Contract grant sponsor: Department of Defense; Contract grant number: W81XWH-11-2-0079.
2013 ADAA Scientific Symposium
DEVICE-BASED BRAIN STIMULATION TO AUGMENT FEAR EXTINCTION: IMPLICATIONS FOR PTSD TREATMENT AND BEYOND
Article first published online: 13 MAR 2014
© 2014 Wiley Periodicals, Inc.
Depression and Anxiety
Volume 31, Issue 4, pages 269–278, April 2014
How to Cite
Marin, M.-F., Camprodon, J. A., Dougherty, D. D. and Milad, M. R. (2014), DEVICE-BASED BRAIN STIMULATION TO AUGMENT FEAR EXTINCTION: IMPLICATIONS FOR PTSD TREATMENT AND BEYOND. Depress. Anxiety, 31: 269–278. doi: 10.1002/da.22252
- Issue published online: 10 APR 2014
- Article first published online: 13 MAR 2014
- Manuscript Accepted: 18 JAN 2014
- Manuscript Revised: 10 JAN 2014
- Manuscript Received: 21 OCT 2013
- Department of Defense. Grant Number: W81XWH-11-2-0079
- fear learning;
- extinction retention;
- exposure therapy;
- anxiety disorders;
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.