Cannabinoid facilitation of fear extinction memory recall in humans.
- Authors
- Rabinak, Christine A; Angstadt, Mike; Sripada, Chandra S; Abelson, James L; Liberzon, Israel; Milad, Mohammed R; Phan, K Luan
- Year
- 2013
- Journal
- Neuropharmacology
- PMID
- 22796109
- DOI
- 10.1016/j.neuropharm.2012.06.063
- PMCID
- PMC3445738
A first-line approach to treat anxiety disorders is exposure-based therapy, which relies on extinction processes such as repeatedly exposing the patient to stimuli (conditioned stimuli; CS) associated with the traumatic, fear-related memory. However, a significant number of patients fail to maintain their gains, partly attributed to the fact that this inhibitory learning and its maintenance is temporary and conditioned fear responses can return. Animal studies have shown that activation of the cannabinoid system during extinction learning enhances fear extinction and its retention. Specifically, CB1 receptor agonists, such as Ξ9-tetrahydrocannibinol (THC), can facilitate extinction recall by preventing recovery of extinguished fear in rats. However, this phenomenon has not been investigated in humans. We conducted a study using a randomized, double-blind, placebo-controlled, between-subjects design, coupling a standard Pavlovian fear extinction paradigm and simultaneous skin conductance response (SCR) recording with an acute pharmacological challenge with oral dronabinol (synthetic THC) or placebo (PBO) 2 h prior to extinction learning in 29 healthy adult volunteers (THC = 14; PBO = 15) and tested extinction retention 24 h after extinction learning. Compared to subjects that received PBO, subjects that received THC showed low SCR to a previously extinguished CS when extinction memory recall was tested 24 h after extinction learning, suggesting that THC prevented the recovery of fear. These results provide the first evidence that pharmacological enhancement of extinction learning is feasible in humans using cannabinoid system modulators, which may thus warrant further development and clinical testing. This article is part of a Special Issue entitled 'Cognitive Enhancers'.
Schematic of the experimental protocol.
LLM interpretation
This figure is a schematic diagram illustrating a three-day experimental protocol for fear acquisition, extinction learning, and memory recall. Day 1 shows fear acquisition using colored squares (blue, yellow, red) paired with auditory stimuli; Day 2 depicts extinction learning following the administration of 7.5 mg THC or PBO with a 120-minute delay; Day 3 shows the extinction memory recall test. Each day includes boxes detailing the number of trials for various stimulus conditions (e.g., CS+E, CS+U, CS-).
Skin conductance responses (SCRs) to the CS+E during extinction learning. Mean SCRs to the CS+E during early (average first four trials) and late (average last four trials) extinction learning. PBO (green bars) and THC (red bars).
LLM interpretation
This bar chart displays mean skin conductance responses (SCR [$\mu\text{S}^{1/2}$]) for PBO (green) and THC (red) groups during early and late extinction learning. SCR values are higher during early extinction compared to late extinction for both groups. In the early phase, the THC group shows a higher mean SCR than the PBO group, whereas the values are nearly identical during the late phase.
Skin conductance responses (SCRs) during the extinction memory recall test. Mean differential SCRs during the first two trials of the CS+E minus the first two trials of the CS+U during the extinction memory recall test. Difference scores greater than zero reflect greater responding to the CS+E, difference scores equal to zero reflect no difference in responding between the CS+E and CS+U, and scores less than zero reflect greater responding to the CS+U (LaBar et al., 1998; LaBar et al., 1995). PBO (green bars) and THC (red bars).
LLM interpretation
This bar chart displays the mean difference in skin conductance responses (SCR) between the CS+E and CS+U conditions during an extinction memory recall test. The PBO group (green bar) shows a positive mean difference, while the THC group (red bar) shows a negative mean difference. The y-axis is labeled "Mean Difference SCR (SC+E - CS+U) [$\mu$S$^{1/2}$]" and ranges from -0.3 to 0.3.
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