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ISSN : 1226-9654

논문 상세

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논문 투고

Vol.30 No.1

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기억 응고화 또는 재응고화를 이용한 외상후 스트레스장애의 치료

Memory Consolidation or Reconsolidation for the Treatment of Posttraumatic Stress Disorder

한국심리학회지: 인지 및 생물 / The Korean Journal of Cognitive and Biological Psychology, (P)1226-9654; (E)2733-466X
2018, v.30 no.1, pp.1-14
https://doi.org/10.22172/cogbio.2018.30.1.001
김문수 (전남대학교)
이혜진 (전남대학교)
김문수, & 이혜진. (2018). 기억 응고화 또는 재응고화를 이용한 외상후 스트레스장애의 치료. 한국심리학회지: 인지 및 생물, 30(1), 1-14, https://doi.org/10.22172/cogbio.2018.30.1.001

초록

기억은 일반적으로 학습이 끝난 후 불안정한 상태에서 시간이 지남에 따라 안정된 상태로 변화하는데, 이러한 과정을 기억 응고화라고 한다. 따라서 학습 후 불안정한 상태일 때 어떤 처치를 가하면 기억에 영향을 줄 수 있다. 또한, 기억을 회상하면 그 기억이 다시 불안정한 상태가 되었다가 안정화되는 재응고화 과정이 진행되는데, 역시 이 과정에 개입하여 기억을 변경시킬 수 있다. 기억의 응고화 또는 재응고화를 조절하려는 연구에서 가장 많이 사용된 약물 중 하나가 스트레스 호르몬인 에피네프린의 효과를 차단하는 프로프라놀롤이다. 본 논문은 기억의 응고화와 재응고화에 대한 기초 실험 연구들을 쉽게 설명하고, 이러한 연구들을 토대로 프로프라놀롤을 사용하여 외상후 스트레스장애(PTSD)를 예방하거나 치료하려는 임상 연구들을 살펴보았다. 기초 실험 연구 결과는 프로프라놀롤이 기억에 미치는 효과를 상당히 일관되게 입증하고 있으나, 임상 연구 결과는 프로프라놀롤이 PTSD 치료에 쓰일 수 있는지에 관하여 현재 긍정적인 결과와 부정적인 결과가 혼재되어 있다. 앞으로 기억의 재응고화가 일어나게 되는 경계 조건을 알아낸다면 더 일관성 있는 치료 효과를 얻을 수 있을 것이다. 마지막으로, 그러한 치료법의 개발에 뒤따르는 윤리적 문제를 살펴보았다.

keywords
기억 응고화, 재응고화, 프로프라놀롤, 외상후 스트레스장애, emory consolidation, reconsolidation, propranolol, PTSD

Abstract

Memory is labile immediately upon acquisition and becomes stable over time, and this process is called memory consolidation. If retrieved, previously-consolidated memory becomes labile again and re-consolidates. Thus, memory can be altered by intervening in either the consolidation or reconsolidation process. Propranolol is one promising drug that can block memory consolidation and reconsolidation. The present article reviewed basic research on memory consolidation and reconsolidation, and clinical trials of propranolol for the prevention and treatment of posttraumatic stress disorder. Clinical studies are currently mixed with positive and negative results, and future research is warranted on boundary conditions in which memory reconsolidation occurs. Finally, ethical issues of using memory-altering drugs are discussed.

keywords
기억 응고화, 재응고화, 프로프라놀롤, 외상후 스트레스장애, emory consolidation, reconsolidation, propranolol, PTSD

참고문헌

1.

American Psychiatric Association (2013). Diagnostic and statistical manual of mental disorders (5th ed.) Arlington, VA: American Psychiatric Publishing.

2.

American Psychological Association (2017). Clinical practice guideline for the treatment of PTSD in adults. Washington, DC: Author.

3.

Bell, J. A. (2007). Preventing post-traumatic stress disorder or pathologizing bad memories? American Journal of Bioethics, 7(9), 29-30.

4.

Bradley, R., Greene, J., Russ, E., Dutra, L., & Westen, D. (2005). A multidimensional meta-analysis of psychotherapy for PTSD. American Journal of Psychiatry, 162, 214-227.

5.

Brunet, A., Orr, S. P., Tremblay, J., Robertson, K., Nader, K., & Pitman, R. K. (2008). Effect of post-retrieval propranolol on psychophysiologic responding during subsequent script-driven traumatic imagery in post-traumatic stress disorder. Journal of Psychiatric Research, 42, 503-506.

6.

Brunet, A., Poundja, J., Tremblay, J., Bui, É., Thomas É., Orr, S. P., . . . Pitman, R. K. (2011). Trauma reactivation under the influence of propranolol decreases posttraumatic stress symptoms and disorder: 3 open-label trials. Journal of Clinical Psychopharmacology, 31, 547-550.

7.

Brunet, A., Thomas, É., Saumier, D., Ashbaugh, A. R., Azzoug, A., Pitman, R. K., . . . Tremblay, J. (2014). Trauma reactivation plus propranolol is associated with durably low physiological responding during subsequent script-driven traumatic imagery. Canadian Journal of Psychiatry, 59, 228-232.

8.

Chandavarkar, R., Sangha, S., & Khalil, S. (2016). Resolution of flashbacks of PTSD with propranolol: A case report. Progress in Neurology and Psychiatry, 20(2), 10-13.

9.

Chandler, J. A., Mogyoros, A., Rubio, T. M., & Racine, E. (2013). Another look at the legal and ethical consequences of pharmacological memory dampening: The case of sexual assault. Journal of Law, Medicine & Ethics, 41, 859-871.

