Posts tagged anxiety
Posts tagged anxiety
Chronic trauma can inflict lasting damage to brain regions associated with fear and anxiety. Previous imaging studies of people with post-traumatic stress disorder, or PTSD, have shown that these brain regions can over-or under-react in response to stressful tasks, such as recalling a traumatic event or reacting to a photo of a threatening face. Now, researchers at NYU School of Medicine have explored for the first time what happens in the brains of combat veterans with PTSD in the absence of external triggers.
Their results, published in Neuroscience Letters, and presented today at the annual meeting of the American Psychiatry Association in San Francisco, show that the effects of trauma persist in certain brain regions even when combat veterans are not engaged in cognitive or emotional tasks, and face no immediate external threats. The findings shed light on which areas of the brain provoke traumatic symptoms and represent a critical step toward better diagnostics and treatments for PTSD.
A chronic condition that develops after trauma, PTSD can plague victims with disturbing memories, flashbacks, nightmares and emotional instability. Among the 1.7 million men and women who have served in the wars in Iraq and Afghanistan, an estimated 20% have PTSD. Research shows that suicide risk is higher in veterans with PTSD. Tragically, more soldiers committed suicide in 2012 than the number of soldiers who were killed in combat in Afghanistan that year.
“It is critical to have an objective test to confirm PTSD diagnosis as self reports can be unreliable,” says co-author Charles Marmar, MD, the Lucius N. Littauer Professor of Psychiatry and chair of NYU Langone’s Department of Psychiatry. Dr. Marmar, a nationally recognized expert on trauma and stress among veterans, heads The Steven and Alexandra Cohen Veterans Center for the Study of Post-Traumatic Stress and Traumatic Brain Injury at NYU Langone Medical Center.
The study, led by Xiaodan Yan, a research fellow at NYU School of Medicine, examined “spontaneous” or “resting” brain activity in 104 veterans of combat from the Iraq and Afghanistan wars using functional MRI, which measures blood-oxygen levels in the brain. The researchers found that spontaneous brain activity in the amygdala, a key structure in the brain’s “fear circuitry” that processes fearful and anxious emotions, was significantly higher in the 52 combat veterans with PTSD than in the 52 combat veterans without PTSD. The PTSD group also showed elevated brain activity in the anterior insula, a brain region that regulates sensitivity to pain and negative emotions.
Moreover, the PTSD group had lower activity in the precuneus, a structure tucked between the brain’s two hemispheres that helps integrate information from the past and future, especially when the mind is wandering or disengaged from active thought. Decreased activity in the precuneus correlates with more severe “re-experiencing” symptoms—that is, when victims re-experience trauma over and over again through flashbacks, nightmares and frightening thoughts.
A new study from investigators at the Benson-Henry Institute for Mind/Body Medicine at Massachusetts General Hospital and Beth Israel Deaconess Medical Center finds that eliciting the relaxation response—a physiologic state of deep rest induced by practices such as meditation, yoga, deep breathing and prayer—produces immediate changes in the expression of genes involved in immune function, energy metabolism and insulin secretion.
“Many studies have shown that mind/body interventions like the relaxation response can reduce stress and enhance wellness in healthy individuals and counteract the adverse clinical effects of stress in conditions like hypertension, anxiety, diabetes and aging,” said Herbert Benson, HMS professor of medicine at Mass General and co-senior author of thereport.
Benson is director emeritus of the Benson-Henry Institute.
“Now for the first time we’ve identified the key physiological hubs through which these benefits might be induced,” he said.
Published in the open-access journal PLOS ONE, the study combined advanced expression profiling and systems biology analysis to both identify genes affected by relaxation response practice and to determine the potential biological relevance of those changes.
“Some of the biological pathways we identify as being regulated by relaxation response practice are already known to play specific roles in stress, inflammation and human disease. For others, the connections are still speculative, but this study is generating new hypotheses for further investigation,” said Towia Libermann, HMS associate professor of medicine at Beth Israel Deaconess and co-senior author of the study.
