Mismatch vs. standard intervention during memory reconsolidation blockade with propranolol: effect on psychophysiological reactivity during traumatic imagery

项目总结/摘要 拟议中的R21项目将试图进一步开发一种新的创伤后应激干预措施 受记忆再巩固科学启发而出现的症状对正常人的研究表明， 重新激活稳定的、合并的存储器（即，在适当的条件下，它会恢复为 不稳定状态，在此称为解固结的过程。在这样的状态下，存储器容易受到 各种“遗忘”剂的作用，可能会抑制其重新巩固，从而削弱它。 肾上腺素能阻滞剂普萘洛尔（PPNL）具有这种遗忘特性。最近的研究发现， 为了启动解固结，必须有一个预测误差，或不匹配，什么是 以及当内存重新激活时会发生什么。 我们实验室先前的安慰剂对照随机临床试验（PBO-RCT）发现， 普萘洛尔的给药伴随着心理创伤记忆的重新激活， 记忆力减弱，如随后较低的生理（心率，皮肤电导，面部 在脚本驱动的心理意象过程中的反应。临床适用性进行了评价， PBO-RCT中，接受普萘洛尔的PTSD参与者每周接受6次10-20分钟的治疗， 通过阅读故事刺激的“标准”（STD）创伤记忆再激活。在治疗后，这些 与服用PBO的参与者相比，参与者表现出更大的PTSD症状减轻。的 拟议研究的目标是测试是否有意将创新失配（MM）纳入 创伤记忆的再激活可以改善在脚本驱动的心理意象期间的生理反应。 受试者将被随机分配至2个治疗组之一：STD/PPNL和MM/PPNL。基线评估 将测量对脚本驱动的心理意象的心理生理反应（目标测量）。PPNL将是 在每六周10-20分钟创伤记忆再激活期之前90分钟给药。在MM 条件，不同的、意外的失配（例如，唱叙事）将被纳入 重新激活在STD条件下，参与者每次都以相同的方式阅读叙述。的焦点 R21的建议将是评估MM/PPNL组是否表现出较低的后续生理 比STD/PPNL组的反应。

PROJECT SUMMARY / ABSTRACT The proposed R21 project will attempt to further develop a novel intervention for posttraumatic stress symptoms inspired by the science of memory reconsolidation. Work in normal humans has shown that when a stable, consolidated memory is reactivated (i.e., retrieved) under appropriate conditions, it reverts to an unstable state, a process referred to herein as deconsolidation. In such a state, the memory is susceptible to the action of various “amnestic” agents that may inhibit its reconsolidation, thereby weakening it. The β- adrenergic blocker propranolol (PPNL) possesses such amnestic properties. More recent research has found that in order to initiate deconsolidation, there must be a prediction error, or mismatch, between what is expected and what occurs when the memory is reactivated. Prior placebo-controlled, randomized clinical trials (PBO-RCT) from our laboratory have found that when propranolol is administered concomitant with the reactivation of a psychologically traumatic memory, the memory is weakened, as revealed by subsequent lower physiological (heart rate, skin conductance, facial electromyogram) responding during script-driven mental imagery. Clinical applicability was evaluated in a PBO-RCT, in which PTSD participants receiving propranolol underwent six weekly sessions of 10-20 min of “standard” (STD) traumatic memory reactivation stimulated by reading a narrative. At post-treatment, these participants showed a greater reduction of PTSD symptoms compared to participants who had taken PBO. The goal of the proposed study is to test whether intentionally incorporating innovative mismatch (MM) into traumatic memory reactivation can improve upon physiological responding during script-driven mental imagery. Participants will be randomized to one of 2 treatment arms: STD/PPNL and MM/PPNL. A baseline assessment will measure psychophysiological responsivity to script-driven mental imagery (target measure). PPNL will be administered 90-min prior to each of six weekly 10-20 min. traumatic memory reactivation sessions. In the MM condition, a different, unexpected mismatch (e.g., singing the narrative) will be incorporated into the reactivation. In the STD condition, the participant will read the narrative the same way each time. The focus of the R21 proposal will be to assess whether the MM/PPNL group shows lower subsequent physiological responses than the STD/PPNL group.