzburg, Germany.,Department of Psychiatry and Psychotherapy, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany.,Center for Basics in NeuroModulation, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Ulrike Lueken
- Department of Psychiatry, Psychosomatics, and Psychotherapy, Center of Mental Health, University Hospital of Würzburg, Würzburg, Germany.,Department of Psychology, Humboldt-Universität zu Berlin, Berlin, Germany
| | - Thomas Fydrich
- Department of Psychology, Humboldt-Universität zu Berlin, Berlin, Germany
| | - Lydia Fehm
- Department of Psychology, Humboldt-Universität zu Berlin, Berlin, Germany
| | - Jens Plag
- Department of Psychiatry and Psychotherapy, Campus Charité Mitte, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Andreas Ströhle
- Department of Psychiatry and Psychotherapy, Campus Charité Mitte, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Tilo Kircher
- Department of Psychiatry and Psychotherapy & Center for Mind Brain and Behavior - CMBB, Philipps-University Marburg, Marburg, Germany
| | - Benjamin Straube
- Department of Psychiatry and Psychotherapy & Center for Mind Brain and Behavior - CMBB, Philipps-University Marburg, Marburg, Germany
| | - Winfried Rief
- Department of Clinical Psychology and Psychotherapy, Faculty of Psychology & Center for Mind, Brain and Behavior - CMBB, Philipps-University of Marburg, Marburg, Germany
| | - Katja Koelkebeck
- Institute for Translational Psychiatry, University of Muenster, Muenster, Germany
| | - Volker Arolt
- Institute for Translational Psychiatry, University of Muenster, Muenster, Germany
| | - Udo Dannlowski
- Institute for Translational Psychiatry, University of Muenster, Muenster, Germany
| | - Jürgen Margraf
- Mental Health Research and Treatment Center, Ruhr-Universität Bochum, Bochum, Germany
| | - Christina Totzeck
- Mental Health Research and Treatment Center, Ruhr-Universität Bochum, Bochum, Germany
| | - Silvia Schneider
- Mental Health Research and Treatment Center, Ruhr-Universität Bochum, Bochum, Germany
| | - Peter Neudeck
- Institute of Clinical Psychology & Psychotherapy, Technische Universität Dresden, Dresden, Germany.,Protect-AD Study Site Cologne, Cologne, Germany
| | - Michelle G Craske
- Department of Psychology and Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, USA
| | - Maike Hollandt
- Department of Psychology, Biological and Clinical Psychology, University of Greifswald, Greifswald, Germany
| | - Jan Richter
- Department of Psychology, Biological and Clinical Psychology, University of Greifswald, Greifswald, Germany
| | - Alfons Hamm
- Department of Psychology, Biological and Clinical Psychology, University of Greifswald, Greifswald, Germany
| | - Hans-Ulrich Wittchen
- Institute of Clinical Psychology & Psychotherapy, Technische Universität Dresden, Dresden, Germany.,Department of Psychiatry and Psychotherapy, University Hospital, Ludwig Maximilians University, Munich, Germany
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I Doubt It Is Safe: A Meta-analysis of Self-reported Intolerance of Uncertainty and Threat Extinction Training. BIOLOGICAL PSYCHIATRY GLOBAL OPEN SCIENCE 2021; 1:171-179. [PMID: 36325301 PMCID: PMC9616306 DOI: 10.1016/j.bpsgos.2021.05.011] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2021] [Revised: 05/28/2021] [Accepted: 05/29/2021] [Indexed: 02/07/2023] Open
Abstract
Background Intolerance of uncertainty (IU), the tendency to find uncertainty distressing, is an important transdiagnostic dimension in mental health disorders. Higher self-reported IU has been linked to poorer threat extinction training (i.e., the updating of threat to safe associations), a key process that is targeted in exposure-based therapies. However, it remains to be seen whether IU-related effects during threat extinction training are reliably and specifically driven by the IU construct or a particular subcomponent of the IU construct over other self-reported measures of anxiety. Methods A meta-analysis of studies from different laboratories (18 experiments; sample N = 1006) was conducted on associations between different variants of self-reported IU (i.e., 27-item, 12-item, inhibitory, and prospective subscales), trait anxiety, and threat extinction training via skin conductance response. The specificity of IU and threat extinction training was assessed against measures of trait anxiety. Results All the self-reported variants of IU, but not trait anxiety, were associated with threat extinction training via skin conductance response (i.e., continued responding to the old threat cue). Specificity was observed for the majority of self-reported variants of IU over trait anxiety. Conclusions The findings suggest that the IU construct broadly accounts for difficulties in threat extinction training and is specific over other measures of self-reported anxiety. These findings demonstrate the robustness and specificity of IU-related effects during threat extinction training and highlight potential opportunities for translational work to target uncertainty in therapies that rely on threat extinction principles such as exposure therapy.
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12
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Chaaya N, Wang J, Jacques A, Beecher K, Chaaya M, Battle AR, Johnson LR, Chehrehasa F, Belmer A, Bartlett SE. Contextual Fear Memory Maintenance Changes Expression of pMAPK, BDNF and IBA-1 in the Pre-limbic Cortex in a Layer-Specific Manner. Front Neural Circuits 2021; 15:660199. [PMID: 34295224 PMCID: PMC8291085 DOI: 10.3389/fncir.2021.660199] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2021] [Accepted: 06/07/2021] [Indexed: 12/30/2022] Open
Abstract
Post-traumatic stress disorder (PTSD) is a debilitating and chronic fear-based disorder. Pavlovian fear conditioning protocols have long been utilised to manipulate and study these fear-based disorders. Contextual fear conditioning (CFC) is a particular Pavlovian conditioning procedure that pairs fear with a particular context. Studies on the neural mechanisms underlying the development of contextual fear memories have identified the medial prefrontal cortex (mPFC), or more specifically, the pre-limbic cortex (PL) of the mPFC as essential for the expression of contextual fear. Despite this, little research has explored the role of the PL in contextual fear memory maintenance or examined the role of neuronal mitogen-activated protein kinase (pMAPK; ERK 1/2), brain-derived neurotrophic factor (BDNF), and IBA-1 in microglia in the PL as a function of Pavlovian fear conditioning. The current study was designed to evaluate how the maintenance of two different long-term contextual fear memories leads to changes in the number of immune-positive cells for two well-known markers of neural activity (phosphorylation of MAPK and BDNF) and microglia (IBA-1). Therefore, the current experiment is designed to assess the number of immune-positive pMAPK and BDNF cells, microglial number, and morphology in the PL following CFC. Specifically, 2 weeks following conditioning, pMAPK, BDNF, and microglia number and morphology were evaluated using well-validated antibodies and immunohistochemistry (n = 12 rats per group). A standard CFC protocol applied to rats led to increases in pMAPK, BDNF expression and microglia number as compared to control conditions. Rats in the unpaired fear conditioning (UFC) procedure, despite having equivalent levels of fear to context, did not have any change in pMAPK, BDNF expression and microglia number in the PL compared to the control conditions. These data suggest that alterations in the expression of pMAPK, BDNF, and microglia in the PL can occur for up to 2 weeks following CFC. Together the data suggest that MAPK, BDNF, and microglia within the PL of the mPFC may play a role in contextual fear memory maintenance.
