Pharmacological treatments that facilitate extinction of fear: relevance to psychotherapy.
Pharmacological treatments that facilitate extinction of fear: relevance to psychotherapy.
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DOI：
10.1016/j.nurx.2005.12.008
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发表时间：
2006-01-01
期刊：
影响因子：
--
通讯作者：
Ressler, Kerry J
中科院分区：
文献类型：
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作者：
Davis, Michael;Myers, Karyn M;Ressler, Kerry J
总结：关于条件性恐惧的获得和表达的机制，我们已经知道了很多。最近，抑制条件性恐惧的机制已成为深入研究的主题。在实验室中研究恐惧抑制的主要模型系统是灭绝，其中先前的恐惧条件生物体在没有任何厌恶事件的情况下反复暴露于恐惧引发线索，并且恐惧条件反应下降。已经确定的是，灭绝是一种新的学习形式，而不是忘记或“忘记”条件恐惧，并且假设当将感觉信息传递到杏仁核的感觉通路通过经验依赖性可塑性（如长时程增强）的形式参与GABA能中间神经元时，灭绝就会发生。目前有几个实验室正在研究促进动物恐惧消退的方法，希望这种治疗最终能被证明有助于促进临床人群中焦虑症的基于焦虑的治疗。这篇综述讨论了在这一领域取得的进展，并提出了第一个主要的临床研究的结果，以检查药物，促进动物灭绝的治疗效用。它的结论是，灭绝是一个很好的模型系统的研究恐惧抑制和一个不可或缺的工具，为临床使用的推定药物治疗的筛选。
SUMMARY: A great deal is now known about the mechanisms of conditioned fear acquisition and expression. More recently, the mechanisms of inhibition of conditioned fear have become the subject of intensive study. The major model system for the study of fear inhibition in the laboratory is extinction, in which a previously fear conditioned organism is exposed repeatedly to the fear-eliciting cue in the absence of any aversive event and the fear conditioned response declines. It is well established that extinction is a form of new learning as opposed to forgetting or "unlearning" of conditioned fear, and it is hypothesized that extinction develops when sensory pathways conveying sensory information to the amygdala come to engage GABAergic interneurons through forms of experience-dependent plasticity such as long-term potentiation. Several laboratories currently are investigating methods of facilitating fear extinction in animals with the hope that such treatments might ultimately prove to be useful in facilitating exposure-based therapy for anxiety disorders in clinical populations. This review discusses the advances that have been made in this field and presents the findings of the first major clinical study to examine the therapeutic utility of a drug that facilitates extinction in animals. It is concluded that extinction is an excellent model system for the study of fear inhibition and an indispensable tool for the screening of putative pharmacotherapies for clinical use.