Benson first described the relaxation response—the physiologic opposite of the fight-or-flight response—almost 40 years ago, and his team has pioneered the application of mind/body techniques to a wide range of health problems. Studies in many peer-reviewed journals have documented how the relaxation response both alleviates symptoms of anxiety and many other disorders and also affects factors such as heart rate, blood pressure, oxygen consumption and brain activity.
In 2008, Benson and Libermann led a study finding that long-term practice of the relaxation response changed the expression of genes involved with the body’s response to stress. The current study examined changes produced during a single session of relaxation response practice, as well as those taking place over longer periods of time.
The study enrolled a group of 26 healthy adults with no experience in relaxation response practice, who then completed an 8-week relaxation-response training course.
Before they started their training, they went through what was essentially a control group session: Blood samples were taken before and immediately after the participants listened to a 20-minute health education CD and again 15 minutes later. After completing the training course, a similar set of blood tests was taken before and after participants listened to a 20-minute CD used to elicit the relaxation response as part of daily practice.
The sets of blood tests taken before the training program were designated “novice,” and those taken after training completion were called “short-term practitioners.” For further comparison, a similar set of blood samples was taken from a group of 25 individuals with 4 to 25 years’ experience regularly eliciting the relaxation response through many different techniques before and after they listened to the same relaxation response CD.
Blood samples from all participants were analyzed to determine the expression of more than 22,000 genes at the different time points.
The results revealed significant changes in the expression of several important groups of genes between the novice samples and those from both the short- and long-term sets. Even more pronounced changes were shown in the long-term practitioners.
A systems biology analysis of known interactions among the proteins produced by the affected genes revealed that pathways involved with energy metabolism, particularly the function of mitochondria, were upregulated during the relaxation response. Pathways controlled by activation of a protein called NF-κB—known to have a prominent role in inflammation, stress, trauma and cancer—were suppressed after relaxation response elicitation. The expression of genes involved in insulin pathways was also significantly altered.
“The combination of genomics and systems biology in this study provided great insight into the key molecules and physiological gene interaction networks that might be involved in relaying beneficial effects of relaxation response in healthy subjects,” said Manoj Bhasin, HMS assistant professor of medicine, co-lead author of the study, and co-director of the Beth Israel Deaconess Genomics, Proteomics, Bioinformatics and Systems Biology Center.
Bhasin noted that these insights should provide a framework for determining, on a genomic basis, whether the relaxation response will help alleviate symptoms of diseases triggered by stress. The work could also lead to developing biomarkers that may suggest how individual patients will respond to interventions.
Benson stressed that the long-term practitioners in this study elicited the relaxation response through many different techniques—various forms of meditation, yoga or prayer—but those differences were not reflected in the gene expression patterns.
“People have been engaging in these practices for thousands of years, and our finding of this unity of function on a basic-science, genomic level gives greater credibility to what some have called ‘new age medicine,’ ” he said.
“While this and our previous studies focused on healthy participants, we currently are studying how the genomic changes induced by mind/body interventions affect pathways involved in hypertension, inflammatory bowel disease and irritable bowel syndrome. We have also started a study—a collaborative undertaking between Dana-Farber Cancer Institute, Mass General and Beth Israel Deaconess—in patients with precursor forms of multiple myeloma, a condition known to involve activation of NF-κB pathways,” said Libermann, who is the director of the Beth Israel Deaconess Medical Center Genomics, Proteomics, Bioinformatics and Systems Biology Center.
University of British Columbia researchers have found a new potential use for the over-the-counter pain drug Tylenol. Typically known to relieve physical pain, the study suggests the drug may also reduce the psychological effects of fear and anxiety over the human condition, or existential dread.
Published in the Association for Psychological Science journal Psychological Science, the study advances our understanding of how the human brain processes different kinds of pain.
