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Seligowski AV, Harnett NG, Ellis RA, Grasser LR, Hanif M, Wiltshire C, Ely TD, Lebois LAM, van Rooij SJH, House SL, Beaudoin FL, An X, Neylan TC, Clifford GD, Linnstaedt SD, Germine LT, Bollen KA, Rauch SL, Haran JP, Storrow AB, Lewandowski C, Musey PI, Hendry PL, Sheikh S, Jones CW, Punches BE, Swor RA, Hudak LA, Pascual JL, Seamon MJ, Harris E, Pearson C, Peak DA, Merchant RC, Domeier RM, Rathlev NK, O'Neil BJ, Sergot P, Sanchez LD, Bruce SE, Harte SE, Koenen KC, Kessler RC, McLean SA, Ressler KJ, Stevens JS, Jovanovic T. Probing the neurocardiac circuit in trauma and posttraumatic stress. J Psychiatr Res 2024; 176:173-181. [PMID: 38875773 PMCID: PMC11283955 DOI: 10.1016/j.jpsychires.2024.06.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/21/2023] [Revised: 05/20/2024] [Accepted: 06/04/2024] [Indexed: 06/16/2024]
Abstract
The neurocardiac circuit is integral to physiological regulation of threat and trauma-related responses. However, few direct investigations of brain-behavior associations with replicable physiological markers of PTSD have been conducted. The current study probed the neurocardiac circuit by examining associations among its core regions in the brain (e.g., insula, hypothalamus) and the periphery (heart rate [HR], high frequency heart rate variability [HF-HRV], and blood pressure [BP]). We sought to characterize these associations and to determine whether there were differences by PTSD status. Participants were N = 315 (64.1 % female) trauma-exposed adults enrolled from emergency departments as part of the prospective AURORA study. Participants completed a deep phenotyping session (e.g., fear conditioning, magnetic resonance imaging) two weeks after emergency department admission. Voxelwise analyses revealed several significant interactions between PTSD severity 8-weeks posttrauma and psychophysiological recordings on hypothalamic connectivity to the prefrontal cortex (PFC), insula, superior temporal sulcus, and temporoparietaloccipital junction. Among those with PTSD, diastolic BP was directly correlated with right insula-hypothalamic connectivity, whereas the reverse was found for those without PTSD. PTSD status moderated the association between systolic BP, HR, and HF-HRV and hypothalamic connectivity in the same direction. While preliminary, our findings may suggest that individuals with higher PTSD severity exhibit compensatory neural mechanisms to down-regulate autonomic imbalance. Additional study is warranted to determine how underlying mechanisms (e.g., inflammation) may disrupt the neurocardiac circuit and increase cardiometabolic disease risk in PTSD.
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Affiliation(s)
- Antonia V Seligowski
- Massachusetts General Hospital, Boston, MA, USA; Department of Psychiatry, Harvard Medical School, Boston, MA, USA.
| | - Nathaniel G Harnett
- Department of Psychiatry, Harvard Medical School, Boston, MA, USA; Division of Depression and Anxiety, McLean Hospital, Belmont, MA, USA
| | - Robyn A Ellis
- Department of Psychiatry, Harvard Medical School, Boston, MA, USA; Division of Depression and Anxiety, McLean Hospital, Belmont, MA, USA
| | - Lana R Grasser
- Department of Psychiatry and Behavioral Neurosciences, Wayne State University, Detroit, MI, USA
| | - Mubeena Hanif
- Department of Psychiatry and Behavioral Neurosciences, Wayne State University, Detroit, MI, USA
| | - Charis Wiltshire
- Department of Psychiatry and Behavioral Neurosciences, Wayne State University, Detroit, MI, USA
| | - Timothy D Ely
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA, USA
| | - Lauren A M Lebois
- Department of Psychiatry, Harvard Medical School, Boston, MA, USA; Division of Depression and Anxiety, McLean Hospital, Belmont, MA, USA
| | - Sanne J H van Rooij
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA, USA
| | - Stacey L House
- Department of Emergency Medicine, Washington University School of Medicine, St. Louis, MO, USA
| | - Francesca L Beaudoin
- Department of Epidemiology, Brown University, Providence, RI, USA; Department of Emergency Medicine, Brown University, Providence, RI, USA
| | - Xinming An
- Institute for Trauma Recovery, Department of Anesthesiology, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Thomas C Neylan
- Departments of Psychiatry and Neurology, University of California San Francisco, San Francisco, CA, USA
| | - Gari D Clifford
- Department of Biomedical Informatics, Emory University School of Medicine, Atlanta, GA, USA; Department of Biomedical Engineering, Georgia Institute of Technology and Emory University, Atlanta, GA, USA
| | - Sarah D Linnstaedt
- Institute for Trauma Recovery, Department of Anesthesiology, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Laura T Germine
- Department of Psychiatry, Harvard Medical School, Boston, MA, USA; Institute for Technology in Psychiatry, McLean Hospital, Belmont, MA, USA; The Many Brains Project, Belmont, MA, USA
| | - Kenneth A Bollen
- Department of Psychology and Neuroscience & Department of Sociology, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Scott L Rauch
- Department of Psychiatry, Harvard Medical School, Boston, MA, USA; Institute for Technology in Psychiatry, McLean Hospital, Belmont, MA, USA; Department of Psychiatry, McLean Hospital, Belmont, MA, USA
| | - John P Haran
- Department of Emergency Medicine, University of Massachusetts Chan Medical School, Worcester, MA, USA
| | - Alan B Storrow
- Department of Emergency Medicine, Vanderbilt University Medical Center, Nashville, TN, USA
| | | | - Paul I Musey
- Department of Emergency Medicine, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Phyllis L Hendry
- Department of Emergency Medicine, University of Florida College of Medicine -Jacksonville, Jacksonville, FL, USA
| | - Sophia Sheikh
- Department of Emergency Medicine, University of Florida College of Medicine -Jacksonville, Jacksonville, FL, USA
| | - Christopher W Jones
- Department of Emergency Medicine, Cooper Medical School of Rowan University, Camden, NJ, USA
| | - Brittany E Punches
- Department of Emergency Medicine, Ohio State University College of Medicine, Columbus, OH, USA; Ohio State University College of Nursing, Columbus, OH, USA
| | - Robert A Swor
- Department of Emergency Medicine, Oakland University William Beaumont School of Medicine, Rochester, MI, USA
| | - Lauren A Hudak
- Department of Emergency Medicine, Emory University School of Medicine, Atlanta, GA, USA
| | - Jose L Pascual
- Department of Surgery, Department of Neurosurgery, University of Pennsylvania, Philadelphia, PA, USA; Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Mark J Seamon
- Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA; Department of Surgery, Division of Traumatology, Surgical Critical Care and Emergency Surgery, University of Pennsylvania, Philadelphia, PA, USA
| | - Erica Harris
- Department of Emergency Medicine, Einstein Medical Center, Philadelphia, PA, USA
| | - Claire Pearson
- Department of Emergency Medicine, Wayne State University, Ascension St. John Hospital, Detroit, MI, USA
| | - David A Peak
- Department of Emergency Medicine, Massachusetts General Hospital, Boston, MA, USA
| | - Roland C Merchant
- Department of Emergency Medicine, Brigham and Women's Hospital, Boston, MA, USA
| | - Robert M Domeier
- Department of Emergency Medicine, Trinity Health-Ann Arbor, Ypsilanti, MI, USA
| | - Niels K Rathlev
- Department of Emergency Medicine, University of Massachusetts Medical School-Baystate, Springfield, MA, USA
| | - Brian J O'Neil
- Department of Emergency Medicine, Wayne State University, Detroit Receiving Hospital, Detroit, MI, USA
| | - Paulina Sergot
- Department of Emergency Medicine, McGovern Medical School at UTHealth, Houston, TX, USA
| | - Leon D Sanchez
- Department of Emergency Medicine, Brigham and Women's Hospital, Boston, MA, USA; Department of Emergency Medicine, Harvard Medical School, Boston, MA, USA
| | - Steven E Bruce
- Department of Psychological Sciences, University of Missouri - St. Louis, St. Louis, MO, USA
| | - Steven E Harte
- Department of Anesthesiology, University of Michigan Medical School, Ann Arbor, MI, USA; Department of Internal Medicine-Rheumatology, University of Michigan Medical School, Ann Arbor, MI, USA
| | - Karestan C Koenen
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Harvard University, Boston, MA, USA
| | - Ronald C Kessler
- Department of Health Care Policy, Harvard Medical School, Boston, MA, USA
| | - Samuel A McLean
- Department of Emergency Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA; Institute for Trauma Recovery, Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Kerry J Ressler
- Department of Psychiatry, Harvard Medical School, Boston, MA, USA; Division of Depression and Anxiety, McLean Hospital, Belmont, MA, USA
| | - Jennifer S Stevens
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA, USA
| | - Tanja Jovanovic
- Department of Psychiatry and Behavioral Neurosciences, Wayne State University, Detroit, MI, USA
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2
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Maples-Keller JL, Watkins L, Hellman N, Phillips NL, Rothbaum BO. Treatment Approaches for Posttraumatic Stress Disorder Derived From Basic Research on Fear Extinction. Biol Psychiatry 2024:S0006-3223(24)01458-6. [PMID: 39032727 DOI: 10.1016/j.biopsych.2024.07.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/15/2024] [Revised: 07/02/2024] [Accepted: 07/11/2024] [Indexed: 07/23/2024]
Abstract
This brief review article will describe treatment approaches for posttraumatic stress disorder (PTSD) based on findings from basic research. The focus of this review will be fear conditioning and extinction models, which provide a translational model of PTSD that can help translate basic research in nonhuman animals through well-controlled trials confirming the efficacy of treatment approaches in humans with PTSD such as prolonged exposure therapy. Specific cognitive aspects of fear extinction processes, including consolidation and reconsolidation, are reviewed along with behavioral and pharmacological treatment strategies based on basic research in these areas including attempts to prevent the development of PTSD as well as the treatment of chronic PTSD. Pharmacological, behavioral, and device-based augmentation strategies of PTSD treatment based in basic science findings are reviewed, including those that disrupt noradrenergic receptor processes, medications that act on NMDA receptors, physical exercise, cannabinoids, estradiol, dexamethasone, yohimbine, losartan, dopamine, and MDMA, along with the evidence for their efficacy in human clinical samples. While fear extinction provides an exciting translational opportunity to improve PTSD based on basic science findings, we review limitations and challenges of the extant literature as well as future directions.
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Affiliation(s)
- Jessica L Maples-Keller
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, Georgia
| | - Laura Watkins
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, Georgia
| | - Natalie Hellman
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, Georgia
| | | | - Barbara O Rothbaum
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, Georgia.
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3
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Florido A, Velasco ER, Romero LR, Acharya N, Marin Blasco IJ, Nabás JF, Perez-Caballero L, Rivero G, Olabarrieta E, Nuñez-delMoral A, González-Parra JA, Porta-Casteràs D, Cano M, Steward T, Antony MS, Cardoner N, Torrubia R, Jackson AC, Fullana MA, Andero R. Sex differences in neural projections of fear memory processing in mice and humans. SCIENCE ADVANCES 2024; 10:eadk3365. [PMID: 38985873 PMCID: PMC11235172 DOI: 10.1126/sciadv.adk3365] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/16/2023] [Accepted: 06/05/2024] [Indexed: 07/12/2024]
Abstract
It remains unexplored in the field of fear memory whether functional neuronal connectivity between two brain areas is necessary for one sex but not the other. Here, we show that chemogenetic silencing of centromedial (CeM)-Tac2 fibers in the lateral posterior BNST (BNSTpl) decreased fear memory consolidation in male mice but not females. Optogenetic excitation of CeM-Tac2 fibers in the BNSTpl exhibited enhanced inhibitory postsynaptic currents in males compared to females. In vivo calcium imaging analysis revealed a sex-dimorphic fear memory engram in the BNSTpl. Furthermore, in humans, the single-nucleotide polymorphism (SNP) in the Tac2 receptor (rs2765) (TAC3R) decreased CeM-BNST connectivity in a fear task, impaired fear memory consolidation, and increased the expression of the TAC3R mRNA in AA-carrier men but not in women. These sex differences in critical neuronal circuits underlying fear memory formation may be relevant to human neuropsychiatric disorders with fear memory alterations such as posttraumatic stress disorder.
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Affiliation(s)
- Antonio Florido
- Institut de Neurociències, Universitat Autònoma de Barcelona, Cerdanyola del Vallès, Barcelona, Spain
- Departament de Psicobiologia i de Metodologia de les Ciències de la Salut, Universitat Autònoma de Barcelona, Cerdanyola del Vallès, Barcelona, Spain
| | - Eric R. Velasco
- Institut de Neurociències, Universitat Autònoma de Barcelona, Cerdanyola del Vallès, Barcelona, Spain
| | - Leire R. Romero
- Institut de Neurociències, Universitat Autònoma de Barcelona, Cerdanyola del Vallès, Barcelona, Spain
| | - Neha Acharya
- Institut de Neurociències, Universitat Autònoma de Barcelona, Cerdanyola del Vallès, Barcelona, Spain
| | - Ignacio J. Marin Blasco
- Institut de Neurociències, Universitat Autònoma de Barcelona, Cerdanyola del Vallès, Barcelona, Spain
| | - Jaime F. Nabás
- Institut de Neurociències, Universitat Autònoma de Barcelona, Cerdanyola del Vallès, Barcelona, Spain
| | - Laura Perez-Caballero
- Institut de Neurociències, Universitat Autònoma de Barcelona, Cerdanyola del Vallès, Barcelona, Spain
- Departament de Psicobiologia i de Metodologia de les Ciències de la Salut, Universitat Autònoma de Barcelona, Cerdanyola del Vallès, Barcelona, Spain
| | - Guadalupe Rivero
- Department of Pharmacology, University of the Basque Country, UPV/EHU, Leioa, Spain
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain
- Biobizkaia Health Research Institute, Barakaldo, Spain
| | - Estíbaliz Olabarrieta
- Department of Pharmacology, University of the Basque Country, UPV/EHU, Leioa, Spain
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain
| | - Amaia Nuñez-delMoral
- Department of Pharmacology, University of the Basque Country, UPV/EHU, Leioa, Spain
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain
| | - Jose A. González-Parra
- IMIM-Hospital del Mar Medical Research Institute, Cell-Type Mechanisms in Normal and Pathological Behavior, Barcelona, Spain
| | - Daniel Porta-Casteràs
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain
- Sant Pau Mental Health Research Group, Institut de Recerca Sant Pau (IR SANT PAU), Barcelona, Spain
- Mental Health Department, Unitat de Neurociència Traslacional, Parc Tauli University Hospital, Institut d’Investigació i Innovació Sanitària Parc Taulí (I3PT), Barcelona, Spain
- Department of Psychiatry and Forensic Medicine, School of Medicine Bellaterra, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Marta Cano
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain
- Sant Pau Mental Health Research Group, Institut de Recerca Sant Pau (IR SANT PAU), Barcelona, Spain
| | - Trevor Steward
- Melbourne School of Psychological Sciences, The University of Melbourne, Parkville, Victoria, Australia
- Department of Psychiatry, The University of Melbourne, Parkville, Victoria, Australia
| | - Monica S. Antony
- Department of Physiology and Neurobiology, University of Connecticut, Storrs, CT, USA
| | - Narcís Cardoner
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain
- Sant Pau Mental Health Research Group, Institut de Recerca Sant Pau (IR SANT PAU), Barcelona, Spain
- Mental Health Department, Unitat de Neurociència Traslacional, Parc Tauli University Hospital, Institut d’Investigació i Innovació Sanitària Parc Taulí (I3PT), Barcelona, Spain
- Department of Psychiatry and Forensic Medicine, School of Medicine Bellaterra, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Rafael Torrubia
- Unitat de Psicologia Mèdica, Departament de Psiquiatria i Medicina Legal and Institut de Neurociències, Universitat Autònoma de Barcelona, Bellaterra, Barcelona, Spain
| | - Alexander C. Jackson
- Department of Physiology and Neurobiology, University of Connecticut, Storrs, CT, USA
- The Institute for the Brain and Cognitive Sciences (IBACS), Storrs, CT, USA
| | - Miquel A. Fullana
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain
- Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Adult Psychiatry and Psychology Department, Institute of Neurosciences, Hospital Clinic, Barcelona, Spain
| | - Raül Andero
- Institut de Neurociències, Universitat Autònoma de Barcelona, Cerdanyola del Vallès, Barcelona, Spain
- Departament de Psicobiologia i de Metodologia de les Ciències de la Salut, Universitat Autònoma de Barcelona, Cerdanyola del Vallès, Barcelona, Spain
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain
- Unitat de Neurociència Traslacional, Parc Taulí Hospital Universitari, Institut d’Investigació i Innovació Parc Taulí (I3PT), Sabadell, Spain
- ICREA, Barcelona, Spain
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4
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Hauck A, Michael T, Issler TC, Klein S, Lass-Hennemann J, Ferreira de Sá DS. Can glucose facilitate fear exposure? Randomized, placebo-controlled trials on the effects of glucose administration on fear extinction processes. Behav Res Ther 2024; 178:104553. [PMID: 38728832 DOI: 10.1016/j.brat.2024.104553] [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: 12/01/2023] [Revised: 04/26/2024] [Accepted: 04/27/2024] [Indexed: 05/12/2024]
Abstract
Previous studies showed that glucose has beneficial effects on memory function and can enhance contextual fear learning. To derive potential therapeutic interventions, further research is needed regarding the effects of glucose on fear extinction. In two experimental studies with healthy participants (Study 1: N = 68, 39 females; Study 2: N = 89, 67 females), we investigated the effects of glucose on fear extinction learning and its consolidation. Participants completed a differential fear conditioning paradigm consisting of acquisition, extinction, and return of fear tests: reinstatement, and extinction recall. US-expectancy ratings, skin conductance response (SCR), and fear potentiated startle (FPS) were collected. Participants were pseudorandomized and double-blinded to one of two groups: They received either a drink containing glucose or saccharine 20 min before (Study 1) or immediately after extinction (Study 2). The glucose group showed a significantly stronger decrease in differential FPS during extinction (Study 1) and extinction recall (Study 2). Additionally, the glucose group showed a significantly lower contextual anxiety at test of reinstatement (Study 2). Our findings provide first evidence that glucose supports the process of fear extinction, and in particular the consolidation of fear extinction memory, and thus has potential as a beneficial adjuvant to extinction-based treatments. Registered through the German Clinical Trials Registry (https://www.bfarm.de/EN/BfArM/Tasks/German-Clinical-Trials-Register/_node.html; Study 1: DRKS00010550; Study 2: DRKS00018933).
