Scientists Search for New Treatments for Mental Trauma
Updated Dec. 22, 2013 9:14 p.m. ET
Scientists have zapped an electrical current
to people's brains to erase distressing memories, part of an ambitious
quest to better treat ailments such as mental trauma, psychiatric
disorders and drug addiction.
In an
experiment, patients were first shown a troubling story, in words and
pictures. A week later they were reminded about it and given
electroconvulsive therapy, formerly known as electroshock. That
completely wiped out their recall of the distressing narrative.
"It's
a pretty strong effect. We observed it in every subject," said Marijn
Kroes, neuroscientist at Radboud University Nijmegen in the Netherlands
and lead author of the study, published Sunday in the journal Nature
Neuroscience.
The experiment recalls the
plot of the movie "Eternal Sunshine of the Spotless Mind," in which an
estranged couple erase memories of each other.
Science
has tinkered with similar notions for years. In exposure treatment,
repetitive exposure to a phobia in a nonthreatening way is designed to
help patients confront their fears and gradually weaken the fear
response, a process known as extinction. Some researchers also are
experimenting with antianxiety drug propranolol. The hope is that one
day it may be possible to selectively eliminate a person's unwanted
memories or associations linked to smoking, drug-taking or emotional
trauma.
Scientists used to think that
once a memory took hold in the brain, it was permanently stored and
couldn't be altered. People with anxiety disorders were taught to
overcome their fears by creating a new memory. Yet the old memory
remained and could be reactivated at any time.
About
a decade ago, scientists made a surprising discovery. They showed that
when a lab rodent was given a reminder of some past fear, the memory of
that event appeared to briefly become unstable. If nothing was done,
that memory stabilized for a second time, and thus got ingrained—a
process known as reconsolidation.
But
when certain drugs, known to interfere with the reconsolidation process,
were injected directly into the rodent's brain, they wiped out the
animal's fearful memory altogether. Crucially, other memories weren't
erased.
Whether it was possible to
disrupt the memory-consolidation process in humans was thought to be
difficult to answer because injecting drugs into the human brain is
risky business. Dr. Kroes and his colleagues found a way around the
problem.
Their test subjects were 39
patients who were undergoing electroconvulsive therapy for severe
depression. In ECT treatment, patients get a muscle relaxant and an
anesthetic and an electrical current is passed to part of their brains,
triggering a brief seizure that can help treat the depression. It isn't
clear how the technique works: Some scientists have suggested it changes
the pattern of blood flow or metabolism in the brain, while others
believe it releases certain chemicals in the brain that battle the
depression.
Patients who are treated
with ECT are those who typically haven't responded to an array of other
treatments, including the most powerful drugs available.
The
39 patients were asked to watch two distressing stories on a computer
screen, narrated via a series of pictures and a voice-over. One story
was about a child who is hit by a car and has to have his feet severed
by surgeons. The other involved a pair of sisters, one of whom is
kidnapped and molested.
A week later,
the 39 patients were randomly assigned to one of three groups, A, B and
C. Each person was prompted to recall details about just one of the
troubling stories he or she had seen—an effort to specifically
reactivate that memory.
Group A was
given ECT immediately after. A day later, the patients took a
multiple-choice quiz about both stories. They recalled most details
about the particular story for which their memories hadn't been
reactivated.
However, their recall for
the other story—whose memory had specifically been reactivated—was
extremely poor. It was no better than guesswork, in fact.
Patients
in group B were given ECT immediately after, and their memories were
tested immediately after the procedure. Their recall of both stories was
intact. It suggests that it takes time to impair a memory—something the
scientists had predicted.
The 13
members of group C acted as a control group and didn't receive ECT. When
tested, their memories of the stories were actually enhanced. That
suggests that it requires both reactivation and ECT to prevent
reconsolidation and thereby disrupt memories in people.
"It's a clever demonstration and could provide a new tool for us clinically," said
Karim Nader,
a neuroscientist at McGill University in Canada, who wasn't involved in the Nature study.
A
lot more work needs to be done. It isn't clear whether the memory
erasure is temporary or permanent. And while the technique might work
for simple stories, it needs to be shown that it also works for
real-world traumatic memories.
Some
researchers looking to move beyond ECT are now also experimenting with
propranolol, which inhibits the actions of a hormone that enhances
memory consolidation. This summer, Dr. Nader hopes to test the drug in
about 50 patients suffering from posttraumatic stress disorder.
—Shirley S. Wang contributed to this article.
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