“Pain exists in many forms, including the distress that people feel when exposed to thoughts of existential uncertainty and death,” says lead author Daniel Randles, UBC Dept. of Psychology. “Our study suggests these anxieties may be processed as ‘pain’ by the brain – but Tylenol seems to inhibit the signal telling the brain that something is wrong.”
The study builds on recent American research that found acetaminophen – the generic form of Tylenol – can successfully reduce the non-physical pain of being ostracized from friends. The UBC team sought to determine whether the drug had similar effects on other unpleasant experiences – in this case, existential dread.
In the study, participants took acetaminophen or a placebo while performing tasks designed to evoke this kind of anxiety – including writing about death or watching a surreal David Lynch video – and then assign fines to different types of crimes, including public rioting and prostitution.
Compared to a placebo group, the researchers found the people taking acetaminophen were significantly more lenient in judging the acts of the criminals and rioters – and better able to cope with troubling ideas. The results suggest that participants’ existential suffering was “treated” by the headache drug.
“That a drug used primarily to alleviate headaches may also numb people to the worry of thoughts of their deaths, or to the uneasiness of watching a surrealist film – is a surprising and very interesting finding,” says Randles, a PhD candidate who authored the study with Prof. Steve Heine and Nathan Santos.
While the findings suggest that acetaminophen can help to reduce anxiety, the researchers caution that further research – and clinical trials – must occur before acetaminophen should be considered a safe or effective treatment for anxiety.
Fear of public speaking tops death and spiders as the nation’s number one phobia. But new research shows that learning to rethink the way we view our shaky hands, pounding heart, and sweaty palms can help people perform better both mentally and physically.
Before a stressful speaking task, simply encouraging people to reframe the meaning of these signs of stress as natural and helpful was a surprisingly effective way of handling stage fright, found the study to be published online April 8 in Clinical Psychological Science.
“The problem is that we think all stress is bad,” explains Jeremy Jamieson, the lead author on the study and an assistant professor of psychology at the University of Rochester. “We see headlines about ‘Killer Stress’ and talk about being ‘stressed out.’” Before speaking in public, people often interpret stress sensations, like butterflies in the stomach, as a warning that something bad is about to happen, he says.
“But those feelings just mean that our body is preparing to address a demanding situation,” explains Jamieson. “The body is marshaling resources, pumping more blood to our major muscle groups and delivering more oxygen to our brains.” Our body’s reaction to social stress is the same flight or fight response we produce when confronting physical danger. These physiological responses help us perform, whether we’re facing a bear in the forest or a critical audience.
For many people, especially those suffering from social anxiety disorder, the natural uneasiness experienced before giving a speech can quickly tip over into panic. “If we think we can’t cope with stress, we will experience threat. When threatened, the body enacts changes to concentrate blood in the core and restricts flow to the arms, legs, and brain,” he explains. So, “cold feet” is a real physiological response to threat, not just a colorful expression.
“Lots of current advice for anxious people focuses on learning to ‘relax,’—you know, deep, even breathing and similar tips,” says Jamieson. Such calming techniques, write the authors, may be helpful in situations that do not require peak performance. But when gearing up for a high-stakes exam, a job interview, or, yes, a speaking engagement, reframing how we think about stress may be a better strategy.
Then how can people reap the benefits of being stressed without being overwhelmed by dread? To answer that question, Jamieson and co-authors Matthew Nock, of Harvard University and Wendy Berry Mendes of the University of California in San Francisco, turned to the Trier Social Stress Test. Developed in 1993 by Clemens Kirschbaum and colleagues, this experiment relies on fear of public speaking and has become one of the most reliable laboratory methods for eliciting threat responses.