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Affiliation(s)
- Alexander Hauck
- Division of Clinical Psychology and Psychotherapy, Department of Psychology, Saarland University, Saarbrücken, Germany
| | - Tanja Michael
- Division of Clinical Psychology and Psychotherapy, Department of Psychology, Saarland University, Saarbrücken, Germany
| | - Tobias C Issler
- Division of Clinical Psychology and Psychotherapy, Department of Psychology, Saarland University, Saarbrücken, Germany
| | - Steven Klein
- Division of Clinical Psychology and Psychotherapy, Department of Psychology, Saarland University, Saarbrücken, Germany
| | - Johanna Lass-Hennemann
- Division of Clinical Psychology and Psychotherapy, Department of Psychology, Saarland University, Saarbrücken, Germany
| | - Diana S Ferreira de Sá
- Division of Clinical Psychology and Psychotherapy, Department of Psychology, Saarland University, Saarbrücken, Germany.
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5
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Dymond S, Xia W, Lloyd K, Schlund MW, Zuj DV. Working hard to avoid: Fixed-ratio response effort and maladaptive avoidance in humans. Q J Exp Psychol (Hove) 2023; 76:1889-1912. [PMID: 36112817 DOI: 10.1177/17470218221127660] [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] [Indexed: 07/20/2023]
Abstract
Maladaptive avoidance of safe stimuli is a defining feature of anxiety and related disorders. Avoidance may involve physical effort or the completion of a fixed series of responses to prevent occurrence of, or cues associated with, the aversive event. Understanding the role of response effort in the acquisition and extinction of avoidance may facilitate the development of new clinical treatments for maladaptive avoidance. Despite this, little is known about the impact of response effort on extinction-resistant avoidance in humans. Here, we describe findings from two laboratory-based treatment studies designed to investigate the impact of high and low response effort on the extinction (Experiment 1) and return (Experiment 2) of avoidance. Response effort was operationalised as completion of fixed-ratio (FR) reinforcement schedules for both danger and safety cues in a multi-cue avoidance paradigm with behavioural, self-report, and physiology measures. Completion of the FR response requirements cancelled upcoming shock presentations following danger cues and had no impact on the consequences that followed safety cues. Both experiments found persistence of high response-effort avoidance across danger and safety cues and sustained (Experiment 1) and reinstated (Experiment 2) levels of fear and threat expectancy. Skin conductance responses evoked by all cues were similar across experiments. The present findings and paradigm have implications for translational research on maladaptive anxious coping and treatment development.
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Affiliation(s)
- Simon Dymond
- School of Psychology, Swansea University, Swansea, UK
- Department of Psychology, Reykjavík University, Reykjavík, Iceland
| | - Weike Xia
- School of Psychology, Swansea University, Swansea, UK
| | - Keith Lloyd
- Swansea University Medical School, Swansea University, Swansea, UK
| | - Michael W Schlund
- Department of Psychology, Georgia State University, Atlanta, GA, USA
| | - Daniel V Zuj
- School of Psychology, Swansea University, Swansea, UK
- School of Psychological Sciences, University of Tasmania, Launceston, TAS, Australia
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6
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Zoladz PR, Cordes CN, Weiser JN, Reneau KE, Boaz KM, Helwig SJ, Virden EM, Thebeault CK, Pfister CL, Getnet BA, Niese TD, Parker SL, Stanek ML, Long KE, Norrholm SD, Rorabaugh BR. Pre-Learning Stress That Is Temporally Removed from Acquisition Impairs Fear Learning. BIOLOGY 2023; 12:775. [PMID: 37372060 DOI: 10.3390/biology12060775] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/20/2023] [Revised: 05/19/2023] [Accepted: 05/23/2023] [Indexed: 06/29/2023]
Abstract
Few studies have examined the time-dependent effects of stress on fear learning. Previously, we found that stress immediately before fear conditioning enhanced fear learning. Here, we aimed to extend these findings by assessing the effects of stress 30 min prior to fear conditioning on fear learning and fear generalization. Two hundred and twenty-one healthy adults underwent stress (socially evaluated cold pressor test) or a control manipulation 30 min before completing differential fear conditioning in a fear-potentiated startle paradigm. One visual stimulus (CS+), but not another (CS-), was associated with an aversive airblast to the throat (US) during acquisition. The next day, participants were tested for their fear responses to the CS+, CS-, and several generalization stimuli. Stress impaired the acquisition of fear on Day 1 but had no significant impact on fear generalization. The stress-induced impairment of fear learning was particularly evident in participants who exhibited a robust cortisol response to the stressor. These findings are consistent with the notion that stress administered 30 min before learning impairs memory formation via corticosteroid-related mechanisms and may help us understand how fear memories are altered in stress-related psychological disorders.
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Affiliation(s)
- Phillip R Zoladz
- Psychology Program, The School of Health and Behavioral Sciences, Ohio Northern University, Ada, OH 45810, USA
| | - Chloe N Cordes
- Psychology Program, The School of Health and Behavioral Sciences, Ohio Northern University, Ada, OH 45810, USA
| | - Jordan N Weiser
- Psychology Program, The School of Health and Behavioral Sciences, Ohio Northern University, Ada, OH 45810, USA
| | - Kassidy E Reneau
- Psychology Program, The School of Health and Behavioral Sciences, Ohio Northern University, Ada, OH 45810, USA
| | - Kayla M Boaz
- Psychology Program, The School of Health and Behavioral Sciences, Ohio Northern University, Ada, OH 45810, USA
| | - Sara J Helwig
- Psychology Program, The School of Health and Behavioral Sciences, Ohio Northern University, Ada, OH 45810, USA
| | - Emma M Virden
- Psychology Program, The School of Health and Behavioral Sciences, Ohio Northern University, Ada, OH 45810, USA
| | - Caitlin K Thebeault
- Psychology Program, The School of Health and Behavioral Sciences, Ohio Northern University, Ada, OH 45810, USA
| | - Cassidy L Pfister
- Psychology Program, The School of Health and Behavioral Sciences, Ohio Northern University, Ada, OH 45810, USA
| | - Bruktawit A Getnet
- Psychology Program, The School of Health and Behavioral Sciences, Ohio Northern University, Ada, OH 45810, USA
| | - Taylor D Niese
- Psychology Program, The School of Health and Behavioral Sciences, Ohio Northern University, Ada, OH 45810, USA
| | - Sydney L Parker
- Psychology Program, The School of Health and Behavioral Sciences, Ohio Northern University, Ada, OH 45810, USA
| | - Mercedes L Stanek
- Psychology Program, The School of Health and Behavioral Sciences, Ohio Northern University, Ada, OH 45810, USA
| | - Kristen E Long
- Psychology Program, The School of Health and Behavioral Sciences, Ohio Northern University, Ada, OH 45810, USA
| | - Seth D Norrholm
- Department of Psychiatry and Behavioral Neurosciences, School of Medicine, Wayne State University, Detroit, MI 48202, USA
| | - Boyd R Rorabaugh
- Department of Pharmaceutical Sciences, School of Pharmacy, Marshall University, Huntington, WV 25755, USA
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7
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Battaglia S, Di Fazio C, Vicario CM, Avenanti A. Neuropharmacological Modulation of N-methyl-D-aspartate, Noradrenaline and Endocannabinoid Receptors in Fear Extinction Learning: Synaptic Transmission and Plasticity. Int J Mol Sci 2023; 24:ijms24065926. [PMID: 36983000 PMCID: PMC10053024 DOI: 10.3390/ijms24065926] [Citation(s) in RCA: 30] [Impact Index Per Article: 30.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2022] [Revised: 03/10/2023] [Accepted: 03/13/2023] [Indexed: 03/30/2023] Open
Abstract
Learning to recognize and respond to potential threats is crucial for survival. Pavlovian threat conditioning represents a key paradigm for investigating the neurobiological mechanisms of fear learning. In this review, we address the role of specific neuropharmacological adjuvants that act on neurochemical synaptic transmission, as well as on brain plasticity processes implicated in fear memory. We focus on novel neuropharmacological manipulations targeting glutamatergic, noradrenergic, and endocannabinoid systems, and address how the modulation of these neurobiological systems affects fear extinction learning in humans. We show that the administration of N-methyl-D-aspartate (NMDA) agonists and modulation of the endocannabinoid system by fatty acid amide hydrolase (FAAH) inhibition can boost extinction learning through the stabilization and regulation of the receptor concentration. On the other hand, elevated noradrenaline levels dynamically modulate fear learning, hindering long-term extinction processes. These pharmacological interventions could provide novel targeted treatments and prevention strategies for fear-based and anxiety-related disorders.
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Affiliation(s)
- Simone Battaglia
- Center for Studies and Research in Cognitive Neuroscience, Department of Psychology "Renzo Canestrari", Cesena Campus, Alma Mater Studiorum Università di Bologna, 47521 Cesena, Italy
- Department of Psychology, University of Turin, 10124 Turin, Italy
| | - Chiara Di Fazio
- Center for Studies and Research in Cognitive Neuroscience, Department of Psychology "Renzo Canestrari", Cesena Campus, Alma Mater Studiorum Università di Bologna, 47521 Cesena, Italy
| | - Carmelo M Vicario
- Dipartimento di Scienze Cognitive, Psicologiche, Pedagogiche e Degli Studi Culturali, Università Degli Studi di Messina, 98122 Messina, Italy
| | - Alessio Avenanti
- Center for Studies and Research in Cognitive Neuroscience, Department of Psychology "Renzo Canestrari", Cesena Campus, Alma Mater Studiorum Università di Bologna, 47521 Cesena, Italy
- Neuropsicology and Cognitive Neuroscience Research Center (CINPSI Neurocog), Universidad Católica del Maule, Talca 3460000, Chile
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8
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Sullivan ADW, Brier ZMF, Legrand AC, van Stolk-Cooke K, Jovanovic T, Norrholm SD, Garavan H, Forehand R, Price M. The Enduring Importance of Parenting: Caregiving Quality and Fear-Potentiated Startle in Emerging Adults With a Child Maltreatment History. CHILD MALTREATMENT 2023; 28:97-106. [PMID: 34886701 PMCID: PMC9316457 DOI: 10.1177/10775595211060050] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
Background: The transition to adulthood is a period of increased risk for emergent psychopathology; emerging adults with a childhood maltreatment history are at risk for poor outcomes. Method: Using a multi-measure, transdisciplinary, cross-sectional design, this study tested whether participant-reported positive parenting, a potential resilience-promoting factor, moderated the association between clinician-rated PTSD symptom severity and a transdiagnostic maladjustment biomarker, fear-potentiated startle (FPS), in a sample of 66 emerging adults (Myears = 18.83, SD = 0.89) with a maltreatment history. We hypothesized that characteristics of effective parenting would moderate the relation between PTSD symptoms and FPS. Results: Results indicated that elevated PTSD, as measured by the CAPS, was associated with a more severe startle reaction. The magnitude of the increase in startle reactivity was moderated by parenting such that those with more positive parenting (Accepting [relative to rejecting]: b = -0.42, p < .001; Psychologically-controlling [relative to autonomy-promoting]: b = 2.96, p = .004) had significantly less reactivity across the task at higher levels of PTSD symptoms. Conclusions: Emerging adults with childhood maltreatment histories, high levels of PTSD symptoms, and who perceive present-day high-quality caregiver support may cope better with novel stressors relative to youth lacking that support, potentially translating to better psychological outcomes.