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Affiliation(s)
- Nicholas Chaaya
- School of Clinical Sciences, Faculty of Health, Queensland University of Technology, Brisbane, QLD, Australia.,Translational Research Institute, Faculty of Health, Queensland University of Technology, Brisbane, QLD, Australia
| | - Joshua Wang
- School of Clinical Sciences, Faculty of Health, Queensland University of Technology, Brisbane, QLD, Australia.,Translational Research Institute, Faculty of Health, Queensland University of Technology, Brisbane, QLD, Australia
| | - Angela Jacques
- School of Clinical Sciences, Faculty of Health, Queensland University of Technology, Brisbane, QLD, Australia.,Translational Research Institute, Faculty of Health, Queensland University of Technology, Brisbane, QLD, Australia
| | - Kate Beecher
- School of Clinical Sciences, Faculty of Health, Queensland University of Technology, Brisbane, QLD, Australia.,Translational Research Institute, Faculty of Health, Queensland University of Technology, Brisbane, QLD, Australia
| | - Michael Chaaya
- School of Clinical Sciences, Faculty of Health, Queensland University of Technology, Brisbane, QLD, Australia.,Translational Research Institute, Faculty of Health, Queensland University of Technology, Brisbane, QLD, Australia
| | - Andrew Raymond Battle
- Translational Research Institute, Faculty of Health, Queensland University of Technology, Brisbane, QLD, Australia.,School of Biomedical Science, Faculty of Health, Queensland University of Technology, Brisbane, QLD, Australia.,University of Queensland Diamantina Institute, Translational Research Institute, Brisbane, QLD, Australia
| | - Luke R Johnson
- Translational Research Institute, Faculty of Health, Queensland University of Technology, Brisbane, QLD, Australia.,School of Psychology and Counselling, Faculty of Health, Queensland University of Technology, Brisbane, QLD, Australia.,Center for the Study of Traumatic Stress, Department of Psychiatry, USU School of Medicine, Bethesda, MD, United States
| | - Fatemeh Chehrehasa
- Translational Research Institute, Faculty of Health, Queensland University of Technology, Brisbane, QLD, Australia.,School of Biomedical Science, Faculty of Health, Queensland University of Technology, Brisbane, QLD, Australia
| | - Arnauld Belmer
- School of Clinical Sciences, Faculty of Health, Queensland University of Technology, Brisbane, QLD, Australia.,Translational Research Institute, Faculty of Health, Queensland University of Technology, Brisbane, QLD, Australia
| | - Selena E Bartlett
- School of Clinical Sciences, Faculty of Health, Queensland University of Technology, Brisbane, QLD, Australia.,Translational Research Institute, Faculty of Health, Queensland University of Technology, Brisbane, QLD, Australia
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13
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Waters AM, Ryan KM, Luck CC, Craske MG, Lipp OV. The effects of presenting additional stimuli resembling the CS+ during extinction on extinction retention and generalisation to novel stimuli. Behav Res Ther 2021; 144:103921. [PMID: 34214823 DOI: 10.1016/j.brat.2021.103921] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2020] [Revised: 05/27/2021] [Accepted: 06/24/2021] [Indexed: 01/04/2023]
Abstract
Recent studies have shown that extinction training including the conditional stimulus (CS+) and stimuli similar to the CS + enhances extinction retention and generalisation to novel stimuli. The aim of the present study was to confirm that these effects are specific to presenting stimuli similar to the CS+ during extinction and not merely an effect of additional trials or additional stimuli unrelated to the CS+. In an experiment conducted in a single session on the same day, participants (134 adults; 70.7% female; 17-40 years of age, M = 20.04, SD = 4.36) completed a habituation phase followed by an acquisition phase using dog images presented with (CS+) and without (CS-) a dog growl paired with a scream unconditional stimulus (US). Participants were randomly allocated to four extinction conditions: Multiple exemplar extinction comprising the CSs and two novel dog images similar to the CS+; Standard extinction control matched for the number of CS+ and CS- presentations; Extended extinction control matched for the total number extinction trials, and Other stimuli extinction control comprising the CSs and two novel stimuli unrelated to the CS+. All participants completed an extinction test with the original CSs followed by a generalisation test with two novel dog images. Multiple, Standard and Other stimuli extinction groups exhibited larger skin conductance responses (SCRs) during extinction to the CSs compared to the Extended extinction group. SCRs to the additional dog images in the Multiple group were larger than SCRs to the additional CSs in the Extended group and the novel images in the Other stimuli group. There were no group differences in responses to the CSs during extinction test. Unlike the other groups, SCRs to the first presentation of the novel generalisation dogs did not differ from those to the last CS trials in extinction in the Multiple group. However, this group difference did not persist beyond the initial generalisation trial. Finally, the Multiple, Extended, and Other stimuli groups exhibited more negative CS evaluations after extinction, extinction test, and generalisation test than the Standard extinction group. The results suggest that extinction with the original CSs and additional stimuli resembling the CS + elevated physiological responses during extinction and reduced physiological responses to novel stimuli similar to the CSs. Further studies are needed including clinical samples and trial-by-trial evaluations of the stimuli presented.
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Affiliation(s)
| | | | | | - Michelle G Craske
- Department of Psychology, University of California, Los Angeles, USA
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14
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Morriss J, Zuj DV, Mertens G. The role of intolerance of uncertainty in classical threat conditioning: Recent developments and directions for future research. Int J Psychophysiol 2021; 166:116-126. [PMID: 34097936 DOI: 10.1016/j.ijpsycho.2021.05.011] [Citation(s) in RCA: 37] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2021] [Revised: 05/14/2021] [Accepted: 05/31/2021] [Indexed: 11/25/2022]
Abstract
Intolerance of uncertainty (IU), the tendency to find uncertainty aversive, is an important transdiagnostic dimension in mental health disorders. Over the last decade, there has been a surge of research on the role of IU in classical threat conditioning procedures, which serve as analogues to the development, treatment, and relapse of anxiety, obsessive-compulsive, and trauma- and stressor-related disorders. This review provides an overview of the existing literature on IU in classical threat conditioning procedures. The review integrates findings based on the shared or discrete parameters of uncertainty embedded within classical threat conditioning procedures. Under periods of unexpected uncertainty, where threat and safety contingencies change, high IU, over other self-reported measures of anxiety, is specifically associated with poorer threat extinction learning and retention, as well as overgeneralisation. Under periods of estimation and expected uncertainty, where the parameters of uncertainty are being learned or have been learned, such as threat acquisition training and avoidance learning, the findings are mixed for IU. These findings provide evidence that individual differences in IU play a significant role in maintaining learned fear and anxiety, particularly under volatile environments. Recommendations for future research are outlined, with discussion focusing on how parameters of uncertainty can be better defined to capture how IU is involved in the maintenance of learned fear and anxiety. Such work will be crucial for understanding the role of IU in neurobiological models of uncertainty-based maintenance of fear and anxiety and inform translational work aiming to improve the diagnosis and treatment of relevant psychopathology.
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Affiliation(s)
- Jayne Morriss
- Centre for Integrative Neuroscience and Neurodynamics, School of Psychology and Clinical Language Sciences, University of Reading, Reading, UK
| | - Daniel V Zuj
- Experimental Psychopathology Lab, Department of Psychology, Swansea University, Swansea, UK
| | - Gaëtan Mertens
- Department of Medical and Clinical Psychology, Tilburg University, Tilburg, the Netherlands.
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15
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Felmingham KL, Caruana JM, Miller LN, Ney LJ, Zuj DV, Hsu CMK, Nicholson E, To A, Bryant RA. Lower estradiol predicts increased reinstatement of fear in women. Behav Res Ther 2021; 142:103875. [PMID: 34052606 DOI: 10.1016/j.brat.2021.103875] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2018] [Revised: 10/07/2020] [Accepted: 04/19/2021] [Indexed: 10/21/2022]
Abstract
Low levels of estradiol in women have been associated with impaired fear extinction recall, with suggestions this may promote the return of fear and heighten the female vulnerability for anxiety disorders. A particularly important measure for the return of fear is reinstatement, but no human studies to date have examined the impact of estradiol on fear reinstatement. Forty-two healthy females completed a differential fear conditioning, extinction and reinstatement task with skin conductance response (SCR) amplitude indexing level of conditioned fear. Saliva samples were taken to measure estradiol and progesterone. To examine fear reinstatement, SCR amplitude was compared between the last trial of the late extinction phase to the first re-extinction trial following the unsignaled presentation of two aversive electric shocks. No significant effects of estradiol were found for acquisition of fear conditioning or fear extinction learning. Lower estradiol predicted a significantly larger generalized SCR amplitude at re-extinction (post-reinstatement) in women. This provides novel evidence suggesting a protective role of estradiol in potentially reducing the relapse of fear following re-exposure to aversive stimuli, although further research is necessary in clinical populations to clarify this effect.
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Affiliation(s)
- Kim L Felmingham
- School of Psychological Sciences, University of Melbourne, Australia.
| | - Julia M Caruana
- School of Psychological Sciences, University of Melbourne, Australia
| | - Lisa N Miller
- School of Psychological Sciences, University of Melbourne, Australia
| | - Luke J Ney
- Division of Psychology, School of Medicine, University of Tasmania, Australia
| | - Daniel V Zuj
- Division of Psychology, School of Medicine, University of Tasmania, Australia; Department of Psychology, Swansea University, UK
| | - Chia Ming K Hsu
- Division of Psychology, School of Medicine, University of Tasmania, Australia
| | - Emma Nicholson
- Division of Psychology, School of Medicine, University of Tasmania, Australia
| | - Annie To
- Division of Psychology, School of Medicine, University of Tasmania, Australia
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16
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Nihei M, Hojo D, Sawa K. The renewal effect in fear conditioning with aversive facial expression and negative sentences as unconditioned stimuli. LEARNING AND MOTIVATION 2021. [DOI: 10.1016/j.lmot.2021.101725] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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17
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Wake S, Morriss J, Johnstone T, van Reekum CM, Dodd H. Intolerance of uncertainty, and not social anxiety, is associated with compromised extinction of social threat. Behav Res Ther 2021; 139:103818. [PMID: 33567362 DOI: 10.1016/j.brat.2021.103818] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2020] [Revised: 12/11/2020] [Accepted: 01/27/2021] [Indexed: 01/08/2023]
Abstract
Extinction-resistant threat is regarded as a central hallmark of pathological anxiety. However, it remains relatively under-studied in social anxiety. Here we sought to determine whether self-reported trait social anxiety is associated with compromised threat extinction learning and retention. We tested this hypothesis within two separate, socially relevant conditioning studies. In the first experiment, a Selective Extinction Through Cognitive Evaluation (SECE) paradigm was used, which included a cognitive component during the extinction phase, while experiment 2 used a traditional threat extinction paradigm. Skin conductance responses and subjective ratings of anxiety (experiment 1 and 2) and expectancy (experiment 2) were collected across both experiments. The findings of both studies demonstrated no effect of social anxiety on extinction learning or retention. Instead, results from experiment 1 indicated that individual differences in Intolerance of Uncertainty (IU) were associated with the ability to use contextual cues to decrease a conditioned response during SECE. However, during extinction retention, high IU predicted greater generalisation across context cues. Findings of experiment 2 revealed that higher IU was associated with impaired extinction learning and retention. The results from both studies suggest that compromised threat extinction is likely to be a characteristic of high levels of IU and not social anxiety.
