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Turkson S, van Rooij SJ, Powers A, Ofotokun I, Norrholm SD, N. Neigh G, Jovanovic T, Michopoulos V. HIV Interacts with Posttraumatic Stress Disorder to Impact Fear Psychophysiology in Trauma-Exposed Black Women. WOMEN'S HEALTH REPORTS (NEW ROCHELLE, N.Y.) 2024; 5:231-241. [PMID: 38523844 PMCID: PMC10960165 DOI: 10.1089/whr.2023.0133] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Accepted: 01/31/2024] [Indexed: 03/26/2024]
Abstract
Background The prevalence of posttraumatic stress disorder (PTSD) among people living with HIV (PLWH) is higher than in the general population and can impact health behaviors. The influence of HIV on PTSD psychophysiology requires further investigation due to implications for the treatment of PTSD in PLWH. Objective Utilizing fear-potentiated startle (FPS), we aimed to interrogate the influence of PTSD and HIV on fear responses. Materials and Methods Women (18-65 years of age) recruited from the Women's Interagency HIV Study in Atlanta, GA (n = 70, 26 without HIV and 44 with HIV), provided informed consent and completed a semistructured interview to assess trauma exposure and PTSD symptom severity. Participants also underwent an FPS paradigm to assess fear acquisition and extinction: Psychophysiological indices that measure how individuals learn new fear and then subsequently attempt to suppress this fear. Results Women with PTSD, who did not have HIV, exhibited a greater startle response compared to women without PTSD or HIV during late acquisition to both the danger cue, reinforced conditioned stimulus (CS+, p = 0.013)), and the safety cue, non-reinforced conditioned stimulus (CS-, p = 0.046)), whereas women living with HIV (WLH) and PTSD demonstrated blunted fear responses compared to women with PTSD only. During extinction, WLH comorbid with PTSD exhibited an increased fear response during the extinction period in comparison to all other groups (p = 0.023). Women without PTSD demonstrated a reduction in the fear response during extinction regardless of HIV status. Conclusion Our findings indicate that HIV further modifies fear psychophysiology in WLH with comorbid PTSD, highlighting the importance of considering HIV status in conjunction with PTSD treatment.
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Affiliation(s)
- Susie Turkson
- Department of Anatomy and Neurobiology, Virginia Commonwealth University, Richmond, Virginia, USA
| | - Sanne J.H. van Rooij
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, Georgia, USA
| | - Abigail Powers
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, Georgia, USA
| | - Ighovwerha Ofotokun
- Division of Infectious Diseases, Department of Medicine, Emory University School of Medicine, Atlanta, Georgia, USA
- Grady Health System, Atlanta, Georgia, USA
| | - Seth D. Norrholm
- Department of Psychiatry and Behavioral Neurosciences, Wayne State University, Detroit, Michigan, USA
| | - Gretchen N. Neigh
- Department of Anatomy and Neurobiology, Virginia Commonwealth University, Richmond, Virginia, USA
| | - Tanja Jovanovic
- Department of Psychiatry and Behavioral Neurosciences, Wayne State University, Detroit, Michigan, USA
| | - Vasiliki Michopoulos
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, Georgia, USA
- Emory National Primate Research Center, Atlanta, Georgia, USA
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2
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Stenson AF, France JM, Jovanovic T. Getting Better with Age? A Review of Psychophysiological Studies of Fear Extinction Learning Across Development. Curr Top Behav Neurosci 2023; 64:213-236. [PMID: 37651043 DOI: 10.1007/7854_2023_441] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/01/2023]
Abstract
A critical developmental task is learning what constitutes reliable threat and safety signals in the environment. In humans, atypical fear learning processes are implicated in many mental health conditions, particularly fear and anxiety disorders, pointing to the potential for laboratory measures of fear learning to facilitate early identification of at-risk individuals. This chapter reviews studies of fear learning and extinction learning that incorporate peripheral measures of psychophysiological response and include a developmental sample. Broadly, these studies indicate substantial consistency in differential learning and extinction across development, as assessed with multiple paradigms, across physiological indices. Importantly, though, response coherence across measures (e.g., physiological, neural, and behavioral) was inconsistent across studies. There was also less consistency in results from studies that probed associations between anxiety and fear learning processes. These mixed findings highlight the need for additional examination of when and why there is variability, both across development and in relation to individual differences factors, including mental health, childhood adversity, and sex. In addition, there remains a need for studies that test for developmental change in extinction recall learning and whether stimulus type impacts learning across development. Longitudinal studies designed to address these questions could provide novel insight into the developmental trajectory of fear learning and extinction.