In the study, 69 adults were asked to give a five-minute talk about their strengths and weaknesses with only three minutes to prepare. Roughly half of the participants had a history of social anxiety and all participants were randomly assigned to two groups. The first group was presented information about the advantages of the body’s stress response and encouraged to “reinterpret your bodily signals during the upcoming public speaking task as beneficial.” That group also was asked to read summaries of three psychology studies that showed the benefits of stress. The second group received no information about reframing stress.
Participants delivered their speech to two judges. On purpose, the judges provided negative nonverbal feedback throughout the entire five-minute presentations, shaking their heads in disapproval, tapping on their clipboards, and staring stone-faced ahead. If study subjects ran out of things to say, the judges insisted that they continue speaking for the full five minutes. Following the speech, participants were asked to count backwards for five minutes in steps of seven beginning with the number 996. The evaluators again provided negative feedback throughout and insisted that participants start over if they made any mistakes.
Confronted with scowling judges, participants who received no stress preparation experienced a threat response, as captured by cardiovascular measures. But the group that was prepped about the benefits of stress weathered the trial better. That group reported feeling that they had more resources to cope with the public speaking task and, perhaps more tellingly, their physiological responses confirmed those perceptions. The prepped group pumped more blood through the body per minute compared to the group that did not receive instruction.
Surprisingly, this study also found that individuals who suffer from social anxiety disorder actually experienced no greater increase in physiological arousal while under scrutiny than their non-anxious counterparts, despite reporting more intense feelings of apprehension. This disconnect, argue the authors, supports the theory that our experience of acute or short-term stress is shaped by how we interpret physical cues. “We construct our own emotions,” says Jamieson.
Scientists have known for some time that the human brain’s ability to stay calm and focused is limited and can be overwhelmed by the constant noise and hectic, jangling demands of city living, sometimes resulting in a condition informally known as brain fatigue.
With brain fatigue, you are easily distracted, forgetful and mentally flighty — or, in other words, me.
But an innovative new study from Scotland suggests that you can ease brain fatigue simply by strolling through a leafy park.
The idea that visiting green spaces like parks or tree-filled plazas lessens stress and improves concentration is not new. Researchers have long theorized that green spaces are calming, requiring less of our so-called directed mental attention than busy, urban streets do. Instead, natural settings invoke “soft fascination,” a beguiling term for quiet contemplation, during which directed attention is barely called upon and the brain can reset those overstretched resources and reduce mental fatigue.
But this theory, while agreeable, has been difficult to put to the test. Previous studies have found that people who live near trees and parks have lower levels of cortisol, a stress hormone, in their saliva than those who live primarily amid concrete, and that children with attention deficits tend to concentrate and perform better on cognitive tests after walking through parks or arboretums. More directly, scientists have brought volunteers into a lab, attached electrodes to their heads and shown them photographs of natural or urban scenes, and found that the brain wave readouts show that the volunteers are more calm and meditative when they view the natural scenes.
But it had not been possible to study the brains of people while they were actually outside, moving through the city and the parks. Or it wasn’t, until the recent development of a lightweight, portable version of the electroencephalogram, a technology that studies brain wave patterns.
For the new study, published this month in The British Journal of Sports Medicine, researchers at Heriot-Watt University in Edinburgh and the University of Edinburgh attached these new, portable EEGs to the scalps of 12 healthy young adults. The electrodes, hidden unobtrusively beneath an ordinary looking fabric cap, sent brain wave readings wirelessly to a laptop carried in a backpack by each volunteer.
The researchers, who had been studying the cognitive impacts of green spaces for some time, then sent each volunteer out on a short walk of about a mile and half that wound through three different sections of Edinburgh.
The first half mile or so took walkers through an older, historic shopping district, with fine, old buildings and plenty of pedestrians on the sidewalk, but only light vehicle traffic.
The walkers then moved onto a path that led through a park-like setting for another half mile.
Finally, they ended their walk strolling through a busy, commercial district, with heavy automobile traffic and concrete buildings.
The walkers had been told to move at their own speed, not to rush or dawdle. Most finished the walk in about 25 minutes.