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Affiliation(s)
- Shannon Wake
- School of Psychology and Clinical Language Sciences, University of Reading, Reading, UK.
| | - Jayne Morriss
- School of Psychology and Clinical Language Sciences, University of Reading, Reading, UK
| | - Tom Johnstone
- School of Psychology and Clinical Language Sciences, University of Reading, Reading, UK; Swinburne University of Technology, John Street, Hawthorn, Victoria, 3122, Australia
| | - Carien M van Reekum
- School of Psychology and Clinical Language Sciences, University of Reading, Reading, UK
| | - Helen Dodd
- School of Psychology and Clinical Language Sciences, University of Reading, Reading, UK.
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18
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Magson NR, Handford CM, Norberg MM. The Empirical Status of Cue Exposure and Response Prevention Treatment for Binge Eating: A Systematic Review. Behav Ther 2021; 52:442-454. [PMID: 33622512 DOI: 10.1016/j.beth.2020.06.005] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/27/2020] [Revised: 05/27/2020] [Accepted: 06/08/2020] [Indexed: 12/30/2022]
Abstract
Approximately 50% of individuals fail to obtain treatment benefits when undergoing cognitive-behavioral therapy (CBT) for binge-eating behaviors, making it necessary to evaluate additional approaches. Cue exposure and response prevention (CERP) is one such approach, although its effectiveness across studies has been inconsistent. This may be due to inconsistent implementation of theoretically based CERP strategies. This possibility has not yet been systematically investigated. To address this gap, this review investigated which CERP strategies have been incorporated into treatment protocols for binge eating, and if the use of certain strategies improves treatment effectiveness. Relevant studies were identified through reference lists, grey literature, and searches of electronic databases using multiple search terms related to CERP and binge eating, which resulted in 18 eligible studies. Most studies were underpowered, many were of low methodological quality, and none of the included studies utilized all of the strategies that have been recommended to optimize CERP. Despite these weaknesses, CERP appeared to reduce the frequency of binge eating in the short and long term. This review underscores the need for higher quality research that utilizes larger samples and uniform outcome measures that are more strongly grounded in theory. Such research would help improve treatment outcomes for binge eating.
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19
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Herring MP, Gordon BR, McDowell CP, Quinn LM, Lyons M. Physical activity and analogue anxiety disorder symptoms and status: Mediating influence of social physique anxiety. J Affect Disord 2021; 282:511-516. [PMID: 33433380 DOI: 10.1016/j.jad.2020.12.163] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/04/2020] [Revised: 10/29/2020] [Accepted: 12/23/2020] [Indexed: 12/22/2022]
Abstract
BACKGROUND Associations between physical activity (PA) and subclinical anxiety disorder symptoms and status, and potential mediating effect of social physique anxiety (SPA), remain understudied. We examined associations between PA and analogue Generalized Anxiety Disorder (AGAD), analogue Social Anxiety Disorder (ASAD), and analogue Panic Disorder (APD) symptoms and status, the mediating effect of SPA, and sex-related differences. METHODS Participants (n = 470, 23.2 ± 4.8 years, 298 female) completed the Psychiatric Diagnostic Screening Questionnaire, seven-day PA recall, and Social Physique Anxiety Scale. ANCOVA examined differences in SPA and anxiety disorder symptoms between PA levels. Logistic regression examined associations between PA and analogue anxiety disorder status. Mediation analyses estimated the effect of change in PA on analogue anxiety disorder odds when SPA was at its mean. RESULTS AGAD, ASAD, and APD prevalence was 38.1%, 60.0%, and 15.1%, respectively. AGAD and ASAD symptoms, but not APD symptoms, were significantly lower among higher PA levels. PA was associated with lower odds of AGAD, ASAD, and APD; findings were not significant after adjustment. The pure indirect effect of SPA significantly accounted for 58.2% and 47.9% of the total effect of PA on AGAD and ASAD, respectively; findings were not significant after adjusting for depression. Females showed greater odds of AGAD, ASAD, and APD; mediation findings did not differ based on gender. LIMITATIONS Cross-sectional design, self-reported exposure and outcomes, and sample size are potential limitations. CONCLUSION Symptoms and odds of AGAD and ASAD status were lower among young adults with greater PA; SPA partially mediated associations and warrants experimental investigation.
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Affiliation(s)
- Matthew P Herring
- Department of Physical Education and Sport Sciences, University of Limerick, Limerick, Ireland; Physical Activity for Health Research Cluster, Health Research Institute, University of Limerick, Limerick, Ireland.
| | - Brett R Gordon
- Department of Physical Education and Sport Sciences, University of Limerick, Limerick, Ireland; Physical Activity for Health Research Cluster, Health Research Institute, University of Limerick, Limerick, Ireland.
| | - Cillian P McDowell
- The Irish Longitudinal Study on Ageing, Trinity College Dublin, Dublin, Ireland; School of Medicine, Trinity College Dublin, Dublin, Ireland.
| | - Leanne M Quinn
- Department of Physical Education and Sport Sciences, University of Limerick, Limerick, Ireland
| | - Mark Lyons
- Department of Physical Education and Sport Sciences, University of Limerick, Limerick, Ireland.
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20
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Notaras M, van den Buuse M. Neurobiology of BDNF in fear memory, sensitivity to stress, and stress-related disorders. Mol Psychiatry 2020; 25:2251-2274. [PMID: 31900428 DOI: 10.1038/s41380-019-0639-2] [Citation(s) in RCA: 183] [Impact Index Per Article: 45.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/20/2019] [Revised: 12/01/2019] [Accepted: 12/12/2019] [Indexed: 01/17/2023]
Abstract
Brain-derived neurotrophic factor (BDNF) is widely accepted for its involvement in resilience and antidepressant drug action, is a common genetic locus of risk for mental illnesses, and remains one of the most prominently studied molecules within psychiatry. Stress, which arguably remains the "lowest common denominator" risk factor for several mental illnesses, targets BDNF in disease-implicated brain regions and circuits. Altered stress-related responses have also been observed in animal models of BDNF deficiency in vivo, and BDNF is a common downstream intermediary for environmental factors that potentiate anxiety- and depressive-like behavior. However, BDNF's broad functionality has manifested a heterogeneous literature; likely reflecting that BDNF plays a hitherto under-recognized multifactorial role as both a regulator and target of stress hormone signaling within the brain. The role of BDNF in vulnerability to stress and stress-related disorders, such as posttraumatic stress disorder (PTSD), is a prominent example where inconsistent effects have emerged across numerous models, labs, and disciplines. In the current review we provide a contemporary update on the neurobiology of BDNF including new data from the behavioral neuroscience and neuropsychiatry literature on fear memory consolidation and extinction, stress, and PTSD. First we present an overview of recent advances in knowledge on the role of BDNF within the fear circuitry, as well as address mounting evidence whereby stress hormones interact with endogenous BDNF-TrkB signaling to alter brain homeostasis. Glucocorticoid signaling also acutely recruits BDNF to enhance the expression of fear memory. We then include observations that the functional common BDNF Val66Met polymorphism modulates stress susceptibility as well as stress-related and stress-inducible neuropsychiatric endophenotypes in both man and mouse. We conclude by proposing a BDNF stress-sensitivity hypothesis, which posits that disruption of endogenous BDNF activity by common factors (such as the BDNF Val66Met variant) potentiates sensitivity to stress and, by extension, vulnerability to stress-inducible illnesses. Thus, BDNF may induce plasticity to deleteriously promote the encoding of fear and trauma but, conversely, also enable adaptive plasticity during extinction learning to suppress PTSD-like fear responses. Ergo regulators of BDNF availability, such as the Val66Met polymorphism, may orchestrate sensitivity to stress, trauma, and risk of stress-induced disorders such as PTSD. Given an increasing interest in personalized psychiatry and clinically complex cases, this model provides a framework from which to experimentally disentangle the causal actions of BDNF in stress responses, which likely interact to potentiate, produce, and impair treatment of, stress-related psychiatric disorders.
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Affiliation(s)
- Michael Notaras
- Center for Neurogenetics, Feil Family Brain and Mind Research Institute, Weill Cornell Medical College, Cornell University, New York, NY, USA.
| | - Maarten van den Buuse
- School of Psychology and Public Health, La Trobe University, Melbourne, VIC, Australia. .,College of Public Health, Medical and Veterinary Sciences, James Cook University, Townsville, QLD, Australia. .,Department of Pharmacology, University of Melbourne, Melbourne, VIC, Australia.
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21
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Neural indices of orienting, discrimination, and conflict monitoring after contextual fear and safety learning. COGNITIVE AFFECTIVE & BEHAVIORAL NEUROSCIENCE 2020; 20:917-927. [PMID: 32720204 DOI: 10.3758/s13415-020-00810-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Investigations of fear conditioning have recently begun to evaluate contextual factors that affect attention-related processes. However, much of the extant literature does not evaluate how contextual fear learning influences neural indicators of attentional processes during goal-directed activity. The current study evaluated how early attention for task-relevant stimuli and conflict monitoring were affected when presented within task-irrelevant safety and threat contexts after fear learning. Participants (N = 72) completed a Flanker task with modified context before and after context-dependent fear learning. Flanker stimuli were presented in the same threat and safety contexts utilized in the fear learning task while EEG was collected. Results indicated increased early attention (N1) to flankers appearing in threat contexts and later increased neural indicators (P2) of attention to flankers appearing in safety contexts. Results of this study indicate that contextual fear learning modulates early attentional processes for task-relevant stimuli that appear in the context of safety and threat. Theoretical and clinical implications are discussed.
