Extinction retention and the menstrual cycle: Different associations for women with posttraumatic stress disorder.

Abstract

The propensity to acquire and retain conditioned fear responses may contribute to the risk of developing and maintaining posttraumatic stress disorder (PTSD) following a traumatic event. There is growing evidence that the gonadal hormones estrogen and progesterone are associated with how well women retain extinction of previously conditioned fear responses. Thus, sex steroid effects may contribute to the increased prevalence of PTSD in women. For the current study, 32 nonmedicated female trauma survivors with and without PTSD completed a differential fear conditioning task both during the early follicular phase of the menstrual cycle when estradiol and progesterone levels are low, and during the midluteal phase when estradiol and progesterone levels are high. Skin conductance served as the measure of conditioned fear. Women with PTSD, compared to those without, showed impaired retention of extinction learning in the midluteal phase of the menstrual cycle. Therefore, the impact of menstrual phase on extinction retention may differ between women with and without PTSD. These findings raise potential considerations regarding the coordination of psychopharmacologic and trauma exposure-based treatments for PTSD with specific phases of the menstrual cycle.

Estradiol shifts interactions between the infralimbic cortex and central amygdala to enhance fear extinction memory in female rats

“…Our data support the growing literature indicating that given the relationship between naturally fluctuating endogenous estradiol and fear extinction memory, the success of psychiatric treatment (efficacy, duration, efficiency) may depend on gonadal hormone status (Wegerer et al, 2014; Glover et al, 2015; Pineles et al, 2016). Based on these data, estradiol may strengthen the consolidation of extinction memory via modulation of the amygdalar nuclei by the IL.…”

Assessment of skin conductance in African American and Non–African American participants in studies of conditioned fear

“…SCR to the UCS was calculated by subtracting the mean SCL during the last 2 s of the CS+ interval from the peak SCL during the 6 s following the CS+ offset (e.g., Orr et al, ). Consistent with prior research (Basden, Orr, & Otto, ; Bui et al, ; Pineles et al, ), individuals with a mean unconditioned SCR of less than 0.1 µS were considered to be “SCR nonresponders.” As it is not possible to measure SCR if an individual does not have a measurable SCL, individuals with unmeasurable SCLs were not included in the examinations of SCR nonresponders.…”

“…Sample 2 (AA, n = 29; non‐AA, n = 31) consists of data from a study conducted at the VA Boston Healthcare System examining fear conditioning in female patients with posttraumatic stress disorder (PTSD) and healthy controls at different stages of the menstrual cycle (Pineles et al, ). The non‐AA participants identified as White (61%, n = 19), Asian (23%, n = 7), American Indian (3%, n = 1), and Other (13%, n = 4).…”

Transcranial direct current stimulation may modulate extinction memory in posttraumatic stress disorder

“…Recruitment took place at the Providence VA Medical Center (PVAMC) by chart review and subsequent invitation if eligible and interested, as well as brochures and flyers throughout the hospital and PTSD clinic. Inclusion criteria were clinician‐based diagnosis of warzone‐related PTSD, age 18–70, male sex to avoid confounding issues of menstrual cycle, and hormonal contraceptives on fear conditioning (Glover et al., 2012; Graham & Milad, 2013; Lebron‐Milad & Milad, 2012; Milad et al., 2006; Sundström Poromaa & Gingnell, 2014; Pineles et al., 2016). Exclusion criteria were presence of any neurological/cognitive disorders, bipolar disorder, current substance abuse, or contraindication to tDCS (i.e., metal present in cranial cavity).…”