Throughout that time, the portable EEGs on their heads continued to feed information about brain wave patterns to the laptops they carried.
Afterward, the researchers compared the read-outs, looking for wave patterns that they felt were related to measures of frustration, directed attention (which they called “engagement”), mental arousal and meditativeness or calm.
What they found confirmed the idea that green spaces lessen brain fatigue.
When the volunteers made their way through the urbanized, busy areas, particularly the heavily trafficked commercial district at the end of their walk, their brain wave patterns consistently showed that they were more aroused, attentive and frustrated than when they walked through the parkland, where brain-wave readings became more meditative.
While traveling through the park, the walkers were mentally quieter.
Which is not to say that they weren’t paying attention, said Jenny Roe, a professor in the School of the Built Environment at Heriot-Watt University, who oversaw the study. “Natural environments still engage” the brain, she said, but the attention demanded “is effortless. It’s called involuntary attention in psychology. It holds our attention while at the same time allowing scope for reflection,” and providing a palliative to the nonstop attentional demands of typical, city streets.
Of course, her study was small, more of a pilot study of the nifty new, portable EEG technology than a definitive examination of the cognitive effects of seeing green.
But even so, she said, the findings were consistent and strong and, from the viewpoint of those of us over-engaged in attention-hogging urban lives, valuable. The study suggests that, right about now, you should consider “taking a break from work,” Dr. Roe said, and “going for a walk in a green space or just sitting, or even viewing green spaces from your office window.” This is not unproductive lollygagging, Dr. Roe helpfully assured us. “It is likely to have a restorative effect and help with attention fatigue and stress recovery.”
-by Gretchen Reynolds, The New York Times
Focusing on the present rather than letting the mind drift may help to lower levels of the stress hormone cortisol, suggests new research from the Shamatha Project at the University of California, Davis.
The ability to focus mental resources on immediate experience is an aspect of mindfulness, which can be improved by meditation training.
“This is the first study to show a direct relation between resting cortisol and scores on any type of mindfulness scale,” said Tonya Jacobs, a postdoctoral researcher at the UC Davis Center for Mind and Brain and first author of a paper describing the work, published this week in the journal Health Psychology.
High levels of cortisol, a hormone produced by the adrenal gland, are associated with physical or emotional stress. Prolonged release of the hormone contributes to wide-ranging, adverse effects on a number of physiological systems.
The new findings are the latest to come from the Shamatha Project, a comprehensive long-term, control-group study of the effects of meditation training on mind and body.
Led by Clifford Saron, associate research scientist at the UC Davis Center for Mind and Brain, the Shamatha Project has drawn the attention of both scientists and Buddhist scholars including the Dalai Lama, who has endorsed the project.
In the new study, Jacobs, Saron and their colleagues used a questionnaire to measure aspects of mindfulness among a group of volunteers before and after an intensive, three-month meditation retreat. They also measured cortisol levels in the volunteers’ saliva.
During the retreat, Buddhist scholar and teacher B. Alan Wallace of the Santa Barbara Institute for Consciousness Studies trained participants in such attentional skills as mindfulness of breathing, observing mental events, and observing the nature of consciousness. Participants also practiced cultivating benevolent mental states, including loving kindness, compassion, empathic joy and equanimity.
At an individual level, there was a correlation between a high score for mindfulness and a low score in cortisol both before and after the retreat. Individuals whose mindfulness score increased after the retreat showed a decrease in cortisol.
“The more a person reported directing their cognitive resources to immediate sensory experience and the task at hand, the lower their resting cortisol,” Jacobs said.
The research did not show a direct cause and effect, Jacobs emphasized. Indeed, she noted that the effect could run either way — reduced levels of cortisol could lead to improved mindfulness, rather than the other way around. Scores on the mindfulness questionnaire increased from pre- to post-retreat, while levels of cortisol did not change overall.
