Department of Psychiatry, Weill Cornell Medical College of Cornell University, New York, NY 10065, USA.
Proc Natl Acad Sci U S A. 2012 Oct 2;109(40):16318-23. doi: 10.1073/pnas.1206834109. Epub 2012 Sep 17.
The only evidence-based behavioral treatment for anxiety and stress-related disorders involves desensitization techniques that rely on principles of extinction learning. However, 40% of patients do not respond to this treatment. Efforts have focused on individual differences in treatment response, but have not examined when, during development, such treatments may be most effective. We examined fear-extinction learning across development in mice and humans. Parallel behavioral studies revealed attenuated extinction learning during adolescence. Probing neural circuitry in mice revealed altered synaptic plasticity of prefrontal cortical regions implicated in suppression of fear responses across development. The results suggest a lack of synaptic plasticity in the prefrontal regions, during adolescence, is associated with blunted regulation of fear extinction. These findings provide insight into optimizing treatment outcomes for when, during development, exposure therapies may be most effective.
唯一基于证据的焦虑和压力相关障碍的行为治疗涉及脱敏技术，该技术依赖于消除学习的原则。然而，40%的患者对此治疗没有反应。人们一直致力于研究治疗反应的个体差异，但尚未研究在何时，在发展过程中，这些治疗可能最有效。我们在小鼠和人类中研究了恐惧消除学习的发展情况。平行的行为研究表明，青少年时期的消退学习减弱。对小鼠神经回路的探测揭示了前额皮质区域的突触可塑性发生改变，这些区域在整个发育过程中对抑制恐惧反应具有重要作用。结果表明，青春期前额叶区域缺乏突触可塑性与恐惧消退的调节能力减弱有关。这些发现为优化治疗结果提供了线索，即何时、在发展过程中，暴露疗法可能最有效。
