Abstract
Current pharmacological and psychological treatments for disorders of emotional memory only dampen the affective response while leaving the original fear memory intact. Under adverse circumstances, these original memories regain prominence, causing relapses in many patients. The (re)discovery in neuroscience that after reactivation consolidated fear memories may return to a transient labile state, requiring a process of restabilization in order to persist, offers a window of opportunity for modifying fear memories with amnestic agents. This process, known as memory reconsolidation, opens avenues for developing a revolutionary treatment for emotional memory disorders. The reconsolidation intervention challenges the dominant pharmacological and psychological models of treatment: it is only effective when the amnestic drug is given in conjunction with memory reactivation during a specific time window, and a modification of cognitive processes is a boundary condition for changing fear. Notwithstanding the dramatic effects of targeting memory reconsolidation in the laboratory (i.e. proof of principle), the greatest hurdle to overcome is that the success of the manipulation depends on subtle differences in the reactivation procedure. These experimental parameters cannot be easily controlled in clinical practice. In harnessing the clinical potential of memory reconsolidation, a heuristic for bi-directionally translating behavioural neuroscience and clinical science is proposed.This article is part of a discussion meeting issue ‘Of mice and mental health: facilitating dialogue between basic and clinical neuroscientists’.
Highlights
While many of our precious memories fall into oblivion, fear memories are typically strong and resistant to decay
In a series of laboratory experiments, we convincingly demonstrated that disrupting the process of memory reconsolidation with a drug neutralized the affective expression of a fear memory without changing the actual recollection of the threatening event [4,5,6,7,8,9,10,11,12,13]
The procedure is more like ‘neurosurgery’ than psychotherapy. These findings suggest the possibility of a paradigm shift in clinical practice, a reconsolidation intervention for horrific or otherwise undesirable memories has not left the hypothetical arena
Summary
While many of our precious memories fall into oblivion, fear memories are typically strong and resistant to decay. An abrupt reduction in fear response using a single amnestic drug administered upon memory reactivation has only been reliably demonstrated for very specific fears, which are typically induced in the laboratory, and more recently in a subclinical sample of people with spider fear [4,5,6,7,8,9,10,11,12,13,15] Irrespective of these dramatic effects (i.e. proof of principle), the results of the reconsolidation intervention for more severe emotional memory disorders such as chronic posttraumatic stress disorder (PTSD) are both promising and disappointing [19,20,21,22,23]. These insights and observations provide operational tools for testing novel hypotheses on different levels of analysis: 2 from behavioural neuroscience to clinical science, and vice versa
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