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Affiliation(s)
| | - Zoe M. F. Brier
- Department of Psychological Science, University of Vermont, Burlington, VT, USA
| | - Alison C. Legrand
- Department of Psychological Science, University of Vermont, Burlington, VT, USA
| | | | - Tanja Jovanovic
- Department of Psychiatry and Behavioral Neurosciences, Wayne State University School of Medicine, Detroit, MI, USA
| | - Seth D. Norrholm
- Department of Psychiatry and Behavioral Neurosciences, Wayne State University School of Medicine, Detroit, MI, USA
| | - Hugh Garavan
- Department of Psychiatry, University of Vermont, Burlington, VT, USA
| | - Rex Forehand
- Department of Psychological Science, University of Vermont, Burlington, VT, USA
| | - Matthew Price
- Department of Psychological Science, University of Vermont, Burlington, VT, USA
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9
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Provencher J, Cernik R, Marin MF. Impact of Stress and Exercise on Fear Extinction. Curr Top Behav Neurosci 2023; 64:157-178. [PMID: 37498495 DOI: 10.1007/7854_2023_432] [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] [Indexed: 07/28/2023]
Abstract
This chapter reviews the literature on the impact of stress and exercise on fear extinction. Given that key brain regions of the fear circuitry (e.g., hippocampus, amygdala and frontal cortex) can be modulated by stress hormones, it is important to investigate how stress influences this process. Laboratory-based studies performed in healthy adults have yielded mixed results, which are most likely attributable to various methodological factors. Among these factors, inter-individual differences modulating the stress response and timing of stressor administration with respect to the task may contribute to this heterogeneity. Given that fear is a core manifestation of various psychopathologies and that exposure-based therapy relies on fear extinction principles, several studies have attempted to assess the role of stress hormones on exposure-based therapy in patients suffering from post-traumatic stress disorder or anxiety disorders. These studies tend to suggest a beneficial impact of stress hormones (through either natural endogenous variations or synthetic administration) on exposure-based therapy as assessed mostly by subjective fear measures. Similar to stress, exercise can have an impact on many physiological and biological systems in humans. Of note, exercise modulates biomarkers such as brain-derived neurotrophic factor (BDNF) and anandamide (EAE) that act on brain regions implicated in the fear circuitry, supporting the importance of studying the impact of exercise on fear extinction. Overall, the results converge and indicate that fear extinction (tested in the laboratory or via exposure-based therapy in clinical populations) can be enhanced with exercise. Further research is needed to understand the mechanisms by which stress and exercise modulate fear learning and extinction processes, as well as to maximize the applicability to clinical contexts.
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Affiliation(s)
- Jessie Provencher
- Department of Psychology, Université du Québec à Montréal, Montreal, QC, Canada
- Research Centre of the Institut Universitaire en Santé Mentale de Montréal, Montreal, QC, Canada
| | - Rebecca Cernik
- Department of Psychology, Université du Québec à Montréal, Montreal, QC, Canada
- Research Centre of the Institut Universitaire en Santé Mentale de Montréal, Montreal, QC, Canada
| | - Marie-France Marin
- Department of Psychology, Université du Québec à Montréal, Montreal, QC, Canada.
- Research Centre of the Institut Universitaire en Santé Mentale de Montréal, Montreal, QC, Canada.
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10
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Woodford J, Riser M, Norrholm SD. Understanding Human Fear Extinction: Insights from Psychophysiology. Curr Top Behav Neurosci 2023; 64:59-77. [PMID: 37528308 DOI: 10.1007/7854_2023_435] [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] [Indexed: 08/03/2023]
Abstract
The study of fear extinction has been driven largely by Pavlovian fear conditioning methods across the translational spectrum. The primary methods used to study these processes in humans have been recordings of skin conductance (historically termed galvanic skin response) and fear-potentiation of the acoustic startle reflex. As outlined in the following chapter, the combined corpus of this work has demonstrated the value of psychophysiology in better understanding the underlying neurobiology of extinction learning in healthy humans as well as those with psychopathologies. In addition, psychophysiological approaches, which allow for the preservation of methods between species, have shown their applicability to the assessment of wide-ranging treatment effects. The chapter concludes with potential trajectories for future study in this area.
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Affiliation(s)
- Jessica Woodford
- Department of Psychiatry and Behavioral Neurosciences, Neuroscience Center for Anxiety, Stress, and Trauma, Wayne State University School of Medicine, Detroit, MI, USA
| | - Manessa Riser
- Department of Psychiatry and Behavioral Neurosciences, Neuroscience Center for Anxiety, Stress, and Trauma, Wayne State University School of Medicine, Detroit, MI, USA
| | - Seth Davin Norrholm
- Department of Psychiatry and Behavioral Neurosciences, Neuroscience Center for Anxiety, Stress, and Trauma, Wayne State University School of Medicine, Detroit, MI, USA.
- Department of Behavioral Sciences and Leadership, United States Air Force Academy, Colorado Springs, CO, USA.
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11
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Zoladz P, Reneau K, Weiser J, Cordes C, Virden E, Helwig S, Thebeault C, Pfister C, Getnet B, Boaz K, Niese T, Stanek M, Long K, Parker S, Rorabaugh B, Norrholm S. Childhood Maltreatment in Females Is Associated with Enhanced Fear Acquisition and an Overgeneralization of Fear. Brain Sci 2022; 12:1536. [PMID: 36421860 PMCID: PMC9688290 DOI: 10.3390/brainsci12111536] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2022] [Revised: 11/05/2022] [Accepted: 11/11/2022] [Indexed: 06/27/2024] Open
Abstract
Childhood maltreatment may alter fear neurocircuitry, which results in pathological anxiety and depression. One alteration of fear-related behaviors that has been observed in several psychiatric populations is an overgeneralization of fear. Thus, we examined the association between childhood maltreatment and fear generalization in a non-clinical sample of young adults. Two hundred and ninety-one participants underwent differential fear conditioning in a fear-potentiated startle paradigm. One visual stimulus (CS+), but not another (CS-), was associated with an aversive airblast to the throat (US) during acquisition. The next day, participants were tested for their fear responses to the CS+, CS-, and several generalization stimuli (GS) without the presence of the US. Participants also completed questionnaires that assessed symptoms of childhood maltreatment, anxiety, depression, and post-traumatic stress disorder (PTSD). Participants reporting high childhood maltreatment (n = 71; 23 males, 48 females) exhibited significantly greater anxiety, depression, and symptoms of PTSD than participants reporting low childhood maltreatment (n = 220; 133 males, 87 females). Females reporting high childhood maltreatment demonstrated significantly enhanced fear learning and greater fear generalization, based on their fear-potentiated startle responses. Our findings suggest that childhood maltreatment may sex-dependently influence the development of fear neurocircuitry and result in greater fear generalization in maltreated females.
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Affiliation(s)
- Phillip Zoladz
- Psychology Program, The School of Health and Behavioral Sciences, Ohio Northern University, Ada, OH 45810, USA
| | - Kassidy Reneau
- Psychology Program, The School of Health and Behavioral Sciences, Ohio Northern University, Ada, OH 45810, USA
| | - Jordan Weiser
- Psychology Program, The School of Health and Behavioral Sciences, Ohio Northern University, Ada, OH 45810, USA
| | - Chloe Cordes
- Psychology Program, The School of Health and Behavioral Sciences, Ohio Northern University, Ada, OH 45810, USA
| | - Emma Virden
- Psychology Program, The School of Health and Behavioral Sciences, Ohio Northern University, Ada, OH 45810, USA
| | - Sara Helwig
- Psychology Program, The School of Health and Behavioral Sciences, Ohio Northern University, Ada, OH 45810, USA
| | - Caitlin Thebeault
- Psychology Program, The School of Health and Behavioral Sciences, Ohio Northern University, Ada, OH 45810, USA
| | - Cassidy Pfister
- Psychology Program, The School of Health and Behavioral Sciences, Ohio Northern University, Ada, OH 45810, USA
| | - Bruktawit Getnet
- Psychology Program, The School of Health and Behavioral Sciences, Ohio Northern University, Ada, OH 45810, USA
| | - Kayla Boaz
- Psychology Program, The School of Health and Behavioral Sciences, Ohio Northern University, Ada, OH 45810, USA
| | - Taylor Niese
- Psychology Program, The School of Health and Behavioral Sciences, Ohio Northern University, Ada, OH 45810, USA
| | - Mercedes Stanek
- Psychology Program, The School of Health and Behavioral Sciences, Ohio Northern University, Ada, OH 45810, USA
| | - Kristen Long
- Psychology Program, The School of Health and Behavioral Sciences, Ohio Northern University, Ada, OH 45810, USA
| | - Sydney Parker
- Psychology Program, The School of Health and Behavioral Sciences, Ohio Northern University, Ada, OH 45810, USA
| | - Boyd Rorabaugh
- Department of Pharmaceutical Sciences, Marshall University School of Pharmacy, Huntington, WV 25755, USA
| | - Seth Norrholm
- Department of Psychiatry and Behavioral Neurosciences, Wayne State University School of Medicine, Detroit, MI 48202, USA
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12
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Hauck A, Michael T, Ferreira de Sá DS. Fear learning and generalization during pandemic fear: How COVID-19-related anxiety affects classical fear conditioning with traumatic film clips. J Psychiatr Res 2022; 155:90-99. [PMID: 35998471 PMCID: PMC9365308 DOI: 10.1016/j.jpsychires.2022.07.068] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/30/2022] [Revised: 07/25/2022] [Accepted: 07/30/2022] [Indexed: 11/27/2022]
Abstract
The COVID-19 pandemic greatly disrupted our daily lives. Worldwide, people were confronted with health, financial, and existential fears or trauma-like experiences. Recent studies have identified an increase in stress, anxiety, and fear symptoms in connection with the pandemic. Furthermore, fear learning processes are central mechanisms in the development and maintenance of anxiety disorders. Patients commonly show impairments not only in fear learning but also in its generalization. Thus, pandemic-related anxiety may constitute a risk factor for both enhanced fear acquisition and generalization. In a pre-registered online study with a final sample of 220 healthy university students, we investigated whether participants with higher COVID-19-related anxiety (COVID-Anxiety) show impaired fear learning and generalization. For this purpose, we used a differential fear conditioning paradigm with a traumatic film clip as the unconditioned stimulus (US) and collected US-expectancy as the main measure of interest. Participants with high COVID-Anxiety show a tendency toward poorer discrimination between the reinforced conditioned stimulus (CS+) and the unreinforced conditioned stimulus (CS-) during acquisition and significantly poorer discrimination patterns during generalization. Furthermore, participants with high COVID-Anxiety show greater general fear throughout the whole experiment. Our results show that the subjective effects of the COVID-19 pandemic on psychological well-being are associated with impairments in both fear learning and fear generalization. As expected, high COVID-Anxiety leads to poorer performance in stimulus discrimination and greater levels of fear, which might contribute to a higher risk of anxiety disorders. GERMAN CLINICAL TRIAL REGISTER: DRKS00022761.
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Affiliation(s)
| | | | - Diana S. Ferreira de Sá
- Corresponding author. Division of Clinical Psychology and Psychotherapy, Department of Psychology, Saarland University Campus, Building A 1.3, 66123, Saarbrücken, Germany
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13
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Espinosa L, Bonsall MB, Becker N, Holmes EA, Olsson A. Pavlovian threat conditioning can generate intrusive memories that persist over time. Behav Res Ther 2022; 157:104161. [DOI: 10.1016/j.brat.2022.104161] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2021] [Revised: 06/27/2022] [Accepted: 07/08/2022] [Indexed: 11/02/2022]
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14
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Maples-Keller J, Watkins LE, Nylocks KM, Yasinski C, Coghlan C, Black K, Jovanovic T, Rauch SA, Rothbaum BO, Norrholm SD. Acquisition, extinction, and return of fear in veterans in intensive outpatient prolonged exposure therapy: A fear-potentiated startle study. Behav Res Ther 2022; 154:104124. [PMID: 35642990 DOI: 10.1016/j.brat.2022.104124] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2021] [Revised: 04/27/2022] [Accepted: 05/13/2022] [Indexed: 11/02/2022]
Abstract
Prolonged exposure (PE) therapy is a first-line treatment for posttraumatic stress disorder (PTSD) and involves repeated presentation of trauma-related cues without aversive outcomes. A primary learning mechanism of PE is fear extinction (new learning that a dangerous cue is now safe) and its retention (maintaining this new learning over time). Extant research suggests extinction is impaired in PTSD patients. In this study, we employed an established fear-potentiated startle-based paradigm to examine fear acquisition, extinction learning and retention before and after completion of intensive outpatient treatment. First, PTSD patients undergoing PE (n = 55) were compared to trauma-exposed patients without PTSD (n = 57). We identified excessive fear in PTSD patients during acquisition and extinction before treatment compared to non-PTSD patients. At post-treatment, we examined the return of fear after extinction in PTSD patients showing high or low treatment response to PE (≥50% change in PTSD symptom severity vs. < 50%). High PE responders maintained fear extinction learning whereas low PE responders showed significant return of fear at post-treatment. These results replicate and extend previous findings of impaired extinction in PTSD and provide support for the proposed theoretical link between fear extinction and PE response.
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15
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Maples-Keller JL, Norrholm SD, Burton M, Reiff C, Coghlan C, Jovanovic T, Yasinski C, Jarboe K, Rakofsky J, Rauch S, Dunlop BW, Rothbaum BO. A randomized controlled trial of 3,4-methylenedioxymethamphetamine (MDMA) and fear extinction retention in healthy adults. J Psychopharmacol 2022; 36:368-377. [PMID: 35166140 DOI: 10.1177/02698811211069124] [Citation(s) in RCA: 19] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
BACKGROUND Fear conditioning and extinction are well-characterized cross-species models of fear-related posttraumatic stress disorder (PTSD) symptoms, and recent animal data suggest that 3,4-methylenedioxymethamphetamine (MDMA) enhances fear extinction retention. AIMS This study investigated the effect of MDMA on fear learning, extinction training, and retention in healthy humans. METHODS The study involved a randomized placebo-controlled, two-group, parallel design trial in a sample of healthy adults, age 21-55 recruited from a major metropolitan area. The experimental paradigm included a fear acquisition session followed by an extinction training session 24 hours later, and 2 hours after study drug administration. Fear extinction retention was measured 48 hours after extinction training. Participants (N = 34; 70.6% male and 29.4% female) were randomly assigned in 1:1 ratio to 100 mg MDMA or placebo. All randomized participants completed the trial and were included in primary analyses. Safety was monitored via adverse events and vital signs. MDMA was well-tolerated with no serious adverse events. RESULTS Results indicated a significant main effect of session between extinction training and retention with no significant group differences. Significantly more participants in the MDMA group retained extinction learning compared to the placebo group (χ2 = 7.29, p = 0.007). CONCLUSION Although we did not observe the hypothesized facilitation of extinction retention, the findings from this initial human trial provide compelling rationale to continue to explore the potential for MDMA to impact extinction retention.Clinical Trials Registry Name and Identifier: Evaluation of MDMA on Startle Response (NCT0318176) https://clinicaltrials.gov/ct2/show/NCT03181763?term = MDMA&draw = 2&rank = 9.
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Affiliation(s)
- Jessica L Maples-Keller
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA, USA
| | - Seth D Norrholm
- Department of Psychiatry and Behavioral Neurosciences, Wayne State University School of Medicine, Detroit, MI, USA
| | - Mark Burton
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA, USA
| | - Collin Reiff
- Department of Psychiatry, New York University, New York, NY, USA
| | - Callan Coghlan
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA, USA
| | - Tanja Jovanovic
- Department of Psychiatry and Behavioral Neurosciences, Wayne State University School of Medicine, Detroit, MI, USA
| | - Carly Yasinski
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA, USA
| | - Kathleen Jarboe
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA, USA
| | - Jeffrey Rakofsky
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA, USA
| | - Sheila Rauch
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA, USA.,Atlanta VA Healthcare System
| | - Boadie W Dunlop
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA, USA
| | - Barbara O Rothbaum
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA, USA
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16
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Toumbelekis M, Liddell BJ, Bryant RA. Secure attachment priming protects against relapse of fear in Young adults. Transl Psychiatry 2021; 11:584. [PMID: 34775464 PMCID: PMC8590684 DOI: 10.1038/s41398-021-01715-x] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/17/2020] [Revised: 10/21/2021] [Accepted: 11/01/2021] [Indexed: 11/09/2022] Open
Abstract
Previous studies have shown that activating the attachment system attenuates fear learning. This study aimed to explore whether attachment priming can also impact on fear extinction processes, which underpin the management of anxiety disorders. In this study, 81 participants underwent a standard fear conditioning and extinction protocol on day 1 and returned 24 h later for an extinction recall and reinstatement test. Half the participants were primed to imagine their closest attachment figure prior to undergoing extinction training, while the other half were instructed to imagine a positive situation. Fear-potentiated startle and subjective expectancies of shock were measured as the primary indicators of fear. Attachment priming led to less relapse during the reinstatement test at the physiological but not subjective levels. These findings have translational potential to imply that activating awareness of attachment figures might augment long-term safety memories acquired in existing treatments to reduce relapse of fear.
