Premium
DEVICE‐BASED BRAIN STIMULATION TO AUGMENT FEAR EXTINCTION: IMPLICATIONS FOR PTSD TREATMENT AND BEYOND
Author(s) -
Marin MarieFrance,
Camprodon Joan A.,
Dougherty Darin D.,
Milad Mohammed R.
Publication year - 2014
Publication title -
depression and anxiety
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.634
H-Index - 129
eISSN - 1520-6394
pISSN - 1091-4269
DOI - 10.1002/da.22252
Subject(s) - extinction (optical mineralogy) , neuroscience , psychology , amygdala , transcranial magnetic stimulation , vagus nerve stimulation , neuromodulation , brain stimulation , ventromedial prefrontal cortex , prefrontal cortex , exposure therapy , stimulation , fear conditioning , hippocampus , transcranial direct current stimulation , anxiety , recall , deep brain stimulation , cognitive psychology , medicine , psychiatry , disease , cognition , vagus nerve , parkinson's disease , paleontology , pathology , biology
Conditioned fear acquisition and extinction paradigms have been widely used both in animals and humans to examine the neurobiology of emotional memory. Studies have also shown that patients suffering from posttraumatic stress disorder (PTSD) exhibit deficient extinction recall along with dysfunctional activation of the fear extinction network, including the ventromedial prefrontal cortex, amygdala, and hippocampus. A great deal of overlap exists between this fear extinction network and brain regions associated with symptom severity in PTSD. This suggests that the neural nodes of fear extinction could be targeted to reduce behavioral deficits that may subsequently translate into symptom improvement. In this article, we discuss potential applications of brain stimulation and neuromodulation methods, which, combined with a mechanistic understanding of the neurobiology of fear extinction, could be used to further our understanding of the pathophysiology of anxiety disorders and develop novel therapeutic tools. To this end, we discuss the following stimulation approaches: deep‐brain stimulation, vagus nerve stimulation, transcranial direct current stimulation, and transcranial magnetic stimulation. We propose new translational research avenues that, from a systems neuroscience perspective, aim to expand our understanding of circuit dynamics and fear processing toward the practical development of clinical tools, to be used alone or in combination with behavioral therapies.