Memory suppression can help after trauma Therapists have discussed for a long time whether attempts to voluntarily suppress the intrusion of trauma memories are helpful to combat the distressing impacts of trauma. Mary et al. studied survivors of the 2015 Paris terrorist attacks who developed posttraumatic stress disorder and those who did not (see the Perspective by Ersche). Using functional magnetic resonance imaging, they investigated the neural networks underlying the control and suppression of memory retrieval. The results suggest that the characteristic symptoms of the disorder are not related to the memory itself but to its maladaptive control. These results offer new insights into the development of post-traumatic stress disorder and potential avenues for treatment. Science, this issue p. eaay8477; see also p. 734 A brain imaging study of survivors of the 2015 Paris terror attacks suggests that memory suppression shields against posttraumatic stress disorder. INTRODUCTION One of the fundamental questions in clinical neuroscience is why some individuals can cope with traumatic events, while others remain traumatized by a haunting past they cannot get rid of. The expression and persistence of vivid and distressing intrusive memories is a central feature of posttraumatic stress disorder (PTSD). Current understanding of PTSD links this persistence to a failure to reduce the fear associated with the trauma, a deficit rooted in the dysfunction of memory. In this study, we investigated whether this deficit may additionally be rooted in the disruption of the brain system that normally allows control over memory. RATIONALE To test this hypothesis in a laboratory setting, we implemented neutral and inoffensive intrusive memories paired with a reminder cue in a group of 102 individuals exposed to the 2015 Paris terrorist attacks and in a group of 73 nonexposed individuals (i.e., individuals who did not experience the attacks). The exposed group was composed of 55 individuals suffering from PTSD symptoms (denoted PTSD+) and 47 individuals showing no noticeable impairment after the trauma (denoted PTSD−). We used functional magnetic resonance imaging to measure how the dorsolateral prefrontal cortex (DLPFC), a core hub of the brain control system, regulated and suppressed memory activity during the reexperiencing of these intrusive memories. We focused our analyses on both the functional and causal dependency between control and memory neural circuits during attempts to suppress the reemergence of these intrusive memories. RESULTS In healthy individuals (PTSD− and nonexposed), attempts to prevent the unwanted emergence of intrusive memory into consciousness was associated with a significant reduction of the functional coupling between control and memory systems, compared with situations where the reminder did not trigger such intrusion. In contrast, there was a near-absence of such a decrease in connectivity in PTSD+. Additional analyses focusing on the directionality of the underlying neural flow communications revealed that the suppression of intrusive memories in healthy individuals arose from the regulation of the right anterior DLPFC, which tuned the response of memory processes to reduce their responses. Notably, this regulation was directed at two key regions previously associated with the reexperiencing of traumatic memories: the hippocampus and the precuneus. CONCLUSION We observed a generalized disruption in PTSD of the regulation signal that controls the reactivation of unwanted memories. This disruption could constitute a central factor in the persistence of traumatic memories, undercutting the ability to deploy the necessary coping resources that maintain healthy memory. Such a deficit may explain maladaptive and unsuccessful suppression attempts often seen in PTSD. Our study suggests that the general mental operations typically engaged to banish and suppress the intrusive expression of unwanted memories might contribute to positive adaptation in the aftermath of a traumatic event, paving the way for new treatments. Mechanisms of memory suppression after trauma. (A) Exposed individuals with or without PTSD were asked to suppress the reexperiencing of neutral intrusive memories. (B) Analyses focused on the functional and causal dependencies between control and memory systems during suppression attempts. (C) Extensive decreased coupling to counteract intrusion was seen in nonexposed and PTSD− groups but not in the PTSD+ group. SFG, superior frontal gyrus; MFG, middle frontal gyrus; IFG, inferior frontal gyrus; CC, cingulate cortex; Hipp, hippocampus; PhG, parahippocampal gyrus; FusG, fusiform gyrus; PCun, precuneus. (D) This decreased coupling was mediated by top-down regulation of involuntary memory processing arising from the right DLPFC. In the aftermath of trauma, little is known about why the unwanted and unbidden recollection of traumatic memories persists in some individuals but not others. We implemented neutral and inoffensive intrusive memories in the laboratory in a group of 102 individuals exposed to the 2015 Paris terrorist attacks and 73 nonexposed individuals, who were not in Paris during the attacks. While reexperiencing these intrusive memories, nonexposed individuals and exposed individuals without posttraumatic stress disorder (PTSD) could adaptively suppress memory activity, but exposed individuals with PTSD could not. These findings suggest that the capacity to suppress memory is central to positive posttraumatic adaptation. A generalized disruption of the memory control system could explain the maladaptive and unsuccessful suppression attempts often seen in PTSD, and this disruption should be targeted by specific treatments.

