Choose any combination of the search options below. If you do not wish to include an option in your search, leave the box blank, or select "Any."
Your Results - you searched for the keyword Cortical Volumetric Changes 49 Results
1. Huber, M., Siol, T., Herholz, K., Lenz, O., Köhle, K., & Heiss, W. D. (2001, December). Activation of thalamo-cortical systems in post-traumatic flashbacks: A positron emission tomography study. Traumatology, 7(4), 131-141. doi:10.1177/153476560100700402.
Language: English
Format: Journal
Abstract:
Trauma victims with post-traumatic stress disorder (PTSD) often experience ‘flashbacks’ that are described as being different from memories of other fearful biographic situations. We used Positron Emission Tomography and Statistical Parametric Mapping to compare in the same subject brain activation patterns during induced flashbacks with recall of fearful non-traumatic situations. During fearful recall there were significant activations of right precuneus. When traumatic memories were compared to neutral, right lingual gyrus, right thalamus / mamillary bodies, and right cerebellum were significantly activated. When brain activation during flashbacks was compared to simple fear, right mediodorsal thalamus (MD), right precuneus, and right cerebellum were significantly more active. With respect to recent experimental evidence concerning the function of thalamo-cortical systems, we hypothesize that post-traumatic flashback experiences are based on hyperactive thalamo-cortical ‘closed loop’ networks.
Keywords: Flashbacks Mediodorsal Thalamus PET Positron Emission Tomography Post-Trauamtic Stress Disorder PTSD Statistical Parameter Mapping Thalamo-Cortical Systems Trauma Victims
Accuracy Verified: Yes
2. O'Shea, K. (2009, May). Anger, imagination and EMDR. Presentation at the EMDR Canada Conference, Vancouver, British Columbia Canada.
Language: English
Format: Conference
Abstract:
Anger is typically associated with destructive behavior, yet it is frequently released non-destructively during EMDR
sessions, via the imagination. Participants will learn 1) how to help clients accept anger as potentially necessary
and valuable when learning from traumatic experiences (including the neuroscience that supports the existence of
sub-cortical anger circuitry); 2) how to easily reset clients’ anger circuits; 3) Interweaves that facilitate its nondestructive
release; 4) how to ensure anger has been fully released; and 5) ways to facilitate clients’ safe release of
anger during and outside sessions.
Keywords: Anger Imagination
Accuracy Verified: Yes
3. Keller, B., Stevens, L. C., Boyce, K., Lui, C., & Murray, J. (2011). Bilateral eye movements and EEG coherence during positive memories: Implications for PTSD and EMDR. Presentation at the American Psychological Association Conference, Washington, DC.
Language: English
Format: Conference
Abstract:
The purpose of this study was to investigate the role of bilateral eye movements in the processing of long-term emotional memories, especially as it pertains to the treatment method for PTSD known as EMDR. EMDR utilizes methods similar to cognitive therapy and exposure but also employs saccadic eye movements to facilitate the treatment. The saccadic eye movements are theorized by Shapiro and others to decrease emotional valence and vividness of episodic memories allowing for easier reprocessing. There remains some disagreement as to the actual role and importance of the saccadic eye movements as well as to the neurological effects of EMDR.
This study used EEG power-spectral analysis and measures of interhemispheric coherence on 30 individuals who underwent one of three conditions while recalling positive episodic memories. The 3 conditions were (1) a solid black dot with no eye movement (control), (2) a low frequency color changing dot with no eye movement, and (3) a bilateral eye movement condition simulating EMDR. After a 5’ eyes-open baseline, participants experienced one of the three conditions while recalling a positive memory for five 1’ episodes. After each episode, each participant had 19-channel EEGs recorded while they stared ahead eyes opened. EEG data were noise artifacted, power spectral analyzed, and statistically analyzed for interhemispheric coherence differences between conditions for clusters of frontal pole (Fp), frontal (F), central (C), parietal (P), and occipital (O) electrodes.
ANCOVA analysis of post-treatment coherence values, with baseline values as the covariate, across conditions showed significantly increased Low Beta (12-20Hz) activity in the Frontal region of the brain during the saccadic eye movements condition compared to the low frequency dot condition (p=.012). Also found were significantly increased Low Theta (4-6Hz) coherence values in the Parietal region of the brain in the low frequency dot condition compared to both the eye fixation (p=.017) and saccadic eye movement (p=.022) conditions. Self reports of memory clarity and vividness indicated significantly increased measures across all conditions. LORETA cortical localization analyses revealed Low Beta (12-20Hz) activation during the saccadic eye movements condition occurring primarily in Brodmanns Area 11 (BA11) and Brodmann Area 25 (BA25) and Low Theta (4-6Hz) activation during the low frequency dot condition focused in BA35 and BA36. LORETA neuroimages are presented.