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17
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Seligowski AV, Steuber ER, Hinrichs R, Reda MH, Wiltshire CN, Wanna CP, Winters SJ, Phillips KA, House SL, Beaudoin FL, An X, Stevens JS, Zeng D, Neylan TC, Clifford GD, Linnstaedt SD, Germine LT, Bollen KA, Guffanti G, Rauch SL, Haran JP, Storrow AB, Lewandowski C, Musey PI, Hendry PL, Sheikh S, Jones CW, Punches BE, Kurz MC, Murty VP, McGrath ME, Hudak LA, Pascual JL, Seamon MJ, Datner EM, Chang AM, Pearson C, Peak DA, Merchant RC, Domeier RM, Rathlev NK, O'Neil BJ, Sanchez LD, Bruce SE, Miller MW, Pietrzak RH, Joormann J, Barch DM, Pizzagalli DA, Sheridan JF, Luna B, Harte SE, Elliott JM, Koenen KC, Kessler RC, McLean SA, Ressler KJ, Jovanovic T. A prospective examination of sex differences in posttraumatic autonomic functioning. Neurobiol Stress 2021; 15:100384. [PMID: 34485632 PMCID: PMC8397921 DOI: 10.1016/j.ynstr.2021.100384] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2021] [Revised: 08/16/2021] [Accepted: 08/20/2021] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND Cross-sectional studies have found that individuals with posttraumatic stress disorder (PTSD) exhibit deficits in autonomic functioning. While PTSD rates are twice as high in women compared to men, sex differences in autonomic functioning are relatively unknown among trauma-exposed populations. The current study used a prospective design to examine sex differences in posttraumatic autonomic functioning. METHODS 192 participants were recruited from emergency departments following trauma exposure (Mean age = 35.88, 68.2% female). Skin conductance was measured in the emergency department; fear conditioning was completed two weeks later and included measures of blood pressure (BP), heart rate (HR), and high frequency heart rate variability (HF-HRV). PTSD symptoms were assessed 8 weeks after trauma. RESULTS 2-week systolic BP was significantly higher in men, while 2-week HR was significantly higher in women, and a sex by PTSD interaction suggested that women who developed PTSD demonstrated the highest HR levels. Two-week HF-HRV was significantly lower in women, and a sex by PTSD interaction suggested that women with PTSD demonstrated the lowest HF-HRV levels. Skin conductance response in the emergency department was associated with 2-week HR and HF-HRV only among women who developed PTSD. CONCLUSIONS Our results indicate that there are notable sex differences in autonomic functioning among trauma-exposed individuals. Differences in sympathetic biomarkers (BP and HR) may have implications for cardiovascular disease risk given that sympathetic arousal is a mechanism implicated in this risk among PTSD populations. Future research examining differential pathways between PTSD and cardiovascular risk among men versus women is warranted.
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Affiliation(s)
- Antonia V. Seligowski
- Department of Psychiatry, Harvard Medical School, Boston, MA, 02115, USA
- Division of Depression and Anxiety, McLean Hospital, Belmont, MA, 02478, USA
| | | | - Rebecca Hinrichs
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA, 30329, USA
| | - Mariam H. Reda
- Department of Psychiatry and Behavioral Neurosciences, Wayne State University, Detroit, MA, 48202, USA
| | | | - Cassandra P. Wanna
- Department of Psychiatry and Behavioral Neurosciences, Wayne State University, Detroit, MA, 48202, USA
| | - Sterling J. Winters
- Department of Psychiatry and Behavioral Neurosciences, Wayne State University, Detroit, MA, 48202, USA
| | - Karlye A. Phillips
- McLean Hospital, Belmont, MA, 02478, USA
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, 21205, USA
| | - Stacey L. House
- Department of Emergency Medicine, Washington University School of Medicine, St. Louis, MO, 63110, USA
| | - Francesca L. Beaudoin
- Department of Emergency Medicine & Department of Health Services, Policy, and Practice, The Alpert Medical School of Brown University, Rhode Island Hospital and the Miriam Hospital, Providence, RI, 02930, USA
| | - Xinming An
- Institute for Trauma Recovery, Department of Anesthesiology, University of North Carolina at Chapel Hill, Chapel Hill, NC, 27559, USA
| | - Jennifer S. Stevens
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA, 30329, USA
| | - Donglin Zeng
- Department of Biostatistics, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC, 27559, USA
| | - Thomas C. Neylan
- Departments of Psychiatry and Neurology, University of California San Francisco, San Francisco, CA, 94143, USA
| | - Gari D. Clifford
- Department of Biomedical Informatics, Emory University School of Medicine, Atlanta, GA, 30332, USA
- Department of Biomedical Engineering, Georgia Institute of Technology and Emory University, Atlanta, GA, 30332, USA
| | - Sarah D. Linnstaedt
- Institute for Trauma Recovery, Department of Anesthesiology, University of North Carolina at Chapel Hill, Chapel Hill, NC, 27559, USA
| | - Laura T. Germine
- Department of Psychiatry, Harvard Medical School, Boston, MA, 02115, USA
- Institute for Technology in Psychiatry, McLean Hospital, Belmont, MA, 02478, USA
- The Many Brains Project, Belmont, MA, 02478, USA
| | - Kenneth A. Bollen
- Department of Psychology and Neuroscience & Department of Sociology, University of North Carolina at Chapel Hill, Chapel Hill, NC, 27559, USA
| | - Guia Guffanti
- Department of Psychiatry, Harvard Medical School, Boston, MA, 02115, USA
- Division of Depression and Anxiety, McLean Hospital, Belmont, MA, 02478, USA
| | - Scott L. Rauch
- Department of Psychiatry, Harvard Medical School, Boston, MA, 02115, USA
- Institute for Technology in Psychiatry, McLean Hospital, Belmont, MA, 02478, USA
- Department of Psychiatry, McLean Hospital, Belmont, MA, 02478, USA
| | - John P. Haran
- Department of Emergency Medicine, University of Massachusetts Medical School, Worcester, MA, 01655, USA
| | - Alan B. Storrow
- Department of Emergency Medicine, Vanderbilt University Medical Center, Nashville, TN, 37232, USA
| | | | - Paul I. Musey
- Department of Emergency Medicine, Indiana University School of Medicine, Indianapolis, IN, 46202, USA
| | - Phyllis L. Hendry
- Department of Emergency Medicine, University of Florida College of Medicine -Jacksonville, Jacksonville, FL, 32209, USA
| | - Sophia Sheikh
- Department of Emergency Medicine, University of Florida College of Medicine -Jacksonville, Jacksonville, FL, 32209, USA
| | - Christopher W. Jones
- Department of Emergency Medicine, Cooper Medical School of Rowan University, Camden, NJ, 08103, USA
| | - Brittany E. Punches
- Department of Emergency Medicine, University of Cincinnati College of Medicine, Cincinnati, OH, 45267, USA
- College of Nursing, University of Cincinnati, Cincinnati, OH, 45221, USA
| | - Michael C. Kurz
- Department of Emergency Medicine, University of Alabama School of Medicine, Birmingham, AL, 35294, USA
- Department of Surgery, Division of Acute Care Surgery, University of Alabama School of Medicine, Birmingham, AL, 35294, USA
- Center for Injury Science, University of Alabama at Birmingham, Birmingham, AL, 35294, USA
| | - Vishnu P. Murty
- Department of Psychology, Temple University, Philadelphia, PA, 19121, USA
| | - Meghan E. McGrath
- Department of Emergency Medicine, Boston Medical Center, Boston, MA, 02118, USA
| | - Lauren A. Hudak
- Department of Emergency Medicine, Emory University School of Medicine, Atlanta, GA, 30329, USA
| | - Jose L. Pascual
- Department of Surgery, Department of Neurosurgery, University of Pennsylvania, Pennsylvania, PA, 19104, USA
- Perelman School of Medicine, University of Pennsylvania, Pennsylvania, PA, 19104, USA
| | - Mark J. Seamon
- Perelman School of Medicine, University of Pennsylvania, Pennsylvania, PA, 19104, USA
- Department of Surgery, Division of Traumatology, Surgical Critical Care and Emergency Surgery, University of Pennsylvania, Pennsylvania, PA, 19104, USA
| | - Elizabeth M. Datner
- Department of Emergency Medicine, Einstein Healthcare Network, Pennsylvania, PA, 19141, USA
- Department of Emergency Medicine, Sidney Kimmel Medical College, Thomas Jefferson University, Pennsylvania, PA, 19107, USA
| | - Anna M. Chang
- Department of Emergency Medicine, Jefferson University Hospitals, Pennsylvania, PA, 19107, USA
| | - Claire Pearson
- Department of Emergency Medicine, Wayne State University, Detroit, MA, 48202, USA
| | - David A. Peak
- Department of Emergency Medicine, Massachusetts General Hospital, Boston, MA, 02114, USA
| | - Roland C. Merchant
- Department of Emergency Medicine, Brigham and Women's Hospital, Boston, MA, 02115, USA
| | - Robert M. Domeier
- Department of Emergency Medicine, Saint Joseph Mercy Hospital, Ypsilanti, MI, 48197, USA
| | - Niels K. Rathlev
- Department of Emergency Medicine, University of Massachusetts Medical School-Baystate, Springfield, MA, 01107, USA
| | - Brian J. O'Neil
- Department of Emergency Medicine, Wayne State University, Detroit, MA, 48202, USA
| | - Leon D. Sanchez
- Department of Emergency Medicine, Brigham and Women's Hospital, Boston, MA, 02115, USA
- Department of Emergency Medicine, Harvard Medical School, Boston, MA, 02115, USA
| | - Steven E. Bruce
- Department of Psychological Sciences, University of Missouri - St. Louis, St. Louis, MO, 63121, USA
| | - Mark W. Miller
- National Center for PTSD, Behavioral Science Division, VA Boston Healthcare System, Boston, MA, 02130, USA
- Department of Psychiatry, Boston University School of Medicine, Boston, MA, 02118, USA
| | - Robert H. Pietrzak
- National Center for PTSD, Clinical Neurosciences Division, VA Connecticut Healthcare System, West Haven, CT, 06516, USA
- Department of Psychiatry, Yale School of Medicine, New Haven, CT, 06510, USA
| | - Jutta Joormann
- Department of Psychology, Yale School of Medicine, New Haven, CT, 06510, USA
| | - Deanna M. Barch
- Department of Psychological & Brain Sciences, Washington University in St. Louis, St. Louis, MO, 63130, USA
| | - Diego A. Pizzagalli
- Department of Psychiatry, Harvard Medical School, Boston, MA, 02115, USA
- Division of Depression and Anxiety, McLean Hospital, Belmont, MA, 02478, USA
| | - John F. Sheridan
- Department of Biosciences, OSU Wexner Medical Center, Columbus, OH, 43210, USA
- Institute for Behavioral Medicine Research, OSU Wexner Medical Center, Columbus, OH, 43211, USA
| | - Beatriz Luna
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA, 15213, USA
| | - Steven E. Harte
- Department of Anesthesiology, University of Michigan Medical School, Ann Arbor, MI, 48109, USA
- Department of Internal Medicine-Rheumatology, University of Michigan Medical School, Ann Arbor, MI, 48109, USA
| | - James M. Elliott
- Kolling Institute of Medical Research, University of Sydney, St Leonards, New South Wales, 2065, Australia
- Faculty of Medicine and Health, University of Sydney, Northern Sydney Local Health District, New South Wales, 2006, Australia
- Physical Therapy & Human Movement Sciences, Feinberg School of Medicine, Northwestern University, Chicago, IL, 60208, USA
| | - Karestan C. Koenen
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Harvard University, Boston, MA, 02115, USA
| | - Ronald C. Kessler
- Department of Health Care Policy, Harvard Medical School, Boston, MA, 02115, USA
| | - Samuel A. McLean
- Institute for Trauma Recovery, Department of Anesthesiology, University of North Carolina at Chapel Hill, Chapel Hill, NC, 27559, USA
- Department of Emergency Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC, 27559, USA
| | - Kerry J. Ressler
- Department of Psychiatry, Harvard Medical School, Boston, MA, 02115, USA
- Division of Depression and Anxiety, McLean Hospital, Belmont, MA, 02478, USA
| | - Tanja Jovanovic
- Department of Psychiatry and Behavioral Neurosciences, Wayne State University, Detroit, MA, 48202, USA
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18
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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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19
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Marković V, Vicario CM, Yavari F, Salehinejad MA, Nitsche MA. A Systematic Review on the Effect of Transcranial Direct Current and Magnetic Stimulation on Fear Memory and Extinction. Front Hum Neurosci 2021; 15:655947. [PMID: 33828472 PMCID: PMC8019721 DOI: 10.3389/fnhum.2021.655947] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2021] [Accepted: 02/25/2021] [Indexed: 12/13/2022] Open
Abstract
Anxiety disorders are among the most prevalent mental disorders. Present treatments such as cognitive behavior therapy and pharmacological treatments show only moderate success, which emphasizes the importance for the development of new treatment protocols. Non-invasive brain stimulation methods such as repetitive transcranial magnetic stimulation (rTMS) and transcranial direct current stimulation (tDCS) have been probed as therapeutic option for anxiety disorders in recent years. Mechanistic information about their mode of action, and most efficient protocols is however limited. Here the fear extinction model can serve as a model of exposure therapies for studying therapeutic mechanisms, and development of appropriate intervention protocols. We systematically reviewed 30 research articles that investigated the impact of rTMS and tDCS on fear memory and extinction in animal models and humans, in clinical and healthy populations. The results of these studies suggest that tDCS and rTMS can be efficient methods to modulate fear memory and extinction. Furthermore, excitability-enhancing stimulation applied over the vmPFC showed the strongest potential to enhance fear extinction. We further discuss factors that determine the efficacy of rTMS and tDCS in the context of the fear extinction model and provide future directions to optimize parameters and protocols of stimulation for research and treatment.
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Affiliation(s)
- Vuk Marković
- Department of Psychology and Neurosciences, Leibniz Research Centre for Working Environment and Human Factors, Dortmund, Germany
- International Graduate School of Neuroscience, Ruhr-University-Bochum, Bochum, Germany
| | | | - Fatemeh Yavari
- Department of Psychology and Neurosciences, Leibniz Research Centre for Working Environment and Human Factors, Dortmund, Germany
| | - Mohammad A. Salehinejad
- Department of Psychology and Neurosciences, Leibniz Research Centre for Working Environment and Human Factors, Dortmund, Germany
| | - Michael A. Nitsche
- International Graduate School of Neuroscience, Ruhr-University-Bochum, Bochum, Germany
- Department of Neurology, University Medical Hospital Bergmannsheil, Bochum, Germany
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20
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Reist C, Jovanovic T, Kantarovich D, Weingast L, Hollifield M, Novin M, Khalaghizadeh S, Jafari B, George R, Riser M, Woodford J, Norrholm SD. An analysis of fear inhibition and fear extinction in a sample of veterans with obstructive sleep apnea (OSA): Implications for co-morbidity with post-traumatic stress disorder (PTSD). Behav Brain Res 2021; 404:113172. [PMID: 33577879 DOI: 10.1016/j.bbr.2021.113172] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2020] [Revised: 01/13/2021] [Accepted: 02/04/2021] [Indexed: 01/05/2023]
Abstract
Obstructive sleep apnea (OSA) is a respiratory condition characterized by interrupted sleep due to repeated, temporary collapse of the soft tissue of the upper airway that can lead to a cascade of physiological and psychological adverse health outcomes. The most common therapeutic interventions for OSA patients include the application of continuous positive airway pressure (CPAP) which acts to keep the airway open and, as such, provides less interrupted and more restorative sleep. Improved sleep has been linked to more efficacious treatments for psychiatric conditions most notably those that include cognitive-behavioral elements, new learning, and memory consolidation. In the current study, we investigated the acquisition, inhibition, and extinction of conditioned fear in OSA patients, before and after CPAP therapy, using an established fear-potentiated startle paradigm. Patients with OSA displayed an intact ability to acquire, inhibit, and extinguish fear prior to CPAP treatment and this ability was significantly enhanced following CPAP usage. In addition, those patients with more severe OSA, as measured by apnea-hypopnea index (AHI), were more likely to show improved fear inhibition and extinction. Lastly, we observed impairments in discrimination between reinforced and nonreinforced conditioned stimuli, in the inhibition of fear, and in fear extinction in a subset of patients with OSA and co-morbid posttraumatic stress disorder (PTSD). These data suggest that evolving treatment algorithms for PTSD should address disrupted sleep problems prior to initiation of inhibition/extinction-based exposure therapies.