中文翻译：

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创伤后的恢复力：记忆抑制的作用

创伤后记忆抑制会有所帮助 治疗师们长期以来一直在讨论试图自愿抑制创伤记忆的侵入是否有助于对抗创伤的痛苦影响。玛丽等人。研究了 2015 年巴黎恐怖袭击的幸存者，他们患有创伤后应激障碍，而那些没有（参见 Ersche 的观点）。他们使用功能磁共振成像研究了控制和抑制记忆检索的神经网络。结果表明，该障碍的特征性症状与记忆本身无关，而是与其适应不良的控制有关。这些结果为创伤后应激障碍的发展和潜在的治疗途径提供了新的见解。科学，这个问题 p。eaay8477; 另见第 734 对 2015 年巴黎恐怖袭击幸存者的脑部成像研究表明，记忆抑制可以预防创伤后应激障碍。引言 临床神经科学中的一个基本问题是，为什么有些人可以应对创伤性事件，而另一些人却因无法摆脱的令人难以忘怀的过去而受到创伤。生动和令人痛苦的侵入性记忆的表达和持续存在是创伤后应激障碍 (PTSD) 的一个核心特征。目前对 PTSD 的理解将这种持久性与未能减少与创伤相关的恐惧联系起来，这是一种根源于记忆功能障碍的缺陷。在这项研究中，我们调查了这种缺陷是否还可能源于通常允许控制记忆的大脑系统的破坏。基本原理为了在实验室环境中测试这一假设，我们在 102 名暴露于 2015 年巴黎恐怖袭击的人和一组 73 名未暴露的人（即没有暴露的人）中实施了中性和无害的侵入性记忆和提醒提示体验攻击）。暴露组由 55 名患有 PTSD 症状的人（表示为 PTSD+）和 47 名在创伤后没有表现出明显损伤的人（表示为 PTSD-）组成。我们使用功能性磁共振成像来测量背外侧前额叶皮层 (DLPFC)（大脑控制系统的核心枢纽）如何在重新体验这些侵入性记忆期间调节和抑制记忆活动。在试图抑制这些侵入性记忆的重新出现期间，我们将分析重点放在控制和记忆神经回路之间的功能和因果依赖性上。结果在健康个体（PTSD-和非暴露）中，与提醒没有触发这种侵入的情况相比，试图防止侵入性记忆意外出现到意识中与控制和记忆系统之间的功能耦合显着减少有关。相比之下，PTSD+ 的连通性几乎没有这种下降。关注潜在神经流通信方向性的其他分析表明，健康个体对侵入性记忆的抑制源于右前 DLPFC 的调节，它调整了记忆过程的反应以减少它们的反应。值得注意的是，该调节针对先前与创伤记忆的重新体验相关的两个关键区域：海马体和楔前叶。结论 我们观察到 PTSD 中控制不需要的记忆重新激活的调节信号的普遍中断。这种中断可能构成创伤性记忆持续存在的核心因素，削弱了部署必要的应对资源以维持健康记忆的能力。这种缺陷可以解释在 PTSD 中常见的适应不良和不成功的抑制尝试。我们的研究表明，通常用于消除和抑制不需要的记忆的侵入性表达的一般心理操作可能有助于在创伤性事件之后进行积极的适应，为新的治疗方法铺平道路。创伤后记忆抑制的机制。(A) 有或没有 PTSD 的暴露个体被要求抑制中性侵入性记忆的重新体验。(B) 分析侧重于抑制尝试期间控制和记忆系统之间的功能和因果关系。(C) 在非暴露组和 PTSD- 组中观察到对抵消入侵的广泛减少的耦合，但在 PTSD+ 组中没有。SFG，额上回；MFG，额中回；IFG，额下回；CC，扣带皮层；Hipp，海马体；PhG，海马旁回；FusG，梭状回；电脑村，楔前叶。(D) 这种减少的耦合是由正确的 DLPFC 引起的非自愿记忆处理的自上而下调节介导的。在创伤之后，人们对为什么不想要的和不经要求的创伤记忆的回忆会在某些人身上持续存在而在其他人身上却持续存在的原因知之甚少。我们在实验室中对 102 名暴露于 2015 年巴黎恐怖袭击事件的人和 73 名未暴露的人（他们在袭击期间不在巴黎）进行了中性和无害的侵入性记忆。在重新体验这些侵入性记忆时，未暴露的个体和没有创伤后应激障碍 (PTSD) 的暴露个体可以适应性地抑制记忆活动，但暴露的 PTSD 个体则不能。这些发现表明，抑制记忆的能力是积极的创伤后适应的核心。