Disarming emotional memories using Targeted Memory Reactivation during Rapid Eye Movement sleep

Emotional responses are dampened across sleep, and this is thought to be mediated by neural reactivation during Rapid Eye Movement (REM) Sleep. Such reactivation can be triggered by targeted memory reactivation (TMR), a technique in which a tone previously associated with a memory during wake is re-presented during subsequent sleep. Prior work has shown that TMR in REM reduces arousal responses to negative stimuli. The present study builds on this by measuring autonomic responses and brain activity as well as behaviour. Participants rated the arousal of 48 affective images, paired with semantically matching sounds. Half of these sounds were cued during REM in the subsequent overnight sleep cycle. Participants rated the images in a Magnetic Resonance Imaging (MRI) scanner with pulse oximetry 48 hours after encoding, and again after two weeks. Results showed that TMR during REM was also associated with reduced brain activity in the two primary nodes of the Salience Network (SN): the Anterior Insula and dorsal Anterior Cingulate Cortex (dACC), as well as the orbitofrontal cortex, subgenual cingulate, and left amygdala, all of which are known to be important for emotional processing. TMR markedly reduced the emotional heart rate deceleration (HRD) response, and also reduced subjective arousal ratings for highly arousing images, while increasing ratings for less arousing images. We conclude that REM TMR can facilitate a decrease in physiological and neurological responses to arousal. These findings have potential implications for the use of TMR in treatment of depression and anxiety disorders.