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Affiliation(s)
- Christopher Reist
- Research Service, Long Beach VA Healthcare System, 5901 East 7(th) Street, Long Beach, CA, 90822, United States; Science 37, 12121 Bluff Creek Drive, Los Angeles, CA, 90094, United States
| | - Tanja Jovanovic
- Neuroscience Center for Anxiety, Stress, and Trauma (NeuroCAST), Department of Psychiatry and Behavioral Neurosciences, Wayne State University School of Medicine, 3901 Chrysler Service Drive, Detroit, MI, 48201, United States
| | - Diana Kantarovich
- Chicago Medical School, Rosalind Franklin University, 3333 Green Bay Road, North Chicago, IL, 60064, United States
| | - Leah Weingast
- Teachers College, Columbia University, 525 West 120(th) Street, New York, NY, 10027, United States
| | - Michael Hollifield
- Research Service, Long Beach VA Healthcare System, 5901 East 7(th) Street, Long Beach, CA, 90822, United States
| | - Mahmood Novin
- Research Service, Long Beach VA Healthcare System, 5901 East 7(th) Street, Long Beach, CA, 90822, United States
| | - Sakineh Khalaghizadeh
- Research Service, Long Beach VA Healthcare System, 5901 East 7(th) Street, Long Beach, CA, 90822, United States
| | - Behrouz Jafari
- Research Service, Long Beach VA Healthcare System, 5901 East 7(th) Street, Long Beach, CA, 90822, United States
| | - Renie George
- Neuroscience Center for Anxiety, Stress, and Trauma (NeuroCAST), Department of Psychiatry and Behavioral Neurosciences, Wayne State University School of Medicine, 3901 Chrysler Service Drive, Detroit, MI, 48201, United States
| | - Manessa Riser
- Neuroscience Center for Anxiety, Stress, and Trauma (NeuroCAST), Department of Psychiatry and Behavioral Neurosciences, Wayne State University School of Medicine, 3901 Chrysler Service Drive, Detroit, MI, 48201, United States
| | - Jessica Woodford
- Neuroscience Center for Anxiety, Stress, and Trauma (NeuroCAST), Department of Psychiatry and Behavioral Neurosciences, Wayne State University School of Medicine, 3901 Chrysler Service Drive, Detroit, MI, 48201, United States
| | - Seth D Norrholm
- Neuroscience Center for Anxiety, Stress, and Trauma (NeuroCAST), Department of Psychiatry and Behavioral Neurosciences, Wayne State University School of Medicine, 3901 Chrysler Service Drive, Detroit, MI, 48201, United States.
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21
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Chen W, Li J, Xu L, Zhao S, Fan M, Zheng X. Destabilizing Different Strengths of Fear Memories Requires Different Degrees of Prediction Error During Retrieval. Front Behav Neurosci 2021; 14:598924. [PMID: 33488366 PMCID: PMC7820768 DOI: 10.3389/fnbeh.2020.598924] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2020] [Accepted: 11/26/2020] [Indexed: 11/13/2022] Open
Abstract
Reactivation of consolidated memories can induce a labile period, in which these reactivated memories might be susceptible to change and need reconsolidation. Prediction error (PE) has been recognized as a necessary boundary condition for memory destabilization. Moreover, memory strength is also widely accepted as an essential boundary condition to destabilize fear memory. This study investigated whether different strengths of conditioned fear memories require different degrees of PE during memory reactivation in order for the memories to become destabilized. Here, we assessed the fear-potentiated startle and skin conductance response, using the post-retrieval extinction procedure. A violation of expectancy (PE) was induced during retrieval to reactivate enhanced (unpredictable-shock) or ordinary (predictable-shock) fear memories that were established the day before. Results showed that a PE retrieval before extinction can prevent the return of predictable-shock fear memory but cannot prevent the return of unpredictable-shock fear memory, indicating that a single PE is insufficient to destabilize enhanced fear memory. Therefore, we further investigated whether increasing the degree of PE could destabilize enhanced fear memory using different retrieval strategies (multiple PE retrieval and unreinforced CS retrieval). We found that spontaneous recovery of enhanced fear memory was prevented in both retrieval strategies, but reinstatement was only prevented in the multiple PE retrieval group, suggesting that a larger amount of PE is needed to destabilize enhanced fear memory. The findings suggest that behavioral updating during destabilization requires PE, and the degree of PE needed to induce memory destabilization during memory retrieval depends on the strength of fear memory. The study indicates that memory reconsolidation inference can be used to destabilize stronger memories, and the findings shed lights on the treatment of posttraumatic stress disorders and anxiety disorders.
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Affiliation(s)
- Wei Chen
- Key Laboratory of Brain, Cognition and Education Sciences (South China Normal University), Ministry of Education, Guangzhou, China.,School of Psychology, Center for Studies of Psychological Application, Guangdong Key Laboratory of Mental Health and Cognitive Science, South China Normal University, Guangzhou, China
| | - Junjiao Li
- College of Teacher Education, Guangdong University of Education, Guangzhou, China
| | - Liang Xu
- Guangdong Communication Polytechnic, Guangzhou, China
| | - Shaochen Zhao
- Key Laboratory of Brain, Cognition and Education Sciences (South China Normal University), Ministry of Education, Guangzhou, China.,School of Psychology, Center for Studies of Psychological Application, Guangdong Key Laboratory of Mental Health and Cognitive Science, South China Normal University, Guangzhou, China.,China People's Police University, Guangzhou, China
| | - Min Fan
- Key Laboratory of Brain, Cognition and Education Sciences (South China Normal University), Ministry of Education, Guangzhou, China.,School of Psychology, Center for Studies of Psychological Application, Guangdong Key Laboratory of Mental Health and Cognitive Science, South China Normal University, Guangzhou, China
| | - Xifu Zheng
- Key Laboratory of Brain, Cognition and Education Sciences (South China Normal University), Ministry of Education, Guangzhou, China.,School of Psychology, Center for Studies of Psychological Application, Guangdong Key Laboratory of Mental Health and Cognitive Science, South China Normal University, Guangzhou, China
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22
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Hessl D, Libero L, Schneider A, Kerns C, Winder-Patel B, Heath B, Lee J, Coleman C, Sharma N, Solomon M, Nordahl CW, Amaral DG. Fear Potentiated Startle in Children With Autism Spectrum Disorder: Association With Anxiety Symptoms and Amygdala Volume. Autism Res 2020; 14:450-463. [PMID: 33372389 DOI: 10.1002/aur.2460] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2020] [Revised: 12/05/2020] [Accepted: 12/08/2020] [Indexed: 12/16/2022]
Abstract
Atypical responses to fearful stimuli and the presence of various forms of anxiety are commonly seen in children with autism spectrum disorder (ASD). The fear potentiated startle paradigm (FPS), which has been studied both in relation to anxiety and as a probe for amygdala function, was carried out in 97 children aged 9-14 years including 48 (12 female) with ASD and 49 (14 female) with typical development (TD). In addition, exploratory analyses were conducted examining the association between FPS and amygdala volume as assessed with magnetic resonance imaging in a subset of the children with ASD with or without an anxiety disorder with available MRI data. While the startle latency was increased in the children with ASD, there was no group difference in FPS. FPS was not significantly associated with traditional Diagnostic and Statistical Manual (DSM) or "autism distinct" forms of anxiety. Within the autism group, FPS was negatively correlated with amygdala volume. Multiple regression analyses revealed that the association between FPS and anxiety severity was significantly moderated by the size of the amygdala, such that the association between FPS and anxiety was significantly more positive in children with larger amygdalas than smaller amygdalas. These findings highlight the heterogeneity of emotional reactivity associated with ASD and the difficulties in establishing biologically meaningful probes of altered brain function. LAY SUMMARY: Many children with autism spectrum disorder (ASD) have additional problems such as anxiety that can greatly impact their lives. How these co-occurring symptoms develop is not well understood. We studied the amygdala, a region of the brain critical for processing fear and a laboratory method called fear potentiated startle for measuring fear conditioning, in children with ASD (with and without an anxiety disorder) and typically developing children. Results showed that the connection between fear conditioning and anxiety is dependent on the size of the amygdala in children with ASD.
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Affiliation(s)
- David Hessl
- The MIND Institute, University of California Davis, Sacramento, CA, USA.,Department of Psychiatry and Behavioral Sciences, University of California Davis, Sacramento, CA, USA
| | - Lauren Libero
- The MIND Institute, University of California Davis, Sacramento, CA, USA.,Department of Psychiatry and Behavioral Sciences, University of California Davis, Sacramento, CA, USA
| | - Andrea Schneider
- The MIND Institute, University of California Davis, Sacramento, CA, USA.,Department of Pediatrics, University of California Davis, Sacramento, CA, USA
| | - Connor Kerns
- Department of Psychology, University of British Columbia, Vancouver, British Columbia, Canada
| | - Breanna Winder-Patel
- The MIND Institute, University of California Davis, Sacramento, CA, USA.,Department of Pediatrics, University of California Davis, Sacramento, CA, USA
| | - Brianna Heath
- Department of Psychiatry and Behavioral Sciences, University of California Davis, Sacramento, CA, USA
| | - Joshua Lee
- The MIND Institute, University of California Davis, Sacramento, CA, USA.,Department of Psychiatry and Behavioral Sciences, University of California Davis, Sacramento, CA, USA
| | - Cory Coleman
- Department of Psychiatry and Behavioral Sciences, University of California Davis, Sacramento, CA, USA
| | - Natasha Sharma
- Department of Psychiatry and Behavioral Sciences, University of California Davis, Sacramento, CA, USA
| | - Marjorie Solomon
- The MIND Institute, University of California Davis, Sacramento, CA, USA.,Department of Psychiatry and Behavioral Sciences, University of California Davis, Sacramento, CA, USA
| | - Christine Wu Nordahl
- The MIND Institute, University of California Davis, Sacramento, CA, USA.,Department of Psychiatry and Behavioral Sciences, University of California Davis, Sacramento, CA, USA
| | - David G Amaral
- The MIND Institute, University of California Davis, Sacramento, CA, USA.,Department of Psychiatry and Behavioral Sciences, University of California Davis, Sacramento, CA, USA
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23
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Krueger JN, Sangha S. On the basis of sex: Differences in safety discrimination vs. conditioned inhibition. Behav Brain Res 2020; 400:113024. [PMID: 33290755 DOI: 10.1016/j.bbr.2020.113024] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2020] [Revised: 10/19/2020] [Accepted: 11/18/2020] [Indexed: 01/04/2023]
Abstract
Inaccurate discrimination between threat and safety cues is a common symptom of anxiety disorders such as Post-Traumatic Stress Disorder (PTSD). Although females experience higher rates of these disorders than males, the body of literature examining sex differences in safety learning is still growing. Learning to discriminate safety cues from threat cues requires downregulating fear to the safety cue while continuing to express fear to the threat cue. However, successful discrimination between safety and threat cues does not necessarily guarantee that the safety cue can effectively reduce fear to the threat cue when they are presented together. The conditioned inhibitory ability of a safety cue to reduce fear in the presence of both safety and threat is most likely dependent on the ability to discriminate between the two. There are relatively few studies exploring conditioned inhibition as a method of safety learning. Adding to this knowledge gap is the general lack of inclusion of female subjects within these studies. In this review, we provide a qualitative review of our current knowledge of sex differences in safety discrimination versus conditioned inhibition in both humans and rodents. Overall, the literature suggests that while females and males perform similarly in discrimination learning, females show deficits in conditioned inhibition compared to males. Furthermore, while estrogen appears to have a protective effect on safety learning in humans, increased estrogen in female rodents appears to be correlated with impaired safety learning performance.
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Affiliation(s)
- Jamie N Krueger
- Department of Psychological Sciences, Purdue University, West Lafayette, IN, 47907, USA; Purdue Institute for Integrative Neuroscience, Purdue University, West Lafayette, IN, 47907, USA.
| | - Susan Sangha
- Department of Psychological Sciences, Purdue University, West Lafayette, IN, 47907, USA; Purdue Institute for Integrative Neuroscience, Purdue University, West Lafayette, IN, 47907, USA.
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24
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Seligowski AV, Reffi AN, Phillips KA, Orcutt HK, Auerbach RP, Pizzagalli DA, Ressler KJ. Neurophysiological responses to safety signals and the role of cardiac vagal control. Behav Brain Res 2020; 396:112914. [PMID: 32976862 DOI: 10.1016/j.bbr.2020.112914] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2020] [Revised: 09/03/2020] [Accepted: 09/10/2020] [Indexed: 01/03/2023]
Abstract
BACKGROUND Deficits in safety signal learning are well-established in fear-related disorders (e.g., PTSD, phobias). The current study used a fear conditioning paradigm to test associations among eye blink startle and event-related brain potential (ERP) latency measures of safety signal learning, as well as the role of cardiac vagal control (a measure of top-down inhibition necessary for safety learning). METHODS Participants were 49 trauma-exposed women ages 17 to 28 years. Eyeblink startle response and ERP amplitudes/latencies were derived for conditioned stimuli associated (CS+) and not associated (CS-) with an aversive unconditioned stimulus. ERPs included the P100 and late positive potential (LPP), which index early visual processing and sustained emotional encoding, respectively. Cardiac vagal control was assessed with resting heart rate variability (HRV). RESULTS P100 and LPP latencies for the CS- (safety signal stimulus) were significantly negatively associated with startle to the CS-, but not the CS + . LPP CS- latencies were significantly negatively associated with PTSD Intrusion scores, and this relationship was moderated by vagal control, such that the effect was only present among those with low HRV. CONCLUSIONS ERP-based markers of safety signal learning were associated with startle response to the CS- (but not CS+) and PTSD symptoms, indicating that these markers may have relevance for fear-related disorders. Cardiac vagal control indexed by HRV is a moderating factor in these associations and may be relevant to safety signal learning.