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22
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Novara C, Vivet B, Raffard S. Le dégoût dans le trouble obsessionnel compulsif, mécanismes, évaluation, implications pour des pistes thérapeutiques. PRAT PSYCHOL 2020. [DOI: 10.1016/j.prps.2019.08.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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23
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Modecki KL, Murphy LK, Waters AM. Exposure to violence and neglect images differentially influences fear learning and extinction. Biol Psychol 2020; 151:107832. [PMID: 31904403 DOI: 10.1016/j.biopsycho.2019.107832] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2019] [Revised: 10/24/2019] [Accepted: 12/18/2019] [Indexed: 11/16/2022]
Abstract
The mechanisms by which exposure to adversity contributes to psychopathology development are poorly understood. Recent models link experiences of threat of harm and deprivation to psychopathology via disruptions in learning mechanisms underlying fear acquisition and extinction. We empirically tested dimensional elements of this model, by examining whether exposure to images of community violence or neglect differentially influenced fear learning and extinction relative to exposure to neutral images. Participants were randomly allocated to one of three exposure conditions: viewing images depicting neglect (n = 25), violence (n = 25) or control images (n = 24). All participants then completed a fear conditioning and extinction task in which the CS+ was paired with an aversive tone, and the CS- was presented alone during conditioning. Both CSs were presented alone during extinction and extinction retest. Skin conductance responses (SCR) and subjective ratings were assessed. Relative to control images, viewing scenes of neglect attenuated SCRs to the CSs during conditioning, extinction and extinction retest. Exposure to images of community violence accentuated SCRs during US anticipation on CS+ trials and impaired the retention of safety learning (larger SCRs to the CS+ compared to the CS- at retest and the CS+ at the end of extinction). No significant group differences emerged in subjective ratings. Findings lend preliminary support for suggestions that adverse experiences may be linked to impairments in fear and safety learning and provide key evidence suggesting that the expression of these impairments may differ as a function of the type of adversity.
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Affiliation(s)
| | - Laura K Murphy
- School of Applied Psychology, Griffith University, Australia
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24
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Noble LJ, Chuah A, Callahan KK, Souza RR, McIntyre CK. Peripheral effects of vagus nerve stimulation on anxiety and extinction of conditioned fear in rats. ACTA ACUST UNITED AC 2019; 26:245-251. [PMID: 31209119 PMCID: PMC6581007 DOI: 10.1101/lm.048447.118] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2019] [Accepted: 05/07/2019] [Indexed: 11/30/2022]
Abstract
Vagus nerve stimulation (VNS) enhances extinction of conditioned fear in rats. Previous findings support the hypothesis that VNS effects on extinction are due to enhanced consolidation of extinction memories through promotion of plasticity in extinction-related brain pathways however, alternative explanations are plausible. According to one hypothesis, VNS may produce a hedonic effect and enhance extinction through counter-conditioning. According to another hypothesis, VNS reduces anxiety during exposure and this weakens the association of conditioned stimuli with aversive conditioned responses. The present set of experiments (1) used conditioned place preference (CPP) to identify potential rewarding effects associated with VNS and (2) examined the peripheral effects of VNS on anxiety and extinction enhancement. Male Sprague–Dawley rats were surgically implanted with cuff electrodes around the vagus nerve and subjected to a CPP task in which VNS and sham stimulation were each paired with one of two distinct contexts over the course of 5 d. Following this procedure, rats did not show a place preference, suggesting that VNS is not rewarding or aversive. The role of the peripheral parasympathetic system in the anxiolytic effect of VNS on the elevated plus maze was examined by blocking peripheral muscarinic receptors with intraperitoneal administration of methyl scopolamine prior to VNS. Methyl scopolamine blocked the VNS-induced reduction in anxiety but did not interfere with VNS enhancement of extinction of conditioned fear, indicating that the anxiety-reducing effect of VNS is not necessary for the extinction enhancement.
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Affiliation(s)
- Lindsey J Noble
- School of Behavior and Brain Sciences, The University of Texas at Dallas, Richardson, Texas 75080-3021, USA.,Texas Biomedical Device Center, The University of Texas at Dallas, Richardson, Texas 75080-3021, USA
| | - Ashleigh Chuah
- School of Behavior and Brain Sciences, The University of Texas at Dallas, Richardson, Texas 75080-3021, USA
| | - Kathleen K Callahan
- School of Behavior and Brain Sciences, The University of Texas at Dallas, Richardson, Texas 75080-3021, USA
| | - Rimenez R Souza
- School of Behavior and Brain Sciences, The University of Texas at Dallas, Richardson, Texas 75080-3021, USA.,Texas Biomedical Device Center, The University of Texas at Dallas, Richardson, Texas 75080-3021, USA
| | - Christa K McIntyre
- School of Behavior and Brain Sciences, The University of Texas at Dallas, Richardson, Texas 75080-3021, USA.,Texas Biomedical Device Center, The University of Texas at Dallas, Richardson, Texas 75080-3021, USA
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25
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Levy HC, Stevens MC, Glahn DC, Pancholi K, Tolin DF. Distinct resting state functional connectivity abnormalities in hoarding disorder and major depressive disorder. J Psychiatr Res 2019; 113:108-116. [PMID: 30928618 PMCID: PMC6486431 DOI: 10.1016/j.jpsychires.2019.03.022] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/27/2018] [Revised: 02/27/2019] [Accepted: 03/21/2019] [Indexed: 02/03/2023]
Abstract
Emerging research suggests that hoarding disorder (HD) is associated with abnormal hemodynamic activity in frontal brain regions. Prior studies have not examined intrinsic network connectivity in HD during unstructured "resting state" fMRI. Furthermore, it remains unclear whether previously observed HD abnormalities might be better explained by the presence of other disorders frequently comorbid with HD, such as major depressive disorder (MDD). The current study compared resting state functional connectivity in HD-only patients (n = 17), MDD-only patients (n = 8), patients with co-occurring HD and MDD (n = 10), and healthy control participants (n = 18). Using independent component analysis, we found that HD-only patients exhibited lower functional connectivity in a "task positive" cognitive control network, compared to the other three groups. The HD group also had greater connectivity in regions of the "task negative" default mode network than did the other groups. Findings suggest that HD is associated with a unique neurobiological profile, and are discussed in terms of recent neurological and neuropsychological findings and models in HD and related disorders.
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Affiliation(s)
- Hannah C. Levy
- Anxiety Disorders Center, Institute of Living/Hartford Hospital, 200 Retreat Avenue, Hartford, CT 06106 USA,Correspondence concerning this article should be addressed to Hannah Levy, Anxiety Disorders Center, Institute of Living/Hartford Hospital, 200 Retreat Avenue, Hartford, CT 06106. Tel.: 860-545-7847. Fax: 860-545-7105.
| | - Michael C. Stevens
- Olin Neuropsychiatry Research Center, Institute of Living/Hartford Hospital, 400 Washington Street, Hartford, CT 06106 USA,Department of Psychiatry, Yale University School of Medicine, 300 George Street, New Haven, CT 06511 USA
| | - David C. Glahn
- Olin Neuropsychiatry Research Center, Institute of Living/Hartford Hospital, 400 Washington Street, Hartford, CT 06106 USA,Department of Psychiatry, Yale University School of Medicine, 300 George Street, New Haven, CT 06511 USA
| | - Krishna Pancholi
- Olin Neuropsychiatry Research Center, Institute of Living/Hartford Hospital, 400 Washington Street, Hartford, CT 06106 USA
| | - David F. Tolin
- Anxiety Disorders Center, Institute of Living/Hartford Hospital, 200 Retreat Avenue, Hartford, CT 06106 USA,Department of Psychiatry, Yale University School of Medicine, 300 George Street, New Haven, CT 06511 USA
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26
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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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27
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Noble LJ, Souza RR, McIntyre CK. Vagus nerve stimulation as a tool for enhancing extinction in exposure-based therapies. Psychopharmacology (Berl) 2019; 236:355-367. [PMID: 30091004 PMCID: PMC6368475 DOI: 10.1007/s00213-018-4994-5] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/23/2018] [Accepted: 08/01/2018] [Indexed: 02/04/2023]
Abstract
RATIONALE Emotionally traumatic experiences can lead to maladaptive memories that are enduring and intrusive. The goal of exposure-based therapies is to extinguish conditioned fears through repeated, unreinforced exposures to reminders of traumatic events. The extinction of conditioned fear depends upon the consolidation of new memories made during exposure to reminders. An impairment in extinction recall, observed in certain patient populations, can interfere with progress in exposure-based therapies, and the drive to avoid thoughts and reminders of the trauma can undermine compliance and increase dropout rate. Effective adjuncts to exposure-based therapies should improve the consolidation and maintenance of the extinction memory or improve the tolerability of the therapy. Under stressful conditions, the vagus nerve responds to elevations in epinephrine and signals the brain to facilitate the storage of new memories while, as part of the parasympathetic nervous system, it slows the sympathetic response. OBJECTIVE Here, we review studies relevant to fear extinction, describing the anatomical and functional characteristics of the vagus nerve and mechanisms of vagus nerve stimulation (VNS)-induced memory enhancement and plasticity. RESULTS We propose that stimulation of the left cervical vagus nerve during exposure to conditioned cues signals the brain to store new memories just as epinephrine or emotional arousal would do, but bypasses the peripheral sympathetic "fight-or-flight" response. CONCLUSIONS In support of this hypothesis, we have found that VNS accelerates extinction and prevents reinstatement of conditioned fear in rats. Finally, we propose future studies targeting the optimization of stimulation parameters and the search for biomarkers of VNS effectiveness that may improve exposure therapy outcomes.
