The Role Of Carbonic Anhydrases in Extinction Of Contextual Fear Memory
Mar 10, 2022
For more information:ali.ma@wecistanche.com
Carbonic anhydrases (CAs; EC 4.2.1.1) are metalloenzymes present in mammals with 16 isoforms that differ in terms of catalytic activity as well as cellular and tissue distribution. CAS catalyzes the conversion of CO, to bicarbonate and protons and is involved in various physiological processes, including learning and memory. Here we report that the integrity of CA activity in the brain is necessary for the consolidation of fear extinction memory. We found that systemic administration of acetazolamide, a CA inhibitor, immediately after the extinction session dose-dependently impaired the consolidation of fear extinction memory of rats trained in contextual fear conditioning. D-phenylalanine, a CA activator, displayed an opposite action, whereas C18, a membrane-impermeable CA inhibitor that is unable to reach the brain tissue, had no effect. Simultaneous administration of acetazolamide fully prevented the procognitive effects of D-phenylalanine. Whereas D phenylalanine potentiated extinction, acetazolamide impaired extinction also when infused locally into the ventromedial prefrontal cortex, basolateral amygdala, or hippocampal CA1 region.No effects were observed when acetazolamide or D-phenylalanine was infused locally into the substantia nigra pars compact. Moreover, systemic administration of acetazolamide immediately after the extinction training session modulated c-Fos expression on a retention test in the ventromedial prefrontal cortex of rats trained in contextual fear conditioning. These findings reveal that the engagement of CAs in some brain regions is essential for providing the brain with the resilience necessary to ensure the consolidation of extinction of emotionally salient events.

Click to cistanche tubulosa benefits and side effects and Cistanche products for memory
Emotional experiences leave long-lasting traces in the brain, like memories that are formed following stressful events may be initially labile but over time may become insensitive to disruption and may last a lifetime through a process known as consolidation (1-3). This memory persistence is pivotal for individuals to respond adequately to danger (4,5). Disruption of these memories may trigger maladaptive responses in such mental illnesses as obsessive-compulsive disorders. phobias. posttraumatic stress disorder(PTSD) and generalized anxiety(6,7). Insight leading to improved treatments of these disorders can be gained by better understanding the neural mechanisms underlying emotional memory. Memory is a multistage process that includes acquisition. consolidation, and retrieval (8). Retrieval reactivates a mnemonic trace, returning it to a labile state and consequently initiating its reconsolidation or extinction. Reconsolidation allows for the updating of the original memory, rendering it persistent(9-11). Conversely, extinction refers to a new memory trace that inhibits retrieval of the original memory (12,13).

Fear-motivated learning tasks have greatly contributed to the knowledge of extinction memory and are considered a valuable translational model for investigating disorders such as phobias, anxiety, and PTSD (5.12.14). Extinction forms the basis of exposure therapy(15-17), currently the gold standard treatment for these disorders(18,19). However, not all patients experience the beneficial effects of this therapy. Since extinction does not erase the original memory but is new learning that inhibits its expression (20), extinguished behaviors can recover spontaneously with time (21, 22). Drugs promoting fear extinction could represent a novel therapeutic strategy to treat these disorders (19. 23-25)

Carbonic anhydrases(CAs; EC4.2.1.1)are enzymes present in mammals with 16 isoforms that differ in terms of catalytic activity as well as cellular and tissue distribution (26). CAS catalyzes the conversion of CO, to bicarbonate and protons and is involved in several physiological processes(27), including memory formation (28).CA activation was found to ameliorate spatial memory in rats (29).In keeping with these findings, mice genetically deficient in the CA IX isoform performed more poorly in the same task than wild-type littermates(30). More recently, it was reported that administration of the widely used CA inhibitor acetazolamide (ACTZ) (31) to CD1 mice reduced CA activity in the brain and caused amnesia in the object recognition(OR)test. whereas treatment with D-phenylalanine (D-phen)enhanced CA activity and potentiated OR memory as a result of extracellular signal-regulated kinase (ERK)activation (31.32). In line with these results, inhibition of CAs also impaired fear memory consolidation in rats through inhibition of ERK phosphorylation (33). Thus. it is conceivable that CAs are involved in fear extinction memory as well.
Scheila Daiane Schmidt, Alessia Costa,Barbara Ranib, Eduarda Godfried Nachtigall, Maria Beatrice PassaniP,Fabrizio Carta, Alessio Nocentini, Jociane de Carvalho Myskiwd, Cristiane Regina Guerino Furinid, Claudiu T. Supuran, lvan lzquierdo, Patrizio Blandina, and Gustavo Provensi
Memory Center, Brain Institute of Ro Grande do Sul, the Pontifical Catholic University of Rio Grande do Sul Porto Alegre 90619-900. Brazil Department of Health Sciences University of Florence, 50121 Horence, Ital; Department of Neuroscience, Psychology, Drug Research, and Child Health, University of Florence, 50121 Florence, Italy; and "National Institute of Translational Neuroscience (INNT), National Research Council of Brazil, FederalUniversity of Rio de Janeiro, Rio de Janeiro 21941-902, Brazil
The present study was specifically designed to address this question in rats using contextual fear conditioning(CFC), an associative learning paradigm that has greatly contributed to the understanding of extinction processes(34). CA activity was modulated pharmacologically with inhibitors and activators of the enzymes that were administered systemically or locally in brain areas involved in extinction memory. c-Fos expression was also evaluated in these brain regions after the retention test. The results indicate that CA modulation in selected brain regions affects the consolidation of fear extinction memory. This may represent a previously unexplored mechanism to develop drugs for improved treatment of mental illnesses.