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Affiliation(s)
- Antonia V Seligowski
- Department of Psychiatry, Harvard Medical School, Boston, MA, USA; McLean Hospital, Belmont, MA, USA.
| | - Anthony N Reffi
- Department of Psychology, Northern Illinois University, DeKalb, IL, USA
| | | | - Holly K Orcutt
- Department of Psychology, Northern Illinois University, DeKalb, IL, USA
| | - Randy P Auerbach
- Department of Psychiatry, Columbia University, New York, NY, USA; Division of Clinical Developmental Neuroscience, Sackler Institute, New York, NY USA
| | - Diego A Pizzagalli
- Department of Psychiatry, Harvard Medical School, Boston, MA, USA; McLean Hospital, Belmont, MA, USA
| | - Kerry J Ressler
- Department of Psychiatry, Harvard Medical School, Boston, MA, USA; McLean Hospital, Belmont, MA, USA
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25
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Borgomaneri S, Battaglia S, Garofalo S, Tortora F, Avenanti A, di Pellegrino G. State-Dependent TMS over Prefrontal Cortex Disrupts Fear-Memory Reconsolidation and Prevents the Return of Fear. Curr Biol 2020; 30:3672-3679.e4. [DOI: 10.1016/j.cub.2020.06.091] [Citation(s) in RCA: 33] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2019] [Revised: 06/05/2020] [Accepted: 06/25/2020] [Indexed: 01/09/2023]
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26
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Krisch KA, Bandarian-Balooch S, Neumann DL, Zhong J. Eliciting and attenuating reinstatement of fear: Effects of an unextinguished CS. LEARNING AND MOTIVATION 2020. [DOI: 10.1016/j.lmot.2020.101650] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
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27
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Meulders A. Fear in the context of pain: Lessons learned from 100 years of fear conditioning research. Behav Res Ther 2020; 131:103635. [DOI: 10.1016/j.brat.2020.103635] [Citation(s) in RCA: 50] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2019] [Revised: 04/20/2020] [Accepted: 04/24/2020] [Indexed: 02/06/2023]
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28
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Measuring learning in human classical threat conditioning: Translational, cognitive and methodological considerations. Neurosci Biobehav Rev 2020; 114:96-112. [DOI: 10.1016/j.neubiorev.2020.04.019] [Citation(s) in RCA: 36] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2019] [Revised: 04/15/2020] [Accepted: 04/18/2020] [Indexed: 02/06/2023]
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29
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Pöhlchen D, Leuchs L, Binder FP, Blaskovich B, Nantawisarakul T, Topalidis P, Brückl TM, Norrholm SD, Jovanovic T, Spoormaker VI, Binder EB, Czisch M, Erhardt A, Grandi NC, Ilic-Cocic S, Lucae S, Sämann P, Tontsch A. No robust differences in fear conditioning between patients with fear-related disorders and healthy controls. Behav Res Ther 2020; 129:103610. [DOI: 10.1016/j.brat.2020.103610] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2019] [Revised: 03/09/2020] [Accepted: 03/23/2020] [Indexed: 11/29/2022]
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30
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Wickramasuriya DS, Faghih RT. A mixed filter algorithm for sympathetic arousal tracking from skin conductance and heart rate measurements in Pavlovian fear conditioning. PLoS One 2020; 15:e0231659. [PMID: 32324756 PMCID: PMC7179889 DOI: 10.1371/journal.pone.0231659] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2019] [Accepted: 03/29/2020] [Indexed: 01/09/2023] Open
Abstract
Pathological fear and anxiety disorders can have debilitating impacts on individual patients and society. The neural circuitry underlying fear learning and extinction has been known to play a crucial role in the development and maintenance of anxiety disorders. Pavlovian conditioning, where a subject learns an association between a biologically-relevant stimulus and a neutral cue, has been instrumental in guiding the development of therapies for treating anxiety disorders. To date, a number of physiological signal responses such as skin conductance, heart rate, electroencephalography and cerebral blood flow have been analyzed in Pavlovian fear conditioning experiments. However, physiological markers are often examined separately to gain insight into the neural processes underlying fear acquisition. We propose a method to track a single brain-related sympathetic arousal state from physiological signal features during fear conditioning. We develop a state-space formulation that probabilistically relates features from skin conductance and heart rate to the unobserved sympathetic arousal state. We use an expectation-maximization framework for state estimation and model parameter recovery. State estimation is performed via Bayesian filtering. We evaluate our model on simulated and experimental data acquired in a trace fear conditioning experiment. Results on simulated data show the ability of our proposed method to estimate an unobserved arousal state and recover model parameters. Results on experimental data are consistent with skin conductance measurements and provide good fits to heartbeats modeled as a binary point process. The ability to track arousal from skin conductance and heart rate within a state-space model is an important precursor to the development of wearable monitors that could aid in patient care. Anxiety and trauma-related disorders are often accompanied by a heightened sympathetic tone and the methods described herein could find clinical applications in remote monitoring for therapeutic purposes.
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Affiliation(s)
- Dilranjan S. Wickramasuriya
- Department of Electrical and Computer Engineering, University of Houston, Houston, Texas, United States of America
| | - Rose T. Faghih
- Department of Electrical and Computer Engineering, University of Houston, Houston, Texas, United States of America
- * E-mail:
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Taylor JE, Lau H, Seymour B, Nakae A, Sumioka H, Kawato M, Koizumi A. An Evolutionarily Threat-Relevant Odor Strengthens Human Fear Memory. Front Neurosci 2020; 14:255. [PMID: 32425741 PMCID: PMC7212458 DOI: 10.3389/fnins.2020.00255] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2019] [Accepted: 03/06/2020] [Indexed: 11/13/2022] Open
Abstract
Olfaction is an evolutionary ancient sense, but it remains unclear to what extent it can influence routine human behavior. We examined whether a threat-relevant predator odor (2-methyl-2-thiazoline) would contextually enhance the formation of human fear memory associations. Participants who learned to associate visual stimuli with electric shock in this predator odor context later showed stronger fear responses to the visual stimuli than participants who learned in an aversiveness-matched control odor context. This effect generalized to testing in another odor context, even after extinction training. Results of a separate experiment indicate that a possible biological mechanism for this effect may be increased cortisol levels in a predator odor context. These results suggest that innate olfactory processes can play an important role in human fear learning. Modulatory influences of odor contexts may partly explain the sometimes maladaptive persistence of human fear memory, e.g., in post-traumatic stress disorders.
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Affiliation(s)
- Jessica E Taylor
- Department of Decoded Neurofeedback (DecNef), Computational Neuroscience Laboratories, Advanced Telecommunications Research Institute International, Kyoto, Japan
| | - Hakwan Lau
- Department of Decoded Neurofeedback (DecNef), Computational Neuroscience Laboratories, Advanced Telecommunications Research Institute International, Kyoto, Japan.,Department of Psychology, Brain Research Institute, University of California, Los Angeles, Los Angeles, CA, United States.,Department of Psychology, University of Hong Kong, Pokfulam, Hong Kong
| | - Ben Seymour
- Center for Information and Neural Networks (CiNet), National Institute of Information and Communications Technology (NICT), Osaka, Japan.,Computational and Biological Learning Lab, Department of Engineering, University of Cambridge, Cambridge, United Kingdom.,Department of Neural Computation for Decision-Making, Cognitive Mechanisms Laboratories, Advanced Telecommunications Research Institute International, Kyoto, Japan
| | - Aya Nakae
- Graduate School of Frontier Biosciences, Osaka University, Osaka, Japan
| | - Hidenobu Sumioka
- Hiroshi Ishiguro Laboratories, Advanced Telecommunications Research Institute International, Kyoto, Japan
| | - Mitsuo Kawato
- Department of Decoded Neurofeedback (DecNef), Computational Neuroscience Laboratories, Advanced Telecommunications Research Institute International, Kyoto, Japan.,Center for Information and Neural Networks (CiNet), National Institute of Information and Communications Technology (NICT), Osaka, Japan
| | - Ai Koizumi
- Department of Decoded Neurofeedback (DecNef), Computational Neuroscience Laboratories, Advanced Telecommunications Research Institute International, Kyoto, Japan.,Center for Information and Neural Networks (CiNet), National Institute of Information and Communications Technology (NICT), Osaka, Japan.,Sony Computer Science Laboratories, Inc., Tokyo, Japan
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Ferreira de Sá DS, Römer S, Brückner AH, Issler T, Hauck A, Michael T. Effects of intranasal insulin as an enhancer of fear extinction: a randomized, double-blind, placebo-controlled experimental study. Neuropsychopharmacology 2020; 45:753-760. [PMID: 31896118 PMCID: PMC7076012 DOI: 10.1038/s41386-019-0593-3] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/05/2019] [Revised: 11/26/2019] [Accepted: 12/16/2019] [Indexed: 01/27/2023]
Abstract
Fear-extinction based psychotherapy (exposure) is the most effective method for treating anxiety disorders. Notwithstanding, since some patients show impairments in the unlearning of fear and insufficient fear remission, there is a growing interest in using cognitive enhancers as adjuvants to exposure. As insulin plays a critical role in stress processes and acts as a memory enhancer, this study aimed to assess the capacity of intranasal insulin to augment fear extinction. A double-blind, placebo-controlled differential fear-conditioning paradigm was conducted in 123 healthy participants (63 females). Pictures of faces with neutral expressions were used as conditioned stimuli and electric shocks as unconditioned stimuli. The paradigm consisted of four phases presented on three consecutive days: acquisition (day 1), extinction (day 2), reinstatement and re-extinction (day 3). A single intranasal dose of insulin (160 IU) or placebo was applied on day 2, 45 min before fear extinction. Skin conductance response (SCR), fear-potentiated startle (FPS) and expectancy ratings were assessed. During extinction, the insulin group (independent of sex) showed a significantly stronger decrease in differential FPS in comparison with the placebo group. Furthermore, a sex-specific effect was found for SCR, with women in the insulin group showing a greater decrease of differential SCR both at early extinction and at late re-extinction. Our results provide first evidence that intranasal insulin facilitates fear extinction processes and is therefore a promising adjuvant for extinction-based therapies in anxiety and related disorders. Sex-specific effects should be taken into consideration in future studies.
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Affiliation(s)
- Diana S. Ferreira de Sá
- 0000 0001 2167 7588grid.11749.3aDivision of Clinical Psychology and Psychotherapy, Department of Psychology, Saarland University, Saarbrücken, Germany
| | - Sonja Römer
- 0000 0001 2167 7588grid.11749.3aDivision of Clinical Psychology and Psychotherapy, Department of Psychology, Saarland University, Saarbrücken, Germany
| | - Alexandra H. Brückner
- 0000 0001 2167 7588grid.11749.3aDivision of Clinical Psychology and Psychotherapy, Department of Psychology, Saarland University, Saarbrücken, Germany
| | - Tobias Issler
- 0000 0001 2167 7588grid.11749.3aDivision of Clinical Psychology and Psychotherapy, Department of Psychology, Saarland University, Saarbrücken, Germany
| | - Alexander Hauck
- 0000 0001 2167 7588grid.11749.3aDivision of Clinical Psychology and Psychotherapy, Department of Psychology, Saarland University, Saarbrücken, Germany
| | - Tanja Michael
- 0000 0001 2167 7588grid.11749.3aDivision of Clinical Psychology and Psychotherapy, Department of Psychology, Saarland University, Saarbrücken, Germany
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Pittig A, Wong AH, Glück VM, Boschet JM. Avoidance and its bi-directional relationship with conditioned fear: Mechanisms, moderators, and clinical implications. Behav Res Ther 2020; 126:103550. [DOI: 10.1016/j.brat.2020.103550] [Citation(s) in RCA: 49] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2019] [Revised: 12/16/2019] [Accepted: 01/07/2020] [Indexed: 02/08/2023]
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Sjouwerman R, Lonsdorf TB. Experimental boundary conditions of reinstatement-induced return of fear in humans: Is reinstatement in humans what we think it is? Psychophysiology 2020; 57:e13549. [PMID: 32072648 DOI: 10.1111/psyp.13549] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2019] [Revised: 01/17/2020] [Accepted: 02/01/2020] [Indexed: 11/27/2022]
Abstract
Experimental paradigms used to study reinstatement of fear in humans are characterized by procedural heterogeneity. Reinstatement protocols involve unexpected (re)-presentations of the unconditioned stimulus (USs) after fear extinction training. Here, we address the number of reinstatement USs administered as a potential boundary condition that may explain divergent findings in the field. A sample of 171 participants is exposed to a fear acquisition training, immediate extinction training, and reinstatement test experiment. Three groups differing in the number of reinstatement US are employed: one (n = 57) or four (n = 55) in experimental groups and zero (n = 59) in the control group. We adopt Bayesian statistical approaches beyond classical null hypothesis significance testing (NHST) to qualify evidence for or against this potential methodological boundary condition in reinstatement-induced return of fear. Startle potentiation to the reinstatement administration context was increased for the RI-USone compared to the RI-USzero group, supporting the role of context conditioning in reinstatement. This effect was weaker in the RI-USfour group. This, however, did not transfer to responding to conditioned stimuli during the return of fear-test: no evidence for an effect of the number of reinstatement USs (zero, one, four) was observed in behavioral or physiological measures. In sum, our results speak against the number of reinstatement USs as a potential boundary condition in experimentally induced return of fear in humans. This may challenge what we think we know about the reinstatement phenomenon in humans and call for critical reconsideration of paradigms as well as mechanisms that may underlie some reinstatement effects in the literature.
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Affiliation(s)
- Rachel Sjouwerman
- Department of Systems Neuroscience, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Tina B Lonsdorf
- Department of Systems Neuroscience, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
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Haaker J, Maren S, Andreatta M, Merz CJ, Richter J, Richter SH, Meir Drexler S, Lange MD, Jüngling K, Nees F, Seidenbecher T, Fullana MA, Wotjak CT, Lonsdorf TB. Making translation work: Harmonizing cross-species methodology in the behavioural neuroscience of Pavlovian fear conditioning. Neurosci Biobehav Rev 2019; 107:329-345. [PMID: 31521698 PMCID: PMC7822629 DOI: 10.1016/j.neubiorev.2019.09.020] [Citation(s) in RCA: 51] [Impact Index Per Article: 10.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2019] [Revised: 07/08/2019] [Accepted: 09/11/2019] [Indexed: 12/22/2022]
Abstract
Translational neuroscience bridges insights from specific mechanisms in rodents to complex functions in humans and is key to advance our general understanding of central nervous function. A prime example of translational research is the study of cross-species mechanisms that underlie responding to learned threats, by employing Pavlovian fear conditioning protocols in rodents and humans. Hitherto, evidence for (and critique of) these cross-species comparisons in fear conditioning research was based on theoretical viewpoints. Here, we provide a perspective to substantiate these theoretical concepts with empirical considerations of cross-species methodology. This meta-research perspective is expected to foster cross-species comparability and reproducibility to ultimately facilitate successful transfer of results from basic science into clinical applications.
