Targeted memory reactivation during sleep improves emotional memory modulation following imagery rescripting

Targeted Memory Reactivation (TMR) during sleep benefits memory integration and consolidation. In this pre-registered study, we investigated the effects of TMR applied during non-rapid eye movement (NREM) sleep following modulation and updating of aversive autobiographical memories using imagery rescripting (ImR). During 2-5 nights postImR, 80 healthy participants were repeatedly presented with either idiosyncratic words from an ImR updated memory during sleep (experimental group) or with no or neutral words (control groups) using a wearable EEG device (Mobile Health Systems Lab-Sleepband, MHSL-SB) [1] implementing a close-loop cueing procedure. Multivariate analysis were conducted to assess change score trajectories in five key emotional memory characteristics (positive and negative valence, emotional distress, arousal, and vividness) across assessments (timepoints, t) and between the study groups (TMR condition). While ImR showed significant effects on all memory characteristics (d = 0.76-1.66), there were significant additional improvements in the experimental group. Memories were significantly less vivid and afflicted with less emotional distress and arousal following ImR-words cueing. TMR during sleep in individuals' homes was feasible and further improved some ImR's adaptive memory effects. If replicated in clinical samples, TMR may be utilized to augment the effects of ImR and other clinical memory modulation procedures and create personalized treatment options. Such advances in emotional memory treatments are direly needed, as aversive memories are a salient feature across mental disorders, such as post-traumatic stress disorder (PTSD).