Cortical localizations of increased Low Beta interhemispheric coherence in BA11 (VentroMedial Frontal Cortex) and BA25 (Subgenual Anterior Cingulate Cortex) following bilateral eye movements during the recall of positive memories suggest a synchronization of information processing activities in parts of the frontal cortex involved in planning, reasoning, and decision making (11) and in verbal episodic memory retrieval (25). These functions are consistent with the assigned tasks of review of positive episodic memories in this study. Coincident with this pattern of cortical activation was an obtained increase in memory clarity and vividness during episodic memory retrieval. It is possible that the obtained effects on beta activity were an artifact of eye movements; however, the lack of significantly increased signal coherence at the Fp region and the removal of eye movement artifacts prior to data analysis reduce this possibility. These results provide support for an Interhemispheric Coherence Model as an explanation for the positive effects of Eye Movement Desensitization and Reprocessing of retrieved memories. Additionally, these outcomes suggest that it is the saccadic eye movements, not a repetition of a rhythmic stimulus, that elicits the changes in interhemispheric coherence, and possibly in emotional valence and vividness, highlighting the importance of saccadic eye movements in EMDR.
Keywords: Bilateral Stimulation EEG Coherence Eye Movements: Positive Memories Posttraumatic Stress Disorder PTSD
Accuracy Verified: No
4. Christman, S. D., & Stieber, P. (2005, February). Bilateral eye movements lead to a neutralization of affective state. Poster presented at the 33rd annual meeting of the International Neuropsychological Society, St. Louis, MO.
Language: English
Format: Conference
Abstract: Engaging in bilateral eye movements (EM) leads to increases in Stroop interference, improvements in episodic memory, and decreases in false memories in a converging semantic associates paradigm. These results are interpreted as reflecting EM-induced equalization of cortical activation and subsequent enhancement of interhemispheric interaction. Since increased right versus left hemisphere activation is associated with negative versus positive affect, respectively, it was hypothesized that EMs following a mood-induction procedure should result in neutralization of affect. Seventy three right-handed participants engaged in happy or sad mood induction procedures, providing mood ratings on a 1-9 scale, followed by 30 seconds of either bilateral EMs or, as a control, watching a dot change color repeatedly. Participants then supplied a second mood rating. Analyses of the Happy condition showed no mood differences after mood induction, with all participants yielding scores significantly happier than neutral. After administration of the visual condition, participants in the Colored Dot condition showed no change in mood. In the EM condition, however, participants showed a significant reduction in positive affect. Analyses of the Sad condition showed that the mood induction procedure failed, with participants reporting neutral moods after mood induction. Post hoc analyses of only those participants reporting sad moods after induction showed that participants in the EM condition exhibited a marginally greater neutralization of affect than in the Colored Dot condition. The results provide tentative support for the hypothesis that bilateral EMs result in neutralization of emotional states, reflecting an equalization of cortical activation in the left and right hemispheres.
Keywords: Bilateral Stimulation Eye Movements
Accuracy Verified: Yes
5. Christman, S., & Garvey, K. (2001, June). Bilateral eye movements reduce cortical activation asymmetries. Presentation at the 2001 EMDR International Association Conference, Austin, TX.
Language: English
Format: Conference
Abstract:
Alternating left-right eye movements (EMs) have been shown to enhance episodic memory recall (Christman & Garvey, 2000). In turn, enhanced recall of episodic, or autobiographical, memories has been linked to increased interhemispheric interaction (Christman & Propper, 2001; Propper & Christman, 1997). Since leftward versus rightward EMs induce right versus hemisphere activation, respectively (Bakan & Svorad, 1969), bilateral EMs may facilitate interhemispheric interaction by balancing hemispheric activation levels. In other words, asymmetries in cortical activation may impair interhemispheric communication. Christman and Garvey (2000), however, demonstrated only that bilateral EMs enhance episodic memory performance; they did not directly measure hemispheric activation. To test this hypothesis directly, participants were administered two behavioral tests that are sensitive to variations in hemispheric activation. The Chimeric Faces Test (Levy, Heller, Banich, & Burton, 1983) involves mirror-image pairs of faces, with one smiling hemiface and one neutral hemiface, presented under conditions of free viewing. Participants are asked to judge which member of a pair looks happier. Right versus left hemiface biases are associated with relative increases in left versus right hemispheric activation. Line bisection tasks also tap into hemispheric activation, with leftward versus rightward bisection errors reflecting increased right versus left hemisphere activation. Bisection tasks, however, are also influenced by premotor asymmetries (e.g., Luh, 1995), and thus represent a less pure measure of hemispheric activation.
METHODS Participants performed blocks of chimeric face and line bisection trials. They then engaged in 30 seconds of alternating left-right saccades (2 eye movements per second). Participants then performed a second block of trials for both tasks.
RESULTS Results showed that behavioral asymmetries in the chimeric face task were significantly reduced after the EMs (p<.029). This supports the hypothesis that bilateral EMs reduce hemispheric activation asymmetries. Performance on line bisection task, however, was unaffected by EMs (F<1), perhaps reflecting the fact that this task is a less direct measure of hemispheric activation.