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Affiliation(s)
- Jan Haaker
- Department of Systems Neuroscience, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
| | - Stephen Maren
- Department of Psychological and Brain Sciences and Institute for Neuroscience, Texas A&M University, College Station, TX, 77843, USA
| | - Marta Andreatta
- Department of Psychology, University of Würzburg, Würzburg, Germany; Department of Psychology, Education & Child Studies, Erasmus University Rotterdam, Netherlands
| | - Christian J Merz
- Ruhr University Bochum, Faculty of Psychology, Institute of Cognitive Neuroscience, Department of Cognitive Psychology, Germany
| | - Jan Richter
- Department of Biological and Clinical Psychology/Psychotherapy, University of Greifswald, Greifswald, Germany
| | - S Helene Richter
- Department of Behavioural Biology, University of Münster, Münster, Germany
| | - Shira Meir Drexler
- Ruhr University Bochum, Faculty of Psychology, Institute of Cognitive Neuroscience, Department of Cognitive Psychology, Germany
| | - Maren D Lange
- Institute of Physiology I, University of Münster, Münster, Germany
| | - Kay Jüngling
- Institute of Physiology I, University of Münster, Münster, Germany
| | - Frauke Nees
- Department of Cognitive and Clinical Neuroscience, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | | | - Miquel A Fullana
- Institute of Neurosciences, Hospital Clinic, Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Barcelona, Spain
| | - Carsten T Wotjak
- Neuronal Plasticity Research Group, Department of Stress Neurobiology and Neurogenetics, Max Planck Institute of Psychiatry, 80804, Munich, Germany
| | - Tina B Lonsdorf
- Department of Systems Neuroscience, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
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Riggenbach MR, Weiser JN, Mosley BE, Hipskind JJ, Wireman LE, Hess KL, Duffy TJ, Handel JK, Kaschalk MG, Reneau KE, Rorabaugh BR, Norrholm SD, Jovanovic T, Zoladz PR. Immediate pre-learning stress enhances baseline startle response and fear acquisition in a fear-potentiated startle paradigm. Behav Brain Res 2019; 371:111980. [PMID: 31145979 DOI: 10.1016/j.bbr.2019.111980] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2019] [Revised: 04/29/2019] [Accepted: 05/25/2019] [Indexed: 11/29/2022]
Abstract
Extensive work has shown that stress time-dependently influences hippocampus-dependent learning and memory. In particular, stress that is administered immediately before learning enhances long-term memory, while stress that is temporally separated from learning impairs long-term memory. We have extended these findings by examining the impact of immediate, pre-learning stress on an amygdala-dependent fear conditioning task. One hundred and forty-one healthy participants underwent a stress (socially evaluated cold pressor test) or control manipulation immediately before completing differential fear conditioning in a fear-potentiated startle paradigm. Participants then completed extinction and extinction memory testing sessions 24 and 48 h later, respectively. Stress administered immediately before acquisition increased baseline startle responses and enhanced fear learning, as evidenced by greater fear-potentiated startle to the CS + . Although no group differences were observed during extinction training on Day 2, stressed participants exhibited evidence of impaired extinction processes on Day 3, an effect that was driven by group differences in acquisition. Importantly, stressed participants' cortisol responses to the stressor on Day 1 were positively associated with CS discrimination on Days 2 and 3. These findings suggest that stress immediately before fear conditioning strengthens fear memory formation and produces a more enduring fear memory, perhaps via corticosteroid activity. Such a paradigm could be useful for understanding factors that influence traumatic memory formation.
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Affiliation(s)
- Mackenzie R Riggenbach
- Department of Psychology, Sociology, & Criminal Justice, Ohio Northern University, Ada, OH, 45810, USA
| | - Jordan N Weiser
- Department of Psychology, Sociology, & Criminal Justice, Ohio Northern University, Ada, OH, 45810, USA
| | - Brianne E Mosley
- Department of Psychology, Sociology, & Criminal Justice, Ohio Northern University, Ada, OH, 45810, USA
| | - Jennifer J Hipskind
- Department of Psychology, Sociology, & Criminal Justice, Ohio Northern University, Ada, OH, 45810, USA
| | - Leighton E Wireman
- Department of Psychology, Sociology, & Criminal Justice, Ohio Northern University, Ada, OH, 45810, USA
| | - Kelsey L Hess
- Department of Psychology, Sociology, & Criminal Justice, Ohio Northern University, Ada, OH, 45810, USA
| | - Tessa J Duffy
- Department of Psychology, Sociology, & Criminal Justice, Ohio Northern University, Ada, OH, 45810, USA
| | - Julie K Handel
- Department of Psychology, Sociology, & Criminal Justice, Ohio Northern University, Ada, OH, 45810, USA
| | - MacKenzie G Kaschalk
- Department of Psychology, Sociology, & Criminal Justice, Ohio Northern University, Ada, OH, 45810, USA
| | - Kassidy E Reneau
- Department of Psychology, Sociology, & Criminal Justice, Ohio Northern University, Ada, OH, 45810, USA
| | - Boyd R Rorabaugh
- Department of Pharmaceutical & Biomedical Sciences, Raabe College of Pharmacy, Ohio Northern University, Ada, OH, 45810, USA
| | - Seth D Norrholm
- Mental Health Service Line, Atlanta VA Medical Center, Decatur, GA, USA; Department of Psychiatry and Behavioral Sciences, Emory University, Atlanta, GA, USA
| | - Tanja Jovanovic
- Department of Psychiatry and Behavioral Sciences, Emory University, Atlanta, GA, USA
| | - Phillip R Zoladz
- Department of Psychology, Sociology, & Criminal Justice, Ohio Northern University, Ada, OH, 45810, USA.
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37
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Acute exercise-induced enhancement of fear inhibition is moderated by BDNF Val66Met polymorphism. Transl Psychiatry 2019; 9:131. [PMID: 30967530 PMCID: PMC6456490 DOI: 10.1038/s41398-019-0464-z] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/09/2018] [Revised: 02/27/2019] [Accepted: 03/23/2019] [Indexed: 01/09/2023] Open
Abstract
Rodent research indicates that acute physical exercise facilitates fear learning and inhibition. Expression of brain-derived neurotrophic factor (BDNF) may moderate the memory enhancing effects of acute exercise. We assessed the role of acute exercise in modulating extinction retention in humans, and investigated the extent to which the BDNF polymorphism influenced extinction retention. Seventy non-clinical participants engaged in a differential fear potentiated startle paradigm involving conditioning and extinction followed by random assignment to either intense exercise (n = 35) or no exercise (n = 35). Extinction retention was assessed 24 h later. Saliva samples were collected to index BDNF genotype. Exercised participants displayed significantly lower fear 24 h later relative to non-exercised participants. Moderation analyses indicated that after controlling for gender, the BDNF Val66Met polymorphism moderated the relationship between exercise and fear recovery 24 h later, such that exercise was associated with greater fear recovery in individuals with the Met allele. These findings provide initial evidence that acute exercise can impact fear extinction in humans and this effect is reduced in Met-allele carriers. This finding accords with the role of BDNF in extinction learning, and has implications for augmenting exposure-based therapies for anxiety disorders.
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Raber J, Arzy S, Bertolus JB, Depue B, Haas HE, Hofmann SG, Kangas M, Kensinger E, Lowry CA, Marusak HA, Minnier J, Mouly AM, Mühlberger A, Norrholm SD, Peltonen K, Pinna G, Rabinak C, Shiban Y, Soreq H, van der Kooij MA, Lowe L, Weingast LT, Yamashita P, Boutros SW. Current understanding of fear learning and memory in humans and animal models and the value of a linguistic approach for analyzing fear learning and memory in humans. Neurosci Biobehav Rev 2019; 105:136-177. [PMID: 30970272 DOI: 10.1016/j.neubiorev.2019.03.015] [Citation(s) in RCA: 30] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2018] [Revised: 01/30/2019] [Accepted: 03/18/2019] [Indexed: 01/04/2023]
Abstract
Fear is an emotion that serves as a driving factor in how organisms move through the world. In this review, we discuss the current understandings of the subjective experience of fear and the related biological processes involved in fear learning and memory. We first provide an overview of fear learning and memory in humans and animal models, encompassing the neurocircuitry and molecular mechanisms, the influence of genetic and environmental factors, and how fear learning paradigms have contributed to treatments for fear-related disorders, such as posttraumatic stress disorder. Current treatments as well as novel strategies, such as targeting the perisynaptic environment and use of virtual reality, are addressed. We review research on the subjective experience of fear and the role of autobiographical memory in fear-related disorders. We also discuss the gaps in our understanding of fear learning and memory, and the degree of consensus in the field. Lastly, the development of linguistic tools for assessments and treatment of fear learning and memory disorders is discussed.
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Affiliation(s)
- Jacob Raber
- Department of Behavioral Neuroscience, ONPRC, Oregon Health & Science University, Portland, OR, USA; Departments of Neurology and Radiation Medicine, and Division of Neuroscience, ONPRC, Oregon Health & Science University, Portland, OR, USA.
| | - Shahar Arzy
- Department of Medical Neurobiology, Hebrew University, Jerusalem 91904, Israel
| | | | - Brendan Depue
- Departments of Psychological and Brain Sciences and Anatomical Sciences and Neurobiology, University of Louisville, Louisville, KY, USA
| | - Haley E Haas
- Department of Psychiatry and Behavioral Science, Emory University School of Medicine, Atlanta, GA, USA
| | - Stefan G Hofmann
- Department of Psychological and Brain Sciences, Boston University, Boston, MA, USA
| | - Maria Kangas
- Department of Psychology, Macquarie University, Sydney, Australia
| | | | - Christopher A Lowry
- Department of Integrative Physiology and Center for Neuroscience, University of Colorado Boulder, Boulder, CO, USA
| | - Hilary A Marusak
- Department of Pharmacy Practice, Wayne State University, Detroit, MI, USA
| | - Jessica Minnier
- School of Public Health, Oregon Health & Science University, Portland, OR, USA
| | - Anne-Marie Mouly
- Lyon Neuroscience Research Center, CNRS-UMR 5292, INSERM U1028, Université Lyon, Lyon, France
| | - Andreas Mühlberger
- Department of Psychology (Clinical Psychology and Psychotherapy), University of Regensburg, Regensburg, Germany; PFH - Private University of Applied Sciences, Department of Psychology (Clinical Psychology and Psychotherapy Research), Göttingen, Germany
| | - Seth Davin Norrholm
- Department of Psychiatry and Behavioral Science, Emory University School of Medicine, Atlanta, GA, USA
| | - Kirsi Peltonen
- Faculty of Social Sciences/Psychology, Tampere University, Tampere, Finland
| | - Graziano Pinna
- The Psychiatric Institute, Department of Psychiatry, University of Illinois at Chicago, Chicago, IL, USA
| | - Christine Rabinak
- Department of Pharmacy Practice, Wayne State University, Detroit, MI, USA
| | - Youssef Shiban
- Department of Psychology (Clinical Psychology and Psychotherapy), University of Regensburg, Regensburg, Germany; PFH - Private University of Applied Sciences, Department of Psychology (Clinical Psychology and Psychotherapy Research), Göttingen, Germany
| | - Hermona Soreq
- Department of Biological Chemistry, Edmond and Lily Safra Center of Brain Science and The Institute of Life Sciences, Hebrew University, Jerusalem 91904, Israel
| | - Michael A van der Kooij
- Translational Psychiatry, Department of Psychiatry and Psychotherapy, Universitatsmedizin der Johannes Guttenberg University Medical Center, Mainz, Germany
| | | | - Leah T Weingast
- Department of Psychiatry and Behavioral Science, Emory University School of Medicine, Atlanta, GA, USA
| | - Paula Yamashita
- School of Public Health, Oregon Health & Science University, Portland, OR, USA
| | - Sydney Weber Boutros
- Department of Behavioral Neuroscience, ONPRC, Oregon Health & Science University, Portland, OR, USA
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Abstract
The processing and regulation of fear is one of the key components of posttraumatic stress disorder (PTSD). Fear can involve both acute and potential threats that can manifest in different behaviors and result from activity within different neural nodes and networks. Fear circuits have been studied extensively in animal models for several decades and in human neuroimaging research for almost 20 years. Therefore, the centrality of fear processing to PTSD lends the disorder to be more tractable to investigation at the level of brain and behavior, and provides several observable phenotypes that can be linked to PTSD symptoms. Moreover, psychophysiological metrics of fear conditioning offer tools that can be used to shift diagnostic paradigms in psychiatry toward neurobiology-consistent with a Research Domain Criteria approach to PTSD. In general, mammalian fear processing can be divided into fear learning (or acquisition), during which an association develops between previously neutral stimuli and aversive outcomes, and fear extinction, in which the latter associations are suppressed by a new form of learning. This review describes translational research in both fear acquisition and extinction, along with their relevance to PTSD and PTSD treatment, focusing specifically on the empirical value and potential clinical utility of psychophysiological methods.
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Zuccolo PF, Hunziker MHL. A review of boundary conditions and variables involved in the prevention of return of fear after post-retrieval extinction. Behav Processes 2019; 162:39-54. [PMID: 30708059 DOI: 10.1016/j.beproc.2019.01.011] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2018] [Revised: 12/26/2018] [Accepted: 01/25/2019] [Indexed: 11/28/2022]
Abstract
Experimental evidence suggests that the return of fear may be prevented by post-retrieval extinction (PRE), a procedure consisting of extinction training after the presentation of a retrieval cue. However, attempts to replicate these findings have yielded mixed results, with some studies showing diminished fear responses after PRE, whereas others show no effect on the return of fear following this procedure. The discrepancies across studies have been interpreted as evidence that there might be conditions under which PRE is not effective (boundary conditions), but these variables have yet to be fully described. We aimed to provide an overview of PRE in humans. We briefly present the theory and research that originated post-retrieval procedures with a focus on the experimental setup used in human studies. We continue with a compilation of possible experimental boundary conditions along with some questions for future research.
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Zuj DV, Norrholm SD. The clinical applications and practical relevance of human conditioning paradigms for posttraumatic stress disorder. Prog Neuropsychopharmacol Biol Psychiatry 2019; 88:339-351. [PMID: 30134147 DOI: 10.1016/j.pnpbp.2018.08.014] [Citation(s) in RCA: 47] [Impact Index Per Article: 9.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/20/2018] [Revised: 07/31/2018] [Accepted: 08/15/2018] [Indexed: 01/17/2023]
Abstract
The classical conditioning paradigm of fear learning has spawned a number of experimental variations for the explanation of posttraumatic stress disorder (PTSD) etiology. These paradigms include extinction learning and recall, fear inhibition, fear generalization, and conditioned avoidance. As such, each of these paradigms have significant applications for understanding the development, maintenance, treatment, and relapse of the fear-related features of PTSD. In the present review, we describe each of these conditioning-based paradigms with reference to the clinical applications, and supported by case examples from patients with severe PTSD symptoms. We also review the neurobiological models of conditioning and extinction in animals, psychiatrically healthy humans, and PTSD patients, and discuss the current balance of evidence suggesting a number of biological, behavioral, and cognitive mechanisms/moderators of the conditioning and extinction process in experimental and clinical contexts.
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Affiliation(s)
- Daniel V Zuj
- Department of Psychology, Swansea University, UK
| | - Seth Davin Norrholm
- Atlanta Veterans Affairs Medical Center, Mental Health Service Line, USA; Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, USA.
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You can do that?!: Feasibility of virtual reality exposure therapy in the treatment of PTSD due to military sexual trauma. J Anxiety Disord 2019; 61:55-63. [PMID: 30005843 DOI: 10.1016/j.janxdis.2018.06.004] [Citation(s) in RCA: 38] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/07/2017] [Revised: 03/30/2018] [Accepted: 06/14/2018] [Indexed: 01/23/2023]
Abstract
This initial feasibility study examined the use of virtual reality exposure therapy (VRE) in the treatment of MST-related PTSD, with newly developed content tailored to MST. Participants included 15 veterans (26% male) with MST-related PTSD. Assessment of PTSD, depression, and psychophysiological indicators of distress occurred at pre-treatment, post-treatment, and 3-month follow-up. Treatment included 6-12 VRE sessions. There were significant reductions in pre- to post-treatment PTSD (CAPS severity: t(10) = 3.69, p = .004; PCL-5: t(10) = 3.79, p = .004) and depressive symptoms, (PHQ-9: t(8) = 2.83, p = .022), which were maintained at follow-up. There also was a significant pre- to post-treatment reduction in heart rate response to a trauma cue. Cohen's d effect sizes were large (CAPS: d = 1.11; PCL-5: d = 1.14, PHQ-9: d = .94), and the percentage of participants meeting PTSD criteria continued to decline from post-treatment (53%) to follow-up (33%). Findings indicate VRE can be safely delivered and is a promising treatment for MST-related PTSD.
