Rewriting the valuation and salience of alcohol-related stimuli via memory reconsolidation

Abstract

The transient period of memory instability that can be triggered when memories are retrieved under certain conditions offers an opportunity to modify the maladaptive memories at the heart of substance use disorders (SUDs). However, very well-learned memories (such as those in excessive drinking and alcohol use disorders) are resistant to destabilisation when retrieved or may not destabilise at all. Memory retrieval and intervention procedures that reliably destabilise and update maladaptive motivational memories may help to improve the long-term treatment of SUDs. In 59 hazardous drinkers, we tested a novel retrieval procedure for destabilising well-learned cue-drinking memory networks that maximises prediction error (PE) via guided expectancy violation during retrieval of these memories. This was compared with a retrieval procedure without PE and no-retrieval controls. We subsequently counterconditioned alcohol cues with disgusting tastes and images in all groups and assessed responding to alcohol stimuli 1 week later. Counterconditioning following PE retrieval produced generalised reductions in oculomotor attentional bias, explicit valuation and outcome expectancies in response to alcohol cues 1 week after intervention, evidence of updating of distributed motivational drinking memory networks. These findings demonstrate that well-learned cue-drinking memories can be destabilised and that learning history need not constrain memory destabilisation if PE is maximised at retrieval. Broad rewriting of diverse aspects of maladaptive memory by counterconditioning is achievable following this procedure. The procedure described may provide a platform for the development of novel memory-modifying interventions for SUDs.

Counterconditioning During Reconsolidation Prevents Relapse of Cocaine Memories

“…Therefore, utilizing the retrieval-counterconditioning procedure to replace these unwanted memories with adaptive memories is a potentially novel behavioral therapeutic approach for these neuropsychiatric disorders. Indeed, Das et al (2015) recently demonstrated that human hazardous drinkers expressed less attention bias towards alcohol-related stimuli after exposure to aversive taste or pictures during reconsolidation, further pointing to the translational value of the present approach to reduce cue-induced craving and relapse in drug addicts.…”

An Update on Memory Reconsolidation Updating

“…Neutral context memory can acquire threatening properties when reconsolidation mediates the incorporation of new threat learning experience [36]; contextual threat memories can strengthen with additional learning after retrieval in a process depending selectively on reconsolidation mechanisms [37]; and appetitive associative memories can lose their rewarding properties using the reactivation-extinction procedure [38, 39]. Another updating process that has effectively reduced reward-related responding involves reactivation followed by counterconditioning [40–42], where the appetitive conditioned stimulus is paired with an aversive outcome during reconsolidation.…”

“…Taking a potentially more robust approach, a recent study used reactivation followed by counterconditioning in hazardous alcoholic drinkers [40]. The study induced memory reactivation using an actual alcoholic drink as the reminder, which the participants were almost allowed to drink but were stopped.…”

Reconsolidation and psychopathology: Moving towards reconsolidation-based treatments

“…For example, in hazardous alcohol drinkers, post-retrieval ethanol cue reappraisal or counterconditioning blocked reconsolidation in a retrieval-dependent manner (Das et al 2015b; Hon et al 2015). Furthermore, in these studies, no behavioral effect was elicited when the design did not explicitly elicit a prediction error, which is thought to enhance memory lability memory and initiate reconsolidation (Exton-McGuinness et al 2015; Torregrossa and Taylor 2016; Corlett and Taylor 2013).…”