Targeted Reactivation during Sleep Differentially Affects Negative Memories in Socially Anxious and Healthy Children and Adolescents.

Cognitive models propose a negative memory bias as one key factor contributing to the emergence and maintenance of social anxiety disorder (SAD). The long-term consolidation of memories relies on memory reactivations during sleep. We investigated in SAD patients and healthy controls the role of memory reactivations during sleep in the long-term consolidation of positive and negative information. Socially anxious and healthy children and adolescents learnt associations between pictures showing ambiguous situations and positive or negative words defining the situations' outcome. Half of the words were re-presented during postlearning sleep (i.e., they were cued). Recall of picture-word associations and subjective ratings of pleasantness and arousal in response to the pictures was tested for cued and uncued stimuli. In the morning after cueing, cueing facilitated retention of positive and negative memories equally well in SAD patients and healthy controls. One week later, cueing led to reduced ratings of pleasantness of negative information in SAD but not in healthy controls. Coincidental to these findings was more pronounced EEG theta activity over frontal, temporal and parietal regions in response to negative stimuli in SAD patients. Our findings suggest that the preferential abstraction of negative emotional information during sleep might represent one factor underlying the negative memory bias in SAD.SIGNIFICANCE STATEMENT We aim to uncover mechanisms underlying the characteristic negative memory bias in social anxiety disorder (SAD). The formation of long-lasting memories-a process referred to as memory consolidation-depends on the reactivation of newly acquired memories during sleep. We demonstrated that experimentally induced memory reactivation during sleep renders long-term memories of negative experiences more negative in SAD patients but not in healthy controls. We also found in SAD patients that the reactivation of negative experiences coincided with more pronounced oscillatory theta activity. These results provide first evidence that memory reactivation during sleep might contribute to the negative memory bias in SAD.

Cortisol increases CXCR4 expression but does not affect CD62L and CCR7 levels on specific T cell subsets in humans.

Glucocorticoids are well known to affect T cell migration, leading to a redistribution of the cells from blood to the bone marrow, accompanied by a concurrent suppression of lymph node homing. Despite numerous studies in this context, with most of them employing synthetic glucocorticoids in nonphysiological doses, the mechanisms of this redistribution are not well understood. Here, we investigated in healthy men the impact of cortisol at physiological concentrations on the expression of different migration molecules on eight T cell subpopulations in vivo and in vitro. Hydrocortisone (cortisol, 22 mg) infused during nocturnal rest when endogenous cortisol levels are low, compared with placebo, differentially reduced numbers of T cell subsets, with naive CD4(+) and CD8(+) subsets exhibiting the strongest reduction. Hydrocortisone in vivo and in vitro increased CXCR4 expression, which presumably mediates the recruitment of T cells to the bone marrow. Expression of the lymph node homing receptor CD62L on total CD3(+) and CD8(+) T cells appeared reduced following hydrocortisone infusion. However, this was due to a selective extravasation of CD62L(+) T cell subsets, as hydrocortisone affected neither CD62L expression on a subpopulation level nor CD62L expression in vitro. Corresponding results in the opposite direction were observed after blocking of endogenous cortisol synthesis by metyrapone. CCR7, another lymph node homing receptor, was also unaffected by hydrocortisone in vitro. Thus, cortisol seems to redirect T cells to the bone marrow by upregulating their CXCR4 expression, whereas its inhibiting effect on T cell homing to lymph nodes is apparently regulated independently of the expression of classical homing receptors.

Prior knowledge is essential for the beneficial effect of targeted memory reactivation during sleep.

Prior knowledge speeds up system consolidation and accelerates integration of newly acquired memories into existing neocortical knowledge networks. By using targeted memory reactivations, we demonstrate that prior knowledge is also essential for successful reactivation and consolidation of memories during sleep, both on the behavioral and oscillatory level (i.e., theta and fast spindle activity). Thus, prior knowledge is a prerequisite for new memories to enter processes of system consolidation during sleep.

Widespread reduction in sleep spindle activity in socially anxious children and adolescents.

Social anxiety disorder (SAD) is one of the most prevalent psychiatric diseases typically emerging during childhood and adolescence. Biological vulnerabilities such as a protracted maturation of prefrontal cortex functioning together with heightened reactivity of the limbic system leading to increased emotional reactivity are discussed as factors contributing to the emergence and maintenance of SAD. Sleep slow wave activity (SWA, 0.75-4.5 Hz) and sleep spindle activity (9-16 Hz) reflect processes of brain maturation and emotion regulation. We used high-density electroencephalography to characterize sleep SWA and spindle activity and their relationship to emotional reactivity in children and adolescents suffering from SAD and healthy controls (HC). Subjectively rated arousal was assessed using an emotional picture-word association task. SWA did not differ between socially anxious and healthy participants. We found a widespread reduction in fast spindle activity (13-16 Hz) in SAD patients compared to HC. SAD patients rated negative stimuli to be more arousing and these arousal ratings were negatively correlated with fast spindle activity. These results suggest electrophysiological alterations that are evident at an early stage of psychopathology and that are closely linked to one core symptom of anxiety disorders such as increased emotional reactivity. The role of disturbed GABAergic neurotransmission is discussed as an underlying factor.

Memory cueing during sleep modifies the interpretation of ambiguous scenes in adolescents and adults.

