Targeted Memory Reactivation During REM Sleep in Patients With Social Anxiety Disorder

Article Article scientifique Article Targeted Memory Reactivation During REM Sleep in Patients With Social Anxiety Disorder eng 2022-06-20 2022-06-20 author Borghese Francesca 801250 author Henckaerts Pauline Annette 841118 author Guy Fanny 956308 author Perez Mayo Coral 952756 author Delplanque Sylvain 0000-0002-9025-4754 634389 author Schwartz Sophie 0000-0001-7718-4053 35633 author Perogamvros Lampros 718036 904704 10.3389/fpsyt.2022.904704 35845468 1664-0640 PMC9281560 https://www.frontiersin.org/articles/10.3389/fpsyt.2022.904704/full Background: Social anxiety disorder (SAD) is characterized by a significant amount of fear when confronted to social situations. Exposure therapy, which is based on fear extinction, does not often lead to full remission. Here, based on evidence showing that rapid eye movement (REM) sleep promotes the consolidation of extinction memory, we used targeted memory reactivation (TMR) during REM sleep to enhance extinction learning in SAD. Methods: Forty-eight subjects with SAD were randomly assigned to two groups: control or TMR group. All patients had two successive exposure therapy sessions in a virtual reality (VR) environment, where they were asked to give a public talk in front of a virtual jury. At the end of each session, and only in the TMR group ( N = 24), a sound was paired to the positive feedback phase of therapy (i.e., approval of their performance), which represented the memory to be strengthened during REM sleep. All participants slept at home with a wearable headband device which automatically identified sleep stages and administered the sound during REM sleep. Participants' anxiety level was assessed using measures of parasympathetic (root mean square of successive differences between normal heartbeats, RMSSD) and sympathetic (non-specific skin conductance responses, ns-SCRs) activity, and subjective measures (Subjective Units of Distress Scale, SUDS), during the preparation phase of their talks before (T1) and after (T2) one full-night's sleep and after 1 week at home (T3). Participants also filled in a dream diary. Results: We observed an effect of time on subjective measures of anxiety (SUDS). We did not find any difference in the anxiety levels of the two groups after 1 week of TMR at home. Importantly, the longer the total duration of REM sleep and the more stimulations the TMR group had at home, the less anxious (increased RMSSD) these participants were. Finally, fear in dreams correlated positively with ns-SCRs and SUDS at T3 in the TMR group. Conclusion: TMR during REM sleep did not significantly modulate the beneficial effect of therapy on subjective anxiety. Yet, our results support that REM sleep can contribute to extinction processes and substantiate strong links between emotions in dreams and waking stress levels in these patients. REM sleep Dreaming Exposure therapy Sleep Social anxiety Targeted memory reactivation Dewey 128.37 Dewey 616.8 Dewey 616.89 Medical Direction of University Hospitals of Geneva PRD 18-2019-I Swiss National Science Foundation Memory reactivation across distinct vigilance states: A multimodal neural decoding approach in humans 320030_159862 CH Project funding Swiss National Science Foundation Deciphering the neural impact of sleep loss on metacognition and empathic judgments for pain in others 320030_182589 CH Project funding Swiss National Science Foundation The Nightmare Catcher: modulating dreams with targeted memory reactivation CH Project funding;Project funding (special) 15 Centre interfacultaire en sciences affectives 0D8 53 Département de neurosciences fondamentales 21A 60 Département de psychiatrie 225 false 593 Emergence et expression de l'émotion (E3 Lab) 495 Neuroimagerie du Sommeil et de la Cognition 832 https://www.clinicaltrials.gov/ct2/show/NCT05261659 Frontiers in psychiatry 13 affde847-dd22-4e7b-9737-66a1cdcb257d Article (Published version) Public fpsyt-13-904704.pdf 1134622 application/pdf CC BY-4.0 openAccess Centres et instituts / Centre interfacultaire en sciences affectives Faculté de médecine / Section de médecine fondamentale / Département de neurosciences fondamentales Faculté de médecine / Section de médecine clinique / Département de psychiatrie

Title	Published in	Access level	OA Policy	Year	Views	Downloads

Targeted Memory Reactivation During REM Sleep in Patients With Social Anxiety Disorder	Frontiers in psychiatry			2022	334	601

Archive ouverte UNIGE

Guy, Fanny