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Scientific surveys provide sufficient evidence that anxiety disorders are one of the most common psy-chiatric disorders in the world. The lifetime prevalence rate of anxiety disorder is 28.8% (Kessler, et al., 2005). The most widely studied anxiety disorders are as follows panic disorder (PD), post-traumatic stress disorder (PTSD), obsessive-compulsive disorder (OCD), social phobia (or social anxiety disorder), specific phobias, and generalized anxiety disorder (GAD). (NIMH Article, 2009). Classical conditioning is the stable paradigm used from the last one century to understand the neurobi-ology of fear learning. Neurobiological mechanism of fear learning is well documented with the condi-tioning studies. In the therapy of anxiety disorders, exposure based therapies are known to be the most effective approaches. Flooding is a form of exposure therapy in which a participant is exposed to the fear situation and kept in that situation until their fear dissipates. The exposure therapy is based on the phenomena of extinction; this means that a conditioned response diminishes if the conditioned stimulus (CS) is repeatedly presented without an unconditioned stimulus (UCS). One problem with extinction as well as with exposure-based therapy is the problem of fear return (for e.g. renewal, spontaneous recov-ery and reinstatement) after successful extinction. Therefore, extinction does not delete the fear memory trace. It has been well documented that memory processes can be modulated or disrupted using several sci-entific paradigms such as behavioral (for e.g. exposure therapy), pharmacological (for e.g. drug manipu-lation), non-invasive stimulation (for e.g. non-invasive stimulation such as electroconvulsive shock (ECS), transcranial magnetic stimulation (TMS), transcranial direct current stimulation (tDCS), etc. However, modulation of memory processes after reactivation or via non-invasive stimulation is still not clear, which is the focus of the current study. In addition, study of genetic variant suggests that genetic differences play a vital role in the psychiatric disorder especially in fear learning. Hence, it is also one of the concerns of the current dissertation to investigate the interaction between gene and reconsolidation of memory. With respect to fear-conditioning, there are three findings in the current dissertation, which are as fol-lows: (i) In the first study we investigated that non-invasive weak electrical stimulation interferes with the consolidation process and disrupts the fear consolidation to attain stable form. This might offer an effective treatment in the pathological memories, for e.g. PTSD, PD, etc. (ii) In the second study we demonstrated whether a brief single presentation of the CS will inhibit the fear recovery. Like earlier studies we also found that reactivation followed by reconsolidation douses fear return. Attenuation of fear recovery was observed in the reminder group compared to the no-reminder group. (iii) Finally, in our third study we found a statistically significant role of brain derived neurotrophic factor (BDNF) polymorphism in reconsolidation. Results of the third study affirm the involvement of BDNF variants (Met vs. Val) in the modulation of conditioned fear memory after its reactivation. In summary, we were able to show in the current thesis modulation of associative learning and recon-solidation via transcranial direct current stimulation and genetic polymorphism.
Renewal of fear is one form of relapse that occurs after successful therapy, resulting from an encounter with a feared object in a context different from the context of the exposure therapy. According to Bouton (1994), the return of fear, provoked by context change, indicates that the fear was not erased in the first place. More importantly, the return of fear indicates that during the exposure session a new association was learned that connected the feared object with “no fear”; yet, as Bouton further argues, this association is context dependent. Such dependence could explain effects like renewal. In a new context, the therapeutic association will not be expressed and thus will no longer inhibit the fear. The assumption that an association is context dependent has been tested and showed robust results (Balooch & Neumann, 2011; Siavash Bandarian Balooch, Neumann, & Boschen, 2012; Culver, Stoyanova, & Craske, 2011; Kim & Richardson, 2009; Neumann & Kitlertsirivatana, 2010). Research for the treatment of anxiety disorders, aiming to reduce fear and, more importantly, prevent relapse, is flourishing. There are several exposure protocols currently under investigation: multiple contexts exposure (MCE), which aims at reducing the return of fear due to renewal (e.g., Balooch & Neumann, 2011); prolonged exposure (PE), which aims at strengthening the inhibitory association during the extinction learning (e.g., Thomas, Vurbic, & Novak, 2009); and reconsolidation update (RU), which aims at “updating” the reconsolidation process by briefly exposing the CS+ before the actual extinction takes place (Schiller et al., 2010). So far, however, few clinical studies conducted on humans have investigated these novel treatment protocols, and as far as I know none has investigated the mechanisms of action behind these protocols with a human clinical sample. The present thesis has three main goals. The first is to demonstrate that exposure therapy in multiple contexts reduces the likelihood of renewal. The second is to examine the mechanisms contributing to the effect of MCE and the third is to shed light on the concept of context in the framework of the conditioning and extinction paradigm. To this end, three studies were conducted. The first study investigated the effect of MCE on renewal, the second and third studies examined working mechanisms of MCE. In the first study thirty spider-phobic participants were exposed four times to a virtual spider. The exposure trials were conducted