恐惧消退过程中的神经加工预测侵入性记忆。
Neural Processing During Fear Extinction Predicts Intrusive Memories.
机构信息
Clinical Stress and Emotion Laboratory, Division of Clinical Psychology, Psychotherapy, and Health Psychology, Department of Psychology, University of Salzburg, Salzburg, Austria.
Clinical Stress and Emotion Laboratory, Division of Clinical Psychology, Psychotherapy, and Health Psychology, Department of Psychology, University of Salzburg, Salzburg, Austria.
出版信息
Biol Psychiatry Cogn Neurosci Neuroimaging. 2020 Apr;5(4):403-411. doi: 10.1016/j.bpsc.2019.12.017. Epub 2020 Jan 13.
BACKGROUND
Deficient extinction learning has been suggested as an important mechanism involved in the etiology of posttraumatic stress disorder. A key feature of posttraumatic stress disorder, reexperiencing the trauma in form of intrusions, may be linked to deficient extinction learning. This link is investigated in a novel, functional magnetic resonance imaging-compatible fear conditioning procedure that uses trauma films. Based on previous results, we expected deficient fear extinction indexed by exaggerated responding in the anterior insula and dorsal anterior cingulate cortex to predict subsequent intrusions.
METHODS
A total of 58 healthy participants underwent acquisition and extinction learning with faces as conditioned stimuli (CS) and highly aversive 16-second films depicting interpersonal violence as unconditioned stimuli. During the subsequent 3 days, participants reported intrusive memories on their smartphone.
RESULTS
Successful fear acquisition was evidenced by differential (CS+ > CS-) activity (threat cues associated with trauma films > cues paired only with neutral films) of a widespread network, including the anterior insula and dorsal anterior cingulate cortex, whereas extinction was characterized exclusively by differential anterior insula activity. Differential conditioned responding during late extinction in the anterior insula and dorsal anterior cingulate cortex was positively related to intrusive memory frequency independent of unconditioned stimuli responding. Exploratory analysis also revealed intrusion sensitivity of the hippocampus, rostral anterior cingulate cortex, and ventromedial prefrontal cortex, among others.
CONCLUSIONS
Results support the role of extinction learning in intrusive memory formation; a failure to uncouple conditioned emotional responding from external threat cues was associated with subsequent intrusive memories, representing a potential risk marker for developing posttraumatic stress disorder symptomatology after trauma.
背景
有研究表明，缺乏消退学习是创伤后应激障碍发病机制的一个重要因素。创伤后应激障碍的一个关键特征是创伤的再体验，表现为侵入性记忆，这可能与消退学习不足有关。本研究采用新型功能性磁共振成像兼容的恐惧条件反射程序，利用创伤影片来探究这一关联。基于先前的研究结果，我们预计前岛叶和背侧前扣带回中反应过度的恐惧消退不足会预测随后的侵入性记忆。
方法
共有 58 名健康参与者接受了面孔作为条件刺激（CS）和高度厌恶的 16 秒人际暴力影片作为非条件刺激的获取和消退学习。在随后的 3 天里，参与者通过智能手机报告侵入性记忆。
结果
成功的恐惧习得表现为广泛网络的差异（CS+>CS-）活动（与创伤影片相关的威胁线索>仅与中性影片配对的线索），包括前岛叶和背侧前扣带回，而消退仅以差异的前岛叶活动为特征。在晚期消退过程中，前岛叶和背侧前扣带回的差异条件反应与侵入性记忆频率呈正相关，与非条件刺激反应无关。探索性分析还揭示了海马体、前扣带皮质腹侧部和腹内侧前额叶皮质等结构的侵入性记忆敏感性。
结论
研究结果支持消退学习在侵入性记忆形成中的作用；未能将条件性情绪反应与外部威胁线索分离与随后的侵入性记忆有关，这可能是创伤后发展创伤后应激障碍症状的潜在风险标志物。
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