The effect of acutely administered MDMA on subjective and BOLD-fMRI responses to favourite and worst autobiographical memories
The effect of acutely administered MDMA on subjective and BOLD-fMRI responses to favourite and worst autobiographical memories
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DOI：
10.1017/s1461145713001405
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发表时间：
2014-04-01
影响因子：
4.8
通讯作者：
Nutt, D. J.
中科院分区：
文献类型：
--
作者：
Carhart-Harris, R. L.;Wall, M. B.;Nutt, D. J.
3,4-亚甲基二氧甲基苯丙胺（MDMA）是一种有效的单胺释放剂，被广泛用作娱乐性药物。初步研究支持MDMA在创伤后应激障碍（PTSD）心理治疗中的潜力。然而，其假定功效背后的神经生物学机制却知之甚少。创伤后应激障碍的心理治疗通常要求患者重温创伤记忆，有人认为服用MDMA更容易做到这一点。采用功能磁共振成像（fMRI）研究MDMA对自传体记忆（AMs）的影响。有MDMA用药经验的19名参与者（5名女性）在摄入100mg MDMA- hcl或抗坏血酸（安慰剂）后进行了阻断AM回忆（AMR）范式，采用双盲、重复测量设计。他们在扫描仪中读取描述参与者的记忆线索。服用MDMA后，最喜欢的记忆被认为比安慰剂更生动、情绪更强烈、更积极，而最糟糕的记忆被认为不那么消极。来自17名参与者的功能性MRI数据显示，在已知与AMR有关的区域，AMR有强劲的激活。记忆效价也有显著的影响：海马区对最喜欢的记忆表现出优先激活，而执行区对最糟糕的记忆表现出优先激活。MDMA增强了双侧梭状回和躯体感觉皮层对最喜欢记忆的激活，减弱了左侧前颞叶皮层对最糟糕记忆的激活。这些发现与可能由MDMA的前单胺能药理学介导的积极情绪偏见一致。
3,4-methylenedioxymethamphetamine (MDMA) is a potent monoamine-releaser that is widely used as a recreational drug. Preliminary work has supported the potential of MDMA in psychotherapy for post-traumatic stress disorder (PTSD). The neurobiological mechanisms underlying its putative efficacy are, however, poorly understood. Psychotherapy for PTSD usually requires that patients revisit traumatic memories, and it has been argued that this is easier to do under MDMA. Functional magnetic resonance imaging (fMRI) was used to investigate the effect of MDMA on recollection of favourite and worst autobiographical memories (AMs). Nineteen participants (five females) with previous experience with MDMA performed a blocked AM recollection (AMR) paradigm after ingestion of 100mg of MDMA-HCl or ascorbic acid (placebo) in a double-blind, repeated-measures design. Memory cues describing participants' AMs were read by them in the scanner. Favourite memories were rated as significantly more vivid, emotionally intense and positive after MDMA than placebo and worst memories were rated as less negative. Functional MRI data from 17 participants showed robust activations to AMs in regions known to be involved in AMR. There was also a significant effect of memory valence: hippocampal regions showed preferential activations to favourite memories and executive regions to worst memories. MDMA augmented activations to favourite memories in the bilateral fusiform gyrus and somatosensory cortex and attenuated activations to worst memories in the left anterior temporal cortex. These findings are consistent with a positive emotional-bias likely mediated by MDMA's pro-monoaminergic pharmacology.