Exposure therapy is a successful treatment for patients with anxiety and fear-related disorders. Extinction of conditioned fear comprises one important mechanism underlying the effects of exposure therapy. Yet, relapses frequently occur in the long-term, probably related to difficulties in generalizing the extinction of conditioned fear to new contexts, leading to renewal of conditioned fear. Extinction training in multiple extinction contexts depicts a promising opportunity to reduce this renewal of conditioned fear. However, the underlying neural correlates are unknown yet. In this functional magnetic resonance imaging study, 49 healthy men participated in a fear conditioning paradigm with fear acquisition training in context A on a first day, extinction training in a single context (B1) or in four different contexts (B1-B4) one day later, and fear and extinction recall and reinstatement in context B1 and a novel context C on a third day one week later. Multiple extinction contexts led to a stronger differential activation decrease in the hippocampus during extinction learning compared to a single extinction context. One week later, the multiple context group compared with the single context group showed reduced differential amygdala activation during fear renewal in the novel context C compared with the extinction context B1. Furthermore, multiple extinction contexts diminished amygdala activation during a subsequent reinstatement test in context B1. However, there were no significant differences in differential conditioned SCRs. These results indicate that the use of multiple extinction contexts during extinction training leads to reduced conditioned responses in the amygdala-hippocampus complex.

中文翻译：

---

多个灭绝情境调节了与情境相关的灭绝学习和检索的神经相关性。

暴露疗法是患有焦虑症和与恐惧有关的疾病的成功疗法。条件性恐惧的消除包括暴露疗法影响的一种重要机制。然而，从长期来看，复发经常发生，可能与将条件性恐惧的消亡推广到新环境中的困难有关，从而导致条件性恐惧的更新。在多个物种灭绝的环境中进行灭绝训练，为减少这种条件性恐惧的更新提供了一个有前途的机会。但是，潜在的神经相关性尚不清楚。在这项功能性磁共振成像研究中，有49名健康男性在第一天就参加了恐惧条件训练，其中包括在情景A中进行恐惧获取训练，在单一情景中（B1）或在四种不同情景（B1-B4）中进行灭绝训练。之后，一周后的第三天，在上下文B1和一个新颖的上下文C中，恐惧和灭绝的回忆和恢复。与单个灭绝环境相比，在灭绝学习过程中，多种灭绝环境导致海马的差异激活减弱更强。一周后，与灭绝背景B1相比，多背景组与单背景组相比，在恐惧更新过程中，差异性杏仁核激活减少。此外，在背景B1的后续恢复测试期间，多个灭绝环境减少了杏仁核的激活。但是，差分条件可控硅没有显着差异。