Modulation of naturalistic maladaptive memories using behavioural and pharmacological reconsolidation-interfering strategies: A systematic review and meta-analysis of clinical and 'sub-clinical' studies
Modulation of naturalistic maladaptive memories using behavioural and pharmacological reconsolidation-interfering strategies: A systematic review and meta-analysis of clinical and 'sub-clinical' studies
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使用行为和药理再巩固干扰策略调节自然适应不良记忆：临床和“亚临床”研究的系统回顾和荟萃分析
DOI：
10.1101/282293
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发表时间：
2018
期刊：
影响因子：
--
通讯作者：
Walsh K
中科院分区：
文献类型：
--
作者：
Walsh K
背景巩固记忆可以通过调节再巩固的提取依赖治疗而经历持久的修改。这代表了一种潜在的变革性战略，以削弱或覆盖导致物质使用和焦虑/创伤相关障碍的不良适应记忆。然而，自然不良适应记忆的调节可能会受到这些记忆性质对重新巩固过程施加的‘边界条件’的限制。方法我们对行为和药理学研究进行了系统的回顾和荟萃分析，分别考察了(亚)临床物质使用和焦虑/创伤中奖赏和威胁相关记忆的提取依赖调节。结果在4938篇评估合格的文献中，8篇关于物质使用的研究和10篇与焦虑(恐怖)和创伤相关的症状进入Meta分析。总体而言，这些发现是在预测的方向上进行的，大多数研究都支持“取回+治疗”的情况。然而，影响的大小取决于治疗的性质，在恐惧症/创伤的研究中，药物干预显示出中等效果(g= 0.59，p= 0.03)，行为治疗显示出相对较小的效果(g= 0.32，p= 0.10)。在对物质使用的研究中，提取后行为干预产生的效果(g= 0.60，p<； 0.001)比药物治疗(g= − 0.03，p= 0.91)更大，治疗类型是有统计学意义的调节因素(χ2(1) = 4.20，p= 0.04)。结论在再巩固过程中修改自然适应不良记忆似乎是治疗物质使用和恐惧症/创伤障碍的可行策略。然而，高度的异质性和方法学差异限制了现阶段从回顾研究中得出的结论的强度。
BackgroundConsolidated memories can undergo enduring modification through retrieval-dependent treatments that modulate reconsolidation. This represents a potentially transformative strategy for weakening or overwriting the maladaptive memories that underlie substance use and anxiety/trauma-related disorders. However, modulation ofnaturalisticmaladaptive memories may be limited by ‘boundary conditions’ imposed on the reconsolidation process by the nature of these memories.MethodsWe conducted a systematic review and meta-analyses of behavioural and pharmacological studies examining retrieval-dependent modulation of reward- and threat-related memories in (sub) clinical substance use and anxiety/trauma, respectively.ResultsOf 4938 publications assessed for eligibility, 8 studies of substance use and 10 of anxiety (phobia)- and trauma-related symptoms were included in the meta-analyses. Overall, the findings were in the predicted direction, with most studies favouring the ‘retrieval + treatment’ condition. However, the magnitude of effects was dependent upon the nature of treatment, with pharmacological interventions showing a medium-sized effect (g= 0.59,p= 0.03) and behavioural treatments, a relatively small effect (g= 0.32,p= 0.10) in studies of phobia/trauma. Among studies of substance use, post-retrieval behavioural interventions yielded a larger effect (g= 0.60,p< 0.001) relative to pharmacological treatments (g= − 0.03,p= 0.91), with treatment type being a statistically significant moderator (χ2(1) = 4.20,p= 0.04).ConclusionModification of naturalistic maladaptive memories during reconsolidation appears to be a viable treatment strategy for substance use and phobias/trauma disorders. However, high levels of heterogeneity and methodological variation limit the strength of conclusions that can be drawn from the reviewed studies at this stage.