The individual tendency to interpret ambiguous situations negatively is associated with mental disorders. Interpretation biases are already evident during adolescence and due to the greater plasticity of the developing brain it may be easier to change biases during this time. We investigated in healthy adolescents and adults whether stabilizing memories of positive or negative scenes modulates the later interpretation of similar scenes. In the evening, participants learnt associations between ambiguous pictures and words that disambiguate the valence of the pictures in a positive or negative direction. Half of the words were acoustically presented (i.e. cued) during post-learning sleep which is known to benefit memory consolidation by inducing reactivation of learned information. Cued compared to un-cued stimuli were remembered better the next morning. Importantly, cueing positively disambiguated pictures resulted in more positive interpretations whereas cueing negatively disambiguated pictures led to less positive interpretations of new ambiguous pictures with similar contents the next morning. These effects were not modulated by participants' age indicating that memory cueing was as efficient in adolescents as in adults. Our findings suggest that memory cueing during sleep can modify interpretation biases by benefitting memory stabilization and generalization. Implications for clinical settings are discussed.

Differential contribution of mineralocorticoid and glucocorticoid receptors to memory formation during sleep.

Corticosteroids are known to modulate the consolidation of memories during sleep, specifically in the hippocampus-dependent declarative memory system. However, effects of the major human corticosteroid cortisol are conveyed via two different receptors, i.e., mineralocorticoid (MRs) and glucocorticoid receptors (GRs) whose specific contributions to memory consolidation are unclear. Whereas a shift in the balance between MR and GR activation toward predominant GR activation has been found to impair sleep-dependent consolidation of declarative memories, the effect of predominant MR activation is not well characterized. Here, we examined differential corticosteroid receptor contributions to memory consolidation during post-learning sleep in two placebo-controlled double-blind studies in humans, by comparing the effects of the selective MR agonist fludrocortisone (0.2 mg, orally, Study 1) and of hydrocortisone (22 mg, intravenously, Study 2) with strong binding affinity to both MR and GR. We hypothesized increased activation of MRs during sleep to enhance declarative memory consolidation, but the joint MR/GR activation to impair it. Participants (16 men in each study) learned a declarative (word pair associates) and a procedural task (mirror tracing) before a 7-h period of nocturnal retention sleep, with the substances administered before sleep (Study 1) and during sleep (Study 2), respectively. As hypothesized, retention of word pairs, but not of mirror tracing skill, was selectively enhanced by the MR agonist fludrocortisone. An impairing effect of hydrocortisone on word pair retention remained non-significant possibly reflecting that hydrocortisone administration failed to establish robust predominance of GR activation. Our results show that predominant MR activation benefits declarative memory consolidation presumably by enhancing the sleep-dependent reactivation of hippocampal memories and resultant synaptic plastic processes. The effect is counteracted by additional GR activation. Insufficient MR activation, like GR overactivation, might be a factor contributing to memory impairment in pathological conditions.

Slow wave sleep induced by GABA agonist tiagabine fails to benefit memory consolidation.

STUDY OBJECTIVES: Slow wave sleep (SWS) plays a pivotal role in consolidating memories. Tiagabine has been shown to increase SWS in favor of REM sleep without impacting subjective sleep. However, it is unknown whether this effect is paralleled by an improved sleep-dependent consolidation of memory. DESIGN: This double-blind within-subject crossover study tested sensitivity of overnight retention of declarative neutral and emotional materials (word pairs, pictures) as well as a procedural memory task (sequence finger tapping) to oral administration of placebo or 10 mg tiagabine (at 22:30). PARTICIPANTS: Fourteen healthy young men aged 21.9 years (range 18-28 years). MEASUREMENTS AND RESULTS: Tiagabine significantly increased the time spent in SWS and decreased REM sleep compared to placebo. Tiagabine also enhanced slow wave activity (0.5-4.0 Hz) and density of < 1 Hz slow oscillations during NREM sleep. Fast (12-15 Hz) and slow (9-12 Hz) spindle activity, in particular that occurring phase-locked to the slow oscillation cycle, was decreased following tiagabine. Despite signs of deeper and more SWS, overnight retention of memory tested after sleep the next evening (19:30) was generally not improved after tiagabine, but on average even lower than after placebo, with this impairing effect reaching significance for procedural sequence finger tapping. CONCLUSIONS: Our data show that increasing slow wave sleep with tiagabine does not improve memory consolidation. Possibly this is due to functional differences from normal slow wave sleep, i.e., the concurrent suppressive influence of tiagabine on phase-locked spindle activity.

Contribution of norepinephrine to emotional memory consolidation during sleep.

BACKGROUND: There is increasing evidence indicating that slow wave sleep (SWS) supports memory consolidation. This effect may in part originate from phasic noradrinergic (NE) activity occurring during SWS in the presence of tonically lowered NE levels. Here, we examined whether NE supports the consolidation of amygdala-dependent emotional memory during SWS. METHODS: In a double-blind cross-over study, 15 men learned emotional and neutral materials (stories, pictures) in the evening before a 3-h period of early SWS-rich retention sleep, during which either placebo or clonidine, an α2-adrenoceptor agonist which blocks locus coeruleus NE release, was intravenously infused. Memory retrieval as well as affective ratings and heart rate responses to the pictures were assessed 23 h after learning. RESULTS: Clonidine reduced plasma NE levels but had no effect on SWS. While retention of story content words and pictures per se remained unaffected, clonidine distinctly blocked the superiority of emotional compared to neutral memory for temporal order, with this superiority of emotional over neutral memories observed only in the placebo condition. Heart rate responses to pictures were not affected, but whereas under placebo conditions familiar negative pictures were rated less arousing and with a more negative valence compared to pictures not seen before; these differences were abolished after clonidine. CONCLUSION: Given that memory for the temporal order of events depends on the hippocampus to a greater extent than item memory, our findings suggest that NE activity during early SWS-rich sleep facilitates consolidation of memories that involve both, a strong amygdalar and hippocampal component.