Sensory cortical disinhibition is required for long-term fear memory in humans

The transformation of transient threats into enduring memories is fundamental to survival, yet how the human brain constructs long-term fear memory remains elusive. Early sensory cortex, traditionally viewed as a passive feature analyzer, is increasingly recognized as an active participant in fear processing. Here, using a multimodal approach combining high-definition α-frequency transcranial alternating current stimulation (HD α-tACS) with simultaneous EEG-fMRI and transformer-based neural decoding, we tracked fear memory development across early formation, consolidation, and long-term retention stages (assessed at 15 min, 24 h, and 7 days post-conditioning). Spatiotemporal memory representations were evident at all three time points, beginning at an early sensory stage (40-60 ms post-stimulus). Conditioning potentiated occipital α-oscillation desynchronization (a marker of visual cortical disinhibition), which predicted the strength of subsequent long-term memory traces. Critically, targeted α-tACS over early visual cortex induced V1/V2 inhibition, abolished conditioning-potentiated α desynchronization, and selectively disrupted fear-memory consolidation and retention while leaving initial acquisition intact. These findings establish sensory cortical disinhibition as a necessary mechanism for long-term fear memory in humans and identify early sensory cortex as a causal node for interventions targeting persistent maladaptive fear.