DISCUSSION These results provide further insight into mechanisms underlying EMDR therapy used for PTSD patients. Reduction in hemispheric activation asymmetry arising from bilateral EMs employed in the current study (and in EMDR) may enhance interhemispheric communication. This interpretation is consistent with Ramachandran (1995), who showed that vestibular stimulation (inducing optokinetic nystagmus and resulting in involuntary left-right EMs) reduces the denial of deficit found in anosagnosia patients.
Ramachandran (1995) suggested that the procedure benefits the hypoaroused right hemisphere, bringing its activation level up to par with the left hemisphere. Similarly, EMs used in EMDR may balance hemispheric activation levels, in turn enhancing interhemispheric communication and retrieval of episodic memories.
Keywords: Bilateral Stimulation Eye Movements
Accuracy Verified: Yes
6. van der Kolk, B. A. (1994, January). The body keeps the score: Memory and the evolving psychobiology of posttraumatic stress. Harvard Review of Psychiatry, 1(5), 253-265. doi:10.3109/10673229409017088.
Language: English
Format: Journal
Abstract:
Ever since people's responses to overwhelming experiences have been systematically explored, researchers have noted that a trauma is stored in somatic memory and expressed as changes in the biological stress response. Intense emotions at the time of the trauma initiate the long-term conditional responses to reminders of the event, which are associated both with chronic alterations in the physiological stress response and with the amnesias and hypermnesias characteristic of posttraumatic stress disorder (PTSD). Continued physiological hyperarousal and altered stress hormone secretion affect the ongoing evaluation of sensory stimuli as well. Although memory is ordinarily an active and constructive process, in PTSD failure of declarative memory may lead to organization of the trauma on a somatosensory level (as visual images or physical sensations) that is relatively impervious to change. The inability of people with PTSD to integrate traumatic experiences and their tendency, instead, to continuously relieve the past are mirrored physiologically and hormonally in the misinterpretation of innocuous stimuli as potential threats. Animal research suggests that intense emotional memories are processed outside of the hippocampally mediated memory system and are difficult to extinguish. Cortical activity can inhibit the expression of these subcortically based emotional memories. The effectiveness of this inhibition depends, in part, on physiological arousal and neurohormonal activity. These formulations have implications for both the psychotherapy and the pharmacotherapy of PTSD.[MLM MEDLINE]
Keywords: Neurobiology Posttraumatic Stress Disorder Practice PTSD Theory
Accuracy Verified: Yes
7. Pagani, M., Salmaso, D., Looi, J., & Hogberg, G. (2008, June). Brain functional and volumetric analyses post traumatic stress disorder treated by EMDR. Presentation at the annual meeting of the EMDR Europe Association, London, England.
Language: English
Format: Conference
Abstract:
Neuro-imaging investigations in PTSD have reported findings for either functional or structural modifications.
Only two studies have investigated the changes in cerebral blood flow (CBF) following EMDR therapy and one
single-patient study recently reported EMDR-related structural changes. The aim of this study was to analyse the
structural and functional changes occurring in brain regions implicated in the patho-physiology of PTSD along
with the impact on CBF and volumetric data after EMDR treatment. Thirty six train drivers having being exposed
to traumatic experiences at work were assigned to different two groups: symptomatic (S, n=17) or nonsymptomatic
(NS, n=19), according to PTSD diagnosis. SPECT, following administration of an individualised
35
trauma script, and MRI were performed and EMDR therapy was administered to S. According to EMDR outcome S
were further subdivided in responders (R, n=11) and non-responders (NS, n=5). One patient was not treated. CBF
and volumetric analyses were performed on temporal lobes, hippocampi and nuclei caudati. ANOVA showed a
significantly higher CBF distribution in the left temporal lobe of S as compared to NS and the right nc.caudatus
was significantly larger in S. The R group had larger hippocampi and nc.caudati as compared to NR and the size of
hippocampi correctly identified 81% of R and NR. The increased left temporal lobe CBF distribution among
symptomatic PTSD subjects may reflect the affective significance of higher effort in emotional episodic memory
stimulation among symptomatic individuals. Hippocampi volume as measured before EMDR was shown to
predict with high accuracy the therapy outcome.
Keywords: Posttraumatic Stress Disorder PSTD
Accuracy Verified: Yes
8. Falaschi, R., & Tizzani, E. (2001, October). Changes in electroencephalographic quantitative analysis in patients treated with EMDR. In International CIANS Conference (CIANS: Collegium Internationale Activitatis Nervosae Superioris; International Association for Integrative Nervous Functions, Neurobiology of behaviour and Psychosomatics), (p 159) Palermo.