Results
Effect of Systemic Administration of CA Inhibitors on Fear Extinction Memory.
The experimental design is shown in Fig.LA.At 24 h after CFC training, animals were exposed to a 30-min extinction training session, immediately followed by i.p. administration of ACTZ(10 mg/kg or 30 mg/kg)or 1-N-(4-sulfamophenv-ethyl)-2,4,6-trimethylpyridinium perchlorate(C18;30 mg/kg).Controls received comparable injections of vehicles. Since extinction is essentially new learning, treatment applied after the extinction training session will affect consolidation but not acquisition (35). A 3-min retention test was delivered 24 h after the extinction session: the results are displayed in Fig. 1B. We observed that freezing was extinguished throughout the extinction sessions, as indicated by a decrease in freezing time during the final 3 min(27-30) compared with the initial 3 min(0-3)(Fig 1B). This is a clear indication that all rats learned the extinction of CFC. Moreover, extinction memory lasted at least 24 h, since rats given vehicle spent significantly less time freezing in the retention test than in the initial 3-min interval(0-3)of the extinction session(Fig.1B). However, freezing behavior displayed at the retention test by rats injected with 30 mg/kg of ACTZ did not differ significantly from that expressed in the initial3 min(0-3) of the extinction session (Fig. 1B), revealing that ACTZ at this dosage impaired the consolidation of CFC extinction. Accordingly, rats injected with 30 mg/kg of ACTZ spent significantly more time freezing than all other groups of rats in the retention test (Fig.1B).

Freezing behavior was not affected by changes in locomotion, as no significant difference in the general motor, activity was detected comparing vehicle-treated animals with those given 30 mg/kg of ACTZor C18(SIAppendix, Fig S2), in agreement with earlier reports from our and other laboratories(32,33). ACTZ at a lower dose (10 mg/kg) or C18 did not impair the consolidation of CFC extinction, as rats administered ACTZ 10 mg/kg or C18 spent significantly less time freezing in the retention test than during the first 3 min (0-3)of the extinction session(Fig.1B).C18 is a CA inhibitor that, unlike ACTZ, does not cross the blood-brain barrier (36). Therefore. inhibition of CA peripheral activity elicited by C18 left the consolidation of CFC extinction intact.
p-Phen Potentiated CFC Extinction.
We tested the effects of CA activation on CFC extinction by administering D-phen, an activator of several CA isoforms (37). D-phen (300 mg/kg IP.)did not influence locomotion(SI Appendix, Fig. S2). The experimental design is shown in Fig. 24. At 24 h after CFC training, animals were exposed to a 15-min extinction training session, followed immediately by IP.administration of D-phen (300 mg/kg) with or without ACTZ(30 mg/kg). Controls received comparable injections of vehicles.
To evaluate a potentiating effect, a weaker extinction protocol was induced by shortening the extinction session to 15 min. according to previous studies(38). Results are shown in Fig. 2B. Vehicle-treated rats showed no significant differences in freezing duration in the initial(0-3) and final (12-15)3 min of the extinction session or in the retention test (Fig.2B). Conversely, rats treated with D-phen spent significantly less time freezing than vehicle-treated rats in the retention test(Fig. 2B). They also demonstrated significantly less freezing behavior in the retention test than during the initial 3 min(0-3)or the final 3 min(12-15)of the extinction training session (Fig. 2B). Thus, administration of D-phen at 300 mg/kg enhanced extinction memory, as a short extinction session that normally does not produce long-term extinction memory was effective.
To assess whether the improved learning in D-phen-treated rats may depend on CAs activation, we tested the effects of ACTZ(30 mg/kg IP.) on the procognitive effects elicited by 300 mg/kg D-phen(Fig. 2B). Rats of this group received both D-phen and ACTZthrough separate IP. injections at the end of the extinction training session (Fig.24). These rats did not differ significantly in freezing time in the retention test orin the initial (0-3)and final (12-15)3 min of the extinction session. Moreover, freezing time at retention was not significantly different from that of vehicle-treated animals(Fig.2B). D-phen/ACTZ-treated rats spent significantly more time freezing than rats given D-phen alone (Fig. 2B). Therefore, inhibition of CAs abolished the extinction memory enhancement elicited by D-phen.
Effect of ACT Local Administration into Selected Brain Regions on CEC Extinction, We next asked whether local infusions of ACTZ into the ventromedial prefrontal cortex(vmPFC), the basolateral amygdala (BLA). the CA1 region of the dorsal hippocampus (CA1), or the substantia nigra pars compacta(SNpc)affected the extinction of CFC. All animals, distributed into four experimental subsets according to the brain region investigated, were subjected to a CFC training session and, 24 h later, a 30-min extinction training session. immediately followed by bilateral infusions of ACTZ(10 nmol/side) or vehicle into separate brain areas(Fig.3A). A 3-min retention test was performed 24 h after the extinction session (Fig 3A4). The effects of drug infusion into the vmPFC are shown in Fig. 3B.
