Noradrenergic interactions via autonomic nervous system: a promising target for extinction-based exposure therapy?

Fearful associations can be replaced by neutral associations through repetitive exposure of an individual to the fearful situation without the aversive component. Recently, Peña and colleagues (Peña DF, Engineer ND, McIntyre CK. Biol Psychiatry 73: 1071-1077, 2013) demonstrated that pairing activation of noradrenergic (NA) pathways through vagus nerve stimulation (VNS) with extinction learning accelerates consolidation of extinction memories in rats. Their findings stress the importance of activating the NA system through VNS in treatment of anxiety disorders such as PTSD or phobia.