Kuijer Eloise J, Ferragud Antonio, Milton Amy L
Department of Psychology, University of Cambridge, Cambridge, United Kingdom.
Leiden University Medical Centre, Leiden University, Leiden, Netherlands.
Front Behav Neurosci. 2020 Feb 20;14:23. doi: 10.3389/fnbeh.2020.00023. eCollection 2020.
Addicted individuals are highly susceptible to relapse when exposed to drug-associated conditioned stimuli (CSs; "drug cues") even after extensive periods of abstinence. Until recently, these maladaptive emotional drug memories were believed to be permanent and resistant to change. The rediscovery of the phenomenon of memory reconsolidation-by which retrieval of the memory can, under certain conditions, destabilize the previously stable memory before it restabilizes in its new, updated form-has led to the hypothesis that it may be possible to disrupt the strong maladaptive drug-memories that trigger a relapse. Furthermore, recent work has suggested that extinction training "within the reconsolidation window" may lead to a long-term reduction in relapse without the requirement for pharmacological amnestic agents. However, this so-called "retrieval-extinction" effect has been inconsistently observed in the literature, leading some to speculate that rather than reflecting memory updating, it may be the product of facilitation of extinction. In this mini review article, we will focus on factors that might be responsible for the retrieval-extinction effects on preventing drug-seeking relapse and how inter-individual differences may influence this therapeutically promising effect. A better understanding of the psychological and neurobiological mechanisms underpinning the "retrieval-extinction" paradigm, and individual differences in boundary conditions, should provide insights with the potential to optimize the translation of "retrieval-extinction" to clinical populations.
成瘾个体即使在长期禁欲后，当暴露于与药物相关的条件刺激（CSs；“药物线索”）时，仍极易复发。直到最近，这些适应不良的情感性药物记忆还被认为是永久性的且难以改变。记忆再巩固现象的重新发现——即在某些条件下，记忆的提取可以在其以新的、更新的形式重新稳定之前破坏先前稳定的记忆——引发了一种假设，即有可能破坏引发复发的强烈适应不良的药物记忆。此外，最近的研究表明，在“再巩固窗口”内进行消退训练可能会长期减少复发，而无需使用药理学遗忘剂。然而，这种所谓的“提取-消退”效应在文献中观察结果并不一致，这使得一些人推测，它可能不是反映记忆更新，而是消退促进的产物。在这篇小型综述文章中，我们将关注可能导致“提取-消退”效应预防觅药复发的因素，以及个体差异如何影响这种具有治疗前景的效应。更好地理解支撑“提取-消退”范式的心理和神经生物学机制，以及边界条件下的个体差异，应该能够为优化“提取-消退”向临床人群的转化提供有潜在价值的见解。