Freezing extinguished throughout the extinction session in both groups of animals, as its duration in the final 3 min (27-30) was significantly shorter than that in the initial 3 min (0-3)(Fig. 3B). Extinction memory lasted at least 24 h since in the retention test. vehicle-treated rats displayed significantly reduced freezing behavior compared with that observed during the first 3 min(0-3)of the extinction session(Fig.3B). However, the freezing time of ACTZ-infused rats in the retention test was significantly longer than that during the final 3 min (27-30)of the extinction training session(Fig. 3B). Furthermore, in the retention test ACIZ-treated rats froze for a significantly longer period than vehicle-treated rats (Fig. 3B).
The effects of ACTZ infusion into the BLA are shown in Fig.3C.All animals learned extinction since freezing duration in the final 3 min (27-30) was significantly shorter than that in the initial 3 min (0-3)of the extinction session (Fig, 3C). Extinction memory was long-lasting. as vehicle-treated rats exhibited significantly reduced freezing behavior in the retention test than during the first 3 min (0-3)of the extinction training session (Fig, 3C), Conversely, rats that received ACTZinfusioninto the BLA exhibited a significantly longer freezing time in the retention test than during the final 3 min(27-30)of the extinction training session (Fig. 3C). Moreover, freezing behavior was significantly longer in these rats compared with vehicle-treated rats in the retention test.
Fig. 3D shows the effects of ACTZinfusion into the hippocampal CA1 region. Freezing was extinguished in both groups of animals throughout the extinction session, with a significantly decreased duration in the final 3 min (27-30) compared with the initial 3 min (0-3)(Fig. 3D). In the retention test, vehicle-treated rats exhibited a significantly shorter freezing time compared with that observed during the initial 3 min (0-3)of the extinction training session: however. ACTZ-infused rats had a significantly longer freezing time in the retention test than in the final 3 min(27-30)of the extinction session(Fig.3D).In addition, the ACTZ-infused rats exhibited a significantly longer freezing time than the vehicle-treated rats in the retention test (Fig. 3D). The effects of ACTZ infusion into the SNpc are shown in Fig. 3E. Freezing was extinguished throughout the extinction training session in both experimental groups, with a significant drop in duration in the final (27-30)3-min interval compared with the initial (0-3)3-min interval(Fig. 3E). In the retention test, the freezing time did not differ between the vehicle- and ACTZ-treated rats, but it was significantly shorter than that seen during the initial 3 min(0-3)of the extinction training session (Fig. 3E). Taken together, these findings suggest the inactivation of CAs in the vmPFC, BLA., and CA1.but not in the SNpc, impaired the consolidation of CFC extinction.
Effect of Local p-Phen Administration into Selected Brain Regions on CFC Extinction.
To further support the observation that CA in-activation by ACTZ administration in the vmPFC, BLA, and CAl, but not in the SNpc, weakened consolidation of CFCex-tinction, we tested whether CA activation in the same regions led to the opposite results. The experimental design is shown in Fig.4A. All animals, distributed into four experimental subsets according to the brain region investigated, were subjected to a CFC training and.24 h later, a 15-min extinction training session, immediately followed by bilateral infusions of p-phen (50 nmol/side)or vehicle into separate brain regions. To evaluate a potentiating effect, the extinction session was shortened to 15 min to induce weaker extinction. according to the present study and previous studies (38). The effects of drug infusion into the vmPFC are shown in Fig. 4B.

Comparison of the initial3-min (0-3) with the final 3-min (12-15) of freezing revealed that freezing extinguished throughout a 15-min extinction session in both vehicles- and D-phen-treated rats; however, the effect was short-lived, as the freezing time of vehicle-treated rats did not differ significantly between the initial 3 min(0-3)of the extinction session and in the retention test(Fig. 4B). In the retention test, rats given D-phen spent significantly less time freezing compared with vehicle-treated rats (Fig. 4B). In addition, the freezing time of D-phen-treated animals was significantly shorter in the retention test than during the initial 3 min (0-3)of the extinction training session (Fig. 4B). The effects of D-phen infusion into the BLA are displayed in Fig. 4C. Freezing extinguished throughout the extinction session, as its duration in the final 3 min (12-15) was significantly shorter than that of the initial 3-min (0-3) in both vehicle- and D-phen–treated rats (Fig. 4C). However, in the retention test, the freezing behavior of vehicle-treated rats was not significantly different from that exhibited during the first 3 min (0-3) of the extinction session, indicating that extinction learning was short-lived (Fig. 4C). Conversely, rats that received D-phen exhibited a significantly shorter freezing time significantly in the retention test than during the initial 3 min (0-3) of the extinction session (Fig. 4C). Moreover, in the retention test, the D-phen–treated rats spent significantly less time freezing compared with the vehicle-treated rats (Fig. 4C). Fig. 4D shows the effects of D-phen infusion into the hippocampal CA1 region.

Extinction occurred in all rats since the duration of freezing during the extinction session decreased significantly in the final 3min (12-15)compared with the initial3 min(0-3)(Fig.4D).but this was not long-lasting, as the freezing time of vehicle-treated rats was not significantly different between the initial 3 min (0-3)of the extinction session and in the retention test (Fig.4D). The D-phen-treated rats exhibited a significantly shorter freezing time in the retention test than during the initial3 min (0-3)of the extinction session(Fig. 4D). Freezing time in the retention test was significantly shorter in the D-phen-infused rats compared with the vehicle-treated rats(Fig. 4D).
The effects of D-phen infusion into the SNpc are shown in Fig. 4E. Freezing was extinguished throughout the extinction training session, with a significantly decreased duration in the final3 min(12-15)compared with the initial3 min(0-3). The freezing times of the vehicle- and D-phen-treated rats did not differ significantly in the retention test, and did not differ significantly from those observed during the initial 3 min (0-3) of the extinction session (Fig.4E). Taken together, these findings suggest that the activation of CAsin the vmPFC, BLA, and CAl, but not in the SNpc, potentiated the consolidation of CFCextinction.