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43
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Mertens G, Boddez Y, Sevenster D, Engelhard IM, De Houwer J. A review on the effects of verbal instructions in human fear conditioning: Empirical findings, theoretical considerations, and future directions. Biol Psychol 2018; 137:49-64. [DOI: 10.1016/j.biopsycho.2018.07.002] [Citation(s) in RCA: 52] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2017] [Revised: 07/05/2018] [Accepted: 07/06/2018] [Indexed: 12/14/2022]
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Seligowski AV, Bondy E, Singleton P, Orcutt HK, Ressler KJ, Auerbach RP. Testing neurophysiological markers related to fear-potentiated startle. Psychiatry Res 2018; 267:195-200. [PMID: 29913378 DOI: 10.1016/j.psychres.2018.06.023] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/09/2018] [Revised: 06/08/2018] [Accepted: 06/10/2018] [Indexed: 11/19/2022]
Abstract
Fear-potentiated startle (FPS) paradigms provide insight into fear learning mechanisms that contribute to impairment among individuals with posttraumatic stress symptoms (PTSS). Electrophysiology also has provided insight into these mechanisms through the examination of event-related potentials (ERPs) such as the P100 and LPP. It remains unclear, however, whether the P100 and LPP may be related to fear learning processes within the FPS paradigm. To this end, we tested differences in ERP amplitudes for conditioned stimuli associated (CS+) and not associated (CS-) with an aversive unconditioned stimulus (US) during fear acquisition. Participants included 54 female undergraduate students (mean age = 20.26). The FPS response was measured via electromyography of the orbicularis oculi muscle. EEG data were collected during the FPS paradigm. While the difference between CS+ and CS- P100 amplitude was not significant, LPP amplitudes were significantly enhanced following the CS+ relative to CS-. Furthermore, the LPP difference wave (CS+ minus CS-) was associated with FPS scores for the CS- during the later portion of fear acquisition. These findings suggest that conditioned stimuli may have altered emotional encoding (LPP) during the FPS paradigm. Thus, the LPP may be a promising neurophysiological marker that is related to fear learning processes.
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Affiliation(s)
- Antonia V Seligowski
- Department of Psychiatry, Harvard Medical School, Boston, MA, USA; McLean Hospital, Belmont, MA, USA.
| | - Erin Bondy
- Department of Psychological and Brain Sciences, Washington University in St. Louis, St. Louis, MO, USA
| | - Paris Singleton
- Department of Psychiatry, Harvard Medical School, Boston, MA, USA; McLean Hospital, Belmont, MA, USA
| | - Holly K Orcutt
- Department of Psychology, Northern Illinois University, DeKalb, IL, USA
| | - Kerry J Ressler
- Department of Psychiatry, Harvard Medical School, Boston, MA, USA; McLean Hospital, Belmont, MA, USA
| | - Randy P Auerbach
- McLean Hospital, Belmont, MA, USA; Department of Psychiatry, Columbia University, New York, NY USA; Division of Clinical Developmental Neuroscience, New York, NY USA
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Zuj DV, Palmer MA, Malhi GS, Bryant RA, Felmingham KL. Greater sleep disturbance and longer sleep onset latency facilitate SCR-specific fear reinstatement in PTSD. Behav Res Ther 2018; 110:1-10. [PMID: 30145363 DOI: 10.1016/j.brat.2018.08.005] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2018] [Revised: 07/31/2018] [Accepted: 08/16/2018] [Indexed: 12/15/2022]
Abstract
Fear reinstatement is one of several paradigms designed to measure fear return following extinction, as a laboratory model for the relapse of Posttraumatic Stress Disorder (PTSD) symptoms. Sleep is a key factor in emotional memory consolidation, and here we examined the relationship between sleep quality and fear reinstatement in PTSD, relative to trauma-exposed and non-exposed controls. The Pittsburgh Sleep Quality Index (PSQI) was used as a subjective measure of sleep quality, and skin conductance responses (SCR) and unconditioned stimulus (US)-expectancy ratings were used to index threat responses during a differential fear conditioning, extinction, and reinstatement paradigm. There were no significant between-group differences in the reinstatement of conditioned responding. Sleep disturbance and sleep onset latency were significant moderators between reinstatement of fear and PTSD symptom severity, such that there was a positive relationship between PTSD symptoms and fear reinstatement for higher levels - but not lower levels - of sleep disturbance and sleep onset latency. To our knowledge, this is the first study to investigate PTSD-specific reinstatement patterns and sleep as a boundary condition of reinstatement. Future research using polysomnographic measures of sleep-wave architecture may further clarify the relationship between fear reinstatement and sleep quality in clinical samples with PTSD relative to controls.
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Affiliation(s)
- Daniel V Zuj
- Division of Psychology, School of Medicine, University of Tasmania, TAS, Australia; Department of Psychology, Swansea University, Wales, United Kingdom.
| | - Matthew A Palmer
- Division of Psychology, School of Medicine, University of Tasmania, TAS, Australia
| | - Gin S Malhi
- Department of Psychiatry, Royal North Shore Hospital, St Leonards, NSW, Australia; Sydney Medical School, University of Sydney, NSW, Australia
| | - Richard A Bryant
- School of Psychology, University of New South Wales, NSW, Australia
| | - Kim L Felmingham
- School of Psychological Sciences, University of Melbourne, VIC, Australia
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Straus LD, Norman SB, Risbrough VB, Acheson DT, Drummond SPA. REM sleep and safety signal learning in posttraumatic stress disorder: A preliminary study in military veterans. Neurobiol Stress 2018; 9:22-28. [PMID: 30116769 PMCID: PMC6084022 DOI: 10.1016/j.ynstr.2018.07.001] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2018] [Revised: 07/17/2018] [Accepted: 07/19/2018] [Indexed: 01/06/2023] Open
Abstract
Background Posttraumatic Stress Disorder (PTSD) is associated with a number of negative physical and mental health consequences. Fear conditioning plays an important mechanistic role in PTSD, and PTSD patients also show deficits in safety signal learning. Sleep, particularly REM sleep, is linked to improved safety learning and extinction processes in animal models and healthy humans. No studies have examined the link between REM sleep and safety signal learning or extinction memory in clinical populations. Methods This study examined the relationship between REM sleep, safety signal learning, and extinction processes in veterans with PTSD (n = 13). Patients' overnight sleep was characterized in the laboratory via polysomnography (PSG). The next day, participants underwent a fear conditioning paradigm during which they acquired fear toward a visual cue. This testing session also included a visual cue that became a safety signal (CS-). Following conditioning, the veterans' sleep was monitored overnight again, after which they underwent extinction training. Following a third night of sleep, extinction recall and safety recall were tested. Bivariate correlations examined the relationship between the slope of safety signal learning and subsequent REM sleep, as well as the relationship between REM sleep and subsequent extinction recall and safety recall on the last day of testing. Results Veterans learned to differentiate the CS+ and the CS- on the first day of testing. Veterans who underwent safety learning more quickly on the first day of testing showed more efficient REM sleep that night (r = .607, p = .028). On the second day of testing, the patients successfully underwent extinction learning. Patients with a higher percentage of REM sleep on the last night of the study showed more safety recall early on the last day of testing (r = .688, p = .009). Conclusion To our knowledge, this was the first study to examine the relationship between objective sleep and fear-potentiated startle performance in veterans with PTSD. Study methods were well tolerated by participants, supporting feasibility of the experimental design. Results indicated REM sleep was associated with both initial safety learning and subsequent safety recall. Taken together with previous studies in healthy controls, these preliminary results provide additional evidence suggesting REM sleep could play a mechanistic role in the maintenance of PTSD and thus identify a modifiable biological process to target in treatment of PTSD. These findings should be replicated in larger samples.
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Affiliation(s)
- Laura D Straus
- Mental Illness Research Education and Clinical Centers, San Francisco VA Healthcare System, San Francisco, CA, USA.,Department of Psychiatry, University of California, San Francisco, San Francisco, CA, USA
| | - Sonya B Norman
- National Center for PTSD, White River Junction, VT, USA.,VA Center of Excellence for Stress and Mental Health, San Diego, CA, USA.,University of California, San Diego, School of Medicine, San Diego, CA, USA
| | - Victoria B Risbrough
- VA Center of Excellence for Stress and Mental Health, San Diego, CA, USA.,University of California, San Diego, School of Medicine, San Diego, CA, USA
| | - Dean T Acheson
- VA Center of Excellence for Stress and Mental Health, San Diego, CA, USA.,University of California, San Diego, School of Medicine, San Diego, CA, USA
| | - Sean P A Drummond
- Monash Institute for Cognitive and Clinical Neuroscience, School of Psychological Sciences, Monash University, Clayton, VIC, Australia
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Ganella DE, Drummond KD, Ganella EP, Whittle S, Kim JH. Extinction of Conditioned Fear in Adolescents and Adults: A Human fMRI Study. Front Hum Neurosci 2018; 11:647. [PMID: 29358913 PMCID: PMC5766664 DOI: 10.3389/fnhum.2017.00647] [Citation(s) in RCA: 42] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2017] [Accepted: 12/18/2017] [Indexed: 01/03/2023] Open
Abstract
Little is known about the neural correlates of fear learning in adolescents, a population at increased risk for anxiety disorders. Healthy adolescents (mean age 16.26) and adults (mean age 29.85) completed a fear learning paradigm across two stages during functional magnetic resonance imaging (fMRI). Stage 1 involved conditioning and extinction, and stage 2 involved extinction recall, re-conditioning, followed by re-extinction. During extinction recall, we observed a higher skin conductance response to the CS+ relative to CS− in adolescents compared to adults, which was accompanied by a reduction in dorsolateral prefrontal cortex (dlPFC) activity. Relative to adults, adolescents also had significantly reduced activation in the ventromedial PFC, dlPFC, posterior cingulate cortex (PCC), and temporoparietal junction (TPJ) during extinction recall compared to late extinction. Age differences in PCC activation between late extinction and late conditioning were also observed. These results show for the first time that healthy adolescent humans show different behavioral responses, and dampened PFC activity during short-term extinction recall compared to healthy adults. We also identify the PCC and TPJ as novel regions that may be associated with impaired extinction in adolescents. Also, while adults showed significant correlations between differential SCR and BOLD activity in some brain regions during late extinction and recall, adolescents did not show any significant correlations. This study highlights adolescent-specific neural correlates of extinction, which may explain the peak in prevalence of anxiety disorders during adolescence.
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Affiliation(s)
- Despina E Ganella
- Behavioral Neuroscience Division, The Florey Institute of Neuroscience and Mental Health, Parkville, VIC, Australia.,Florey Department of Neuroscience and Mental Health, The University of Melbourne, Parkville, VIC, Australia
| | - Katherine D Drummond
- Behavioral Neuroscience Division, The Florey Institute of Neuroscience and Mental Health, Parkville, VIC, Australia.,Florey Department of Neuroscience and Mental Health, The University of Melbourne, Parkville, VIC, Australia
| | - Eleni P Ganella
- Melbourne Neuropsychiatry Centre, Department of Psychiatry, The University of Melbourne and Melbourne Health, Parkville, VIC, Australia
| | - Sarah Whittle
- Melbourne Neuropsychiatry Centre, Department of Psychiatry, The University of Melbourne and Melbourne Health, Parkville, VIC, Australia
| | - Jee Hyun Kim
- Behavioral Neuroscience Division, The Florey Institute of Neuroscience and Mental Health, Parkville, VIC, Australia.,Florey Department of Neuroscience and Mental Health, The University of Melbourne, Parkville, VIC, Australia
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Young MB, Norrholm SD, Khoury LM, Jovanovic T, Rauch SAM, Reiff CM, Dunlop BW, Rothbaum BO, Howell LL. Inhibition of serotonin transporters disrupts the enhancement of fear memory extinction by 3,4-methylenedioxymethamphetamine (MDMA). Psychopharmacology (Berl) 2017; 234:2883-2895. [PMID: 28741031 PMCID: PMC5693755 DOI: 10.1007/s00213-017-4684-8] [Citation(s) in RCA: 60] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/23/2017] [Accepted: 06/24/2017] [Indexed: 12/23/2022]
Abstract
RATIONALE 3,4-Methylenedioxymethamphetamine (MDMA) persistently improves symptoms of post-traumatic stress disorder (PTSD) when combined with psychotherapy. Studies in rodents suggest that these effects can be attributed to enhancement of fear memory extinction. Therefore, MDMA may improve the effects of exposure-based therapy for PTSD, particularly in treatment-resistant patients. However, given MDMA's broad pharmacological profile, further investigation is warranted before moving to a complex clinical population. OBJECTIVES We aimed to inform clinical research by providing a translational model of MDMA's effect, and elucidating monoaminergic mechanisms through which MDMA enhances fear extinction. METHODS We explored the importance of monoamine transporters targeted by MDMA to fear memory extinction, as measured by reductions in conditioned freezing and fear-potentiated startle (FPS) in mice. Mice were treated with selective inhibitors of individual monoamine transporters prior to combined MDMA treatment and fear extinction training. RESULTS MDMA enhanced the lasting extinction of FPS. Acute and chronic treatment with a 5-HT transporter (5-HTT) inhibitor blocked MDMA's effect on fear memory extinction. Acute inhibition of dopamine (DA) and norepinephrine (NE) transporters had no effect. 5-HT release alone did not enhance extinction. Blockade of MDMA's effect by 5-HTT inhibition also downregulated 5-HT2A-mediated behavior, and 5-HT2A antagonism disrupted MDMA's effect on extinction. CONCLUSIONS We validate enhancement of fear memory extinction by MDMA in a translational behavioral model, and reveal the importance of 5-HTT and 5-HT2A receptors to this effect. These observations support future clinical research of MDMA as an adjunct to exposure therapy, and provide important pharmacological considerations for clinical use in a population frequently treated with 5-HTT inhibitors.
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Affiliation(s)
- Matthew B Young
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, 954 Gatewood Rd NE #2101, Atlanta, GA, 30329, USA
| | - Seth D Norrholm
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, 954 Gatewood Rd NE #2101, Atlanta, GA, 30329, USA
- Atlanta VA Medical Center, Mental Health Service Line, Decatur, GA, USA
| | | | - Tanja Jovanovic
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, 954 Gatewood Rd NE #2101, Atlanta, GA, 30329, USA
- Atlanta VA Medical Center, Mental Health Service Line, Decatur, GA, USA
| | - Sheila A M Rauch
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, 954 Gatewood Rd NE #2101, Atlanta, GA, 30329, USA
- Atlanta VA Medical Center, Mental Health Service Line, Decatur, GA, USA
| | - Collin M Reiff
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, 954 Gatewood Rd NE #2101, Atlanta, GA, 30329, USA
| | - Boadie W Dunlop
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, 954 Gatewood Rd NE #2101, Atlanta, GA, 30329, USA
| | - Barbara O Rothbaum
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, 954 Gatewood Rd NE #2101, Atlanta, GA, 30329, USA
| | - Leonard L Howell
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, 954 Gatewood Rd NE #2101, Atlanta, GA, 30329, USA.
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49
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Galatzer-Levy IR, Andero R, Sawamura T, Jovanovic T, Papini S, Ressler KJ, Norrholm SD. A cross species study of heterogeneity in fear extinction learning in relation to FKBP5 variation and expression: Implications for the acute treatment of posttraumatic stress disorder. Neuropharmacology 2017; 116:188-195. [DOI: 10.1016/j.neuropharm.2016.12.023] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2016] [Revised: 12/01/2016] [Accepted: 12/21/2016] [Indexed: 02/03/2023]
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50
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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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