Effect of post-retrieval propranolol on psychophysiologic responding during subsequent script-driven traumatic imagery in post-traumatic stress disorder

Brunet, Alain; Orr, Scott P.; Tremblay, Jacques; Robertson, Kate; Nader, Karim; Pitman, Roger K.

doi:10.1016/j.jpsychires.2007.05.006

Cited by 506 publications

(433 citation statements)

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“…The subjective emotional experience of the memories was not affected by cortisol or propranolol either. Even though propranolol was found to attenuate physiological responding (heart rate and SCL) to traumatic scripts in PTSD patients (Brunet et al 2008), we did not find such effects to negative emotional scripts in healthy young men. These results also contrast the finding by Het and Wolf (2007) that cortisol can affect the emotional experience of negative events and the finding that cortisol can reduce the intensity of traumatic memories (Aerni et al 2004).…”

Section: Discussioncontrasting

confidence: 81%

“…In line with the idea that the physiologically arousing components of emotional memories can be attenuated, a recent study by Brunet et al (2008) has shown that postretrieval propranolol administration diminished physiological responses to script-driven imagery of traumatic memories in PTSD patients. These results might indicate that propranolol is more effective in attenuating emotional components of memories than reducing declarative memory.…”

mentioning

confidence: 76%

“…This might lead to consideration of a second possibility, namely, that the dose was too low to affect the physiological responding. In the studies by Brunet et al (2008) and Pitman et al (2002), multiple doses or longer-acting propranolol were used. These studies involved patient groups that are characterized by high blood pressure and heart rate levels overall, and therefore, larger doses of propranolol might be needed to reduce physiological responding.…”

Section: Discussionmentioning

confidence: 99%

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Psychophysiological responding to emotional memories in healthy young men after cortisol and propranolol administration

et al. 2009

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Rationale Propranolol is found to reduce physiological hyper-responsiveness in post traumatic stress disorder (PTSD), possibly by affecting reconsolidation after the reactivation of traumatic memories. Cortisol is found to attenuate declarative memory retrieval, but it is unknown whether it also reduces physiological responses to emotional memories. Objectives To examine whether the effects of propranolol on physiological responding to emotional memories can also be found in healthy controls and to investigate the immediate and prolonged effects of cortisol on physiological responding to emotional memories, we tested these effects in 79 healthy young men. Materials and methods After preparing a script of a negative disturbing memory, participants were instructed to imagine this event 1 week later after ingestion of either 35 mg cortisol, 80 mg propranolol, or a placebo. Physiological responding to the script-driven imagery was recorded. Another week later, after washout, the imagery was repeated again. During all three sessions as well as 8 months later, subjective emotional reactions to the memories were assessed. ResultsThe emotionality of the memories was reduced over time, which was not affected by the treatments, however. The personal emotional script did evoke higher skin conductance responses than a neutral story, which decreased 1 week later, but no effects were found of either propranolol or cortisol on this responsiveness. Conclusions Whereas healthy males do show psychophysiological responding to personal emotional scripts, the effects of cortisol and propranolol on physiological responses to emotional memories might be specific to clinical groups characterized by hyper-responsiveness, like PTSD. Future studies using longer-acting doses and more elaborate reactivation procedures in both healthy men and women could shed more light on the effects of cortisol and propranolol on psychophysiological responding to emotional memories.

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Section: Discussioncontrasting

confidence: 81%

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confidence: 76%

Section: Discussionmentioning

confidence: 99%

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Psychophysiological responding to emotional memories in healthy young men after cortisol and propranolol administration

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“…With this break-down, we are able to investigate whether general memory change in the different groups is the result of participants incorporating new information (i.e. false alarms of pictures from Set 2) into the original memory (Hupbach et al, 2007, 2008) or whether new information only impairs the memory, but is not incorporated into the original memory (i.e. a lower percentage of hits) 1 .…”

Section: Resultsmentioning

confidence: 99%

“…One line of research remained close to the animal studies and demonstrated experimentally that human memories can be changed via pharmacological manipulations (e.g. Brunet et al, 2008; Kindt, Soeter, & Vervliet, 2009; Sevenster, Beckers, & Kindt, 2012, 2013; Soeter & Kindt, 2012), while the other line showed that memories can be altered with behavioural manipulations (e.g. Forcato et al, 2007; Hupbach, Gomez, Hardt, & Nadel, 2007; James et al, 2015; Schwabe & Wolf, 2009; Schiller et al, 2010; Wichert, Wolf, & Schwabe, 2011; 2013a, 2013b; see also van den Hout & Engelhard, 2012).…”