ACTZ Systemic Administration Modulated c-Fos Expression in the Ventromedial Prefrontal Cortex. Rats were trained in CFC and 24 h later exposed to a 30-min extinction training session, followed immediately by i.p.administration of ACTZ (30 mg/kg)or vehicle. Rats were euthanized at 90 min after the retention test (Fig. 5A). In line with the results shown in Fig. 1B. all rats learned CFC extinction, which lasted at least 24 h(SI Appendix, Fig. S1); however, in the rats injected with 30 mg/kg of ACTZ freezing behavior exhibited in the retention test did not differ significantly from that expressed in the initial 3 min (0-3)of the extinction training session (SI Appendix. Fig. S1).confirming that ACTZ at this dosage impaired the consolidation of CFC extinction. We found that c-Fos expression in the vmPFC was significantly higher in rats given ACTZ compared with vehicle-treated rats(Fig. 5C), whereas no differences in c-Fos expression were found in the BLA.CA1.or SNpc of rats treated with ACTZ and those treated with vehicle(SI Appendix, Fig. S3).
Discussion
Spontaneous recovery of fear memories may occur at any time and triggers much distress for people affected by fear-based disorders such as PTSD, generalized anxiety, and phobias. The recommended treatment for these disorders is exposure therapy (39), during which extinction memories override the original fear memory. However, exposure therapy is not always effective, and the original fear often relapses spontaneously after extinction. suggesting that extinction forms a new memory that inhibits or competes with the original fear but does not erase it(34, 40). Thus. novel interventions that may augment extinction and inhibitory learning are needed. In addition to behavioral methods implemented during psychotherapy and device-based stimulation techniques that enhance or reduce activity in different brain regions, there is also increasing support for novel drugs that may augment extinction and inhibitory learning. specifically when combined with exposure-based psychotherapy(41-43). Further investigation of extinction processes is needed to identify targets for these novel drugs.
Here we examined the role of CAs in fear extinction memory in rats by assessing the systemic effects of two CAs inhibitors, ACTZ(31) and C18(37), and of a CA activator, D-phen (38). We found that CAs in the brain are implicated in fear extinction mechanisms. Administration of ACTZ(30 mg/kg IP.)but not of C18.a compound that does not penetrate the brain, immediately after the extinction session impaired consolidation of fear extinction memory. It is widely accepted that the extinction of a behavioral response requires new inhibitory learning (5,34,44). Our results are in agreement with earlier evidence suggesting that brain CA activity is necessary for new memory formation, as inactivation of brain CAs impairs the formation of spatial and fear memory(28,33).In line with these findings, mice genetically deficient in the CAIX isoform exposed to the Morris water maze test had more difficulty than their wild-type littermates in learning to find the hidden platform(30). More recently, our research group reported that systemic administration of ACTZ to male CD1 mice caused amnesia in the object recognition test(32). A detrimental effect on cognition by ACTZ has been reported in humans as well. as a randomized, double-blind,placebo-controlled study showed that this CA inhibitor impaired cognitive performance, executive function, short-term memory, and sustained attention during acute high-altitude exposure (45).

We previously reported that systemic administration of ACTZ (30 mg/kg i.p) significantly decreased CA activity in the mouse brain (32). In the present study. ACIZ caused amnesia at the same dose used in our previous work; therefore, it is conceivable that extinction memory impairment occurred as a consequence of CA inhibition. Thus, increasing CA activity would be expected to improve extinction memory. Our results support this idea; administration of D-phen, a CA activator, produced long-lasting fear extinction memory when given immediately after the extinction session. Accordingly, administration of D-phen to CD1 mice enhanced memory in the OR test and increased brain CA activity (32). Coadministration of ACTZ fully blocked p-phen-elicited memory improvement in both the present study and the previous study(32), clearly indicating a critical role of CA activation as an underlying mechanism and ruling out possible contributions of other effects of D-phen, such as facilitation of aminergic neurotransmitter synthesis and/or transmission (32).
Using local administration of ACTZ or D-phen into discrete brain regions, the present study demonstrates that CAs have a critical role in the consolidation of extinction memory in the vmPFC. BLA.and CA1.All these regions are involved in memory extinction, as shown by studies using techniques ranging from tissue lesions to pharmacologic, optogenetic, and chemo-genetic approaches (22,46). Conversely, CAs in the SNpc are not involved in this process, at least not under the experimental conditions explored in the present study. Our study unequivocally demonstrates that CA activation in these brain regions is necessary to ensure extinction memory consolidation. Neuronal circuits engaging the vmPFC, BLA, and CAl also have been implicated in fear memory acquisition, consolidation, and retrieval(34). Although mnemonic processes for fear memory consolidation and extinction share some similar molecular mechanisms and pathways (34), the patterns of neuronal activation and neuronal signal transduction mechanisms within fear consolidation and fear extinction circuits show marked differences(13.22. 47). These differences might be conferred by procedural dissimilarities regarding the presence or absence of the unconditioned stimulus.