According to Jacobs, training the mind to focus on immediate experience may reduce the propensity to ruminate about the past or worry about the future, thought processes that have been linked to cortisol release.
“The idea that we can train our minds in a way that fosters healthy mental habits and that these habits may be reflected in mind-body relations is not new; it’s been around for thousands of years across various cultures and ideologies,” Jacobs said. “However, this idea is just beginning to be integrated into Western medicine as objective evidence accumulates. Hopefully, studies like this one will contribute to that effort.”
Saron noted that in this study, the authors used the term “mindfulness” to refer to behaviors that are reflected in a particular mindfulness scale, which was the measure used in the study.
“The scale measured the participants’ propensity to let go of distressing thoughts and attend to different sensory domains, daily tasks, and the current contents of their minds. However, this scale may only reflect a subset of qualities that comprise the greater quality of mindfulness, as it is conceived across various contemplative traditions,” he said.
Previous studies from the Shamatha Project have shown that the meditation retreat had positive effects on visual perception, sustained attention, socio-emotional well-being, resting brain activity and on the activity of telomerase, an enzyme important for the long-term health of body cells.
Columbia University Medical Center (CUMC) researchers have found the first evidence that selective activation of the dentate gyrus, a portion of the hippocampus, can reduce anxiety without affecting learning. The findings suggest that therapies that target this brain region could be used to treat certain anxiety disorders, such as panic disorder and post-traumatic stress syndrome (PTSD), with minimal cognitive side effects. The study, conducted in mice, was published in the online edition of the journal Neuron.
The dentate gyrus is known to play a key role in learning. Some evidence suggests that the structure also contributes to anxiety. “But until now no one has been able to figure out how the hippocampus could be involved in both processes,” said senior author Rene Hen, PhD, professor of neuroscience and pharmacology (in psychiatry) at CUMC.
“It turns out that different parts of the dentate gyrus have somewhat different functions, with the dorsal portion largely dedicated to learning and the ventral portion dedicated to anxiety,” said lead author Mazen A. Kheirbek, PhD, a postdoctoral fellow in neuroscience at CUMC.
To examine the role of the dentate gyrus in learning and anxiety, the investigators used a state-of-the-art technique called optogenetics, in which light-sensitive proteins, or opsins, are genetically inserted into neurons in the brains of mice. Neurons with these genes can then be selectively activated or silenced through the application of light (via a fiber-optic strand), allowing researchers to study the function of the cells in real time. Previously, the only way to study the dentate gyrus was to silence portions of it using such long-term manipulations as drugs or lesions, techniques that yielded conflicting results.
In the current study, opsins were inserted into dentate gyrus granule cells (the principal cells of the dentate gyrus). The researchers then activated or silenced the ventral or dorsal portions of the dentate gyrus for three minutes at a time, while the mice were subjected to two well-validated anxiety tests (the elevated plus maze and the open field test).
“Our main findings were that elevating cell activity in the dorsal dentate gyrus increased the animals’ desire to explore their environment. But this also disrupted their ability to learn. Elevating activity in the ventral dentate gyrus lowered their anxiety, but had no effect on learning,” said Dr. Kheirbek. The effects were completely reversible — that is, when the stimulation was turned off, the animals returned to their previous anxiety levels.
“The therapeutic implication is that it may be possible to relieve anxiety in people with anxiety disorders by targeting the ventral dentate gyrus, perhaps with medications or deep-brain stimulation, without affecting learning,” said Dr. Hen, who is also director of the Division of Integrative Neuroscience, the New York State Psychiatric Institute, and a member of The Kavli Institute for Brain Science. “Given the immediate behavioral impact of such manipulations, these strategies are likely to work faster than current treatments, such as serotonin reuptake inhibitors.”