either in one single context or in four different contexts. Finally, all participants completed both a virtual renewal test, with the virtual spider presented in a novel virtual context, and an in vivo behavioral avoidance test with a real spider. This study successfully demonstrated the efficacy of MCE on reducing renewal. Study 2 investigated the working mechanisms behind MCE by utilizing a differential conditioning paradigm and conducting the extinction in multiple contexts, targeting similar renewal attenuation as achieved in study 1. This was followed by two tests that attempted to reveal extinction-relevant associations like ones causing context inhibitory effects. This study had three main hypotheses: (1) The extinction context is associated with the exposure, and thus operates as a safety signal at some point during the extinction; it will therefore compete with the safety learning of the CS, leading to a decreased extinction effect on the CS if the extinction is conducted in only one context. (2) The elements (e.g., room color, furniture) of the extinction context are connected to the therapeutic association and therefore should serve as reminders of the extinction, causing a stronger fear inhibition when presented during a test. (3) Therapy process factors, according to emotional processing theory, determine the renewal effect (e.g., initial fear activation, and within-session and between-session activation are correlated with the strength of renewal). In this study, however, no differences between the groups at the renewal phase were observed, presumably because the extinction was too strong to enable a renewal of fear at the test phase conducted immediately following the extinction. This hence rendered the two inhibitory tests useless. Study 3 aimed at defining the concept of context in the conditioning and exposure framework. Study 3 utilized the phenomenon known as generalization decrement, whereby a conditioned response is reduced due to change in the environment. This allowed context similarity to be quantified. After an acquisition phase in one context, participants were tested in one of three contexts, two of which differed in only one dimension (configuration of objects vs. features). The third group was tested in the same context and served as control group. The goal was to show that both configuration and features play an important role in the definition of context. There was, however, no significant statistical difference between the groups at the test phases, likely because of context novelty effects (participants exposed to a new context following extinction in another context expected a second extinction phase, and thus demonstrated greater fear than expected in all three groups).
In order to survive, organisms avoid threats and seek rewards. Classical conditioning is a simple model to explain how animals and humans learn associations between events that allow them to predict threats and rewards efficiently. In the classical conditioning paradigm, a neutral stimulus is paired with a biologically significant event (the unconditioned stimulus – US). In virtue of this association, the neutral stimulus acquires affective motivational properties, and becomes a conditioned stimulus (CS+). Defensive responses emerge for pairings with an aversive US (e.g., pain), and appetitive responses emerge for pairing with an appetitive event (e.g., reward). It has been observed that animals avoid a CS+ when it precedes an aversive US during a training phase (CS+ US; forward conditioning); whereas they approach a CS+ when it follows an aversive US during the training phase (US CS+; backward conditioning). These findings indicate that the CS+ acquires aversive properties after a forward conditioning, whereas acquires appetitive properties after a backward conditioning. It is thus of interest whether event timing also modulates conditioned responses in such an opponent fashion in humans, who are capable of explicit cognition about the associations. For this purpose, four experiments were conducted in which a discriminative conditioning was applied in groups of participants that only differed in the temporal sequence between CS+ onset and US onset (i.e., the interstimulus interval – ISI). During the acquisition phase (conditioning), two simple geometrical shapes were presented as conditioned stimuli. One shape (CS+) was always associated with a mild painful electric shock (i.e., the aversive US) and the other one (CS-) was never associated with the shock. In a between-subjects design, participants underwent either forward or backward conditioning. During the test phase (extinction), emotional responses to CS+ and CS- were tested and the US was never presented. Additionally, a novel neutral shape (NEW) was presented as control stimulus. To assess cognitive components, participants had to rate both the valence (the degree of unpleasantness or pleasantness) and the arousal (the degree of calmness or excitation) associated with the shapes before and after conditioning. In the first study, startle responses, an ancestral defensive reflex consisting of a fast twitch of facial and body muscles evoked by sudden and intense stimuli, was measured as an index of stimulus implicit valence. Startle amplitude was potentiated in the presence of the forward CS+ whilst attenuated in the presence of the backward CS+. Respectively, the former response indicates an implicit negative valence of the CS+ and an activation of the defensive system; the latter indicated an implicit positive valence of the CS+ and an activation of the appetitive system. In the second study, the blood-oxygen level dependent (BOLD) response was measured by means of functional magnetic resonance imaging (fMRI) to investigate neural responses after event learning. Stronger amygdala activation in response to forward CS+ and stronger striatum activation in response to backward CS+ were found in comparison to CS-. These results support the notion that the defensive