Below is a collection of quotes from this thread with my comments in italics which show that there seem to be two divergent views: (1) that you need successful extinction therapy for HDACi to work (I've omitted the studies referred to in this thread that show that without successful extinction training, the fear memory may actually strengthen!), and (2) that attempting to be calm while taking HDACi may actually ruin the fear extinction process. Very confusing and somewhat risky.
Celebes: "In short, taking a HDAC-inhibitor (like CL-994) creates a window where it's possible to eradicate fear conditioning. My impression is this would only really be useful in a therapeutic setting."
Tree: "Depends on what you call therapeutic setting. Keep in mind the mice didn't need any therapy for it to work. Just recalling memories (for instance by confronting yourself with the anxiety inducing situations) while the window is open is clearly sufficient. GAD sufferers usually have a few things which causes more anxiety than the rest so those are points of confrontation. But if anxiety has gotten to the point were it remains continuous then I'm not sure any confrontation is even required. The anxiety/stress switch is forceably and permanently set to high through epigenetic means. Enter Cl-994 which is an epigenetic resetter."
Question: Why would an epigenetic resetter selectively resest the anxiety switch? What if it resets the "calmness" or some other useful switch as well? Does the same apply to vorinostat? The mice didn't need any therapy for it to work? They did receive extinction training whereby the foot shock was unpaired with the tone so the fear memory could be extinguished!
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Tree: In regard to the earlier question whether aversive memory wiping is the same as removing consistent anxiety/stress states, I recommend this popular science article. It explains the basics of epigenetic storage very well. Negative memories that are stored in the brain AND persistent anxiety are both the results from epigenetic switches being set. The process can be simplified by saying that methylation can be considered an off switch, and acetyl an on switch. While stress/fear causes genes to shut off due to methylation (including genes necessary to normalize stress responces) a compound like Cl-994 is very indiscriminate and hyper-acetylates proteins and genes. This causes them to become active again and effectively resets your entire epi-genome (to one degree or another, depending on dosage and accessibility in the body).
Same question: if it's so indiscriminate, will it hyper-acelate other genes, resulting in detrimental effects? Does the above information also apply to vorinostat?
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Celebes: "TrkB and NMDA agonism are both fear extinctive in themselves (along with CB1, Mu, GABAB, 5-HT1A and H2). HDAC inhibition's upregulation of both (in the absence of therapy) is the most likely explanation for its effects. A big part of the phenotype of trauma or anxiety is just the direct consequence of diminished BDNF and NMDA activity (along with CB1, Mu, GABAB, 5-HT1A and H2). You would expect anything that corrected any of that to take a big chunk out of fear conditioning, which demonstrably it does. I think the 'window' was a misconception, an artifact of the design. What we're really doing here is disinhibiting the biological basis of 'resilience', As with anything involving changing the brain, that takes time.
And another thing: How many situations is exposure therapy actually useful in? Sure it works for phobias but those are pretty much defined by being irrational. How does it work with rational fear? Combat veterans: attack people who can't fight back? Assault victims: be the one doing the beating? Child abuse: become dependent on people who are nice to you? Bullying? Infidelity? Failure? Loss? Now all of those things are actually practiced by the people in those groups. But in an hour or two? What's more, the fear extinction studies exposed the rats to a single stressful event. How many people here have had exactly one stressful experience?"
If the first paragraph is correct, that is very encouraging. The second paragraph is what I was thinking: how do we replicate extinction learning in humans?
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StevesPetRat: "Very interesting experiences, tree. I wonder if an HDACi could help with more general emotional / behavioral plasticity."
This is what I'm wondering also.
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StevesPetRat: "But it sounds like one has to face the fear and then become unafraid during the treatment which if I could do I wouldn't really need the help..."
Exactly.
Edited by tolerant, 12 November 2016 - 03:48 AM.