BJA Advance Access published online on June 25, 2004
British Journal of Anaesthesia, doi:10.1093/bja/aeh211
© 2004 by The Board of Management and Trustees of the British Journal of Anaesthesia
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1 Department of Anesthesiology, Weill Medical College of Cornell University, 525 East 68th Street, New York, NY 10021, USA
* To whom correspondence should be addressed. E-mail: kopryor{at}yahoo.com.
Background. Emotional information has the ability to alter the formation and strength of a memory ('memory modulation'). Memory modulation by negative emotion is mediated by the amygdala. It is not known how gamma aminobutyric acid (GABA)ergic drugs affect the processes involved in memory modulation. This study investigates whether memory for negative emotional stimuli is more refractory to the effects of GABAergic drugs. Methods. Eighty-three healthy volunteers were shown a randomized sequence of 60 visual stimuli consisting of negative, positive and neutral emotive pictures, while receiving a controlled infusion of thiopental (n=31), propofol (n=31), dexmedetomidine (n=10) or placebo (n=11). After a 5 h retention interval, when drug concentration was negligible, subjects performed a recognition task with 'old' pictures randomly mixed with 'new' pictures. Drug effect was calculated as the proportionate reduction in recognition for images of each emotional valence. Results. Forty-eight subjects were included in a within-subject logistic dose-response model analysis. In the thiopental group there was a smaller drug effect seen for negative vs positive images (proportional memory reduction from baseline 0.27 (SD 0.20) vs 0.56 (0.25), P<0.001, n=20 included in analysis).Asimilar trend was seen in the propofol group (0.25 (0.28) vs 0.54 (0.30), n=10), but this did not attain statistical significance.No trend was seen in the dexmedetomidine group (0.33 (0.26) vs 0.24 (0.22), n=7). Conclusions. Over a specific dose range of thiopental (target serum concentration 2-7 µg ml-1), impairment of explicit memory for images with negative emotional valence is less than that for images with positive emotional valence. There is a strong possibility that propofol (target serum concentration 0.3-2.4 µg ml-1) causes a similar effect. Modulation of visual memory by negative emotional content continues at sub-anaesthetic concentrations of GABAergic drugs associated with explicit memory impairment.
Clinical Investigation
Enhanced visual memory effect for negative versus positive emotional content is potentiated at sub-anaesthetic concentrations of thiopental
2 Department of Anesthesiology and Critical Care Medicine, Memorial Sloan-Kettering Cancer Center, 1275 York Ave, New York, NY 10021, USA
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