motivational system is activated after forward conditioning since the amygdala plays a crucial role in fear acquisition and expression. Whilst the appetitive motivational system is activated after backward conditioning since the striatum plays a crucial role in reward processing. In the third study, attentional processes underlying event learning were observed by means of steady-state visual evoked potentials (ssVEPs). This study showed that both forward and backward CS+ caught attentional resources. More specifically, ssVEP amplitude was higher during the last seconds of forward CS+ that is just before the US, but during the first seconds of backward CS+ that is just after the US. Supposedly, attentional processes were located at the most informative part of CS+ in respect to the US. Participants of all three studies rated both forward and backward CS+ more negative and arousing compared to the CS-. This indicated that event timing did not influence verbal reports similarly as the neural and behavioral responses indicating a dissociation between the explicit and implicit responses. Accordingly, dual process theories propose that human behavior is determined by the output of two systems: (1) an impulsive implicit system that works on associative principles, and (2) a reflective explicit system that functions on the basis of knowledge about facts and values. Most importantly, these two systems can operate in a synergic or antagonistic fashion. Hence, the three studies of this thesis congruently suggest that the impulsive and the reflective systems act after backward association in an antagonistic fashion. In sum, event timing may turn punishment into reward in humans even though they subjectively rate the stimulus associated with aversive events as being aversive. This dissociation might contribute to understand psychiatric disorders, like anxiety disorders or drug addiction.
The thesis deals with the question which motivation direction—approach or avoidance—is connected to the emotion relief—a positive, low-arousal emotion, which is caused by an expected or nonexpected, motive-consistent change for the better, thus caused by the absence of an aversive stimulus. Based on the idea of postulating different levels of approach avoidance motivation, the Reflective-Impulsive Model of Behavior (RIM, Strack & Deutsch, 2004) is applied to relief and approach avoidance. The RIM differentiates between an impulsive and a reflective system of information processing, with both systems working in relative independence from each other. Two central variables moderate the relation between relief and approach avoidance. The first is the psychological system in which approach avoidance is processed and assessed. Two levels of approach avoidance are distinguished: an impulsive distance orientation (distance change in relation to specific stimuli) and a reflective goal orientation (attainment of positive versus avoidance of negative end states). The second is the psychological system in which relief developed: In the impulsive system, relief develops as the affect that is conditioned to the absence of negative states; in the reflective system, relief develops as a result of goal-oriented behaviour of controlling or preventing of negative stimulation. The thesis looks at both moderators (level of approach avoidance and psychological system of development of relief) at once. The central prediction for the impulsive distance orientation is: Relief leads to an approach distance orientation (distance reduction), independent from the system in which relief develops. The central prediction for the reflective goal orientation is: Relief leads to an avoidance goal orientation (control of negative end states). This latter prediction is only made for the case when relief was caused by (develops in) the reflective system, that is by one’s own, goal-directed behaviour; it is further necessary for an avoidance goal orientation that the relief state cannot certainly reached, instead there always has to uncertainty in the control of negative states. The methodology in the thesis is based on studies of aversive conditioning. In most studies, a differentiation paradigm is applied. The impulsive relief is operationalized via a classically conditioned relief (aversive CS-), whereas the reflective relief is operationalized via an active avoidance paradigm which ensures the methodological comparability of “reflective relief” to “impulsive relief”. The predictions are as follows: Prediction A: Relief will elicit positive affective valence and an approach distance orientation. This should be true for both relief that is caused by the impulsive system and for relief that is caused by the reflective system (Experiments 2-3). Prediction B: More positive valence of relief—caused by a larger change of affective states—will elicit a stronger approach distance orientation (Experiment 4). Prediction C: Relief caused by the impulsive system will not elicit a specific goal orientation (Experiment 5). Prediction D: Uncertain self-induced relief—caused by the reflective system—will elicit an avoidance goal orientation (Experiments 6-7). In addition, Experiment 1 validated the conditioning paradigm used for the elicitation of relief. The experiments in the thesis support all predictions made in the theoretical part. The work has implications for the assumptions made in the RIM (Strack & Deutsch, 2004). In the impulsive system, the affective valence determines approach avoidance orientation (e.g., R. Neumann & Strack, 2000), the reflective goal not playing an important role. Relief elicits an approach orientation in the impulsive system. In the reflective system, the active goal is decisive for the approach avoidance orientation. Uncertain self-caused relief elicits an avoidance goal orientation in the reflective system. The studies of the thesis thus support and validate the assumptions made in the RIM (Strack & Deutsch, 2004) in the specific field of motivational direction.