According to Dr. Hen, such an intervention would probably work best in people with panic disorder or PTSD. “There is evidence that people with these anxiety disorders tend to have a problem with pattern separation — the ability to distinguish between similar experiences,” he said. “In other words, they overgeneralize, perceiving minor threats to be the same as major ones, leading to a heightened state of anxiety. Such patients could conceivably benefit from therapies that fine-tune hippocampal activity.”
Dr. Hen and his team are currently exploring strategies aimed at modulating the activity of the ventral dentate gyrus by stimulating neurogenesis in the ventral dentate gyrus. “Indeed the dentate gyrus is one of the few areas in the adult brain where neurons are continuously produced, a phenomenon termed adult hippocampal neurogenesis,” added Dr. Hen.
(Image: Catherine E. Myers, Memory Loss and the Brain)
Researchers at Boston University School of Medicine (BUSM) have, for the first time, identified a specific group of cells in the brainstem whose activation during rapid eye movement (REM) sleep is critical for the regulation of emotional memory processing. The findings, published in the Journal of Neuroscience, could help lead to the development of effective behavioral and pharmacological therapies to treat anxiety disorders, such as post-traumatic stress disorder, phobias and panic attacks.
There are two main stages of sleep – REM and non-REM – and both are necessary to maintain health and to regulate multiple memory systems, including emotional memory. During non-REM sleep, the body repairs tissue, regenerates cells and improves the function of the body’s immune system. During REM sleep, the brain becomes more active and the muscles of the body become paralyzed. Additionally, dreaming generally occurs during REM sleep, as well as physiological events including saccadic eye movements and rapid fluctuations of respiration, heart rate and body temperature. One particular physiological event, which is a hallmark sign of REM sleep, is the appearance of phasic pontine waves (P-waves). The P-wave is a unique brain wave generated by the activation of a group of glutamatergic cells in a specific region within the brainstem called the pons.
Memories of fearful experiences can lead to enduring alterations in emotion and behavior and sleep plays a natural emotional regulatory role after stressful and traumatic events. Persistence of sleep disturbances, particularly of REM sleep, is predictive of developing symptoms of anxiety disorders. A core symptom of these disorders frequently reported by patients is the persistence of fear-provoking memories that they are unable to extinguish. Presently, exposure therapy, which involves controlled re-exposure to the original fearful experience, is considered one of the most effective evidence-based treatments for anxiety disorders. Exposure therapy produces a new memory, called an extinction memory, to coexist and compete with the fearful memory when the fearful cue/context is re-encountered.
The strength of the extinction memory determines the efficacy of exposure therapy. A demonstrated prerequisite for the successful development of an extinction memory is adequate sleep, particularly REM sleep, after exposure therapy. However, adequate or increased sleep alone does not universally guarantee its therapeutic efficacy.
“Given the inconsistency and unpredictability of exposure therapy, we are working to identify which process(es) during REM sleep dictate the success or failure of exposure therapy,” said Subimal Datta, PhD, director and principle investigator at the Laboratory of Sleep and Cognitive Neuroscience at BUSM who served as the study’s lead author.
The researchers used contextual fear extinction training, which works to turn off the conditioned fear, to study which brain mechanisms play a role in the success of exposure therapy. The study results showed that fear extinction training increased REM sleep. Surprisingly, however, only 57 percent of subjects retained fear extinction memory, meaning that they did not experience the fear, after 24 hours. There was a tremendous increase of phasic P-wave activity among those subjects. In 43 percent of subjects, however, the wave activity was absent and they failed to retain fear extinction memory, meaning that they re-experienced fear.
“The study results provide direct evidence that the activation of phasic P-wave activity within the brainstem, in conjunction with exposure therapy, is critical for the development of long-term retention of fear extinction memory,” said Datta, who also is a professor of psychiatry and neurology at BUSM. In addition, the study indicates the important role that the brainstem plays in regulating emotional memory.
Future research will explore how to activate this mechanism in order to help facilitate the development of new potential pharmacological treatments that will complement exposure therapy to better treat anxiety and other psychological disorders.