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Affiliation(s)
- Anaïs F Stenson
- Department of Psychiatry and Behavioral Neurosciences, Wayne State University School of Medicine, Detroit, MI, USA.
| | - John M France
- Department of Psychiatry and Behavioral Neurosciences, Wayne State University School of Medicine, Detroit, MI, USA
| | - Tanja Jovanovic
- Department of Psychiatry and Behavioral Neurosciences, Wayne State University School of Medicine, Detroit, MI, USA
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3
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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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4
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Rasmusson AM, Pineles SL, Brown KD, Pinna G. A role for deficits in GABAergic neurosteroids and their metabolites with NMDA receptor antagonist activity in the pathophysiology of posttraumatic stress disorder. J Neuroendocrinol 2022; 34:e13062. [PMID: 34962690 PMCID: PMC9233411 DOI: 10.1111/jne.13062] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/01/2021] [Revised: 10/15/2021] [Accepted: 10/29/2021] [Indexed: 02/03/2023]
Abstract
Trauma-focused psychotherapies show general efficacy in post-traumatic stress disorder (PTSD), although outcomes vary substantially among individuals with PTSD and many patients do not achieve clinically meaningful symptom improvement. Several factors may contribute to poor treatment response, including genetic or environmental (e.g., stress) effects on neurobiological factors involved in learning and memory processes critical to PTSD recovery. In this review, we discuss the relationship between deficient GABAergic neurosteroid metabolites of progesterone, allopregnanolone (Allo) and pregnanolone (PA), and PTSD symptoms in men and women or PTSD-like behavioral abnormalities observed in male rodent models of PTSD. We also review the role and molecular underpinnings of learning and memory processes relevant to PTSD recovery, including extinction, extinction retention, reconsolidation of reactivated aversive memories and episodic non-aversive memory. We then discuss preclinical and clinical research that supports a role in these learning and memory processes for GABAergic neurosteroids and sulfated metabolites of Allo and PA that allosterically antagonize NMDA receptor function. Studies supporting the possible therapeutic impact of appropriately timed, acutely administered Allo or Allo analogs to facilitate extinction retention and/or block reconsolidation of aversive memories are also reviewed. Finally, we discuss important future directions for research in this area. Examining the varied and composite effects in PTSD of these metabolites of progesterone, as well as neuroactive derivatives of other parent steroids produced in the brain and the periphery, will likely enable a broadening of targets for treatment development. Defining contributions of these neuroactive steroids to common PTSD-comorbid psychiatric and medical conditions, as well as subpopulation-specific underlying dysfunctional physiological processes such as hypothalamic-pituitary-adrenal axis and immune system dysregulation, may also enable development of more effective multisystem precision medicines to prevent and treat the broader, polymorbid sequelae of extreme and chronic stress.
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Affiliation(s)
- Ann M. Rasmusson
- VA National Center for PTSD, Women’s Health Science Division, Department of Veterans Affairs, Boston, MA 02130, U.S.A
- Department of Psychiatry, Boston University School of Medicine, Boston, MA, 02118
| | - Suzanne L. Pineles
- VA National Center for PTSD, Women’s Health Science Division, Department of Veterans Affairs, Boston, MA 02130, U.S.A
- Department of Psychiatry, Boston University School of Medicine, Boston, MA, 02118
| | - Kayla D. Brown
- Behavioral Neurosciences PhD Program, Boston University Medical Campus, Boston, MA, 02118, U.S.A
| | - Graziano Pinna
- The Psychiatric Institute, Department of Psychiatry, University of Illinois at Chicago, Chicago, Illinois, 60612, U.S.A
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5
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Hollifield M, Hsiao AF, Carrick K, Gory Munoz A, Calloway T, Cocozza K, Smith B, Smith T, Jovanovic T, Norrholm S, Sokhadze E, Reist C. Acupuncture for combat post-traumatic stress disorder: trial development and methodological approach for a randomized controlled clinical trial. Trials 2021; 22:594. [PMID: 34488824 PMCID: PMC8419889 DOI: 10.1186/s13063-021-05394-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2020] [Accepted: 06/23/2021] [Indexed: 11/10/2022] Open
Abstract
Background Post-traumatic stress disorder (PTSD) is a significant public health problem, affecting approximately 7% of the general population and 13–18% of the combat Veteran population. The first study using acupuncture for PTSD in a civilian population showed large pre- to post-treatment effects for an empirically developed verum protocol, which was equivalent to group cognitive behavior therapy and superior to a wait-list control. The primary objective of this study is to determine both clinical and biological effects of verum acupuncture for combat-related PTSD in treatment-seeking US Veterans. Methods This is a two-arm, parallel-group, prospective randomized placebo-controlled clinical trial. The experimental condition is verum acupuncture and the placebo control is sham (minimal) acupuncture in 1-h sessions, twice a week for 12 weeks. Ninety subjects will provide adequate power and will be allocated to group by an adaptive randomization procedure. The primary outcome is change in PTSD symptom severity from pre- to post-treatment. The secondary biological outcome is change from pre- to post-treatment in psychophysiological response, startle by electromyographic (EMG) eyeblink. Assessments will be conducted at pre-, mid-, post-, and 1-month post-treatment, blind to group allocation. Intent-to-treat analyses will be conducted. Discussion The study results will be definitive because both clinical and biological outcomes will be assessed and correlated. Issues such as the number needed for recruitment and improvement, use of sham acupuncture, choice of biological measure, and future research need will be discussed. Trial registration ClinicalTrials.gov NCT02869646. Registered on 17 August 2016. Supplementary Information The online version contains supplementary material available at 10.1186/s13063-021-05394-3.