Language: English
Format: Other
Abstract:
EMDR’s basic working theory assumes that traumatic memories remain unprocessed because the innate information processing system is stuck by the psychophysiological effects of trauma. Traumatic events are stored in their original form, and the recall of traumatic memories causes a high level of disturbance.
Left-right rhythmic stimulations of EMDR seem to remove the block in the traumatic memories processing and help memories storing mechanism function at an adaptive level. In recent years, many scientific researches have focused on the opportunity to assess the functional connection between different brain areas through quantitative analysis of EEG.
According to the aim of this presentation, our attention was drawn to the correlation between slow bands (4- 7 Hz) and the activity in the sub-cortical areas involved in working memory and, also, high frequency ranges (> 36 Hz) and cortical activities during sensorial stimuli processing. There are a few quantitative EEG studies on patients with PTSD. The EEG analysis of subject with childhood abuse histories revealed less synchronization in the two hemispheres functioning compared to normal control subjects.
EEG quantitative analysis in abused children showed a higher intra-hemispheric left coherence and a lower intra-hemispheric right coherence in comparison with normal control subjects. According to these results, the aim of this presentation is to test if there are recordable changes in the intra and inter hemispheric synchronization between brain areas where information processing occurs (limbic system, prefrontal cortical area, and posterior cortical areas) in patients with PTSD after EMDR treatment.
Keywords: EEG Posttraumatic Stress Disorder PTSD
Accuracy Verified: Yes
9. Williams, K. (2006, August). A comparative experimental treatment outcome study: Female survivors of sexual assault suffering from posttraumatic stress disorder, depression, and trauma-related guilt – self-report and psychophysiological measures. Trinity Western University, Langley, British Columbia, CAN.
Language: English
Format: Dissertation/Thesis
Abstract:
Diverse psychotherapeutic approaches for treating trauma-related sequelae have emerged over the last several decades in response to the widespread prevalence of sexual assault and resultant posttraumatic stress disorder among women (PTSD). In a recent formal study (Grace, 2003), a newer treatment called one eye integration (OEI) has been shown to be effective for traumatized individuals. The purpose of this study was to build upon those findings by comparing the effectiveness of two treatments for reducing PTSD symptoms with a breathing, relaxation, autogenics, imagery, and grounding (BRAIN) control condition. Twenty-seven female rape or sexual assault survivors who met the criteria for PTSD according to the Diagnostic and Statistical Manual of Mental Disorders-Text-Revision, (DSM-IV-TR; APA, 2000) were randomly assigned to three groups: (a) a neurologically-based therapy called OEI, (b) an information processing model referred to as cognitive processing therapy-revised (CPT-R), or (c) a control condition (BRAIN), PTSD, depression, and trauma-related guilt symptoms were assessed pretreatment, posttreatment and at 3-month follow up, and qualitative electroencephalography (qEEG) brainwave patterns of two regions of the scalp (frontal and parietal) were measured pre and posttreatment. The following dependent measures were used: Clinician-Administered PTSD Scale (CAPS), Beck Depression Inventory II (BDI-II), and t he Trauma-Related Guilt Inventory (TRGI). Though there were no significant differences in PTSD symptoms between groups from pretreatment to post treatment assessments, a significant difference occurred between pretreatment and 3-month follow up, with OEI manifesting greater reductions than CPT-R or BRAIN. There were no significant differences between groups in depression, but there was a reduction in BDI-II scores over time. Reduction in guilt-related symptoms occurred on several scales and subscales for all three groups over time from pretreatment of posttreatment assessments, though not significantly by group. A significant difference was found for the Global Guilt subscale at 3-month follow up, with greater improvement for the OEI group. Preliminary results from cortical brain activity assessments indicate typical qEEG asymmetry patterns for PTSD and depression, though there were no significant group differences apart from minor post hoc analyses. Implications of these findings for clinical work and directions for future research were discussed.
Keywords: Depression Female Guilt Posttraumatic Stress Disorder PTSD Sexual Assault Survivors
Accuracy Verified: Yes
10. Pagani, M., Högberg, G., Fernandez, I., & Siracusano, A. (2013). Correlates of EMDR therapy in functional and structural neuroimaging: A critical summary of recent findings. Journal of EMDR Practice and Research, 7(1), 29-38. doi:10.1891/1933-3196.7.1.29.
Language: English
Format: Journal
Abstract:
Neuroimaging investigations of the effects of psychotherapies treating posttraumatic stress disorder
(PTSD), including eye movement desensitization and reprocessing (EMDR), have reported findings
consistent
with modifications in cerebral blood flow (CBF; single photon emission computed tomography
[SPECT]), in neuronal volume and density (magnetic resonance imaging [MRI]), and more recently in
brain electric signal (electroencephalography [EEG]). Additionally in the recent past, EMDR-
related neurobiological
changes were monitored by EEG during therapy itself and showed a shift of the maximal
activation from emotional limbic to cortical cognitive brain regions. This was the first time in which
neurobiological changes occurring during any psychotherapy session have been reported,
making
EMDR
the first psychotherapy with a proven neurobiological effect. The purpose of this article was to review the
results of functional and structural changes taking place at PTSD treatment and presented during the
period of 1999–2012 by various research groups. The reported pathophysiological changes are presented
by neuropsychological technique and implemented methodology
and critically analyzed.