During fear conditioning, brain circuits are activated by ani mal's exposure to both an unconditioned stimulus (shock) and a conditioned stimulus (in our case. the context), whereas fear extinction is induced presenting only the conditioned stimulus. Several protein kinases (Fyn, CDK5. PKA.and PKC), protein phosphatases(calcineurin and SHP1/2), transcription factors, and immediate early genes (CARP. CREB.c-Fos, c-Jun. JunB. and June) come into play during fear conditioning or extinction, being either increased or decreased in various ways (reviewed in ref.47). Impairment of both fears memory consolidation(33)and extinction (the present study) appears to be associated with reduced brain CA activity. The brain is rich in various CA isoforms, differentially distributed in different brain regions (26). Since ACTZ is a nonselective inhibitor of several of these isoforms, its effect may mask distinct contributions by different isoforms(48)and specific involvement of certain brain areas (see below).
Findings from several studies focusing on the role of my PFC in extinction indicate that neurons of this region are necessary for extinction learning (12). In particular, brief stimulation of the infralimbic cortex (a subregion of the vmPFC) was found to reduce fear memory and strengthen extinction (12. 49). More recently, systemic administration of ACTZ was found to inhibit prefrontal cortical single-unit firing in vivo, leading to the reduced basal neuronal activity of the prefrontal cortex(50). Taken together, these findings suggest that ACTZ impairs fear extinction memory through inhibition of vmPFC firing.
At 90 min after the extinction retention test,cFos-immunopositive nuclei were numerous in the vmPFC of ACTZ-treated rats, significantly more numerous than in vehicle-treated rats. The most parsimonious interpretation of our results suggests that ACTZ-treated rats exhibited high levels of freezing behavior and an increased number of c-Fos-positive nuclei in the vmPFC at retention. as they did not consolidate extinction but rather re-membered the CFC training administered 48 h earlier. Indeed. much experimental evidence suggests a key role of the PFC in processing and recalling remote contextual fear memories(51, 52)and during extinction consolidation, rather than after a retention test (52-54). c-Fos immunostaining in the BLA and hippocampal CA1 region after extinction retrieval was low in the brains of vehicle-treated rats and not significantly different from that in brains of ACTZ-treated rats. A time-limited role of BLA and CA1 neurons in fear memory retrieval has been described (55)that may explain why we detected very low c-Fos immunostaining in rats that did not learn extinction(ACTZ-treated)and supposedly remembered the training experience. Furthermore. a bidirectional regulation of c-Fos induction in the mPFC (high)and the BLA(low)has been reported during extinction training and spontaneous recovery(56, 57); however, other studies have found high c-Fos expression in the BLA and CA1 after extinction retrieval(54). The literature covering the role of the hippocampus in fear memory recall and extinction is vast and quite controversial (reviewed in ref.52). Orsini et al.(58) found no significant increase of c-Fos expression in the ventral hippocampus of extinguished rats, and another study found no significant cFos increase in the dorsal hippocampus on remote contextual fear recall of extinction(59). Furthermore, early work suggested that the involvement of the dorsal hippocampus in contextual consolidation is limited to the early period of the memorization phase (60). The aforementioned studies used different protocols(e.g. auditory extinction, repeated extinction sessions over several days), which may be partially responsible for these discrepancies. Clearly. further work is necessary to explore these controversial results.
In conclusion, the present study provides several important insights into the involvement of CAs in fear memory. We have demonstrated that (i) the selective inhibition of CAs in the brain correlates with impairments of extinction; () the selective activation of CAs in the brain has a beneficial effect on extinction; and (i) CA activity is involved in extinction modulation only in specific brain regions. The mechanisms underlying the efects of CAs on extinction remain mostly unknown. By inhibiting CAs, ACTZ diminishes the buffering capacity. thereby influencing intracellular and extracellular pH and affecting proteins, NMDA. and y-aminobutyric acid (GABA)receptor function(51). CA inhibitors also increase intracellular CO, accumulation. block an-ion transport and increase GABA levels. leading to modulation of the firing rate (61). Early studies demonstrated that in the CA1 hippocampal region, the associated activation of multi-synaptic inputs on pyramidal neurons transiently transforms GABAergic inhibitory postsynaptic potentials (IPSPs)to excitatory postsynaptic potentials(62-64). The transformed synaptic inputs from the GABAergic interneurons provide a mechanism for modulating signal flow through the hippocampal network, enhancing the signal-to-noise ratio and selectively amplifying synaptic weights relevant to a particular memory(64). This synaptic transformation depends on a depolarizing transmembrane HCO3-flux that is reduced or eliminated by ACTZ(64). Furthermore, in the presence of p-phen, subthreshold inputs to pyramidal neurons switched the GABA-mediated IPSPs to depolarizing responses (65). The modification of information flow through the hippocampal network may explain the memory-impairing effects of ACTZ. Hippocampal output to the mPFC also would be affected by CA inhibitors, as ACTZ was found to increase the afferent drive from the hippocampus while reducing the basal neuronal activity of prefrontal cortex neurons (50).
It was recently reported that ACTZ inhibits fear conditioning-induced ERK phosphorylation in the amygdala(33), consistent with the reported impairment of extinction (66. In this regard. it is important to note that D-phen administration has been found to rapidly activate ERK pathways in the cortex and the hippocampus and to enhance OR memory(32) and water maze performance (29).
The extinction of unwanted responses, when exposed to reminders of previous trauma, is a core process underlying exposure therapy. Systemic drugs that facilitate extinction, such as cannabinoids, noradrenergic, histaminergic drugs, and neurotrophic factors, might be useful in improving the clinical response of exposure-based therapies(3.5.12). Based on results from this study, brain CA activators(67), as molecules able to improve extinction, may improve the exposure-based treatment of such disorders as phobias, anxiety, and PISD. The clinical potentials of these compounds are not diminished by the lack of knowledge about the underlying mechanism, although attempts to optimize their use will have a much greater likelihood of success when their mechanism of eliciting fear attenuation is understood.
