Fear conditioning in posttraumatic stress disorder: Evidence for delayed extinction of autonomic, experiential, and behavioural responses

Blechert, Jens; Michael, Tanja; Vriends, Noortje; Margraf, Jürgen; Wilhelm, Frank H.

doi:10.1016/j.brat.2007.02.012

Cited by 430 publications

(338 citation statements)

References 44 publications

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“…Additionally, individuals with PTSD have shown resistance to extinction in fear conditioning in the laboratory (e.g., Blechert, et al, 2007;Wessa and Flor, 2007). In this regard, our results do not support a predisposing or causative relationship between mTBI and PTSD.…”

Section: Discussioncontrasting

confidence: 70%

Neurocognitive and Biomarker Evaluation of Combination mTBI from Blast Overpressure and Traumatic Stress

Genovese¹

2013

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Public reporting burden for this collection of information is estimated to average 1 hour per response, including the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing this collection of information. Send comments regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden to Department of Defense, Washington Headquarters Services, Directorate for Information Operations and Reports (0704-0188), 1215 Jefferson Davis Highway, Suite 1204, Arlington, VA 22202-4302. Respondents should be aware that notwithstanding any other provision of law, no person shall be subject to any penalty for failing to comply with a collection of information if it does not display a currently valid OMB control number. PLEASE DO NOT RETURN YOUR FORM TO THE ABOVE ADDRESS. REPORT DATE (DD-MM-YYYY)September 2013 (From -To) 1 September 2012 -31 August 2013 REPORT TYPE Annual DATES COVERED TITLE AND SUBTITLENeurocognitive and Biomarker Evaluation of Combination mTBI from Blast Overpressure and Traumatic Stress 5a. CONTRACT NUMBER 5b. GRANT NUMBER W81XWH-10-2-0091 5c. PROGRAM ELEMENT NUMBER AUTHOR(S)Raymond Genovese E-Mail: cpfortmiller@genevusa.org 5d. PROJECT NUMBER 5e. TASK NUMBER 5f. WORK UNIT NUMBER PERFORMING ORGANIZATION NAME(S) AND ADDRESS(ES)The Geneva Foundation Lakewood, WA 96499 PERFORMING ORGANIZATION REPORT NUMBER SPONSORING / MONITORING AGENCY NAME(S) AND ADDRESS(ES) U.S. Army Medical Research and Materiel Command Fort Detrick, Maryland 21702-5012 SPONSOR/MONITOR'S ACRONYM(S) SPONSOR/MONITOR'S REPORT NUMBER(S) DISTRIBUTION / AVAILABILITY STATEMENTApproved for Public Release; Distribution Unlimited SUPPLEMENTARY NOTES ABSTRACTMild traumatic brain injury (mTBI) and post-traumatic stress disorder (PTSD) are major medical issues for the Warfighter. The current project is designed to evaluate the impact of mild traumatic brain injury (using blast overpressure) and the processes involved in traumatic stress (using a predator exposure procedure and a conditioned fear procedure) in a rodent model. The studies evaluate these insults alone and in combination to specifically address the question of whether mTBI can exacerbate the effects of psychological stress. Additionally, following the insults, a molecular biological evaluation is performed based upon the discovery of biomarkers that have been shown to be correlated with other forms of TBI. Thus, the project aims to systematically assess the combined effects of blast overpressure, traumatic stress and learned stress responses in rodents with the aim of understanding how these forces may interact to impact behavior as well as evaluating their outcome on known biomarkers involved in TBI and stress response system activation. SUBJECT TERMSNone provided. Mild traumatic brain injury (mTBI) and post-traumatic stress disorder (PTSD) are medical issues for the war fighter. Sometimes, mTBI and PTSD present a convergence of symptoms, ma...