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Affiliation(s)
- Lindsey J Noble
- School of Behavioral Brain Sciences, The University of Texas at Dallas, 800 West Campbell Road, Richardson, TX, 75080, USA
| | - Rimenez R Souza
- School of Behavioral Brain Sciences, The University of Texas at Dallas, 800 West Campbell Road, Richardson, TX, 75080, USA
| | - Christa K McIntyre
- School of Behavioral Brain Sciences, The University of Texas at Dallas, 800 West Campbell Road, Richardson, TX, 75080, USA.
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28
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Goode TD, Maren S. Common neurocircuitry mediating drug and fear relapse in preclinical models. Psychopharmacology (Berl) 2019; 236:415-437. [PMID: 30255379 PMCID: PMC6373193 DOI: 10.1007/s00213-018-5024-3] [Citation(s) in RCA: 47] [Impact Index Per Article: 9.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/13/2018] [Accepted: 09/03/2018] [Indexed: 12/21/2022]
Abstract
BACKGROUND Comorbidity of anxiety disorders, stressor- and trauma-related disorders, and substance use disorders is extremely common. Moreover, therapies that reduce pathological fear and anxiety on the one hand, and drug-seeking on the other, often prove short-lived and are susceptible to relapse. Considerable advances have been made in the study of the neurobiology of both aversive and appetitive extinction, and this work reveals shared neural circuits that contribute to both the suppression and relapse of conditioned responses associated with trauma or drug use. OBJECTIVES The goal of this review is to identify common neural circuits and mechanisms underlying relapse across domains of addiction biology and aversive learning in preclinical animal models. We focus primarily on neural circuits engaged during the expression of relapse. KEY FINDINGS After extinction, brain circuits involving the medial prefrontal cortex and hippocampus come to regulate the expression of conditioned responses by the amygdala, bed nucleus of the stria terminalis, and nucleus accumbens. During relapse, hippocampal projections to the prefrontal cortex inhibit the retrieval of extinction memories resulting in a loss of inhibitory control over fear- and drug-associated conditional responding. CONCLUSIONS The overlapping brain systems for both fear and drug memories may explain the co-occurrence of fear and drug-seeking behaviors.
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Affiliation(s)
- Travis D Goode
- Department of Psychological and Brain Sciences and Institute for Neuroscience, Texas A&M University, 301 Old Main Dr., College Station, TX, 77843-3474, USA
| | - Stephen Maren
- Department of Psychological and Brain Sciences and Institute for Neuroscience, Texas A&M University, 301 Old Main Dr., College Station, TX, 77843-3474, USA.
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29
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Chaaya N, Jacques A, Belmer A, Richard DJ, Bartlett SE, Battle AR, Johnson LR. Localization of Contextual and Context Removed Auditory Fear Memory within the Basolateral Amygdala Complex. Neuroscience 2018; 398:231-251. [PMID: 30552931 DOI: 10.1016/j.neuroscience.2018.12.004] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2018] [Revised: 11/30/2018] [Accepted: 12/03/2018] [Indexed: 01/20/2023]
Abstract
Debilitating and persistent fear memories can rapidly form in humans following exposure to traumatic events. Fear memories can also be generated and studied in animals via Pavlovian fear conditioning. The current study was designed to evaluate basolateral amygdala complex (BLC) involvement following the formation of different fear memories (two contextual fear memories and one adjusted auditory fear memory). Fear memories were created in the same context with five 1.0 mA (0.50 s) foot-shocks and, where necessary, five auditory tones (5 kHz, 75 dB, 20 s). The adjusted auditory fear conditioning protocol was employed to remove background contextual fear and produce isolated auditory fear memories. Immunofluorescent labeling was utilized to identify neurons expressing immediate early genes (IEGs). We found the two contextual fear conditioning (CFC) procedures to produce similar levels of fear-related freezing to context. Contextual fear memories produced increases in BLC IEG expression with distinct and separate patterns of expression. These data suggest contextual fear memories created in slightly altered contexts, can produce unique patterns of amygdala activation. The adjusted auditory fear conditioning procedure produced memories to a tone, but not to a context. This group, where no contextual fear was present, had a significant reduction in BLC IEG expression. These data suggest background contextual fear memories, created in standard auditory fear conditioning protocols, contribute significantly to increases in amygdala activation.
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Affiliation(s)
- N Chaaya
- School of Psychology and Counselling, Queensland University of Technology, Brisbane, Australia; Institute of Health and Biomedical Innovation, Queensland University of Technology at Translational Research Institute, Brisbane, Australia
| | - A Jacques
- School of Psychology and Counselling, Queensland University of Technology, Brisbane, Australia; Institute of Health and Biomedical Innovation, Queensland University of Technology at Translational Research Institute, Brisbane, Australia
| | - A Belmer
- Institute of Health and Biomedical Innovation, Queensland University of Technology at Translational Research Institute, Brisbane, Australia; School of Clinical Sciences, Queensland University of Technology, Brisbane, Australia
| | - D J Richard
- Institute of Health and Biomedical Innovation, Queensland University of Technology at Translational Research Institute, Brisbane, Australia; School of Biomedical Science, Queensland University of Technology, Brisbane, Australia
| | - S E Bartlett
- Institute of Health and Biomedical Innovation, Queensland University of Technology at Translational Research Institute, Brisbane, Australia; School of Clinical Sciences, Queensland University of Technology, Brisbane, Australia
| | - A R Battle
- Institute of Health and Biomedical Innovation, Queensland University of Technology at Translational Research Institute, Brisbane, Australia; School of Biomedical Science, Queensland University of Technology, Brisbane, Australia; The University of Queensland Diamantina Institute, Brisbane, QLD 4102, Australia
| | - L R Johnson
- School of Psychology and Counselling, Queensland University of Technology, Brisbane, Australia; Institute of Health and Biomedical Innovation, Queensland University of Technology at Translational Research Institute, Brisbane, Australia; Center for the Study of Traumatic Stress, Department of Psychiatry, USU School of Medicine, Bethesda, MD, USA.
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30
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Ryan KM, Zimmer-Gembeck MJ, Neumann DL, Waters AM. The need for standards in the design of differential fear conditioning and extinction experiments in youth: A systematic review and recommendations for research on anxiety. Behav Res Ther 2018; 112:42-62. [PMID: 30502721 DOI: 10.1016/j.brat.2018.11.009] [Citation(s) in RCA: 31] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2017] [Revised: 10/27/2018] [Accepted: 11/19/2018] [Indexed: 10/27/2022]
Abstract
Fear extinction studies in youth have yielded mixed results due to developmental processes and variations in design, methodology and dependent measures. This systematic review focused on studies with healthy youth between 2 and 17 years of age to identify experimental parameters of studies documenting extinction effects. Thirty-five studies met inclusion criteria and the following themes emerged (a) some studies employed parameters and task demands that are complex and require active participant involvement whereas others involved simple stimulus configurations and passive participant involvement, and (b) variation exists among dependent measures in units of measurement, timing and type of measurement. The review identified that studies using geometric shape conditioned stimuli (CS) paired with a tone unconditioned stimulus (US) (e.g., metal scraping on slate), as well as face CSs with a scream US produced the most reliable extinction effects, although the latter combination may be associated with higher drop-out than shape CSs and a tone US. The most commonly used and effective dependent measures for revealing extinction effects were skin conductance responses (SCR) and subjective ratings (SR) of CS valence, fearfulness and arousal. Fear potentiated startle (FPS) blink reflexes were also an effective but less commonly used measure. It is recommended that future studies use shape CSs and the metal scraping on slate US in studies involving children and either shape CSs and the metal scraping on slate US or face CSs paired with a scream US with adolescents. It is also recommended that US expectancy ratings and CS evaluations are assessed trial-by-trial and between-phase, and that startle-eliciting stimuli to measure startle blink reflexes are delivered on every second trial per CS so that SCR and FPS can be examined. However, further research is required to determine whether increased participant involvement due to providing trial-by-trial and between-phase ratings of the CSs and US differentially influences responding, particularly in children relative to adolescents and adults.
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Affiliation(s)
| | | | - David L Neumann
- School of Applied Psychology, Griffith University, Australia
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31
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Abstract
Several studies have revealed that fear recovery is prevented when extinction training is conducted after retrieval of a fear memory. Postretrieval extinction training is related to modification of memory during reconsolidation. Providing new information during reconsolidation can modify the original memory. We propose that avoidance behavior is a relevant factor that prevents subjects from obtaining new safety information during reconsolidation. Postretrieval extinction training without avoidance behavior reduced the fear response to conditioned stimulus and prevented spontaneous recovery in the current study, which corresponded with previous studies. Under the condition of postretrieval extinction training with avoidance behavior, the fear response was not reduced as much as it was in the condition without avoidance. It is possible that avoidance behavior prevents receiving new safety information during postretrieval extinction training.
