Institute for Neuroscience, University of Texas at Austin, Austin, Texas 78712.
Department of Psychiatry School of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania 15213.
J Neurosci. 2022 Jul 20;42(29):5717-5729. doi: 10.1523/JNEUROSCI.0075-22.2022. Epub 2022 Jun 9.
Neurobiological evidence in rodents indicates that threat extinction incorporates reward neurocircuitry. Consequently, incorporating reward associations with an extinction memory may be an effective strategy to persistently attenuate threat responses. Moreover, while there is considerable research on the short-term effects of extinction strategies in humans, the long-term effects of extinction are rarely considered. In a within-subjects fMRI study with both female and male participants, we compared counterconditioning (CC; a form of rewarded-extinction) to standard extinction at recent (24 h) and remote (approximately one month) retrieval tests. Relative to standard extinction, rewarded extinction diminished 24-h relapse of arousal and threat expectancy, and reduced activity in brain regions associated with the appraisal and expression of threat (e.g., thalamus, insula, periaqueductal gray). The retrieval of reward-associated extinction memory was accompanied by functional connectivity between the amygdala and the ventral striatum, whereas the retrieval of standard-extinction memories was associated with connectivity between the amygdala and ventromedial prefrontal cortex (vmPFC). One month later, the retrieval of both standard-extinction and rewarded-extinction was associated with amygdala-vmPFC connectivity. However, only rewarded extinction created a stable memory trace in the vmPFC, identified through overlapping multivariate patterns of fMRI activity from extinction to 24-h and one-month retrieval. These findings provide new evidence that reward may generate a more stable and enduring memory trace of attenuated threat in humans. Prevalent treatments for pathologic fear and anxiety are based on the principles of Pavlovian extinction. Unfortunately, extinction forms weak memories that only temporarily inhibit the retrieval of threat associations. Thus, to increase the translational relevance of extinction research, it is critical to investigate whether extinction can be augmented to form a more enduring memory, especially after long intervals. Here, we used a multiday fMRI paradigm in humans to compare the short-term and long-term neurobehavioral effects of aversive-to-appetitive counterconditioning (CC), a form of augmented extinction. Our results provide novel evidence that including an appetitive stimulus during extinction can reduce short-term threat relapse and stabilize the memory trace of extinction in the ventromedial prefrontal cortex (vmPFC), for at least one month after learning.
啮齿动物的神经生物学证据表明,威胁性消退纳入了奖励神经回路。因此,将奖励联想与消退记忆结合起来可能是一种持久减弱威胁反应的有效策略。此外,尽管人们对人类消退策略的短期影响进行了大量研究,但很少考虑消退的长期影响。在一项有女性和男性参与者参与的基于个体的 fMRI 研究中,我们比较了条件反射(CC;一种奖励性消退)与标准消退在最近(24 小时)和远程(大约一个月)检索测试中的效果。与标准消退相比,奖励性消退减少了 24 小时的唤醒和威胁预期的复发,并减少了与威胁评估和表达相关的大脑区域的活动(例如,丘脑、脑岛、导水管周围灰质)。与奖励相关的消退记忆的检索伴随着杏仁核和腹侧纹状体之间的功能连接,而标准消退记忆的检索与杏仁核和腹内侧前额叶皮层(vmPFC)之间的连接相关。一个月后,标准消退和奖励消退的检索都与杏仁核-vmPFC 的连接有关。然而,只有奖励性消退在 vmPFC 中产生了一个稳定的记忆痕迹,这是通过从消退到 24 小时和一个月的检索的 fMRI 活动的重叠多变量模式来识别的。这些发现提供了新的证据,表明奖励可能在人类中产生更稳定和持久的减弱威胁的记忆痕迹。病理性恐惧和焦虑的流行治疗方法基于条件反射消退的原则。不幸的是,消退形成的记忆很弱,只能暂时抑制威胁联想的检索。因此,为了提高消退研究的转化相关性,关键是要研究消退是否可以增强形成更持久的记忆,特别是在长时间间隔后。在这里,我们使用人类的多日 fMRI 范式来比较厌恶到渴望的条件反射(CC)的短期和长期神经行为效应,这是一种增强的消退形式。我们的研究结果提供了新的证据,表明在消退过程中加入奖励刺激可以减少短期威胁复发,并稳定腹内侧前额叶皮层(vmPFC)中消退的记忆痕迹,至少在学习后一个月内保持稳定。
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