What is it about?
Behavioral therapies for post-traumatic stress disorder are negatively affected by stress. We show that brain areas involved in stress, emotion, and extinction learning are responsible for these adverse effects. During stress, hindbrain locus coeruleus neurons release norepinephrine in the amygdala, which produces a high fear state. This, in turn, reduces neuronal activity in the prefrontal cortex. Reductions in prefrontal activity undermines extinction learning, which is critical for reducing fear during behavioral therapy.
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Why is it important?
Relapse of fear is a major challenge in patients with stress- and trauma-related disorders, including post-traumatic stress disorder (PTSD). We have now shown that drugs that block stress-induced norepinephrine action in the amygdala can normalize prefrontal cortical activity and facilitate extinction learning. Drugs such as propranolol, an FDA-approved beta-blocker, may be an effective in improving the outcomes of behavioral therapy in some patients with PTSD.
Perspectives
We know that stress robs us of cognitive capacity—trying doing a math problem after a car accident. It also interferes with learning that danger has passed, an outcome that undermines therapy in patients with fear and anxiety disorders. We show that all of this results from a bottom up brain circuits(locus coeruleus) that releases norepinephrine and locks an individual into a high fear state. This is underpinned by the amygdala, which overrules the prefrontal cortex leading to disturbed safety learning.
Stephen Maren
University of Illinois at Urbana-Champaign
Read the Original
This page is a summary of: Locus coeruleus–amygdala circuit disrupts prefrontal control to impair fear extinction, Proceedings of the National Academy of Sciences, March 2026, Proceedings of the National Academy of Sciences,
DOI: 10.1073/pnas.2528250123.
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