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Affiliation(s)
- Michael Hollifield
- Tibor Rubin VA Medical Center, 5109 E. 7th Street, Long Beach, CA, 90822, USA. .,The George Washington University School of Medicine and Health Sciences, Washington, DC, 2300 I Street NW, Washington, DC, 20052, USA.
| | - An-Fu Hsiao
- Tibor Rubin VA Medical Center, 5109 E. 7th Street, Long Beach, CA, 90822, USA.,University of California at Riverside, 900 University Ave, Riverside, CA, 92521, USA
| | - Kala Carrick
- Tibor Rubin VA Medical Center, 5109 E. 7th Street, Long Beach, CA, 90822, USA
| | - Andrea Gory Munoz
- Tibor Rubin VA Medical Center, 5109 E. 7th Street, Long Beach, CA, 90822, USA
| | - Teresa Calloway
- Tibor Rubin VA Medical Center, 5109 E. 7th Street, Long Beach, CA, 90822, USA
| | - Karen Cocozza
- Tibor Rubin VA Medical Center, 5109 E. 7th Street, Long Beach, CA, 90822, USA
| | - Besa Smith
- UC Irvine Health Policy Research Institute, 100 Theory, Suite 110, Irvine, CA, 92697, USA
| | - Tyler Smith
- UC Irvine Health Policy Research Institute, 100 Theory, Suite 110, Irvine, CA, 92697, USA
| | | | - Seth Norrholm
- Analydata, 3835 Centraloma Drive, San Diego, CA, 92107, USA
| | - Estate Sokhadze
- Department of Psychiatry and Behavioral Neurosciences, Wayne State University School of Medicine, 3901 Chrysler Service Drive, Detroit, MI, 48201, USA
| | - Christopher Reist
- Tibor Rubin VA Medical Center, 5109 E. 7th Street, Long Beach, CA, 90822, USA.,University of South Carolina School of Medicine - Greenville, 701 Grove Rd, Greenville, SC, 29605, USA
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6
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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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7
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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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8
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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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9
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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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10
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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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11
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Effects of post-exposure naps on exposure therapy for social anxiety. Psychiatry Res 2018; 270:523-530. [PMID: 30340182 PMCID: PMC6292728 DOI: 10.1016/j.psychres.2018.10.015] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/15/2018] [Revised: 10/07/2018] [Accepted: 10/07/2018] [Indexed: 01/13/2023]
Abstract
Exposure therapy for social anxiety disorder (SAD) utilizes fear extinction, a memory process enhanced by sleep. We investigated whether naps following exposure sessions might improve symptoms and biomarkers in response to social stress in adults undergoing 5-week exposure-based group SAD therapy. Thirty-two participants aged 18-39 (18 females) with SAD were randomized. Before and after treatment, participants completed the Liebowitz Social Anxiety Scale (LSAS) and underwent a Trier Social Stress Test with psychophysiological monitoring (mpTSST) that included skin conductance (SCL), electromyographic (EMG) and electrocardiographic recording, and an auditory startle procedure while anticipating the social stressor. At sessions 3 and 4, exposure was followed by either a 120-min polysomnographically monitored sleep opportunity (Nap, N = 17) or wakefulness (Wake, N = 15). Primary hypotheses about SAD symptom change (LSAS) and EMG blink-startle response failed to differ with naps, despite significant symptom improvement (LSAS) with therapy. Some secondary biomarkers, however, provided preliminary support for enhanced extinction learning with naps, with trend-level Time (pre-, post-treatment) × Arm interactions and significant reduction from pre- to post treatment in the Nap arm alone for mpTSST SCL and salivary cortisol rise. Because of the small sample size and limited sleep duration, additional well-powered studies with more robust sleep interventions are indicated.
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12
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Post LM, Michopoulos V, Stevens JS, Reddy R, Maples JL, Morgan JR, Rothbaum AO, Jovanovic T, Ressler KJ, Rothbaum BO. Psychological and psychobiological responses to immediate early intervention in the emergency department: Case report of one-session exposure therapy for the prevention of PTSD. ACTA ACUST UNITED AC 2017; 2:55-65. [PMID: 28993816 DOI: 10.1037/pri0000043] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Research suggests that exposure therapy provided in the hours immediately following trauma exposure may prevent PTSD development. This case report presents data on an at-risk for PTSD participant involved in a motor-vehicle crash that caused her severe distress. She received one session of exposure therapy in the emergency department (ED) as part of an ongoing randomized controlled study examining the optimal dose of exposure therapy in the immediate aftermath of trauma. PTSD and depression measures were collected at pre-treatment assessment and one- and three-month follow-up. Potential PTSD biomarkers were also examined. Psychophysiological reactions were measured using skin conductance data measured on an iPad during the exposure therapy session and the follow-up assessments. A fear-potentiated startle paradigm and an functional magnetic resonance imaging (fMRI) behavioral inhibition task were used at follow-up. The participant demonstrated subjective and psychophysiological extinction from pre- to post-imaginal exposure. At follow-up, she did not meet DSM-IV criteria for PTSD or demonstrate hyperarousal to trauma reminders and showed robust fear extinction and the ability to inhibit responses in an fMRI behavioral inhibition task. In line with previous early intervention for the prevention of PTSD studies, this case report supports the need for ongoing empirical research investigating the possibility that one session of exposure therapy in the ED may attenuate risk for PTSD. Furthermore, the current findings demonstrate psychophysiological extinction serving as a prognostic indicator of treatment response for PTSD early intervention to be an exciting avenue to explore in future systematic research.