Materials and Methods
Three-month-old male Wistar rats were purchased from Chares River Lab-oratories Italia and group-housed in the Center of Services for Laboratory Animal Housing(CeSAL), University of Florence. Fear conditioning was conducted with three electrical foot shocks (0.5 mA 2s)at 30-s intervals. The extinction of contextual fear conditioning was performed as described previously(38,68)with little modification. Then,24 h later, the animals were placed in the same chamber for a 15- or 30-min extinction training session (depending on the experimental set) in the absence of the foot shocks. Immediately after these sessions, vehicle, CA activator (p-phen), or CA inhibitor(ACTZor C18) was administered either systemically (i.p)or infused locally into selected brain regions through cannulae stereotaxically implanted bilaterally. The time the animal spent freezing was manually recorded by a trained observer unaware of the treatments. and statistically significant differences between the experimental groups were determined with repeated measure two-way ANOVA. The source of the detected significance was determined using Bonferroni's multiple-comparison post hoc test P values<0.05 were considered statistically significant. Detail of statistical analysis is provided in S/Appendix, Table S1.
For c-Fos measurements, rats were trained in the CFC task and after 24 h were submitted to a 30-min extinction training. Immediately after this session, they received an IP.injection of a vehicle or ACTZ 30 mg. A 3-min retention test was performed 24 h after the extinction training session. Rats were euthanized at 90 min after the retention test and then perfused transcardially with cold physiological alne. followed b 4% (valval paraformaldehyde in 0.1 M phosphate buffer (pH 7.4). Tissue preparations, immunostaining. and analysis was performed as described previously (69). The student's t-test was used to compare the number of c-Fo5-positive nuclei among different experimental groups.
Details of the study protocol and a list of materials are available in the S/Appendix. The raw data supporting the findings of this study are provided in Dataset S1. Requests for further information should be directed to the corresponding authors.
Reference
1. J. L. McGaugh, Making lasting memories: Remembering the significant. Proc. Natl. Acad. Sci. U.S.A. 110 (suppl. 2), 10402–10407 (2013).
2. C. M. Tyng, H. U. Amin, M. N. M. Saad, A. S. Malik, The influences of emotion on learning and memory. Front. Psychol. 8, 1454 (2017).
3. G. Provensi, M. B. Passani, A. Costa, I. Izquierdo, P. Blandina, Neuronal histamine and the memory of emotionally salient events. Br. J. Pharmacol. 177, 557–569 (2020).
4. M. S. Fanselow, The role of learning in threat imminence and defensive behaviors. Curr. Opin. Behav. Sci. 24, 44–49 (2018).
5. C. Furini, J. Myskiw, I. Izquierdo, The learning of fear extinction. Neurosci. Biobehav. Rev. 47, 670–683 (2014).
6. J. E. LeDoux, Emotion circuits in the brain. Annu. Rev. Neurosci. 23, 155–184 (2000).
7. R. M. Visser, A. Lau-Zhu, R. N. Henson, E. A. Holmes, Multiple memory systems, multiple time points: How science can inform treatment to control the expression of unwanted emotional memories. Philos. Trans. R. Soc. Lond. B Biol. Sci. 373, 20170209 (2018).
8. T. Abel, K. M. Lattal, Molecular mechanisms of memory acquisition, consolidation and retrieval. Curr. Opin. Neurobiol. 11, 180–187 (2001).
9. N. C. Tronson, J. R. Taylor, Molecular mechanisms of memory reconsolidation. Nat. Rev. Neurosci. 8, 262–275 (2007).
10. B. Jones, E. Bukoski, L. Nadel, J. M. Fellous, Remaking memories: Reconsolidation updates positively motivated spatial memory in rats. Learn. Mem. 19, 91–98 (2012).
11. C. Bucherelli, E. Baldi, C. Mariottini, M. B. Passani, P. Blandina, Aversive memory reactivation engages in the amygdala only some neurotransmitters involved in consolidation. Learn. Mem. 13, 426–430 (2006).
12. M. R. Milad, G. J. Quirk, Fear extinction as a model for translational neuroscience: Ten years of progress. Annu. Rev. Psychol. 63, 129–151 (2012).
13. D. W. Bloodgood, J. A. Sugam, A. Holmes, T. L. Kash, Fear extinction requires infralimbic cortex projections to the basolateral amygdala. Transl. Psychiatry 8, 60 (2018).
14. O. Bukalo, C. R. Pinard, A. Holmes, Mechanisms to medicines: Elucidating neural and molecular substrates of fear extinction to identify novel treatments for anxiety disorders. Br. J. Pharmacol. 171, 4690–4718 (2014).
15. M. G. Craske, D. Hermans, B. Vervliet, State-of-the-art and future directions for extinction as a translational model for fear and anxiety. Philos. Trans. R. Soc. Lond. B Biol. Sci. 373, 20170025 (2018).
16. B. M. Graham, M. R. Milad, The study of fear extinction: Implications for anxiety disorders. Am. J. Psychiatry 168, 1255–1265 (2011).
17. J. S. Abramowitz, The practice of exposure therapy: Relevance of cognitive-behavioral theory and extinction theory. Behav. Ther. 44, 548–558 (2013).
