眼动干预通过杏仁核去激活增强了消退。

Eye-Movement Intervention Enhances Extinction via Amygdala Deactivation.

机构信息

Donders Institute for Brain, Cognition, and Behavior, Radboud University and Radboud University Medical Center, 6500 HB, Nijmegen, The Netherlands,

Donders Institute for Brain, Cognition, and Behavior, Radboud University and Radboud University Medical Center, 6500 HB, Nijmegen, The Netherlands.

出版信息

J Neurosci. 2018 Oct 3;38(40):8694-8706. doi: 10.1523/JNEUROSCI.0703-18.2018. Epub 2018 Sep 4.

Abstract

Improving extinction learning is essential to optimize psychotherapy for persistent fear-related disorders. In two independent studies (both = 24), we found that goal-directed eye movements activate a dorsal frontoparietal network and transiently deactivate the amygdala (η = 0.17). Connectivity analyses revealed that this downregulation potentially engages a ventromedial prefrontal pathway known to be involved in cognitive regulation of emotion. Critically, when eye movements followed memory reactivation during extinction learning, it reduced spontaneous fear recovery 24 h later (η = 0.21). Stronger amygdala deactivation furthermore predicted a stronger reduction in subsequent fear recovery after reinstatement ( = 0.39). In conclusion, we show that extinction learning can be improved with a noninvasive eye-movement intervention that triggers a transient suppression of the amygdala. Our finding that another task which taxes working memory leads to a similar amygdala suppression furthermore indicates that this effect is likely not specific to eye movements, which is in line with a large body of behavioral studies. This study contributes to the understanding of a widely used treatment for traumatic symptoms by providing a parsimonious account for how working-memory tasks and goal-directed eye movements can enhance extinction-based psychotherapy, namely through neural circuits (e.g., amygdala deactivation) similar to those that support cognitive control of emotion. Fear-related disorders represent a significant burden on individual sufferers and society. There is a high need to optimize treatment, in particular via noninvasive means. One potentially effective intervention is execution of eye movements following trauma recall. However, a neurobiological understanding of how eye movements reduce traumatic symptoms is lacking. We demonstrate that goal-directed eye-movements, like working-memory tasks, deactivate the amygdala, the core neural substrate of fear learning. Effective connectivity analyses revealed amygdala deactivation potentially engaged dorsolateral and ventromedial prefrontal pathways. When applied during safety learning, this deactivation predicts a reduction in later fear recovery. These findings provide a parsimonious and mechanistic account of how behavioral manipulations taxing working memory and suppressing amygdala activity can alter retention of emotional memories.

摘要

增强消退学习对于优化持续性恐惧相关障碍的心理治疗至关重要。在两项独立研究中(均 n = 24),我们发现目标导向的眼球运动激活了背侧额顶网络,并短暂地使杏仁核失活(η = 0.17)。连通性分析表明,这种下调可能涉及到已知参与情绪认知调节的腹内侧前额叶通路。重要的是,当眼球运动在消退学习过程中跟随记忆再激活时,它会降低 24 小时后自发恐惧的恢复(η = 0.21)。更强的杏仁核失活进一步预测了在重新诱发后恐惧恢复的更强降低(β = 0.39)。总之,我们表明,非侵入性的眼球运动干预可以改善消退学习,从而短暂抑制杏仁核。我们的发现表明,另一个需要工作记忆的任务也会导致类似的杏仁核抑制,这进一步表明这种效应可能不是特定于眼球运动的,这与大量行为研究一致。这项研究通过提供一种简洁的解释,说明了工作记忆任务和目标导向的眼球运动如何增强基于消退的心理治疗,即通过类似支持情绪认知控制的神经回路(例如,杏仁核失活),为理解一种广泛使用的创伤后症状治疗方法做出了贡献。与恐惧相关的障碍给个体患者和社会带来了巨大的负担。非常有必要通过非侵入性手段来优化治疗。一种潜在有效的干预措施是在创伤回忆后执行眼球运动。然而,缺乏对眼球运动如何减轻创伤症状的神经生物学理解。我们证明,目标导向的眼球运动,就像工作记忆任务一样,使杏仁核失活,而杏仁核是恐惧学习的核心神经基质。有效的连通性分析表明,杏仁核失活可能涉及背外侧和腹内侧前额叶通路。当应用于安全学习时,这种失活预测了后来恐惧恢复的减少。这些发现提供了一种简洁而机制的解释,说明如何通过需要工作记忆和抑制杏仁核活动的行为操作来改变情绪记忆的保留。

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