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32
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Yuan J, Yan M, Xu Y, Chen W, Wang X. Social Company Disrupts Fear Memory Renewal: Evidence From Two Rodent Studies. Front Neurosci 2018; 12:565. [PMID: 30174582 PMCID: PMC6107706 DOI: 10.3389/fnins.2018.00565] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2018] [Accepted: 07/27/2018] [Indexed: 11/13/2022] Open
Abstract
Renewal of fear outside treatment context is a challenge for behavioral therapies. Prior studies suggest a social buffering effect that fear response is attenuated in the presence of social company. However, few studies have examined the role of social company in reducing fear renewal. Here, we used a Pavlovian fear conditioning procedure including acquisition, extinction and test stages to examine social buffering effect on fear memory renewal in male rats. The test context was manipulated to be either different from the extinction one in ABC model, or same as that in ACC model. All conditioned subjects underwent extinction individually in Experiment 1 but with a partner in Experiment 2. In test, both experiments manipulated social company (alone vs. accompanied) and context (ABC vs. ACC). Experiment 1 showed more freezing in ABC than in ACC model during the test-alone condition, indicating a fear renewal effect which, however, was absent during the test-accompanied condition. Also, accompanied subjects showed less freezing compared to alone subjects in the ABC model. In Experiment 2, animals showed a similar freezing in ABC and ACC models despite being tested alone, implying that social company offered at extinction disrupted fear renewal. Again, we observed reduced freezing in accompanied relative to alone subjects in the test. These results suggest that social company is effective in disrupting fear renewal after leaving treatment context.
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Affiliation(s)
- Jiajin Yuan
- College of Education Science, Chengdu University, Chengdu, China.,Key Laboratory of Cognition and Personality of Ministry of Education, Faculty of Psychology, Southwest University, Chongqing, China
| | - Minmin Yan
- Key Laboratory of Cognition and Personality of Ministry of Education, Faculty of Psychology, Southwest University, Chongqing, China
| | - Yin Xu
- School of Sociology, China University of Political Science and Law, Beijing, China
| | - Weihai Chen
- Key Laboratory of Cognition and Personality of Ministry of Education, Faculty of Psychology, Southwest University, Chongqing, China
| | - Xiaqing Wang
- Key Laboratory of Cognition and Personality of Ministry of Education, Faculty of Psychology, Southwest University, Chongqing, China
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33
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Kang S, Vervliet B, Engelhard IM, van Dis EA, Hagenaars MA. Reduced return of threat expectancy after counterconditioning versus extinction. Behav Res Ther 2018; 108:78-84. [DOI: 10.1016/j.brat.2018.06.009] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2018] [Revised: 05/10/2018] [Accepted: 06/25/2018] [Indexed: 10/28/2022]
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34
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Chaaya N, Battle AR, Johnson LR. An update on contextual fear memory mechanisms: Transition between Amygdala and Hippocampus. Neurosci Biobehav Rev 2018; 92:43-54. [DOI: 10.1016/j.neubiorev.2018.05.013] [Citation(s) in RCA: 53] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2017] [Revised: 03/02/2018] [Accepted: 05/08/2018] [Indexed: 12/27/2022]
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35
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Krisch KA, Bandarian-Balooch S, Neumann DL. Effects of extended extinction and multiple extinction contexts on ABA renewal. LEARNING AND MOTIVATION 2018. [DOI: 10.1016/j.lmot.2017.11.001] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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36
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Absence of fear renewal and functional connections between prefrontal cortex and hippocampus in infant mice. Neurobiol Learn Mem 2018; 152:1-9. [DOI: 10.1016/j.nlm.2018.04.011] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2017] [Revised: 03/31/2018] [Accepted: 04/18/2018] [Indexed: 11/21/2022]
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37
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McIntyre CK. Is there a role for vagus nerve stimulation in the treatment of posttraumatic stress disorder? ACTA ACUST UNITED AC 2018. [DOI: 10.2217/bem-2018-0002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Affiliation(s)
- Christa K McIntyre
- Associate Professor of Cognition and Neuroscience, School of Behavioral and Brain Sciences, The University of Texas at Dallas, Richardson, TX 75080, USA
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38
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O'Malley KR, Waters AM. Attention avoidance of the threat conditioned stimulus during extinction increases physiological arousal generalisation and retention. Behav Res Ther 2018; 104:51-61. [DOI: 10.1016/j.brat.2018.03.001] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2017] [Revised: 03/01/2018] [Accepted: 03/05/2018] [Indexed: 11/26/2022]
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39
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Gong Z, Zhou Q. Dnmt3a in the dorsal dentate gyrus is a key regulator of fear renewal. Sci Rep 2018; 8:5093. [PMID: 29572461 PMCID: PMC5865109 DOI: 10.1038/s41598-018-23533-w] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2018] [Accepted: 03/14/2018] [Indexed: 12/13/2022] Open
Abstract
Renewal of extinguished fear memory in an altered context is widely believed to be a major limiting issue for exposure therapy in treating various psychiatric diseases. Effective prevention of fear renewal will significantly improve the efficacy of exposure therapy. DNA methyltransferase (DNMTs) mediated epigenetic processes play critical roles in long term memory, but little is known about their functions in fear memory extinction or renewal. Here we investigated whether DNMTs regulate fear renewal after extinction. We found that elevated Dnmt3a level in the dorsal dentate gyrus (dDG) of hippocampus was associated with the absence of fear renewal in an altered context after extinction training. Overexpression and knockdown of Dnmt3a in the dDG regulated the occurrence of fear renewal in a bi-directional manner. In addition, Dnmt3a overexpression was associated with elevated expression of c-Fos in the dDG during extinction training. Furthermore, we found that renewal of remote fear memory can be prevented, and the absence of renewal was concurrent with an elevated Dnmt3a level. Our results indicate that Dnmt3a in the dDG is a key regulator of fear renewal after extinction, and Dnmt3a may play a critical role in controlling fear memory return and thus has therapeutic values.
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Affiliation(s)
- Zhiting Gong
- School of Chemical Biology and Biotechnology, Peking University Shenzhen Graduate School, Shenzhen, China
| | - Qiang Zhou
- School of Chemical Biology and Biotechnology, Peking University Shenzhen Graduate School, Shenzhen, China.
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40
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Merz CJ, Hamacher-Dang TC, Stark R, Wolf OT, Hermann A. Neural Underpinnings of Cortisol Effects on Fear Extinction. Neuropsychopharmacology 2018; 43:384-392. [PMID: 28948980 PMCID: PMC5729571 DOI: 10.1038/npp.2017.227] [Citation(s) in RCA: 59] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/09/2017] [Revised: 08/02/2017] [Accepted: 09/18/2017] [Indexed: 12/26/2022]
Abstract
Extinction of conditioned fear embodies a crucial mechanism incorporated in exposure therapy. Clinical studies demonstrated that application of the stress hormone cortisol before exposure sessions facilitates exposure success, but the underlying neural correlates remain unknown. Context- and stimulus-dependent cortisol effects on extinction learning will be characterized in this study and tested in the extinction and in a new context. Forty healthy men participated in a 3-day fear conditioning experiment with fear acquisition in context A (day 1), extinction training in context B (day 2), and recall in context B and a new context C one week later (day 3). Hydrocortisone (30 mg) or placebo was given before extinction training. Blood-oxygen-level-dependent responses and skin conductance responses (SCRs) served as dependent measures. At the beginning of extinction training, cortisol reduced conditioned SCRs, diminished activation of the amygdala-hippocampal complex, and enhanced functional connectivity of the anterior parahippocampal gyrus with the ventromedial prefrontal cortex (vmPFC). After one week, the cortisol group showed increased hippocampal activation and connectivity to the vmPFC toward an extinguished stimulus and reduced insula activation toward a nonextinguished stimulus in the extinction context. However, this inhibitory cortisol effect did not extend to the new context. Taken together, cortisol reduced fear recall at the beginning of extinction and facilitated the consolidation of the extinction memory as evidenced by an inhibitory activation pattern one week later. The stress hormone exerted a critical impact on the amygdala-hippocampus-vmPFC network underlying fear and extinction memories. However, cortisol did not attenuate the context dependency of extinction.
