暴露療法為現行臨床治療焦慮型疾患最被廣泛使用的療法。透過使患者於療程中重複接觸恐懼刺激，使其恐懼反應逐漸下降而最終消失，這樣的流程屬於帕夫洛夫古典制約恐懼消除的一種。本研究透過一系列抑制型逃避學習記憶消除實驗，試圖提供治療焦慮型疾患的新治療方式，以減輕患者於療程中的不適。在實驗一中，我們發現大鼠能夠成功在右美托嘧啶(dexmedetomidine)誘導的麻醉下建立消除記憶。實驗二則進一步利用腎上腺素作為記憶增強劑，在消除過後立即施打於周邊，發現大鼠可在較短的消除流程中就成功習得原本無法習得的消除記憶。在實驗三中，透過在消除過後立即於內側前額葉的下邊緣皮質(infralimbic cortex)進行顱內注射，我們發現 β-腎上腺素受體拮抗劑 propranolol 能夠阻斷腎上腺素對消除記憶的增強效果。另一方面，將之注射於內側前額葉的前邊緣皮質(prelimbic cortex)則無法阻斷腎上腺素的效果。綜合實驗結果發現，本研究不僅發現消除記憶能夠在麻醉下成功建立，亦發現可透過一種仰賴特定於下邊緣皮質而非前邊緣皮質中 β-腎上腺素受體的機制促進其記憶穩固。透過這些發現，我們提供臨床治療焦慮型疾患一種全新治療法的發展方向，希望能透過麻醉降低患者須於療程中經歷的不適，而能使治療觸及更廣泛的族群。

Extinction-based exposure therapy has long been the most dominant way to treat anxiety-like disorders. Patients have to be exposed to fear stimuli repeatedly during therapies in order to dampen fear responses. In the present study, we found that rat's fear extinction can be established under dexmedetomidine-induced anesthesia in experiment 1. In experiment 2, we further use epinephrine (EPI) as a peripheral memory enhancer and found that rats can acquire extinction memory under anesthesia successfully within fewer days. In experiment 3, by microinjection into infralimbic cortex (IL) of medial prefrontal cortex (mPFC) immediately after each extinction trial, we found that β-adrenoceptor antagonist, propranolol (PROP) can block the EPI memory-enhancing effect found in experiment 2. On the other hand, PROP microinjection into prelimbic cortex (PL) of mPFC shows no impact on the enhancing effect. Together, our present finding suggest that memory extinction can be established under anesthesia, which also can be enhanced by a β-adrenoceptor activation-dependent mechanism specifically in IL but not PL. Our present study provides a new aspect for clinical therapy development to treat anxiety-like disorders, relieving the discomfort of patients during therapies, which may potentially induce the possibility for a larger population to reach out for clinical treatments.

鄭茜馨(2023)。大鼠在右美托嘧啶誘導麻醉下學習味覺嫌惡制約與其神經機制。國立成功大學心理學研究所碩士論文。https://hdl.handle.net/11296/mstfbc
蕭翔允(2017)。大鼠在右美托嘧啶誘導麻醉下學習抑制型逃避學習作業與其神經機制。國立成功大學心理學研究所碩士論文。https://hdl.handle.net/11296/a5kggq
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