Keywords: EEG Limbic System MRI Neurobiology SPECT
Accuracy Verified: Yes
11. Horacek, C. (2005, Winter). EMDR as a therapeutic tool. The Conejo Connection, 4(1), 2-4.
Language: English
Format: Newsletter
Abstract:
The main feature of EMDR is that by bilaterally
stimulating the brain trauma, phobias and other disturbing
experiences are “reprocessed” to move from one part of
the brain to the higher-thinking cortical structures of the
brain, and seem to lose their power to be disturbing. This
is the “eye movement” part. In EMDR, the therapist
moves their fingers back and forth in front of the client’s
face and the client watches by moving their eyes (not
turning their head) left right, left right. However, it has
since been discovered that any type of bilateral stimulation
works—auditory, tactile, even walking up and down,
as the body moves first the left leg and then the right.
Accuracy Verified: Yes
12. Sautai, G. (2011, June). EMDR intensive therapy (EMDRIT). Presentation at the annual meeting of the EMDR Europe Association, Vienna, Austria.
Language: English
Format: Conference
Abstract:
Therapeutic Process seems to be blocked for some patients with strong Developmental Disorders or exposed to Disturbing Early Life Experiences (Bessel A. van der Kolk). A specific approach during EMDR Intensive Therapy (EMDRIT) using the Case Conceptualisation (Andrew Leeds), based on the Adaptive Information Processing (AIP) model (Francine Shapiro), the Attachment Theory (John Bowlby) and the Useful and Necessary Renouncement Principe (Judith Viorst) allow those patients to progress.
As a pilot experience, we have been able to use this EMDRIT framework with 64 clients.
Their complex disorders included, for each of them, at least 3 of the following symptoms:
Anxiety, depression, primary structural dissociation, alcohol addiction, eating behaviour disorders, travel phobia, emotional numbing, affective isolation, hypochondria, phantom limb syndrome, fibromyalgia, cancer, psychological or physical abuse survivor, perpetrator of violent aggressions.
For the 25 first clients, we have used the PCL-S (pathology threshold > 44) test. Their pre-treatment average score was 70. It dropped to 28 after EMDRIT treatment, down to 26 after 3 months and stabilised at 29 after 1 year. These first results allowed us to define a target population and an adapted protocol that provides client safety, efficiency and result sustainability. For the 39 next clients, we measured a decrease of the SCL-90-R (pathology threshold > 1,5) test score from 3 before treatment down to 1,4 after treatment, 1,2 after 3 months and 1,3 after 1 year. We measure efficiency on 87% of the clients and a suppression of 80% of the symptoms after 1 year. At the same time, a control cohort of 20 people with identical pathologies saw their score drop from 3 to 2,3 with the same treatment time, using the standard EMDR protocol. From this preliminary result, we are developing some research hypothesis:
•Selection criteria for EMDRIT, based on the patient ability accessing Adaptive Memory Networks (AMN).
•The Targeting Sequence Plan, seen as an expression of the Dysfunctional Memory Networks (DMN).
•The importance of the client emotional Window Of Tolerance (WOT) for the efficiency of the Adaptive Information Processing system.
•Epigenetic show possible structural brain modifications by rehabilitation of fluid links across the 3 levels of the brain (reptilian, limbic and neo-cortical). These changes are immediate and permanent.
•Need to standardize appropriate scale for database, in order to foster international research and results sharing.
We sea AIP model as an opportunity to move from an analytic and sequential approach to a systemic and integrative approach based on Complex System for a global understanding.
Keywords: EMDR Intensive Therapy EMDRIT
Accuracy Verified: Yes
13. Saêta, L. B. (2012, Novembro). EMDR no tratamento da dor e das sensações fantasmas [EMDR in the treatment of pain and phantom sensations]. In EMDR e dor crônica. Apresentação no II Congresso Brasileiro de EMDR, Brasília, Brasil.