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Affiliation(s)
- Loren M Post
- Emory University School of Medicine, Department of Psychiatry and Behavioral Sciences, Atlanta, Georgia
| | - Vasiliki Michopoulos
- Emory University School of Medicine, Department of Psychiatry and Behavioral Sciences, Atlanta, Georgia.,Yerkes National Primate Research Center, Atlanta, Georgia
| | - Jennifer S Stevens
- Emory University School of Medicine, Department of Psychiatry and Behavioral Sciences, Atlanta, Georgia
| | - Renuka Reddy
- Emory University School of Medicine, Department of Psychiatry and Behavioral Sciences, Atlanta, Georgia
| | - Jessica L Maples
- Emory University School of Medicine, Department of Psychiatry and Behavioral Sciences, Atlanta, Georgia.,University of Georgia, Department of Psychology, Athens, Georgia
| | - Jessica R Morgan
- Emory University School of Medicine, Department of Psychiatry and Behavioral Sciences, Atlanta, Georgia.,Georgia State University, Department of Psychology, Atlanta, Georgia
| | - Alex O Rothbaum
- Emory University School of Medicine, Department of Psychiatry and Behavioral Sciences, Atlanta, Georgia
| | - Tanja Jovanovic
- Emory University School of Medicine, Department of Psychiatry and Behavioral Sciences, Atlanta, Georgia
| | - Kerry J Ressler
- Emory University School of Medicine, Department of Psychiatry and Behavioral Sciences, Atlanta, Georgia.,Yerkes National Primate Research Center, Atlanta, Georgia.,Howard Hughes Medical Institute, Bethesda, Maryland
| | - Barbara O Rothbaum
- Emory University School of Medicine, Department of Psychiatry and Behavioral Sciences, Atlanta, Georgia
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13
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Wicking M, Steiger F, Nees F, Diener SJ, Grimm O, Ruttorf M, Schad LR, Winkelmann T, Wirtz G, Flor H. Deficient fear extinction memory in posttraumatic stress disorder. Neurobiol Learn Mem 2016; 136:116-126. [PMID: 27686278 DOI: 10.1016/j.nlm.2016.09.016] [Citation(s) in RCA: 81] [Impact Index Per Article: 10.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2016] [Accepted: 09/21/2016] [Indexed: 11/16/2022]
Abstract
BACKGROUND Posttraumatic stress disorder (PTSD) might be maintained by deficient extinction memory. We used a cued fear conditioning design with extinction and a post-extinction phase to provoke the return of fear and examined the role of the interplay of amygdala, hippocampus and prefrontal regions. METHODS We compared 18 PTSD patients with two healthy control groups: 18 trauma-exposed subjects without PTSD (nonPTSD) and 18 healthy controls (HC) without trauma experience. They underwent a three-day ABC-conditioning procedure in a functional magnetic resonance imaging scanner. Two geometric shapes that served as conditioned stimuli (CS) were presented in the context of virtual reality scenes. Electric painful stimuli were delivered after one of the two shapes (CS+) during acquisition (in context A), while the other (CS-) was never paired with pain. Extinction was performed in context B and extinction memory was tested in a novel context C. RESULTS The PTSD patients showed significantly higher differential skin conductance responses than the non-PTSD and HC and higher differential amygdala and hippocampus activity than the HC in context C. In addition, elevated arousal to the CS+ during extinction and to the CS- throughout the experiment was present in the PTSD patients but self-reported differential valence or contingency were not different. During extinction recall, differential amygdala activity correlated positively with the intensity of numbing and ventromedial prefrontal cortex activity correlated positively with behavioral avoidance. CONCLUSIONS PTSD patients show heightened return of fear in neural and peripheral measures. In addition, self-reported arousal was high to both danger (CS+) and safety (CS-) cues. These results suggest that a deficient maintenance of extinction and a failure to identify safety signals might contribute to PTSD symptoms, whereas non-PTSD subjects seem to show normal responses.
