Department of Clinical Psychology, University of Amsterdam, Nieuwe Achtergracht 129B, 1018WS, Amsterdam, The Netherlands
Philos Trans R Soc Lond B Biol Sci. 2018 Mar 19;373(1742). doi: 10.1098/rstb.2017.0033.
Current pharmacological and psychological treatments for disorders of emotional memory only dampen the affective response while leaving the original fear memory intact. Under adverse circumstances, these original memories regain prominence, causing relapses in many patients. The (re)discovery in neuroscience that after reactivation consolidated fear memories may return to a transient labile state, requiring a process of restabilization in order to persist, offers a window of opportunity for modifying fear memories with amnestic agents. This process, known as memory reconsolidation, opens avenues for developing a revolutionary treatment for emotional memory disorders. The reconsolidation intervention challenges the dominant pharmacological and psychological models of treatment: it is only effective when the amnestic drug is given in conjunction with memory reactivation during a specific time window, and a modification of cognitive processes is a boundary condition for changing fear. Notwithstanding the dramatic effects of targeting memory reconsolidation in the laboratory (i.e. proof of principle), the greatest hurdle to overcome is that the success of the manipulation depends on subtle differences in the reactivation procedure. These experimental parameters cannot be easily controlled in clinical practice. In harnessing the clinical potential of memory reconsolidation, a heuristic for behavioural neuroscience and clinical science is proposed.This article is part of a discussion meeting issue 'Of mice and mental health: facilitating dialogue between basic and clinical neuroscientists'.
目前，针对情绪记忆障碍的药理学和心理学治疗方法只能抑制情感反应，而使原始的恐惧记忆保持完整。在不利的情况下，这些原始记忆会重新突出，导致许多患者病情复发。神经科学的新发现表明，在重新激活后，巩固的恐惧记忆可能会回到短暂的不稳定状态，需要一个重新稳定的过程才能持续存在，这为使用失忆剂来修改恐惧记忆提供了机会。这个过程被称为记忆再巩固，为开发治疗情绪记忆障碍的革命性疗法开辟了道路。再巩固干预挑战了治疗的主流药理学和心理学模型：只有在失忆药物与特定时间窗口内的记忆再激活同时使用时，它才有效，而改变认知过程是改变恐惧的边界条件。尽管针对记忆再巩固的实验室效果显著（即原理验证），但最大的障碍是，操纵的成功取决于再激活程序中的细微差异。这些实验参数在临床实践中不容易控制。在利用记忆再巩固的临床潜力时，为行为神经科学和临床科学提出了一个启发式方法。本文是“老鼠与心理健康：促进基础和临床神经科学家之间对话”讨论专题的一部分。
