Circuit-informed modulation of traumatic memory in PTSD: integrating extinction, suppression, and reconsolidation.
Molecular Psychiatry June 1, 2026 Xin Yi, Yuan-Bo Zhang, Tong-Zhou Yu et al.
Post-traumatic stress disorder persists when stress biases memory systems, broadening threat engrams and weakening context-appropriate inhibition. Integrating preclinical and human evidence, the authors argue that extinction can be stabilized by engaging hippocampal-prefrontal-amygdala pathways and their thalamic coordinators. Targeted training and sleep-based reactivation strengthen top-down control over intrusions and sharpen safety-threat discrimination. Brief, prediction-error-rich retrieval opens a reconsolidation window through which maladaptive content can be updated; pairing this with state-aligned neuromodulation or psychedelic pharmacology biases plasticity toward safety. Integrating extinction reinforcement with voluntary memory control and reconsolidation editing offers a coherent route to more durable relief from traumatic memories in PTSD.