title: Cannabinoid modulation of fear extinction brain circuits: a novel target to advance anxiety treatment.
abstract: Anxiety disorders, such as post-traumatic stress (PTSD), panic, and phobic disorders, can be conceptualized as a failure to inhibit inappropriate fear responses. A common, effective treatment strategy involves repeated presentations to the feared cue without any danger (extinction). However, extinction learning has a number of important limitations, and enhancing its effects, generalizability and durability via cognitive enhancers may improve its therapeutic impact. In this review we focus specifically on the role of the cannabinoid system in fear extinction learning and its retention. We address the following questions: What are the neural circuits mediating fear extinction?; Can we make fear extinction more effective?; Can cannabinoids facilitate fear extinction in humans?; How might the cannabinoid system effect fear extinction? Collectively, translational evidence suggest that enhancing cannabinoid transmission may facilitate extinction learning and its recall, and that the cannabinoid system is a potential pharmacological target for improving the active learning that occurs during exposure-based behavioral treatments prompting future research in terms of mechanisms research, novel treatment approaches ('cognitive enhancers'), and pharmacotherapeutic drug discovery.
authors.forename: Christine A
authors.initials: CA
authors.lastname: Rabinak
authors.affiliation: Department of Psychiatry, University of Michigan, Rachel Upjohn Building, 4250 Plymouth Road, Ann Arbor, MI 48109-2700. rabinak@med.umich.edu.
authors.forename: K Luan
authors.initials: KL
authors.lastname: Phan
mesh_terms: D000818:Animals; D001008:Anxiety Disorders / Q000188:drug therapy*; D002186:Cannabinoids / Q000494:pharmacology*; D005108:Extinction, Psychological / Q000187:drug effects*; D005239:Fear / Q000187:drug effects*; D006801:Humans; D043884:Receptor, Cannabinoid, CB1 / Q000502:physiology
chemical_list: D002186:Cannabinoids; D043884:Receptor, Cannabinoid, CB1