Language: Portuguese
Format: Conference
Abstract:
Sujeitos vítimas de amputação podem apresentar, imeditamente após a mesma, algum tipo de desconforto no membro ausente, descrito como formigamento, dormência, posição do membro, temperatura, latejamento, choque e apertamento que podem manifestar-se com a presença ou não de dor, tendo sua qualidade de vida reduzida. Observa-se que atualmente, as abordagens terapêuticas usadas no manejo da dor e das sensações fantasmas podem ser organizadas em três modalidades: medicamentosa, de apoio e cirúrgica, feitas em conjunto ou separadamente. Os tratamentos de apoio mais conhecidos incluem estimulação elétrica nervosa transcutânea, terapia vibratória, acupuntura, hipnose e biofeedback. A proposta desse estudo foi verificar a eficiência do EMDR na redução e/ou eliminação das sensações e da dor fantasmas aplicado a seis sujeitos com amputação de membro inferior, num período de um a três meses de duração (de 4 a 12 sessões de 60 a 90 minutos de duração), utilizando o protocolo EMDR padrão e o protocolo EMDR para a dor, e também exercícios corporais de respiração consciente, aliados, em casos de resistência dos sujeitos ao EMDR, à ativação da visão macular dos dois olhos e a exercícios rítmicos de espernear. Tais procedimentos proporcionaram uma melhor comunicação entre os hemisférios cerebrais, numa reorganização cortical que facilitou o aumento da consciência e aceitação da perda do membro amputado, sendo possível presenciar efeitos terapêuticos positivos e rápidos. Constatou-se que as sensações e as dores fantasmas diminuíram significativamente em três participantes e desapareceram por completo nos outros três, comprovando a eficácia e eficiência do EMDR no processo de inclusão e readaptação social em sujeitos vítimas de amputação.
Subjected victims of amputation may have, immediately after it, some kind of discomfort absent member, described as tingling, numbness, limb position, temperature, throbbing, clenching and shock that may occur with the presence or absence of pain, having a reduced quality of life. It is observed that currently, the therapeutic approaches used in the management of pain and phantom sensations can be organized into three types: medication, and surgical support, made jointly or separately. The most popular treatments include support transcutaneous electrical nerve stimulation, vibratory therapy, acupuncture, hypnosis and biofeedback. The purpose of this study was to examine the efficacy of EMDR in the reduction and / or elimination of phantom sensations and pain applied to six subjects with lower limb amputation in a period of one to three months duration (4 to 12 sessions of 60 to 90 minutes), using the standard EMDR protocol and the protocol EMDR for pain, and also body conscious breathing exercises, combined, in cases of resistance to the subject of EMDR, the activation of macular vision in both eyes and rhythmic exercises kicking . These procedures allow for a better communication between the cerebral hemispheres, cortical reorganization in which facilitated the increased awareness and acceptance of the loss of the amputated limb, and you can witness the positive therapeutic effects and fast. It was found that the sensations and phantom pain significantly decreased in three participants and disappeared completely in the other three, proving the efficiency and effectiveness of EMDR in the process of inclusion and social rehabilitation of victims subject to amputation.
Keywords: Amputation Phantom Pain Phantom Sensation
Accuracy Verified: Yes
14. Santarnecchi, E., & Bossini, L. (2011, June). EMDR research on special populations - Cortical and subcortical volumetric changes after EMDR treatment in PTSD. Presentation at the 12th European Conference on Traumatic Stress (ECOTS), Vienna, Austria.
Language: English
Format: Conference
Keywords: Cortical Volumetric Changes Research Subcortical Volumetric Changes Special Populations
Accuracy Verified: Yes
15. Bossini, L., Tavanti, M., & Costrogiovanni, P. (2008, June). EMDR treatment for PTSD: Effect on hippocampal volume. Presentation at the annual meeting of the EMDR Europe Association, London, England.
Language: English
Format: Conference
Abstract:
Animal and human subjects studies have shown that psychotropic drugs promote hippocampus neurogenesis
and block or modulate the effects of stress on the hippocampus. However, the only study that has investigated
the effects of psychotherapy on hippocampus volume failed to show any volumetric increase (1). Purpose of the
Study: Aim of the study is to assess the effects of Eye Movement Desensitization and Reprocessing (EMDR)
treatment on hippocampal volume and on PTSD symptoms in ten drug-free patients with Post Traumatic Stress
Disorder (PTSD). Methods Used: First, we have compared hippocampal volumes of 10 drug-free patients with
chronic PTSD to 10 case-matched non-PTSD comparison subjects. PTSD diagnosis and severity were established
by the administration the Clinician Administered Posttraumatic Stress Disorder Scale (CAPS) (Phase 1). Second,
we have assessed the effect of three months of EMDR treatment on hippocampal volumes and on PTSD
symptoms of 10 outpatients with PTSD (Phase 2). Results: Phase 1 -A p less than .05 was chosen to indicate
statistical significance. The results showed that patients had significantly smaller hippocampal volumes at
baseline compared to the control subjects. Phase 2 - EMDR treatment resulted in a significant increase of right
and left hippocampal volumes and in a significantly decrease of CAPS total score. Conclusions: The first part of
this study confirmed that PTSD patients have smaller hippocampal volumes if compared to comparison subjects.
The second part suggests that EMDR treatment is associated with a significant improvement of PTSD symptoms
and an increase in hippocampal volumes.