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Section: Discussioncontrasting

confidence: 70%

Neurocognitive and Biomarker Evaluation of Combination mTBI from Blast Overpressure and Traumatic Stress

Genovese¹

2013

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“…Consistent with this view, slower extinction of corrugator electromyogram responses were found to represent a pre-trauma risk factor for PTSD-related symptoms following a traumatic event (Guthrie and Bryant, 2006). Although studies have supported impaired extinction learning in PTSD (Blechert et al, 2007;Orr et al, 2000;Peri et al, 2000), no previous studies have reported deficits in extinction retention.…”

Section: Introductionmentioning

confidence: 86%

Presence and acquired origin of reduced recall for fear extinction in PTSD: Results of a twin study

Milad

Orr

Lasko

et al. 2008

Journal of Psychiatric Research

457

393

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Recall of fear extinction, which is thought to aid in recovery from a psychologically traumatic event, is hypothesized to be deficient in post-traumatic stress disorder (PTSD), but this has not yet been demonstrated in the laboratory, nor has its origin been investigated. To address these two issues, 14 pairs of monozygotic twins discordant for combat exposure, in 7 of which the combat-exposed twin had PTSD, underwent a two-day fear conditioning and extinction procedure. On Day 1, subjects viewed colored light conditioned stimuli, some of which were paired with mild electric shock, followed by extinction of the conditioned responses. On Day 2, recall of Day 1 extinction learning (i.e., extinction retention) was assessed. Skin conductance response (SCR) was the dependent measure. There were no group differences during acquisition or extinction learning. However, a significant PTSD Diagnosis (in the exposed twin) x combat Exposure interaction emerged during extinction recall, with the PTSD combat veterans having larger SCRs than their own co-twins, and than the non-PTSD combat veterans and their co-twins. These results indicate that retention of extinction of conditioned fear is deficient in PTSD. Furthermore, they support the conclusion that this deficit is acquired as a result of combat trauma leading to PTSD, rather than being a predisposing factor to developing PTSD upon the stress of combat.

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“…Although the etiology of PTSD is complex, it is widely believed that associative learning processes, including Pavlovian fear conditioning, contribute to its genesis. Moreover, an inability to suppress or extinguish fear memories may sustain pathologically high levels of fear in patients with PTSD years after the trauma (1)(2)(3)(4)(5)(6). A variety of clinical interventions to facilitate fear extinction in patients with PTSD are currently being explored, although effective treatment for many afflicted individuals remains elusive (7,8).…”

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confidence: 99%

Noradrenergic blockade stabilizes prefrontal activity and enables fear extinction under stress

Fitzgerald

Giustino

Seemann

et al. 2015

Proc. Natl. Acad. Sci. U.S.A.

117

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Stress-induced impairments in extinction learning are believed to sustain posttraumatic stress disorder (PTSD). Noradrenergic signaling may contribute to extinction impairments by modulating medial prefrontal cortex (mPFC) circuits involved in fear regulation. Here we demonstrate that aversive fear conditioning rapidly and persistently alters spontaneous single-unit activity in the prelimbic and infralimbic subdivisions of the mPFC in behaving rats. These conditioning-induced changes in mPFC firing were mitigated by systemic administration of propranolol (10 mg/kg, i.p.), a β-noradrenergic receptor antagonist. Moreover, propranolol administration dampened the stress-induced impairment in extinction observed when extinction training is delivered shortly after fear conditioning. These findings suggest that β-adrenoceptors mediate stress-induced changes in mPFC spike firing that contribute to extinction impairments. Propranolol may be a helpful adjunct to behavioral therapy for PTSD, particularly in patients who have recently experienced trauma.fear | extinction | propranolol | prefrontal cortex | rat

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Fear conditioning in posttraumatic stress disorder: Evidence for delayed extinction of autonomic, experiential, and behavioural responses

Cited by 430 publications

References 44 publications

Neurocognitive and Biomarker Evaluation of Combination mTBI from Blast Overpressure and Traumatic Stress

Neurocognitive and Biomarker Evaluation of Combination mTBI from Blast Overpressure and Traumatic Stress

Presence and acquired origin of reduced recall for fear extinction in PTSD: Results of a twin study

Noradrenergic blockade stabilizes prefrontal activity and enables fear extinction under stress

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