10.

Henry, M., Fishman, J. R., & Youngner, S. J. (2007). Propranolol and the prevention of Post-traumatic stress disorder: Is it wrong to erase the “sting” of bad memories? The American Journal of Bioethics, 7(9), 12-20.

11.

Hoge, E. A., Worthington, J. J., Nagurney, J. T., Chang, Y., Kay, E. B., Feterowski, C. M., . . . Pitman, R. K. (2012). Effect of acute posttrauma propranolol on PTSD outcome and physiological responses during script-driven imagery. CNS Neuroscience & Therapeutics, 18, 21-27.

12.

Kindt, M., & van Emmerik, A. (2016). New avenues for treating emotional memory disorders: Towards a reconsolidation intervention for posttraumatic stress disorder. Therapeutic Advances in Psychopharmacology, 6, 283-295.

13.

Kindt, M., Soeter, M., & Vervliet, B. (2009). Beyond extinction: erasing human fear responses and preventing the return of fear. Nature Neuroscience, 12, 256-258.

14.

Management of Posttraumatic Stress Working Group (2010). VA/DoD clinical practice guideline for the management of posttraumatic stress disorder and acute stress disorder. Washington, DC: Department of Veterans Affairs, Department of Defense.

15.

McGaugh, J. L. (2000). Memory­a century of consolidation. Science, 287, 248-251.

16.

McGaugh, J. L. (2003). Memory and Emotion. New York, NY: Columbia University Press.

17.

McGaugh, J. L. (2015). Consolidating memories. Annual Review of Psychology, 66, 1-24.

18.

McGaugh, J. L., & Roozendaal, B. (2009). Drug enhancement of memory consolidation: historical perspective and neurobiological implications. Psychopharmacology, 202, 3-14.

19.

McGhee, L. L., Maani, C. V., Garza, T. H., DeSocio, P. A., Gaylord, K. M., & Black, I. H. (2009). The effect of propranolol on posttraumatic stress disorder in burned service members. Journal of Burn Care & Research, 30, 92-97.

20.

Menzies, R. P. (2012). Propranolol, traumatic memories, and amnesia: A study of 36 cases. Journal of Clinical Psychiatry, 73, 129-130.

21.

Nader, K., Schafe, G. E., & LeDoux, J. E. (2000). Fear memories require protein synthesis in the amygdala for reconsolidation after retrieval. Nature, 406, 722-726.

22.

Orr, S. P., Metzger, L. J., & Pitman, R. K. (2002). Psychophysiology of post-traumatic stress disorder. Psychiatric Clinics of North America, 25, 271-293.

23.

Pitman, R. K. (1989). Post-traumatic stress disorder, hormones, and memory. Biological Psychiatry, 26, 221-223.

24.

Pitman, R. K., Sanders, K. M., Zusman, R. M., Healy, A. R., Cheema, F., Lasko, N. B., Cahill, L., & Orr, S. P. (2002). Pilot study of secondary prevention of posttraumatic stress disorder with propranolol. Biological Psychiatry, 51, 189-142.

25.

President’s Council on Bioethics (2003). Beyond therapy: Biotechnology and the pursuit of happiness. Washington, DC: Government Printing Office.

26.

Ressler, K. J., & Mayberg, H. S. (2007). Targeting abnormal neural circuits in mood and anxiety disorders: from the laboratory to the clinic. Nature Neuroscience, 10, 1116-1124.

27.

Saladin, M. E., Gray, K., Abbott, T., LaRowe, S., McRae-Clark, A., DeSantis, S., . . . Brady, K. T. (2014). Post-retrieval propranolol may alter reconsolidation of trauma memory in individuals with PTSD and comorbid alcohol dependence. Drug & Alcohol Dependence, 140, e193, doi: 10.1016/j.drugalcdep.2014.02.538

28.

Schiller, D., Monfils, M.-H., Raio, C. M., Johnson, D. C., LeDoux, J. E., & Phelps, E. A. (2010). Preventing the return of fear in humans using reconsolidation update mechanisms, Nature, 463, 49-54.

29.

Schroyens, N., Beckers, T., & Kindt, M. (2017). In search for boundary conditions of reconsolidation: A failure of fear memory interference, Frontiers in Behavioral Neuroscience, 11, 65. doi: 10.3389/fnbeh.2017.00065

30.

Stein, M. B., Kerridge, C., Dimsdale, J. E., & Hoyt, D. B. (2007). Pharmacotherapy to prevent PTSD: Results from a randomized controlled proof-of-concept trial in physically injured patients. Journal of Traumatic Stress, 20, 923-932.

31.

Vaiva, G., Ducrocq, F., Jezequel, K., Averland, B., Lestavel, P., Brunet, A., & Marmar, C. R. (2003). Immediate treatment with propranolol decreases posttraumatic stress disorder two months after trauma. Biological Psychiatry, 54, 947-949.

32.

Walker, M. P., Brakefield, T., Hobson, J. A., & Stickgold, R. (2003). Dissociable stages of human memory consolidation and reconsolidation. Nature, 425, 616-620.

33.

Wood, N. E., Rosasco, M. L., Suris, A. M., Spring, J. D., Marin, M.-F., Lasko, N. B., . . . Pitman, R. K. (2015). Pharmacological blockade of memory reconsolidation in posttraumatic stress disorder: Three negative psychophysiological studies. Psychiatry Research, 225, 31-39.

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