Deficient fear extinction memory in posttraumatic stress disorder

Wicking, Manon; Steiger, Frauke; Nees, Frauke; Diener, Slawomira J.; Grimm, O.; Ruttorf, Michaela; Schad, Lothar R.; Winkelmann, Tobias; Wirtz, Gustav; Flor, Herta

doi:10.1016/j.nlm.2016.09.016

Cited by 99 publications

(68 citation statements)

References 84 publications

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“…However, another study failed to find group differences between PTSD and NEC or TEC during extinction recall (Steiger et al, 2015). The same group also reported increased hippocampal activation in PTSD compared to NEC during a modified ambiguous extinction recall/fear renewal phase; however, interpretation of these results is complicated as this was conducted in a novel context rather than following an ABA or ABB design used in other extinction learning studies (Wicking et al, 2016). Few studies have examined hippocampal activation during fear renewal in PTSD, but Garfinkel et al (2014) reported lower hippocampal activation in PTSD compared to TEC participants and blunted SCR response during fear renewal.…”

Section: Extinction Learning Extinction Recall and Fear Renewalmentioning

confidence: 97%

A review of hippocampal activation in post‐traumatic stress disorder

et al. 2019

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Post‐traumatic stress disorder (PTSD) is often characterized by deficits in memory encoding and retrieval and aberrant fear and extinction learning. The hippocampus plays a critical role in memory and contextual processing and has been implicated in intrinsic functional connectivity networks involved in self‐referential thought and memory‐related processes. This review focuses on hippocampal activation findings during memory and fear and extinction learning tasks, as well as resting state hippocampal connectivity in individuals with PTSD. A preponderance of functional neuroimaging studies to date, using memory, fear learning, and extinction tasks, report decreased or “controls comparable” hippocampal activation in individuals with PTSD, which is usually associated with poorer performance on the task imaged. Existing evidence thus raises the possibility that greater hippocampal recruitment in PTSD participants may be required for similar performance levels. Studies of resting state functional connectivity in PTSD predominantly report reduced within‐network connectivity in the default mode network (DMN), as well as greater coupling between the DMN and salience network (SN) via the hippocampus. Together, these findings suggest that deficient hippocampal activation in PTSD may be associated with poorer performance during memory, extinction recall, and fear renewal tasks. Furthermore, studies of resting state connectivity implicate the hippocampus in decreased within‐network DMN connectivity and greater coupling with SN regions characteristic of PTSD.

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Section: Extinction Learning Extinction Recall and Fear Renewalmentioning

confidence: 97%

A review of hippocampal activation in post‐traumatic stress disorder

et al. 2019

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“…There is strong evidence that fear extinction involves the formation of a competing new memory that inhibits the fear response, rather than an erasure of the original memory 36,37 ; however, fear memories may also weaken during recall through a process called reconsolidation 38 . There have been studies showing that individuals with PTSD are able to encode such new fear extinction memories but have difficulty retaining them 35,39–41 , suggesting that deficits in fear extinction retention underlie PTSD. Furthermore, there is evidence that the size and activity of the ventromedial prefrontal cortex (vmPFC) is associated with the extent of fear extinction deficits in individuals with PTSD 42 as well as evidence for changes to the functional connectivity between the left vmPFC and the amygdala in individuals with PTSD 43 .…”

Section: Intrusion Symptomsmentioning

confidence: 99%

Brain circuit dysfunction in post-traumatic stress disorder: from mouse to man

et al. 2018

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Post-traumatic stress disorder (PTSD) is a prevalent, debilitating and sometimes deadly consequence of exposure to severe psychological trauma. Although effective treatments exist for some individuals, they are limited. New approaches to intervention, treatment and prevention are therefore much needed. In the past few years, the field has rapidly developed a greater understanding of the dysfunctional brain circuits underlying PTSD, a shift in understanding that has been made possible by technological revolutions that have allowed the observation and perturbation of the macrocircuits and microcircuits thought to underlie PTSD-related symptoms. These advances have allowed us to gain a more translational knowledge of PTSD, have provided further insights into the mechanisms of risk and resilience and offer promising avenues for therapeutic discovery.

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“…Renewal of fear poses a considerable challenge to behavioral therapies for fear and anxiety disorder. Indeed, PTSD patients always show heightened return of extinguished fear compared to healthy subjects without trauma experience . Suppression of fear in the therapeutic context may not translate to other context in the patient's life.…”

Section: Introductionmentioning

confidence: 99%

Neural circuits involved in the renewal of extinguished fear

Chen

Wang

et al. 2017

IUBMB Life

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The last 10 years have witnessed a substantial progress in understanding the neural mechanisms for the renewal of the extinguished fear memory. Based on the theory of fear extinction, exposure therapy has been developed as a typical cognitive behavioral therapy for posttraumatic stress disorder. Although the fear memory can be extinguished by repeated presentation of conditioned stimulus without unconditioned stimulus, the fear memory is not erased and tends to relapse outside of extinction context, which is referred to as renewal. Therefore, the renewal is regarded as a great obstruction interfering with the effect of exposure therapy. In recent years, there has been a great deal of studies in understanding the neurobiological underpinnings of fear renewal. These offer a foundation upon which novel therapeutic interventions for the renewal may be built. This review focuses on behavioral, anatomical and electrophysiological studies that interpret roles of the hippocampus, prelimbic cortex and amygdala as well as the connections between them for the renewal of the extinguished fear. Additionally, this review suggests the possible pathways for the renewal: (1) the prelimbic cortex may integrate contextual information from hippocampal inputs and project to the basolateral amygdala to mediate the renewal of extinguished fear memory; the ventral hippocampus may innervate the activities of the basolateral amygdala or the central amygdala directly for the renewal. © 2017 IUBMB Life, 69(7):470-478, 2017.

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Deficient fear extinction memory in posttraumatic stress disorder

Cited by 99 publications

References 84 publications

A review of hippocampal activation in post‐traumatic stress disorder

A review of hippocampal activation in post‐traumatic stress disorder

Brain circuit dysfunction in post-traumatic stress disorder: from mouse to man

Neural circuits involved in the renewal of extinguished fear

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