Converging cross-species evidence indicates that fear extinction (the laboratory basis of exposure therapy for anxiety disorders) in females is modulated by endogenous and exogenous estradiol. The mechanisms underlying estradiol's influences on fear extinction are largely undefined. However, one likely candidate is the NMDA-receptor (NMDAr), activation of which is necessary for estradiol-mediated enhancements in structural and functional neural plasticity, as well as extinction consolidation in males. Here, we demonstrate that systemic co-administration of the non-competitive NMDAr antagonist, MK801, blocked the enhancement of fear extinction by systemic estradiol in ovariectomized rats. In intact rats, MK801 during diestrus (rising estradiol) prevented the enhancement in extinction recall in rats that received extinction training during proestrus (peak estradiol). Systemic administration of the partial NMDAr agonist D-cycloserine (DCS) prior to extinction training facilitated extinction in ovariectomized rats, mimicking the effects of estradiol. In intact rats, DCS administered on the afternoon of proestrus and the morning of estrus (declining estradiol) facilitated extinction in rats that received extinction training during metestrus (low estradiol). Finally, DCS also facilitated extinction in ovariectomized rats when administered immediately after extinction training. Combined, these findings suggest that endogenous and exogenous estradiol enhance fear extinction via NMDAr-dependent mechanisms. Moreover, these findings raise the possibility that fear extinction deficits during periods of low endogenous estradiol levels can be reversed by increasing NMDAr activation via DCS administration, either well prior to, or immediately after, extinction training.
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http://dx.doi.org/10.1016/j.pnpbp.2018.05.003 | DOI Listing |
Cogn Behav Ther
January 2025
Department of Psychology, Vanderbilt University, 312 Wilson Hall, 111 21st Avenue South, Nashville, TN 37240, USA.
Exposure therapy is an efficacious treatment for anxiety-related disorders. Yet, fear often returns after treatment. Occasional reinforcement, in which the feared stimulus is intermittently presented during extinction, increases safety learning and slows fear renewal in conditioning paradigms and analogue samples, but no studies to date have examined this strategy in clinical samples.
View Article and Find Full Text PDFInt J Clin Health Psychol
January 2025
Department of Psychology and Neurosciences, Leibniz Research Centre for Working Environment and Human Factors, Dortmund, Germany.
Fear extinction is the foundation of exposure therapy for anxiety and phobias. However, the stability of extinction memory diminishes over time, coinciding with fear recovery. To augment long-term extinction retention, the temporal distribution of extinction learning sessions is critical.
View Article and Find Full Text PDFJ Neurosci Methods
January 2025
Dept. of Physiology and Pharmacology, Sapienza University of Rome, 00185 Rome, Italy; Neuropharmacology Unit, IRCCS Santa Lucia Foundation, 00143 Rome, Italy. Electronic address:
Background: Only a small percentage of trauma-exposed subjects develop PTSD, with females being twice as likely. Most rodent models focus on males and fail to account for inter-individual variability in females.
New Method: We tested a behavioral PTSD model in female rats to distinguish between susceptible and resilient individuals.
Indian J Psychiatry
December 2024
Department of Psychiatry and Psychotherapy, University Hospital Hamburg-Eppendorf, Hamburg, Germany.
Background: Glucocorticoids increase fear extinction in preclinical and human studies. Endogenous cortisol might influence who will benefit from exposure therapy in anxiety-spectrum disorders.
Methods: To investigate the impact of cortisol levels on within-session habituation of distress - a measure of success of exposure therapy - in obsessive-compulsive disorder (OCD) fifty-one OCD patients were studied during their stressful first cognitive-behavioral exposure therapy session with response prevention.
Curr Neuropharmacol
January 2025
Centro studi e ricerche in Neuroscienze Cognitive, Dipartimento di Psicologia "Renzo Canestrari", Alma Mater Studiorum Università di Bologna, Cesena Campus, Cesena, Italy.
Post-Traumatic Stress Disorder (PTSD) is mainly characterized by dysregulated fear re- sponses, including hyperarousal and intrusive re-experiencing of traumatic memories. This work delves into the intricate interplay between abnormal fear responses, cortisol dysregulation, and the Hypothalamic-Pituitary-Adrenal (HPA) axis, elucidating their role in the manifestation of PTSD. Giv- en the persistent nature of PTSD symptoms and the limitations of conventional therapies, innovative interventions are urgently needed.
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