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confidence: 99%

Modification of episodic memories by novel learning: a failed replication study

Schie

Veen

Hout

et al. 2017

European Journal of Psychotraumatology

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Background: After reactivation, memories can become unstable and sensitive to modification before they are restored into long-term memory. Using behavioural manipulations, reactivated memories may be disrupted via the mechanism of interference (i.e. novel learning). In a laboratory study, Wichert et al. (2013a) showed that new learning after reactivation changed episodic memory, while new learning alone or reactivation alone did not. Objective: Given the potential clinical application of such a procedure in trauma-focused psychological treatments, such as CBT or EMDR, the aim of this study was to replicate Wichert et al. Method: On Day 1, participants (N = 96) viewed and recalled a series of emotional and non-emotional pictures. Then, participants were randomized to one of four groups. One week later, on Day 8, Group 1 reactivated the previously learned pictures and learned new pictures. To control for specific effects of reactivation or new learning, Group 2 only reactivated the previously learned pictures, and Group 3 only learned new pictures. Group 4 received no reactivation and no new learning. On Day 9, all groups indicated for each picture out of a series whether they had seen it on Day 1. Results: The data were analysed using Bayesian hypothesis testing, which allows for quantifying the evidence in favour of the alternative and the null hypothesis. In general, results showed that Group 1 recognized fewer pictures from Day 1 compared to Groups 2 and 4 on Day 9. However, the expected difference between new learning following reactivation (i.e. Group 1) and new learning alone (i.e. Group 3) was not substantially supported by the data for any of our dependent measures. Conclusions: We replicated some of the findings by Wichert et al., but did not find substantial support for the critical difference between new learning following reactivation and new learning alone.

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An Integrated Neuroscience Perspective on Formulation and Treatment Planning for Posttraumatic Stress Disorder

et al. 2017

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Importance Posttraumatic stress disorder (PTSD) is a common psychiatric illness, increasingly in the public spotlight in the United States due its prevalence in the soldiers returning from combat in Iraq and Afghanistan. This educational review presents a contemporary approach for how to incorporate a modern neuroscience perspective into an integrative case formulation. The article is organized around key neuroscience “themes” most relevant for PTSD. Within each theme, the article highlights how seemingly diverse biological, psychological, and social perspectives all intersect with our current understanding of neuroscience. Observations Any contemporary neuroscience formulation of PTSD should include an understanding of fear conditioning, dysregulated circuits, memory reconsolidation, epigenetics, and genetic factors. Fear conditioning and other elements of basic learning theory offer a framework for understanding how traumatic events can lead to a range of behaviors associated with PTSD. A circuit dysregulation framework focuses more broadly on aberrant network connectivity, including between the prefrontal cortex and limbic structures. In the process of memory reconsolidation, it is now clear that every time a memory is reactivated it becomes momentarily labile—with implications for the genesis, maintenance, and treatment of PTSD. Epigenetic changes secondary to various experiences, especially early in life, can have long-term effects, including on the regulation of the hypothalamic-pituitary-adrenal axis, thereby affecting an individual's ability to regulate the stress response. Genetic factors are surprisingly relevant: PTSD has been shown to be highly heritable despite being definitionally linked to specific experiences. The relevance of each of these themes to current clinical practice and its potential to transform future care are discussed. Conclusions and Relevance Together, these perspectives contribute to an integrative, neuroscience-informed approach to case formulation and treatment planning. This may help to bridge the gap between the traditionally distinct viewpoints of clinicians and researchers.

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Effect of post-retrieval propranolol on psychophysiologic responding during subsequent script-driven traumatic imagery in post-traumatic stress disorder

Cited by 506 publications

References 12 publications

Psychophysiological responding to emotional memories in healthy young men after cortisol and propranolol administration

Psychophysiological responding to emotional memories in healthy young men after cortisol and propranolol administration

Modification of episodic memories by novel learning: a failed replication study

An Integrated Neuroscience Perspective on Formulation and Treatment Planning for Posttraumatic Stress Disorder

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