In dieser Doktorarbeit habe ich die Regulation der Expression des zuckerbelohnten Verhaltens durch den Fütterungszustand bei Drosophila melanogaster untersucht. Die Fliegen können während einer Trainingsphase mit Hilfe einer Zuckerbelohnung auf einen bestimmten Duft konditioniert werden. Nach dem Training können die Fliegen dann auf das olfaktorische Gedächtnis getestet werden. Die Bereitschaft das zuckerkonditionierte Gedächtnis im Test zu zeigen wird vom Fütterungszustand kontrolliert, wie ich in Übereinstimmung mit den Ergebnissen früherer Arbeiten demonstrierte (Tempel et al. 1983; Gruber 2006; Krashes et al. 2008). Nur nicht gefütterte Fliegen exprimieren das Gedächtnis, während Fütterungen bis kurz vor dem Test eine reversibel supprimierende Wirkung haben. Einen ähnlichen regulatorischen Einfluss übt der Futterentzug auch auf die Expression anderer futterbezogener Verhaltensweisen, wie z.B. die naive Zuckerpräferenz, aus. Nachdem ich den drastischen Einfluss des Fütterungszustands auf die Ausprägung des zuckerkonditionierten Verhaltens gezeigt bzw. bestätigt hatte, habe ich nach verhaltensregulierenden Faktoren gesucht, die bei einer Fütterung die Gedächtnisexpression unterdrücken. Als mögliche Kandidaten untersuchte ich Parameter, die zum Teil bereits bei verschiedenen futterbezogenen Verhaltensweisen unterschiedlicher Tierarten als „Sättigungssignale“ identifiziert worden waren (Marty et al. 2007; Powley and Phillips 2004; Havel 2001; Bernays and Chapman 1974; Simpson and Bernays 1983; Gelperin 1971a). Dabei stellte sich heraus, dass weder die „ernährende“ Eigenschaft des Futters, noch ein durch Futteraufnahme bedingter Anstieg der internen Glukosekonzentration für die Suppression des zuckerkonditionierten Gedächtnisses notwendig sind. Die Unterdrückung der Gedächtnisexpression kann auch nicht durch Unterschiede in den aufgenommenen Futtermengen, die als verhaltensinhibitorische Dehnungssignale des Verdauungstrakts wirken könnten, oder mit der Stärke des süßen Geschmacks erklärt werden. Die Suppression des zuckerbelohnten Verhaltens folgte den Konzentrationen der gefütterten Substanzen und war unabhängig von deren chemischen Spezifität. Deshalb wird die Osmolarität des aufgenommenen Futters als ein entscheidender Faktor für die Unterdrückung der zuckerkonditionierten Gedächtnisexpression angenommen. Weil nur inkorporierte Substanzen einen Unterdrückungseffekt hatten, wird ein osmolaritätsdetektierender Mechanismus im Körper 67 postuliert, wahrscheinlich im Verdauungstrakt und/oder der Hämolymphe. Die Hämolymphosmolarität ist als „Sättigungssignal“ bei einigen wirbellosen Tieren bereits nachgewiesen worden (Bernays and Chapman 1974; Simpson and Raubenheimer 1993; Gelperin 1971a; Phifer and Prior 1985). Deshalb habe ich mit Hilfe genetischer Methoden und ohne die Fliegen zu füttern, versucht über einen künstlich induzierten Anstieg der Trehaloseund Lipidkonzentrationen die Osmolarität der Hämolymphe in Drosophila zu erhöhen. Eine solche konzentrationserhöhende Wirkung für Lipide und die Trehalose, dem Hauptblutzucker der Insekten, ist bereits für das adipokinetische Hormon (AKH), das von Zellen der Corpora cardiaca exprimiert wird, nachgewiesen worden (Kim and Rulifson 2004; Lee and Park 2004; Isabel et al. 2005). Es stellte sich heraus, dass die künstliche Stimulierung AKH-produzierender Neurone das zuckerkonditionierten Verhalten temporär, reversible und selektiv unterdrückt. Gleiche Behandlungen hatten keinen Effekt auf ein aversiv konditioniertes olfaktorisches Gedächtnis oder ein naives Zuckerpräferenzverhalten. Wie aus dieser Arbeit hervorgeht, stellt wahrscheinlich die Osmolarität des Verdauungstrakts und der Hämolymphe oder nur der Hämolymphe ein physiologisches Korrelat zum Fütterungszustand dar und wirkt als unterdrückendes Signal. Dass Fütterungen das zuckerkonditionierte Verhalten und die Zuckerpräferenz supprimieren, die künstliche Stimulation AKH-produzierender Zellen aber selektiv nur die zuckerbelohnte Gedächtnisexpression unterdrückt, deutet auf mindestens zwei unterschiedliche „Sättigungssignalwege“ hin. Außerdem macht es deutlich wie uneinheitlich futterbezogene Verhaltensweisen, wie das zuckerbelohnte Verhalten und die naive Zuckerpräferenz, reguliert werden.