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Affiliation(s)
- Manon Wicking
- Department of Cognitive and Clinical Neuroscience, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, J5, 68159 Mannheim, Germany.
| | - Frauke Steiger
- Department of Cognitive and Clinical Neuroscience, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, J5, 68159 Mannheim, Germany.
| | - Frauke Nees
- Department of Cognitive and Clinical Neuroscience, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, J5, 68159 Mannheim, Germany.
| | - Slawomira J Diener
- Department of Cognitive and Clinical Neuroscience, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, J5, 68159 Mannheim, Germany.
| | - Oliver Grimm
- Department of Cognitive and Clinical Neuroscience, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, J5, 68159 Mannheim, Germany; Klinik für Psychiatrie, Psychosomatik und Psychotherapie, Klinikum der J.W. Goethe-Universität, Heinrich-Hoffmann-Str. 10, 60528 Frankfurt am Main, Germany.
| | - Michaela Ruttorf
- Computer Assisted Clinical Medicine, Medical Faculty Mannheim, Heidelberg University, Theodor-Kutzer-Ufer 1-3, 68167 Mannheim, Germany.
| | - Lothar R Schad
- Computer Assisted Clinical Medicine, Medical Faculty Mannheim, Heidelberg University, Theodor-Kutzer-Ufer 1-3, 68167 Mannheim, Germany.
| | - Tobias Winkelmann
- Department of Cognitive and Clinical Neuroscience, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, J5, 68159 Mannheim, Germany.
| | - Gustav Wirtz
- Department of Psychiatry and Psychotherapy, SRH Klinikum Karlsbad-Langensteinbach GmbH, Guttmannstr. 1, 76307 Karlsbad, Germany.
| | - Herta Flor
- Department of Cognitive and Clinical Neuroscience, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, J5, 68159 Mannheim, Germany.
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14
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Ayers L, Agostini A, Schulkin J, Rosen JB. Effects of oxytocin on background anxiety in rats with high or low baseline startle. Psychopharmacology (Berl) 2016; 233:2165-2172. [PMID: 27004789 PMCID: PMC4864502 DOI: 10.1007/s00213-016-4267-0] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/07/2015] [Accepted: 02/29/2016] [Indexed: 01/17/2023]
Abstract
RATIONALE Oxytocin has antianxiety properties in humans and rodents. However, the antianxiety effects have been variable. OBJECTIVES To reduce variability and to strengthen the antianxiety effect of oxytocin in fear-potentiated startle, two experiments were performed. First, different amounts of light-shock pairings were given to determine the optimal levels of cue-specific fear conditioning and non-predictable startle (background anxiety). Second, the antianxiety effects of oxytocin were examined in rats with high and low pre-fear conditioning baseline startle to determine if oxytocin differentially affects high and low trait anxiety rats. METHODS Baseline pre-fear conditioning startle responses were first measured. Rats then received 1, 5, or 10 light-shock pairings. Fear-potentiated startle was then tested with two trial types: light-cued startle and non-cued startle trials. In the second experiment, rats fear conditioned with 10 light-shock pairings were administered either saline or oxytocin before a fear-potentiated startle test. Rats were categorized as low or high startlers by their pre-fear conditioning startle amplitude. RESULTS Ten shock pairings produced the largest non-cued startle responses (background anxiety), without increasing cue-specific fear-potentiated startle compared to one and five light-shock pairings. Cue-specific fear-potentiated startle was unaffected by oxytocin. Oxytocin reduced background anxiety only in rats with low pre-fear startle responses. CONCLUSIONS Oxytocin has population selective antianxiety effects on non-cued unpredictable threat, but only in rats with low pre-fear baseline startle responses. The low startle responses are reminiscent of humans with low startle responses and high trait anxiety.
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Affiliation(s)
- Luke Ayers
- Department of Psychology, Widener University, Chester, PA
| | - Andrew Agostini
- Department of Psychological and Brain Sciences, University of
Delaware, Newark, DE
| | - Jay Schulkin
- Department of Neuroscience, Georgetown University, Washington,
DC
| | - Jeffrey B. Rosen
- Department of Psychological and Brain Sciences, University of
Delaware, Newark, DE
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15
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Roy MJ, Costanzo M, Gill J, Leaman S, Law W, Ndiongue R, Taylor P, Kim HS, Bieler GS, Garge N, Rapp PE, Keyser D, Nathan D, Xydakis M, Pham D, Wassermann E. Predictors of Neurocognitive Syndromes in Combat Veterans. Cureus 2015; 7:e293. [PMID: 26251769 PMCID: PMC4524772 DOI: 10.7759/cureus.293] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2015] [Accepted: 07/30/2015] [Indexed: 12/26/2022] Open
Abstract
Traumatic brain injury, depression and posttraumatic stress disorder (PTSD) are neurocognitive syndromes often associated with impairment of physical and mental health, as well as functional status. These syndromes are also frequent in military service members (SMs) after combat, although their presentation is often delayed until months after their return. The objective of this prospective cohort study was the identification of independent predictors of neurocognitive syndromes upon return from deployment could facilitate early intervention to prevent disability. We completed a comprehensive baseline assessment, followed by serial evaluations at three, six, and 12 months, to assess for new-onset PTSD, depression, or postconcussive syndrome (PCS) in order to identify baseline factors most strongly associated with subsequent neurocognitive syndromes. On serial follow-up, seven participants developed at least one neurocognitive syndrome: five with PTSD, one with depression and PTSD, and one with PCS. On univariate analysis, 60 items were associated with syndrome development at p < 0.15. Decision trees and ensemble tree multivariate models yielded four common independent predictors of PTSD: right superior longitudinal fasciculus tract volume on MRI; resting state connectivity between the right amygdala and left superior temporal gyrus (BA41/42) on functional MRI; and single nucleotide polymorphisms in the genes coding for myelin basic protein as well as brain-derived neurotrophic factor. Our findings require follow-up studies with greater sample size and suggest that neuroimaging and molecular biomarkers may help distinguish those at high risk for post-deployment neurocognitive syndromes.