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Affiliation(s)
- Christian Josef Merz
- Institute of Cognitive Neuroscience, Department of Cognitive Psychology, Ruhr-University Bochum, Bochum, Germany,Institute of Cognitive Neuroscience, Department of Cognitive Psychology, Ruhr-University Bochum, Universitätsstraße 150, 44780 Bochum, Germany, Tel: +49 234 3224498, Fax: +49 234 14308, E-mail:
| | | | - Rudolf Stark
- Department of Psychotherapy and Systems Neuroscience, Justus Liebig University Giessen, Giessen, Germany,Bender Institute of Neuroimaging, Justus Liebig University Giessen, Giessen, Germany
| | - Oliver Tobias Wolf
- Institute of Cognitive Neuroscience, Department of Cognitive Psychology, Ruhr-University Bochum, Bochum, Germany
| | - Andrea Hermann
- Department of Psychotherapy and Systems Neuroscience, Justus Liebig University Giessen, Giessen, Germany,Bender Institute of Neuroimaging, Justus Liebig University Giessen, Giessen, Germany
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41
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Howley J, Waters AM. Overt verbalization of strategies to attend to and retain learning about the threat conditioned stimulus reduces US expectancy generalization during extinction. LEARNING AND MOTIVATION 2017. [DOI: 10.1016/j.lmot.2017.05.013] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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42
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Bouchet CA, Lloyd BA, Loetz EC, Farmer CE, Ostrovskyy M, Haddad N, Foright RM, Greenwood BN. Acute exercise enhances the consolidation of fear extinction memory and reduces conditioned fear relapse in a sex-dependent manner. ACTA ACUST UNITED AC 2017; 24:358-368. [PMID: 28716955 PMCID: PMC5516683 DOI: 10.1101/lm.045195.117] [Citation(s) in RCA: 31] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2017] [Accepted: 05/08/2017] [Indexed: 11/25/2022]
Abstract
Fear extinction-based exposure therapy is the most common behavioral therapy for anxiety and trauma-related disorders, but fear extinction memories are labile and fear tends to return even after successful extinction. The relapse of fear contributes to the poor long-term efficacy of exposure therapy. A single session of voluntary exercise can enhance the acquisition and consolidation of fear extinction in male rats, but the effects of exercise on relapse of fear after extinction are not well understood. Here, we characterized the effects of 2 h of voluntary exercise during the consolidation phase of contextual or auditory fear extinction learning on long-term fear extinction memory and renewal in adult, male and female, Long-Evans rats. Results indicate that exercise enhances consolidation of fear extinction memory and reduces fear relapse after extinction in a sex-dependent manner. These data suggest that brief bouts of exercise could be used as an augmentation strategy for exposure therapy, even in previously sedentary subjects. Fear memories of discrete cues, rather than of contextual ones, may be most susceptible to exercise-augmented extinction, especially in males. Additionally, exercise seems to have the biggest impact on fear relapse phenomena, even if fear extinction memories themselves are only minimally enhanced.
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Affiliation(s)
- Courtney A Bouchet
- Department of Psychology, University of Colorado Denver, Denver, Colorado 80217, USA
| | - Brian A Lloyd
- Department of Psychology, University of Colorado Denver, Denver, Colorado 80217, USA
| | - Esteban C Loetz
- Department of Psychology, University of Colorado Denver, Denver, Colorado 80217, USA
| | - Caroline E Farmer
- Department of Psychology, University of Colorado Denver, Denver, Colorado 80217, USA
| | - Mykola Ostrovskyy
- Department of Psychology, University of Colorado Denver, Denver, Colorado 80217, USA
| | - Natalie Haddad
- Department of Psychology, University of Colorado Denver, Denver, Colorado 80217, USA
| | - Rebecca M Foright
- Division of Endocrinology, Metabolism, and Diabetes, Department of Medicine, University of Colorado Anschutz Medical Campus, Aurora, Colorado 80045, USA
| | - Benjamin N Greenwood
- Department of Psychology, University of Colorado Denver, Denver, Colorado 80217, USA
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White AJ, Kleinböhl D, Lang T, Hamm AO, Gerlach AL, Alpers GW. Identifying Patterns in Complex Field Data. ZEITSCHRIFT FUR PSYCHOLOGIE-JOURNAL OF PSYCHOLOGY 2017. [DOI: 10.1027/2151-2604/a000310] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Abstract. Ambulatory assessment methods are well suited to examine how patients with panic disorder and agoraphobia (PD/A) undertake situational exposure. But under complex field conditions of a complex treatment protocol, the variability of data can be so high that conventional analytic approaches based on group averages inadequately describe individual variability. To understand how fear responses change throughout exposure, we aimed to demonstrate the incremental value of sorting HR responses (an index of fear) prior to applying averaging procedures. As part of their panic treatment, 85 patients with PD/A completed a total of 233 bus exposure exercises. Heart rate (HR), global positioning system (GPS) location, and self-report data were collected. Patients were randomized to one of two active treatment conditions (standard exposure or fear-augmented exposure) and completed multiple exposures in four consecutive exposure sessions. We used latent class cluster analysis (CA) to cluster heart rate (HR) responses collected at the start of bus exposure exercises (5 min long, centered on bus boarding). Intra-individual patterns of assignment across exposure repetitions were examined to explore the relative influence of individual and situational factors on HR responses. The association between response types and panic disorder symptoms was determined by examining how clusters were related to self-reported anxiety, concordance between HR and self-report measures, and bodily symptom tolerance. These analyses were contrasted with a conventional analysis based on averages across experimental conditions. HR responses were sorted according to form and level criteria and yielded nine clusters, seven of which were interpretable. Cluster assignment was not stable across sessions or treatment condition. Clusters characterized by a low absolute HR level that slowly decayed corresponded with low self-reported anxiety and greater self-rated tolerance of bodily symptoms. Inconsistent individual factors influenced HR responses less than situational factors. Applying clustering can help to extend the conventional analysis of highly variable data collected in the field. We discuss the merits of this approach and reasons for the non-stereotypical pattern of cluster assignment across exposures.
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Affiliation(s)
- Andrew J. White
- Department of Psychology, School of Social Sciences, University of Mannheim, Germany
| | - Dieter Kleinböhl
- Otto Selz Institute for Applied Psychology – Mannheim Centre for Work and Health, University of Mannheim, Germany
| | - Thomas Lang
- Christoph-Dornier Foundation for Clinical Psychology, Bremen, Germany
- Department of Clinical Psychology and Psychotherapy, University of Hamburg, Germany
| | - Alfons O. Hamm
- Department of Psychology, University of Greifswald, Germany
| | | | - Georg W. Alpers
- Department of Psychology, School of Social Sciences, University of Mannheim, Germany
- Otto Selz Institute for Applied Psychology – Mannheim Centre for Work and Health, University of Mannheim, Germany
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Hermann A, Stark R, Blecker CR, Milad MR, Merz CJ. Brain structural connectivity and context-dependent extinction memory. Hippocampus 2017; 27:883-889. [PMID: 28498605 DOI: 10.1002/hipo.22738] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2016] [Revised: 04/20/2017] [Accepted: 05/02/2017] [Indexed: 02/04/2023]
Abstract
BACKGROUND Extinction of conditioned fear represents an important mechanism in the treatment of anxiety disorders. Return of fear after successful extinction or exposure therapy in patients with anxiety disorders might be linked to poor temporal or contextual generalization of extinction due to individual differences in brain structural connectivity. The goal of this magnetic resonance imaging study was therefore to investigate the association of context-dependent extinction recall with brain structural connectivity. METHODS Diffusion-tensor imaging was used to determine the fractional anisotropy as a measure of white matter structural integrity of fiber tracts connecting central brain regions of the fear and extinction circuit (uncinate fasciculus, cingulum). Forty-five healthy men participated in a two-day fear conditioning experiment with fear acquisition in context A and extinction learning in context B on the first day. Extinction recall in the extinction context as well as renewal in the acquisition context and a novel context C took place one day later. RESULTS Renewal of conditioned fear (skin conductance responses) in the acquisition context was associated with higher structural integrity of the hippocampal part of the cingulum. CONCLUSIONS Enhanced structural integrity of the cingulum might be related to stronger hippocampal modulation of the dorsal anterior cingulate cortex, a region important for modulating conditioned fear output by excitatory projections to the amygdala. This finding underpins the crucial role of individual differences in the structural integrity of relevant fiber tracts for context-dependent extinction recall and return of fear after exposure therapy in anxiety disorders.
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Affiliation(s)
- Andrea Hermann
- Department of Psychotherapy and Systems Neuroscience, Justus Liebig University Giessen, Giessen, Germany.,Bender Institute of Neuroimaging, Justus Liebig University Giessen, Giessen, Germany
| | - Rudolf Stark
- Department of Psychotherapy and Systems Neuroscience, Justus Liebig University Giessen, Giessen, Germany.,Bender Institute of Neuroimaging, Justus Liebig University Giessen, Giessen, Germany
| | - Carlo R Blecker
- Bender Institute of Neuroimaging, Justus Liebig University Giessen, Giessen, Germany
| | - Mohammed R Milad
- Department of Psychiatry, Massachusetts General Hospital and Harvard Medical School, Charlestown, Massachusetts
| | - Christian J Merz
- Institute of Cognitive Neuroscience, Department of Cognitive Psychology, Ruhr-University Bochum, Bochum, Germany
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LaLumiere RT, McGaugh JL, McIntyre CK. Emotional Modulation of Learning and Memory: Pharmacological Implications. Pharmacol Rev 2017; 69:236-255. [PMID: 28420719 DOI: 10.1124/pr.116.013474] [Citation(s) in RCA: 47] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2016] [Accepted: 03/03/2017] [Indexed: 01/06/2023] Open
Abstract
Memory consolidation involves the process by which newly acquired information becomes stored in a long-lasting fashion. Evidence acquired over the past several decades, especially from studies using post-training drug administration, indicates that emotional arousal during the consolidation period influences and enhances the strength of the memory and that multiple different chemical signaling systems participate in this process. The mechanisms underlying the emotional influences on memory involve the release of stress hormones and activation of the basolateral amygdala, which work together to modulate memory consolidation. Moreover, work suggests that this amygdala-based memory modulation occurs with numerous types of learning and involves interactions with many different brain regions to alter consolidation. Additionally, studies suggest that emotional arousal and amygdala activity in particular influence synaptic plasticity and associated proteins in downstream brain regions. This review considers the historical understanding for memory modulation and cellular consolidation processes and examines several research areas currently using this foundational knowledge to develop therapeutic treatments.
