Rewarded Extinction Increases Amygdalar Connectivity and Stabilizes Long-Term Memory Traces in the vmPFC.

Area of Science:

• Neuroscience
• Cognitive Psychology
• Psychiatry

Background:

• Pavlovian extinction is a key treatment for pathological fear and anxiety.
• Standard extinction forms weak memories that only temporarily inhibit threat associations.
• Augmenting extinction to create enduring memories is crucial for translational relevance.

Purpose of the Study:

• To compare the long-term neurobehavioral effects of counterconditioning (CC), a rewarded extinction, with standard extinction.
• To investigate if reward associations enhance extinction memory persistence in humans.
• To examine brain activity and connectivity during recent and remote threat memory retrieval.

Main Methods:

• A within-subjects fMRI study comparing counterconditioning (CC) to standard extinction.
• Participants underwent recent (24 h) and remote (approx. 1 month) retrieval tests.
• Analysis focused on behavioral threat responses and functional brain connectivity (amygdala, ventral striatum, vmPFC).

Main Results:

• Rewarded extinction (CC) reduced 24-h relapse of arousal and threat expectancy compared to standard extinction.
• CC enhanced functional connectivity between the amygdala and ventral striatum during retrieval.
• Only CC created a stable, enduring memory trace in the ventromedial prefrontal cortex (vmPFC) for at least one month.

Conclusions:

• Incorporating reward during extinction learning generates more stable and enduring threat memory attenuation in humans.
• Counterconditioning (CC) offers a promising strategy to enhance the long-term efficacy of extinction-based therapies.
• These findings highlight the role of reward neurocircuitry in stabilizing extinction memories.