Research ArticlePSYCHOLOGY

Propofol-induced deep sedation reduces emotional episodic memory reconsolidation in humans

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Science Advances  20 Mar 2019:
Vol. 5, no. 3, eaav3801
DOI: 10.1126/sciadv.aav3801

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  • RE: Strange, Fernandez & Kroes – a reply to Brunet et al.
    • Bryan A. Strange, Lab head, Laboratory for Clinical Neuroscience, Centre for Biomedical Technology, Universidad Poitecnica de Madrid
    • Other Contributors:
      • Guillén Fernández, Institute Director, Donders Institute for Brain, Cognition, and Behaviour, Radboud University Medical Centre
      • Marijn C.W. Kroes, Group leader, Donders Institute for Brain, Cognition, and Behaviour, Radboud University Medical Centre

    Dear Editor,

    We thank Brunet and colleagues for raising important considerations regarding our study (1). We agree that it is a major challenge to translate experimental psychopathology research to clinical applications and welcome a discussion of these challenges.

    1. Translating experimental psychopathology research to clinical practice

    Many patients suffering from stress-related and anxiety disorders, including posttraumatic stress disorder (PTSD), do not improve or relapse even after intensive evidence-based treatments (2). Experimental psychopathology research is therefore trying to discover improved treatment methods, including enhancement of extinction learning, cognitive regulation, and memory reconsolidation-interventions (3). Memory reconsolidation research in particular has attracted much attention as it theoretically allows for the permanent modification of emotional memories. Yet reconsolidation research is still very much in an exploratory phase. The vast majority of studies have investigated reconsolidation-interventions for threat conditioned defensive responses in rodents. In humans, behavioural and beta-blockade interventions targeting reconsolidation have shown promise in modifying conditioned threat responses in laboratory environments and in reducing threat responses and symptoms in PTSD patients but others have failed to find positive effects (see (1)). As Brunet et al rightfully point out, it is a monumental challenge to transla...

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    Competing Interests: None declared.
  • RE: Propofol-induced deep sedation reduces emotional episodic memory reconsolidation in humans
    • Alain Brunet, Professor, Douglas Institute Research Center, and the Department of Psychiatry, McGill University, Montreal, Canada
    • Other Contributors:
      • Ram P. Sapkota, Postdoctoral Researcher, Douglas Institute Research Center, and the Department of Psychiatry, McGill University, Montreal, Canada
      • Alexandra Bisson Desrochers, Doctoral Student, Douglas Institute Research Center, and the Department of Psychology, Université du Québec à Montréal, Quebec, Canada
      • Daniel Saumier, Professor, Douglas Institute Research Center, and the Department of Community Health Sciences, University of Sherbrooke, Longueuil, Quebec,

    Dear Editor,

    Since the advent of the concept of memory reconsolidation, animal and pre-clinical studies on humans using this paradigm have proliferated. However, clinical translation of this knowledge remains scant. Through a carefully designed study involving patients undergoing endoscopy, Galarza Vallejo et al. (2019) show that intravenous administration of an anesthetic, Propofol, immediately after memory reactivation disrupts reactivated memory while non-reactivated memory remains intact. This study is a positive addition to nascent research in the direction of building a repertoire of reconsolidation blocking pharmacological agents. Having acknowledged this, however, the clinical application of Propofol in a trauma-related mental illness treatment setting appears far-fetched for several reasons.

    TRANSLATING NEGATIVE MEMORY RESEARCH INTO PTSD-AFFECTED POPULATIONS

    As the authors acknowledge, real-life trauma memories are more complex, wide-ranging, often associated with life-or-death situations, and difficult to modulate compared to memories learned in experimental settings. It is relatively straightforward to control for emotionally valanced material in lab settings under conditions where participants encode (consolidate) and recall (reconsolidate) the information. The challenge in a clinical setting is to find an appropriate method for the reactivation of trauma memories that may be several months or years old, unique to each individual, and woven...

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    Competing Interests: None declared.

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