Keywords: Hippocampal Volume Posttraumatic Stress Disorder PTSD
Accuracy Verified: Yes
16. Jacobs, S., de Jong, A., & Strack, M. (2007). EMDR und biofeedback in der therapie posttraumatischer belastungsstörungen: Evaluation eines neuropsychotherapeutischen behandlungsprogramms [EMDR and biofeedback in the therapy of posttraumatic stress disorder: Evaluation of a neuropsychotherapeutic intervention]. VPP - Verhaltenstherapie & Psychosoziale Praxis, 39(4), 855-876.
Language: German
Format: Journal
Abstract:
Eine neu entwickelte multimodale, neuropsychotherapeutic Programm für die Behandlung der Posttraumatischen Belastungsstörung (PTBS) wurde ausgewertet. Ausgehend von neueren Erkenntnissen in der Forschung neuroscienctific, so dass eine Dissoziation zwischen impliziter und expliziter Trauma-Speicher die wichtigste Grundlage der PTBS ist, verschiedene Module wurden im Rahmen der Behandlung integriert anzuzeigen. Die vereinigten Komponenten sind: spezifische Hintergrundinformationen über die Unordnung und typische PTSD-Symptome, eine pädagogische Film für Patienten, spezifische kognitive Verhaltenstherapie und Biofeedback-Techniken unterstützte Eye Movement Desensitization and Reprocessing (EMDR). Das Ziel der Biofeedback-Sitzungen während EMDR ist es, den Patienten eine direkte Rückmeldung über die implizite Prozesse während der Trauma-Exposition. Darüber hinaus Erfassung der physiologischen Daten über Biofeedback ermöglicht das Testen, ob es eine Korrelation zwischen dem Grad der subjektiven Belastung durch traumatische Erinnerungen ausgelöst (quantifiziert mit der SUD-Skala), und messbare physiologische Erregung. Elektrodermale Aktivität (EDA; Hautleitfähigkeit) wurde als eine physiologische Parameter gemessen. Die Ergebnisse einer durchgeführten Pilot-Studie (16 Patienten auf der Grundlage, mit einem wartenden Gruppe als Kontrollgruppe) zeigen verschiedene EDA-Muster während EMDR-desensitivation (fad und assoziative Wiederaufbereitung). Ein offensichtlich Reduktion der PTBS-Symptome gefunden (d = 2,27) sein, die stärker ist als in anderen Behandlungen. Die traumatischen Erinnerungen mit EMDR behandelt wurde weniger Anstrengung, die ebenfalls reflektiert in der Physiologie (verminderte autonome Erregung) und in der subjektiven Belastung fühlte sich durch die Patienten. Die Kürzungen der Erregung (d = 1,01) und subjektive Belastung (d = 2,55) zeigen, dass eine effektive Hemmung der Aktivierung der Amygdala-und damit der Angstreaktion selbst-aufgrund der Intervention geschaffen. Mit EMDR reduziert die Amygdala physiologische Erregung. Wir vermuten, dass aus diesem Grund den medialen präfrontalen Kortex und im Hippocampus kann eine kortikale Inhibition, die erfolgreich reduziert die Angst-Reaktion (Grawe, 2004) zu etablieren. Die berichteten Ergebnisse wurden durch einen dreimonatigen Follow-up-Bewertung bestätigt. Mit einer durchschnittlichen Dauer von 16 Sitzungen und einer nicht vorhandenen Drop-out-Rate (0%), die Intervention erwiesen sich ebenfalls als sehr effizient. (PsycINFO Database Record (c) 2010 APA, alle Rechte vorbehalten)
A newly developed multimodal, neuropsychotherapeutic program for the treatment of posttraumatic stress disorder (PTSD) was evaluated. Starting from recent findings in the neuroscienctific research, which indicate that a dissociation between implicit and explicit trauma-memory is the main basis of PTSD, different modules were integrated within the treatment. The combined components are: specific background information regarding the disorder and typical PTSD-symptoms, an educational movie for patients, specific cognitive behavioral intervention techniques and biofeedback-supported Eye Movement Desensitization and Reprocessing (EMDR). The aim of using biofeedback during EMDR sessions is to give patients a direct feedback about the implicit processes during trauma-exposition. In addition, recording the physiological data via biofeedback allows testing if there is a correlation between the level of subjective strain, triggered by traumatic memories (quantified with the SUD-scale), and measurable physiological arousal. Electrodermal activity (EDA; skin conductance) was measured as a physiological parameter. The results of a conducted pilot-study (based on 16 patients, with a waiting group as a control group) show different EDA-patterns during EMDR-desensitivation (bland and associative reprocessing). An evident reduction of the PTSD-symptoms could be found (d = 2.27), which is stronger than in other treatments. The traumatic memories treated with EMDR became less straining, which reflects likewise in physiology (decreased autonomous arousal) and in the subjective strain felt by the patients. The reductions of arousal (d = 1.01) and subjective strain (d = 2.55) indicate that an effective inhibition of the amygdala activation—and thereby of the anxiety reaction itself—is created due to the intervention. Using EMDR reduces the amygdala induced physiological arousal. We suppose that for this reason the medial prefrontal cortex and the hippocampus can establish a cortical inhibition, which successfully reduces the anxiety reaction (Grawe, 2004). The reported results were confirmed by a three month follow-up evaluation. With an average duration of 16 sessions and a non-existing drop-out rate (0%), the intervention also proved to be very efficient. (PsycINFO Database Record (c) 2010 APA, all rights reserved)
Keywords: Biofeedback PTSD
Accuracy Verified: Yes
17. Hase, M. H. (2005, June). EMDR – Reprocessing of the addiction memory. Presentation at the annual meeting of the EMDR Europe Association, Brussels, Belgium.