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Affiliation(s)
- Michael J Roy
- Department of Medicine, Uniformed Services University of the Health Sciences
| | - Michelle Costanzo
- Department of Medicine, Uniformed Services University of the Health Sciences
| | - Jessica Gill
- National Institute of Nursing Research, National Institutes of Health
| | - Suzanne Leaman
- Department of Medicine, Uniformed Services University of the Health Sciences
| | - Wendy Law
- Traumatic Brain Injury Service, Walter Reed National Military Medical Center
| | - Rochelle Ndiongue
- National Intrepid Center of Excellence, Walter Reed National Military Medical Center
| | - Patricia Taylor
- Department of Medicine, Uniformed Services University of the Health Sciences
| | - Hyung-Suk Kim
- National Institute of Nursing Research , National Institutes of Health
| | | | | | - Paul E Rapp
- Traumatic Injury Research Program, Uniformed Services University of the Health Sciences
| | - David Keyser
- Traumatic Injury Research Program, Uniformed Services University of the Health Sciences
| | - Dominic Nathan
- Traumatic Brain Injury Service, Uniformed Services University of the Health Sciences
| | - Michael Xydakis
- Department of Surgery , Uniformed Services University of the Health Sciences
| | - Dzung Pham
- Image Processing Core, Center for Neuroscience and Regenerative Medicine, Henry Jackson Foundation
| | - Eric Wassermann
- Behavioral Neurology Unit, National Institute of Neurological Disorders and Stroke, National Institutes of Health
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16
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Psychophysiological response to virtual reality and subthreshold posttraumatic stress disorder symptoms in recently deployed military. Psychosom Med 2014; 76:670-7. [PMID: 25333498 DOI: 10.1097/psy.0000000000000109] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVE Subthreshold posttraumatic stress disorder (PTSD) has garnered recent attention because of the significant distress and functional impairment associated with the symptoms as well as the increased risk of progression to full PTSD. However, the clinical presentation of subthreshold PTSD can vary widely and therefore is not clearly defined, nor is there an evidence-based treatment approach. Thus, we aim to further the understanding of subthreshold PTSD symptoms by reporting the use of a virtual combat environment in eliciting distinctive psychophysiological responses associated with PTSD symptoms in a sample of subthreshold recently deployed US service members. METHODS Heart rate, skin conductance, electromyography (startle), respiratory rate, and blood pressure were monitored during three unique combat-related virtual reality scenarios as a novel procedure to assess subthreshold symptoms in a sample of 78 service members. The Clinician-Administered PTSD Scale was administered, and linear regression analyses were used to investigate the relationship between symptom clusters and physiological variables. RESULTS Among the range of psychophysiological measures that were studied, regression analysis revealed heart rate as most strongly associated with Clinician-Administered PTSD Scale-based measures hyperarousal (R = 0.11, p = .035,) reexperiencing (R = 0.24, p = .001), and global PTSD symptoms (R = 0.17, p = .003). CONCLUSIONS Our findings support the use of a virtual reality environment in eliciting physiological responses associated with subthreshold PTSD symptoms.
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17
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Norrholm SD, Jovanovic T, Briscione MA, Anderson KM, Kwon CK, Warren VT, Bosshardt L, Bradley B. Generalization of fear-potentiated startle in the presence of auditory cues: a parametric analysis. Front Behav Neurosci 2014; 8:361. [PMID: 25368559 PMCID: PMC4201100 DOI: 10.3389/fnbeh.2014.00361] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2014] [Accepted: 09/29/2014] [Indexed: 11/13/2022] Open
Abstract
Intense fear responses observed in trauma-, stressor-, and anxiety-related disorders can be elicited by a wide range of stimuli similar to those that were present during the traumatic event. The present study investigated the experimental utility of fear-potentiated startle paradigms to study this phenomenon, known as stimulus generalization, in healthy volunteers. Fear-potentiated startle refers to a relative increase in the acoustic startle response to a previously neutral stimulus that has been paired with an aversive stimulus. Specifically, in Experiment 1 an auditory pure tone (500 Hz) was used as the conditioned stimulus (CS+) and was reinforced with an unconditioned stimulus (US), an airblast to the larynx. A distinct tone (4000 Hz) was used as the nonreinforced stimulus (CS−) and was never paired with an airblast. Twenty-four hours later subjects underwent Re-training followed by a Generalization test, during which subjects were exposed to a range of generalization stimuli (GS) (250, 1000, 2000, 4000, 8000 Hz). In order to further examine the point at which fear no longer generalizes, a follow-up experiment (Experiment 2) was performed where a 4000 Hz pure tone was used as the CS+, and during the Generalization test, 2000 and 8000 Hz were used as GS. In both Experiment 1 and 2 there was significant discrimination in US expectancy responses on all stimuli during the Generalization Test, indicating the stimuli were perceptually distinct. In Experiment 1, participants showed similar levels of fear-potentiated startle to the GS that were adjacent to the CS+, and discriminated between stimuli that were 2 or more degrees from the CS+. Experiment 2 demonstrated no fear-potentiated startle generalization. The current study is the first to use auditory cues to test generalization of conditioned fear responses; such cues may be especially relevant to combat posttraumatic stress disorder (PTSD) where much of the traumatic exposure may involve sounds.