Eine der größten Herausforderungen in der Neurobiologie ist es, die neuronalen Prozesse zu verstehen, die Lernen und Gedächtnis zugrundeliegen. Welche biochemischen Pfade liegen z.B. der Koinzidenzdetektion von Reizen (klassische Konditionierung) oder einer Handlung und ihren Konsequenzen (operante Konditionierung) zugrunde? In welchen neuronalen Unterstrukturen werden diese Informationen gespeichert? Wie ähnlich sind die Stoffwechselwege, die diese beiden Arten des assoziativen Lernens vermitteln und auf welchem Niveau divergieren sie? Drosophila melanogaster ist wegen der Verfügbarkeit von Lern-Paradigmen und neurogenetischen Werkzeugen ein geeigneter Modell-Organismus, zum diese Fragen zu adressieren. Er ermöglicht eine umfangreiche Studie der Funktion des Gens S6KII, das in der Taufliege in klassischer und operanter Konditionierung unterschiedlich involviert ist (Bertolucci, 2002; Putz et al., 2004). Rettungsexperimenten zeigen, dass die olfaktorische Konditionierung in der Tully Maschine (ein klassisches, Pawlow’sches Konditionierungsparadigma) von dem Vorhandensein eines intakten S6KII Gens abhängt. Die Rettung war sowohl mit einer vollständigen, als auch einer partiellen Deletion erfolgreich und dies zeigt, dass der Verlust der phosphorylierenden Untereinheit der Kinase die Hauptursache des Funktionsdefektes war. Das GAL4/UAS System wurde benutzt, um die S6KII Expression zeitlich und räumlich zu steuern. Es wurde gezeigt, dass die Expression der Kinase während des adulten Stadiums für die Rettung hinreichend war. Dieser Befund schließt eine Entwicklungsstörung als Ursache für den mutanten Phänotyp aus. Außerdem zeigte die gezielte räumliche Rettung von S6KII die Notwendigkeit der Pilzkörper und schloss Strukturen wie das mediane Bündel, die Antennalloben und den Zentralkomplex aus. Dieses Muster ist dem vorher mit der rutabaga Mutation identifizierten sehr ähnlich (Zars et al., 2000). Experimente mit der Doppelmutante rut, ign58-1 deuten an, dass rutabaga und S6KII im gleichen Signalweg aktiv sind. Vorhergehende Studien hatten bereits gezeigt, dass die unterschiedlichen Ergebnisse bei operanter und klassischer Konditionierung auf verschiedenen Rollen für S6KII in den zwei Arten des Lernens hindeuten (Bertolucci, 2002; Putz, 2002). Diese Schlussfolgerung wurde durch den mutanten Phänotyp der transgenen Linien in der Positionskonditionierung und ihr wildtypisches Verhalten in der klassischen Konditionierung zusätzlich bekräftigt. Eine neue Art von Lern-Experiment, genannt „Idle Experiment“, wurde entworfen. Es basiert auf der Konditionierung der Laufaktivität, stellt eine operante Aufgabenstellung dar und überwindet einige der Limitationen des „Standard“ Heat-Box Experimentes. Die neue Art des Idle Experimentes erlaubt es, „gelernte Hilflosigkeit“ in Fliegen zu erforschen, dabei zeigte sich eine erstaunliche Ähnlichkeit zu den Vorgängen in komplizierteren Organismen wie Ratten, Mäusen oder Menschen. Gelernte Hilflosigkeit in der Taufliege wurde nur in den Weibchen beobachtet und wird von Antidepressiva beeinflusst.