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Affiliation(s)
- Ryan T LaLumiere
- Department of Psychological and Brain Sciences and Interdisciplinary Neuroscience Program, University of Iowa, Iowa City, Iowa (R.T.L.); Department of Neurobiology and Behavior, University of California, Irvine, California (J.L.M.); and School of Behavioral and Brain Sciences, University of Texas-Dallas, Richardson, Texas (C.K.M.)
| | - James L McGaugh
- Department of Psychological and Brain Sciences and Interdisciplinary Neuroscience Program, University of Iowa, Iowa City, Iowa (R.T.L.); Department of Neurobiology and Behavior, University of California, Irvine, California (J.L.M.); and School of Behavioral and Brain Sciences, University of Texas-Dallas, Richardson, Texas (C.K.M.)
| | - Christa K McIntyre
- Department of Psychological and Brain Sciences and Interdisciplinary Neuroscience Program, University of Iowa, Iowa City, Iowa (R.T.L.); Department of Neurobiology and Behavior, University of California, Irvine, California (J.L.M.); and School of Behavioral and Brain Sciences, University of Texas-Dallas, Richardson, Texas (C.K.M.)
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Waters AM, Theresiana C, Neumann DL, Craske MG. Developmental differences in aversive conditioning, extinction, and reinstatement: A study with children, adolescents, and adults. J Exp Child Psychol 2017; 159:263-278. [PMID: 28347936 DOI: 10.1016/j.jecp.2017.02.012] [Citation(s) in RCA: 36] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2016] [Revised: 02/21/2017] [Accepted: 02/24/2017] [Indexed: 01/21/2023]
Abstract
This study investigated developmental differences in aversive conditioning, extinction, and reinstatement (i.e., the recovery of conditioned aversive associations following reexposure to the unconditioned stimulus [US] post-extinction). This study examined these mechanisms in children (Mage=8.8years), adolescents (Mage=16.1years), and adults (Mage=32.3years) using differential aversive conditioning with a geometric shape conditional stimulus (CS+) paired with an aversive sound US and another shape (CS-) presented alone. Following an extinction phase in which both CSs were presented alone, half of the participants in each age group received three US exposures (reinstatement condition) and the other half did not (control condition), followed by all participants completing an extinction retest phase on the same day. Findings indicated (a) significant differences in generalizing aversive expectancies to safe stimuli during conditioning and extinction that persisted during retest in children relative to adults and adolescents, (b) significantly less positive CS reevaluations during extinction that persisted during retest in adolescents relative to adults and children, and (c) reinstatement of US expectancies to the CS+ relative to the CS- in all age groups. Results suggest important differences in stimulus safety learning in children and stimulus valence reevaluation in adolescents relative to adults.
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Affiliation(s)
- Allison M Waters
- School of Applied Psychology, Griffith University, Mt. Gravatt, Queensland 4122, Australia.
| | - Cindy Theresiana
- School of Applied Psychology, Griffith University, Mt. Gravatt, Queensland 4122, Australia
| | - David L Neumann
- School of Applied Psychology, Griffith University, Mt. Gravatt, Queensland 4122, Australia
| | - Michelle G Craske
- Department of Psychology, University of California, Los Angeles, Los Angeles, CA 90095, USA
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47
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Kuhn M, Mertens G, Lonsdorf TB. State anxiety modulates the return of fear. Int J Psychophysiol 2016; 110:194-199. [DOI: 10.1016/j.ijpsycho.2016.08.001] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2016] [Revised: 07/22/2016] [Accepted: 08/01/2016] [Indexed: 12/12/2022]
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48
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Enhancing dopaminergic signaling and histone acetylation promotes long-term rescue of deficient fear extinction. Transl Psychiatry 2016; 6:e974. [PMID: 27922638 PMCID: PMC5315560 DOI: 10.1038/tp.2016.231] [Citation(s) in RCA: 42] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/26/2016] [Revised: 08/17/2016] [Accepted: 08/18/2016] [Indexed: 01/04/2023] Open
Abstract
Extinction-based exposure therapy is used to treat anxiety- and trauma-related disorders; however, there is the need to improve its limited efficacy in individuals with impaired fear extinction learning and to promote greater protection against return-of-fear phenomena. Here, using 129S1/SvImJ mice, which display impaired fear extinction acquisition and extinction consolidation, we revealed that persistent and context-independent rescue of deficient fear extinction in these mice was associated with enhanced expression of dopamine-related genes, such as dopamine D1 (Drd1a) and -D2 (Drd2) receptor genes in the medial prefrontal cortex (mPFC) and amygdala, but not hippocampus. Moreover, enhanced histone acetylation was observed in the promoter of the extinction-regulated Drd2 gene in the mPFC, revealing a potential gene-regulatory mechanism. Although enhancing histone acetylation, via administering the histone deacetylase (HDAC) inhibitor MS-275, does not induce fear reduction during extinction training, it promoted enduring and context-independent rescue of deficient fear extinction consolidation/retrieval once extinction learning was initiated as shown following a mild conditioning protocol. This was associated with enhanced histone acetylation in neurons of the mPFC and amygdala. Finally, as a proof-of-principle, mimicking enhanced dopaminergic signaling by L-dopa treatment rescued deficient fear extinction and co-administration of MS-275 rendered this effect enduring and context-independent. In summary, current data reveal that combining dopaminergic and epigenetic mechanisms is a promising strategy to improve exposure-based behavior therapy in extinction-impaired individuals by initiating the formation of an enduring and context-independent fear-inhibitory memory.
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Hermann A, Stark R, Milad MR, Merz CJ. Renewal of conditioned fear in a novel context is associated with hippocampal activation and connectivity. Soc Cogn Affect Neurosci 2016; 11:1411-21. [PMID: 27053767 PMCID: PMC5015796 DOI: 10.1093/scan/nsw047] [Citation(s) in RCA: 54] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2015] [Revised: 01/12/2016] [Accepted: 03/31/2016] [Indexed: 01/14/2023] Open
Abstract
Return of fear is a serious problem in exposure-based treatments of anxiety disorders. Renewal of the fear response may occur when re-encountering the conditioned stimulus within a novel context. Findings in rodents underpin the hippocampus' role in conditioned fear renewal in novel contexts, but it has yet to be investigated in humans. Forty-six healthy men took part in a 2-day, context-dependent, cued fear conditioning paradigm with fear acquisition, extinction learning (day 1) and extinction recall in the acquisition, extinction and a novel context one day later. Conditioned evaluative, skin conductance responses (SCRs) and blood-oxygen-level-dependent responses served as dependent variables. Context-dependent fear renewal was reflected in stronger conditioned SCRs. In the acquisition context, individuals with a higher renewal of conditioned SCRs showed stronger activation of the fear circuit. Hippocampal activation distinguished conditioned responding in the novel compared with the extinction context. Individuals with a stronger renewal of conditioned SCRs in the novel context showed increased effective connectivity of hippocampal activation foci with structures in the fear and extinction network. These results outline the pivotal role of the hippocampus and its connectivity in conditioned fear renewal in a novel context in humans and might have important implications for exposure therapy in anxiety disorders.
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Affiliation(s)
- A Hermann
- Department of Psychotherapy and Systems Neuroscience and Bender Institute of Neuroimaging, Justus Liebig University Giessen, Germany
| | - R Stark
- Department of Psychotherapy and Systems Neuroscience and Bender Institute of Neuroimaging, Justus Liebig University Giessen, Germany
| | - M R Milad
- Department of Psychiatry, Massachusetts General Hospital and Harvard Medical School, Charlestown, MA, USA
| | - C J Merz
- Institute of Cognitive Neuroscience, Department of Cognitive Psychology, Ruhr-University Bochum, Germany Department of Biological and Clinical Psychology, University of Trier, Germany
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Laborda MA, Schofield CA, Johnson EM, Schubert JR, George-Denn D, Coles ME, Miller RR. The Extinction and Return of Fear of Public Speaking. Behav Modif 2016; 40:901-921. [DOI: 10.1177/0145445516645766] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Prior studies indicate extinguished fear often partially returns when participants are later tested outside the extinction context. Cues carried from the extinction context to the test context sometimes reduce return of fear, but it is unclear whether such extinction cues (ECs) reduce return of fear of public speaking. Here we assessed return of fear of public speaking, and whether either of two types of ECs can attenuate it. Participants gave speeches of increasing difficulty during an exposure practice session and were tested 2 days later in a different context. Testing occurred in the presence of physical ECs, after mentally rehearsing the exposure session, or without either reminder. Practice reduced fear of public speaking, but fear partially returned at test. Neither physical nor mental ECs reduced partial return of fear of public speaking. The return of extinguished fear of public speaking, although small, was reliable, but not appreciably sensitive to presence of ECs.
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Affiliation(s)
| | - Casey A. Schofield
- Binghamton University, NY, USA
- Skidmore College, Saratoga Springs, NY, USA
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