According to the National Institute of Mental Health, anxiety disorders affect approximately 40 million American adults each year. While anxiety can sometimes be a normal and beneficial reaction to stress, some people experience excessive anxiety that they are unable to control, which can negatively impact their day to day life.
Neuroscientists should help to develop compelling digital games that boost brain function and improve well-being, say two professors specializing in the field in a commentary article published in the science journal Nature.
In the Feb. 28 issue, the two — Daphne Bavelier of the University of Rochester and Richard J. Davidson of the University of Wisconsin-Madison — urge game designers and brain scientists to work together to design new games that train the brain, producing positive effects on behavior, such as decreasing anxiety, sharpening attention and improving empathy. Already, some video games are designed to treat depression and to encourage cancer patients to stick with treatment, the authors note.
Davidson is founder and chair of the Center for Investigating Healthy Minds at the UW’s Waisman Center. Bavelier is a professor in the Department of Brain and Cognitive Sciences at Rochester.
Video game usage, which continues to rise among American children, has been associated with a number of negative outcomes, such as obesity, aggressiveness, antisocial behavior and, in extreme cases, addiction. “At the same time, evidence is mounting that playing games can have a beneficial effects on the brain,” the authors write.
Last year, Bavelier and Davidson presided over a meeting at the White House in which neuroscientists met with entertainment media experts to discuss ways of using interactive technology such as video games to further understanding of brain functions, as well as to provide new, engaging tools for boosting attention and well-being.
Bavelier’s work is focused on how humans learn and how the brain adapts to changes in experience, either by nature (as in deafness) or by training (such as playing video games). Her lab investigates how new media, including video games, can be leveraged to foster learning and brain plasticity.
Davidson, who studies emotion and the brain, is leading a project in collaboration with UW-Madison’s Games + Learning + Society to develop two video games designed to help middle school students develop social and emotional skills, such as empathy, cooperation, mental focus and self-regulation.
“Gradually, this work will begin to document the burning social question of how technology is having an impact on our brains and our lives, and enable us to make evidence-based choices about the technologies of the future, to produce a new set of tools to cultivate positive habits of mind,” the authors conclude.
Fear responses can only be erased when people learn something new while retrieving the fear memory. This is the conclusion of a study conducted by scientists from the University of Amsterdam (UvA) and published in the leading journal Science.
Researchers Dieuwke Sevenster MSc, Dr Tom Beckers and Prof. Merel Kindt have developed a method to determine whether an acquired fear response is susceptible to modification. By doing so, they have revealed the circumstances under which an acquired fear response can be eradicated. In order to measure whether a person actually learnt something new, the researchers used a measure for Prediction Error – in other words, the discrepancy between a person’s anticipation of what is going to happen and what actually happens.
No fear response
Cognitive Behavioural Therapy is currently the most common and effective type of treatment for people suffering from anxiety disorders. However, the effects are often short-lived and the fear returns in many patients. One major finding of Van Kindt’s research lab is that when participants were given propranolol, a beta blocker, while retrieving a specific fear memory, the acquired fear response was shown to be totally erased a day or month later. The researchers repeatedly found that the fear did not come back, despite the use of techniques specifically aimed to make it return. This indicates that the fear memory was either fully eradicated, or could no longer be accessed. One crucial finding was that while participants could still remember the association with the fear, that particular memory no longer triggered the former fear response.
For their study the researchers used a fear conditioning procedure in which a specific picture was followed by a nasty painful stimulus. While the participants viewed the pictures, the researchers measured the anticipation of the painful stimulus as well as the more autonomous fear response on the basis of the startle reflex.
The current findings will contribute to the further development of more effective and efficient therapies for patients suffering from excessive anxiety disorders, such as trauma victims. There was no independent measure to indicate whether the memory is susceptible to modification up until now. The researchers have shown that the fear response can be eradicated completely, provided that the person concerned actually learns something new while retrieving the fear memory.