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Affiliation(s)
- Seth Davin Norrholm
- Atlanta Veterans Affairs Medical Center, Mental Health Service Line Decatur, GA, USA ; Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine Atlanta, GA, USA
| | - Tanja Jovanovic
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine Atlanta, GA, USA
| | - Maria A Briscione
- Atlanta Veterans Affairs Medical Center, Mental Health Service Line Decatur, GA, USA ; Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine Atlanta, GA, USA
| | - Kemp M Anderson
- Atlanta Veterans Affairs Medical Center, Mental Health Service Line Decatur, GA, USA ; Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine Atlanta, GA, USA
| | - Cliffe K Kwon
- Atlanta Veterans Affairs Medical Center, Mental Health Service Line Decatur, GA, USA ; Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine Atlanta, GA, USA
| | - Victor T Warren
- Atlanta Veterans Affairs Medical Center, Mental Health Service Line Decatur, GA, USA ; Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine Atlanta, GA, USA
| | - Lauren Bosshardt
- Atlanta Veterans Affairs Medical Center, Mental Health Service Line Decatur, GA, USA ; Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine Atlanta, GA, USA
| | - Bekh Bradley
- Atlanta Veterans Affairs Medical Center, Mental Health Service Line Decatur, GA, USA ; Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine Atlanta, GA, USA
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18
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Warren VT, Anderson KM, Kwon C, Bosshardt L, Jovanovic T, Bradley B, Norrholm SD. Human fear extinction and return of fear using reconsolidation update mechanisms: the contribution of on-line expectancy ratings. Neurobiol Learn Mem 2014; 113:165-73. [PMID: 24183839 PMCID: PMC4351258 DOI: 10.1016/j.nlm.2013.10.014] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2013] [Revised: 09/25/2013] [Accepted: 10/21/2013] [Indexed: 10/26/2022]
Abstract
Disruption of the reconsolidation of conditioned fear memories has been suggested as a non-pharmacological means of preventing the return of learned fear in human populations. A reconsolidation update paradigm was developed in which a reconsolidation window is opened by a single isolated retrieval trial of a previously reinforced CS+ which is then followed by Extinction Training within that window. However, follow-up studies in humans using multi-methods fear conditioning indices (e.g., fear-potentiated startle, skin conductance, US-expectancy) have failed to replicate the retrieval+extinction effects. In the present study, we further investigated the retrieval+extinction reconsolidation update paradigm by directly comparing the acquisition, extinction, and return of fear-potentiated startle in the absence or presence of US-expectancy measures (using a trial-by-trial response keypad) with and without retrieval of a previously acquired CS-US association. Participants were fear conditioned to two visual cue CS+'s, one of which was presented as a single, isolated retrieval trial before Extinction Training and one that was extinguished as usual. The results show that the inclusion of US-expectancy measures strengthens the CS-US association to provide enhanced fear conditioning and maintenance of fear memories over the experimental sessions. In addition, in the groups that used on-line US-expectancy measures, the retrieval+extinction procedure reduced reinstatement of fear-potentiated startle to both previously reinforced CS+'s, as compared to the extinction as usual group.
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Affiliation(s)
- Victor Taylor Warren
- Atlanta Veterans Affairs Medical Center, Decatur, GA, United States; Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA, United States
| | - Kemp M Anderson
- Atlanta Veterans Affairs Medical Center, Decatur, GA, United States; Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA, United States
| | - Cliffe Kwon
- Atlanta Veterans Affairs Medical Center, Decatur, GA, United States; Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA, United States
| | - Lauren Bosshardt
- Atlanta Veterans Affairs Medical Center, Decatur, GA, United States; Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA, United States
| | - Tanja Jovanovic
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA, United States
| | - Bekh Bradley
- Atlanta Veterans Affairs Medical Center, Decatur, GA, United States; Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA, United States
| | - Seth Davin Norrholm
- Atlanta Veterans Affairs Medical Center, Decatur, GA, United States; Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA, United States.
