Travma Sonrası Stres Bozukluğunun Önlenmesine Yönelik Korku Belleği Üzerine Yapılan Müdahaleler

Year 2023, Volume: 10 Issue: 3, 396 - 412, 30.09.2023

Çınar Furkan İlhan Sezen Kışlal

https://doi.org/10.31682/ayna.1348783

Cited By: 1

Abstract

Klasik korku koşullaması, klinik öncesi çalışmalarda travma sonrası stres bozukluğunu (TSSB) modellemede kullanılmaktadır. Yeniden-bütünleştirme sürecinde anılar belleğe geri çağrıldığında, bellek değişime açık bir hale gelir ve müdahale edilmeye uygundur. Koşullu uyarana (KU’lu uyaran) maruz bırakma ile tetiklenen yeniden-bütünleştirme sürecindeki müdahalelerin sadece maruz bırakılan KU’lu uyaranın tetiklediği korku tepkisinde azalmaya neden olduğu, korku ile ilişkili diğer ipuçlarına genellenmediği gözlenmiştir. Ancak günlük yaşamda, birden çok KU, korku uyandıran olayla ilişkilendirilebilir. Bu nedenle, son çalışmalarda tüm korku belleğinin yenidenbütünleştirme sürecine girmesine yol açtığı düşünülen, koşulsuz uyaran (KU’suz uyaran) ile geri çağırma prosedürüne odaklanılmıştır. KU’suz uyaran ile geri-çağırma ile tetiklenen yeniden-bütünleştirme sürecinde uygulanan müdahalelerin daha etkili olduğu düşünülmektedir. Bu derleme çalışmasında, KU’lu uyaran veya KU’suz uyaran ile aktive edilmiş korku belleği çalışmalara atıfta bulunularak, edinilmiş korkunun davranışsal ve farmakolojik müdahalelerle nasıl söndürülebileceğinden bahsedilmektedir. Ayrıca, korku belleğinde rol oynayan beyin bölgeleri ve cinsiyet farklılıklarının etkisi de ele alınmıştır. Bu derlemenin amacı, korku bozukluklarının daha etkili tedavi yaklaşımlarıyla nasıl çözülebileceğine yönelik alana katkıda bulunmaktır.

Keywords

beta-adrenergic reseptörler, korku koşullaması, NMDA reseptörleri, sönme, Yeniden-bütünleştirme

Interventions on Fear Memory for the Prevention of Post-Traumatic Stress Disorder

Abstract

The classical fear conditioning is extensively used in preclinical studies as an animal model for post traumatic stress disorder (PTSD). During the reconsolidation process, when memories are retrieved, the memory becomes susceptible to change and amenable to intervention. Interventions applied during the reconsolidation process triggered by exposure to a conditioned stimulus (CS) primarily lead to a decrease in fear responses triggered only by the exposed CS, without generalizing to other fear-related cues. However, in real-life scenarios, multiple CS’s can be linked to fear-inducing events. Therefore, recent studies have focused on the reactivation procedure with an unconditioned stimulus (US), which is believed to result in the reconsolidation of the entire fear memory. Interventions applied during the reconsolidation process that are triggered by US-based retrieval are considered more effective. Grounding on the fear memory studies activated by either CS or US, this review study discussed how acquired fear can be extinguished through behavioral and pharmacological interventions. Additionally, the brain regions involved in fear memory and the impact of gender differences on fear memory were also addressed. The aim of this review was to contribute to the field by exploring more effective treatment approaches for fear disorders.

Keywords

beta-adrenergic receptors, fear conditioning, NMDA receptors, extinction, Reconsolidation

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