18. M. B. Powers, J. M. Halpern, M. P. Ferenschak, S. J. Gillihan, E. B. Foa, A meta-analytic review of prolonged exposure for posttraumatic stress disorder. Clin. Psychol. Rev. 30, 635–641 (2010).
19. J. C. Myskiw, I. Izquierdo, C. R. Furini, Modulation of the extinction of fear learning. Brain Res. Bull. 105, 61–69 (2014).
20. G. Zhu et al., Calpain-1 deletion impairs mGluR-dependent LTD and fear memory extinction. Sci. Rep. 7, 42788 (2017).
21. I. P. Pavlov, “An investigation of the physiological activity of the cerebral cortex” in Conditioned Reflexes, G. V. Anrep, Ed. (Oxford University Press, London, UK, 1927).
22. C. A. Orsini, S. Maren, Neural and cellular mechanisms of fear and extinction memory formation. Neurosci. Biobehav. Rev. 36, 1773–1802 (2012).
23. A. Garakani, S. J. Mathew, D. S. Charney, Neurobiology of anxiety disorders and implications for treatment. Mt. Sinai J. Med. 73, 941–949 (2006).
24. L. Ledgerwood, R. Richardson, J. Cranney, D-cycloserine facilitates extinction of learned fear: Effects on reacquisition and generalized extinction. Biol. Psychiatry 57, 841–847 (2005).
25. P. Busquet, A. Hetzenauer, M. J. Sinnegger-Brauns, J. Striessnig, N. Singewald, Role of L-type Ca2+ channel isoforms in the extinction of conditioned fear. Learn. Mem. 15, 378–386 (2008).
26. C. T. Supuran, A. Scozzafava, Carbonic anhydrases as targets for medicinal chemistry. Bioorg. Med. Chem. 15, 4336–4350 (2007).
27. A. Waheed, W. S. Sly, Carbonic anhydrase XII functions in health and disease. Gene 623, 33–40 (2017).
28. M. K. Sun, D. L. Alkon, Carbonic anhydrase gating of attention: Memory therapy and enhancement. Trends Pharmacol. Sci. 23, 83–89 (2002).
29. M. K. Sun, D. L. Alkon, Pharmacological enhancement of synaptic efficacy, spatial learning, and memory through carbonic anhydrase activation in rats. J. Pharmacol. Exp. Ther. 297, 961–967 (2001).
30. P. W. Pan et al., Brain phenotype of carbonic anhydrase IX-deficient mice. Transgenic Res. 21, 163–176 (2012).
31. L. Canto de Souza et al., Carbonic anhydrase activation enhances object recognition memory in mice through phosphorylation of the extracellular signal-regulated kinase in the cortex and the hippocampus. Neuropharmacology 118, 148–156 (2017).
32. T. H. Maren, Pharmacological and renal effects of Diamox (6063), a new carbonic anhydrase inhibitor. Trans. N. Y. Acad. Sci. 15, 53 (1952).
33. M. T. Yang, W. L. Chien, D. H. Lu, H. C. Liou, W. M. Fu, Acetazolamide impairs fear memory consolidation in rodents. Neuropharmacology 67, 412–418 (2013).
34. I. Izquierdo, C. R. Furini, J. C. Myskiw, Fear memory. Physiol. Rev. 96, 695–750 (2016).
35. E. Baldi, C. Bucherelli, Brain sites involved in fear memory reconsolidation and extinction of rodents. Neurosci. Biobehav. Rev. 53, 160–190 (2015).
36. V. Menchise et al., Carbonic anhydrase inhibitors: Stacking with Phe131 determines active site binding region of inhibitors as exemplified by the X-ray crystal structure of a membrane-impermeant antitumor sulfonamide complexed with isozyme II. J. Med. Chem. 48, 5721–5727 (2005).
37. C. Temperini, A. Scozzafava, D. Vullo, C. T. Supuran, Carbonic anhydrase activators. Activation of isoforms I, II, IV, VA, VII, and XIV with L- and D-phenylalanine and crystallographic analysis of their adducts with isozyme II: Stereospecific recognition within the active site of an enzyme and its consequences for the drug design. J. Med. Chem. 49, 3019–3027 (2006).
38. J. de Carvalho Myskiw, F. Benetti, I. Izquierdo, Behavioral tagging of extinction learning. Proc. Natl. Acad. Sci. U.S.A. 110, 1071–1076 (2013).
39. W. W. Eaton, O. J. Bienvenu, B. Miloyan, Specific phobias. Lancet Psychiatry 5, 678–686 (2018).
40. B. Vervliet, M. G. Craske, D. Hermans, Fear extinction and relapse: State of the art. Annu. Rev. Clin. Psychol. 9, 215–248 (2013).
41. J. S. Weisman, T. L. Rodebaugh, Exposure therapy augmentation: A review and extension of techniques informed by an inhibitory learning approach. Clin. Psychol. Rev. 59, 41–51 (2018).
42. E. N. Cahill, A. L. Milton, Neurochemical and molecular mechanisms underlying the retrieval-extinction effect. Psychopharmacology (Berl.) 236, 111–132 (2019).
43. L. A. M. Lebois, A. V. Seligowski, J. D. Wolff, S. B. Hill, K. J. Ressler, Augmentation of extinction and inhibitory learning in anxiety and trauma-related disorders. Annu. Rev. Clin. Psychol. 15, 257–284 (2019).
