School of Biomedical Sciences, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong Special Administrative Region.
School of Biological Sciences, The University of Hong Kong, Hong Kong Special Administrative Region.
Exp Neurol. 2019 Apr;314:9-19. doi: 10.1016/j.expneurol.2019.01.004. Epub 2019 Jan 10.
Anxiety disorders pose one of the greatest threats to mental health. Modern treatment methods exist but are hindered by relapse, toxicity, and low efficacy. The use of neuromodulation to treat anxiety disorders has shown promising results, yet its underpinning mechanisms remain poorly understood. In this review, we make the case for further development of neuromodulation techniques to alter fear memories, with particular regard to future clinical applications in treating anxiety disorders. We start by briefly summarizing the neural circuitry of fear while identifying the pros and cons of possible neuromodulation targets. We then highlight recent advances in neuromodulation techniques that have been used to alter fear memories. Next, we apply a novel network-based approach to elucidate possible mechanisms of neuromodulation which may disrupt the consolidation of fear memory. Finally, we emphasize the need for more systematic neuromodulation studies on animal models and the developing brain. Overall, we aim to provide an integrated framework for future action, identifying key research priorities that must be addressed before effective neuromodulation-based treatments can be developed for practical use.
焦虑障碍对心理健康构成了最大的威胁之一。现代治疗方法虽然存在,但却受到复发、毒性和疗效低的困扰。使用神经调节来治疗焦虑障碍已经显示出了有希望的结果,但它的潜在机制仍知之甚少。在这篇综述中,我们主张进一步开发神经调节技术来改变恐惧记忆,特别是考虑到未来在治疗焦虑障碍方面的临床应用。我们首先简要总结了恐惧的神经回路,同时确定了可能的神经调节靶点的优缺点。然后,我们强调了最近在神经调节技术方面的进展,这些技术已经被用于改变恐惧记忆。接下来,我们应用一种新的基于网络的方法来阐明可能的神经调节机制,这些机制可能会破坏恐惧记忆的巩固。最后,我们强调需要在动物模型和发育中的大脑上进行更系统的神经调节研究。总的来说,我们旨在为未来的行动提供一个综合框架,确定在开发有效的基于神经调节的治疗方法之前必须解决的关键研究重点。