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19
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Gerber B, Yarali A, Diegelmann S, Wotjak CT, Pauli P, Fendt M. Pain-relief learning in flies, rats, and man: basic research and applied perspectives. Learn Mem 2014; 21:232-52. [PMID: 24643725 PMCID: PMC3966540 DOI: 10.1101/lm.032995.113] [Citation(s) in RCA: 97] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
Memories relating to a painful, negative event are adaptive and can be stored for a lifetime to support preemptive avoidance, escape, or attack behavior. However, under unfavorable circumstances such memories can become overwhelmingly powerful. They may trigger excessively negative psychological states and uncontrollable avoidance of locations, objects, or social interactions. It is therefore obvious that any process to counteract such effects will be of value. In this context, we stress from a basic-research perspective that painful, negative events are "Janus-faced" in the sense that there are actually two aspects about them that are worth remembering: What made them happen and what made them cease. We review published findings from fruit flies, rats, and man showing that both aspects, respectively related to the onset and the offset of the negative event, induce distinct and oppositely valenced memories: Stimuli experienced before an electric shock acquire negative valence as they signal upcoming punishment, whereas stimuli experienced after an electric shock acquire positive valence because of their association with the relieving cessation of pain. We discuss how memories for such punishment- and relief-learning are organized, how this organization fits into the threat-imminence model of defensive behavior, and what perspectives these considerations offer for applied psychology in the context of trauma, panic, and nonsuicidal self-injury.
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Affiliation(s)
- Bertram Gerber
- Leibniz Institut für Neurobiologie (LIN), Abteilung Genetik von Lernen und Gedächtnis, 39118 Magdeburg, Germany
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20
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Briscione MA, Jovanovic T, Norrholm SD. Conditioned fear associated phenotypes as robust, translational indices of trauma-, stressor-, and anxiety-related behaviors. Front Psychiatry 2014; 5:88. [PMID: 25101010 PMCID: PMC4104832 DOI: 10.3389/fpsyt.2014.00088] [Citation(s) in RCA: 73] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/21/2014] [Accepted: 07/08/2014] [Indexed: 12/12/2022] Open
Abstract
Post-traumatic stress disorder (PTSD) is a heterogeneous disorder that affects individuals exposed to trauma (e.g., combat, interpersonal violence, and natural disasters). It is characterized by hyperarousal, intrusive reminders of the trauma, avoidance of trauma-related cues, and negative cognition and mood. This heterogeneity indicates the presence of multiple neurobiological mechanisms underlying the development and maintenance of PTSD. Fear conditioning is a robust, translational experimental paradigm that can be employed to elucidate these mechanisms by allowing for the study of fear-related dimensions of PTSD (e.g., fear extinction, fear inhibition, and generalization of fear) across multiple units of analysis. Fear conditioning experiments have identified varying trajectories of the dimensions described, highlighting exciting new avenues of targeted, focused study. Additionally, fear conditioning studies provide a translational platform to develop novel interventions. The current review highlights the versatility of fear conditioning paradigms, the implications for pharmacological and non-pharmacological treatments, the robustness of these paradigms to span an array of neuroscientific measures (e.g., genetic studies), and finally the need to understand the boundary conditions under which these paradigms are effective. Further understanding these paradigms will ultimately allow for optimization of fear conditioning paradigms, a necessary step towards the advancement of PTSD treatment methods.
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Affiliation(s)
- Maria Anne Briscione
- Trauma Recovery Program, Mental Health Service Line, Atlanta Veterans Affairs Medical Center , Decatur, GA , USA ; Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine , Atlanta, GA , USA
| | - Tanja Jovanovic
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine , Atlanta, GA , USA
| | - Seth Davin Norrholm
- Trauma Recovery Program, Mental Health Service Line, Atlanta Veterans Affairs Medical Center , Decatur, GA , USA ; Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine , Atlanta, GA , USA
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21
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Jovanovic T, Nylocks KM, Gamwell KL. Translational neuroscience measures of fear conditioning across development: applications to high-risk children and adolescents. BIOLOGY OF MOOD & ANXIETY DISORDERS 2013; 3:17. [PMID: 24004567 PMCID: PMC3846696 DOI: 10.1186/2045-5380-3-17] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/18/2013] [Accepted: 06/25/2013] [Indexed: 12/05/2022]
Abstract
Several mental illnesses, including anxiety, can manifest during development, with onsets in late childhood. Understanding the neurobiological underpinnings of risk for anxiety is of crucial importance for early prevention and intervention approaches. Translational neuroscience offers tools to investigate such mechanisms in human and animal models. The current review describes paradigms derived from neuroscience, such as fear conditioning and extinction and overviews studies that have used these paradigms in animals and humans across development. The review also briefly discusses developmental trajectories of the relevant neural circuits and the emergence of clinical anxiety. Future studies should focus on developmental changes in these paradigms, paying close attention to neurobiological and hormonal changes associated with childhood and adolescence.
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Affiliation(s)
- Tanja Jovanovic
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, 49 Jesse Hill Jr Dr, Suite 331, Atlanta, GA 30303, USA
| | - Karin Maria Nylocks
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, 49 Jesse Hill Jr Dr, Suite 331, Atlanta, GA 30303, USA
| | - Kaitlyn L Gamwell
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, 49 Jesse Hill Jr Dr, Suite 331, Atlanta, GA 30303, USA
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