44. J. E. Dunsmoor, V. D. Campese, A. O. Ceceli, J. E. LeDoux, E. A. Phelps, Novelty facilitated extinction: Providing a novel outcome in place of an expected threat diminishes recovery of defensive responses. Biol. Psychiatry 78, 203–209 (2015).
45. J. Wang et al., Effects of acetazolamide on cognitive performance during high altitude exposure. Neurotoxicol. Teratol. 35, 28–33 (2013).
46. N. Singewald, A. Holmes, Rodent models of impaired fear extinction. Psychophar mycology (Berl.) 236, 21–32 (2019).
47. N. C. Tronson, K. A. Corcoran, V. Jovasevic, J. Radulovic, Fear conditioning, and extinction: Emotional states encoded by distinct signaling pathways. Trends Neurosci. 35, 145–155 (2012).
48. C. T. Supuran, Applications of carbonic anhydrases inhibitors in renal and central nervous system diseases. Expert Opin. Ther. Pat. 28, 713–721 (2018).
49. M. R. Milad, G. J. Quirk, Neurons in medial prefrontal cortex signal memory for fear extinction. Nature 420, 70–74 (2002).
50. L. S. Bueno-Junior et al., Acetazolamide potentiates the afferent drive to the prefrontal cortex in vivo. Physiol. Rep. 5, e13066 (2017).
51. P. W. Frankland, B. Bontempi, L. E. Talton, L. Kaczmarek, A. J. Silva, The involvement of the anterior cingulate cortex in remote contextual fear memory. Science 304, 881–883 (2004).
52. F. H. Do Monte, G. J. Quirk, B. Li, M. A. Penzo, Retrieving fear memories, as time goes by... Mol. Psychiatry 21, 1027–1036 (2016).
53. F. H. Do-Monte, G. Manzano-Nieves, K. Quiñones-Laracuente, L. Ramos-Medina, G. J. Quirk, Revisiting the role of infralimbic cortex in fear extinction with optogenetics. J. Neurosci. 35, 3607–3615 (2015).
54. E. Knapska, S. Maren, Reciprocal patterns of c-Fos expression in the medial prefrontal cortex and amygdala after extinction and renewal of conditioned fear. Learn. Mem. 16, 486–493 (2009).
55. F. H. Do-Monte, K. Quiñones-Laracuente, G. J. Quirk, A temporal shift in the circuits mediating retrieval of fear memory. Nature 519, 460–463 (2015).
56. C. Herry, N. Mons, Resistance to extinction is associated with impaired immediate early gene induction in medial prefrontal cortex and amygdala. Eur. J. Neurosci. 20, 781–790 (2004).
57. A. C. Huang, B. C. Shyu, S. Hsiao, T. C. Chen, A. B. He, Neural substrates of fear conditioning, extinction, and spontaneous recovery in passive avoidance learning: A c-fos study in rats. Behav. Brain Res. 237, 23–31 (2013).
58. C. A. Orsini, J. H. Kim, E. Knapska, S. Maren, Hippocampal and prefrontal projections to the basal amygdala mediate contextual regulation of fear after extinction. J. Neurosci. 31, 17269–17277 (2011).
59. B. A. Silva, A. M. Burns, J. Gräff, A cFos activation map of remote fear memory attenuation. Psychopharmacology (Berl.) 236, 369–381 (2019).
60. B. Sacchetti, C. A. Lorenzini, E. Baldi, G. Tassoni, C. Bucherelli, Auditory thalamus, dorsal hippocampus, basolateral amygdala, and perirhinal cortex role in the consolidation of conditioned freezing to context and acoustic conditioned stimulus in the rat. J. Neurosci. 19, 9570–9578 (1999).
61. E. Wyllie, G. Cascino, B. Gidal, H. Goodkin, Treatment of Epilepsy: Principles and Practice, (Lippincott Williams & Wilkins, Philadelphia, PA, 2010).
62. K. J. Staley, B. L. Soldo, W. R. Proctor, Ionic mechanisms of neuronal excitation by inhibitory GABAA receptors. Science 269, 977–981 (1995).
63. M. K. Sun, T. J. Nelson, D. L. Alkon, Functional switching of GABAergic synapses by ryanodine receptor activation. Proc. Natl. Acad. Sci. U.S.A. 97, 12300–12305 (2000).
64. M. Sun, D. Dahl, D. L. Alkon, Heterosynaptic transformation of GABAergic gating in the hippocampus and effects of carbonic anhydrase inhibition. J. Pharmacol. Exp. Ther. 296, 811–817 (2001).
65. M. K. Sun, W. Q. Zhao, T. J. Nelson, D. L. Alkon, Theta rhythm of hippocampal CA1 neuron activity: Gating by GABAergic synaptic depolarization. J. Neurophysiol. 85, 269–279 (2001).
66. M. Cammarota et al., Retrieval and the extinction of memory. Cell. Mol. Neurobiol. 25, 465–474 (2005).
67. C. T. Supuran, Carbonic anhydrase activators. Future Med. Chem. 10, 561–573 (2018). 68. S. D. Schmidt et al., PACAP modulates the consolidation and extinction of the contextual fear conditioning through NMDA receptors. Neurobiol. Learn. Mem. 118, 120–124 (2015).
69. R. Fabbri et al., Memory retrieval of inhibitory avoidance requires histamine H1 receptor activation in the hippocampus. Proc. Natl. Acad. Sci. U.S.A. 113, E2714–E2720 (2016).