Language: English
Format: Conference
Abstract:
Substance abuse is always a challenge for the therapist. Substance abuse
and its sequelae often mean intense suffering for the individual and huge
costs for society. Established treatment modalities, as good as they are, lack
effectiveness. Recent research in the field of neuroscience has shown that
most experience is automatically processed on sub cortical levels, i.e. by
"unconscious" interpretations that are made outside of conscious awareness.
Insight and understanding have only a limited influence on the operation of
these sub cortical processes. These findings are also applicable on addicted
people and help to create a new approach. The concept of an addiction
memory is helpful (Wolffgramm 2000: Wolffgramm 2002). It can be
understood as a form of maladaptive memory and EMDR is the tool for
resolution (Shapiro 2001). In this workshop an overview over theory and the practical aspects of EMDR treatment for substance abusers will be given.
Theory in combination with video demonstration will facilitate the transfer of
knowledge into everyday therapy.
Keywords: Addiction
Accuracy Verified: Yes
18. Lanius, U. (2005, April). EMDR, information processing and thalamo-cortical dialogue. Presentation at 3rd Annual Conference of the EMDR Association of UK and Ireland, Jordanstown, Northern Ireland .
Language: English
Format: Conference
Keywords: Information Processing Thalamo-Cortical Dialogue
Accuracy Verified: Yes
19. Stickgold, R. (2002, January). EMDR: A putative neurobiological mechanism of action. Journal of Clinical Psychology, 58(1), 61-75. doi:10.1002/jclp.1129.
Language: English
Format: Journal
Abstract:
Numerous studies have provided evidence for the efficacy of eye movement desensitization and reprocessing therapy (EMDR) in the treatment of PTSD, including recent studies showing it to be more efficient than therapist-directed flooding. But few theoretical explanations of how EMDR might work have been offered. Shapiro, in her original description of EMDR, proposed that its directed eye movements mimic the saccades of rapid eye movement sleep (REM), but provided no clear explanation of how such mimicry might lead to clinical improvment. We now revisit her original proposal and present a complete model for how EMDR could lead to specific improvement in PTSD and related conditions. We propose that the repetitive redirecting of attention in EMDR induces a neurobiological state, similar to that of REM sleep, which is optimally configured to support the cortical integration of traumatic memories into general semantic networks. We suggest that this integration can then lead to a reduction in the strength of hippocampally mediated episodic memories of the traumatic event as well as the memories' associated, amygdala-dependent, negative affect. Experimental data in support of this model are reviewed and possible tests of the model are suggested. [Author Abstract]
Keywords: Cognitive Processes Mechanism of Action Neurobiology Posttraumatic Stress Disorder Psychophysiology PTSD Review Sleep Behavior Treatment Effectiveness
Accuracy Verified: Yes
20. Christman, S., & Garvey, K. (2000, November). Episodic versus semantic memory: Eye movements and cortical activation. Poster presented at the 41st annual meeting of the Psychonomic Society, New Orleans, LA.
Language: English
Format: Conference
Keywords: Cortical Activation Epidosic Memory Eye Movements Poster Semantic Memory
Accuracy Verified: No
21. Doering, S., Bisping, V., Nora Liebergesell, N., Hoffkes, B., Junghofer, M., & Dobel, C. (2012). Erfassung neurobiologischer orrelate der EMDR-behandlung bei patienten mit zahnbehandlungsangst [Detection of neurobiological correlates of EMDR treatment in patients with dental anxiety]. Universitätsklinikum Münster, Kliniken, Psychosomatik und Psychotherapie, Forschung, Munster, Deutschland.
Language: German
Format: Other
Abstract:
Im Rahmen des zuvor dargestellten Projektes werden die Patienten vor und nach der EMDR-Intervention mit einer Magnetencephalografie (MEG) untersucht. Dabei soll erfasst werden, ob die erwarteten angstassoziierten kortikalen Aktivierungen nach der EMDR-Behandlung zurückgehen. Als Angst auslösende Stimuli werden im MEG Bilder, Geräusche und Gerüche dargeboten werden, die in Zusammenhang mit der Zahnbehandlung stehen.
As part of the [Wirksamkeit des Eye Movement Desensitization and Reprocessing (EMDR) bei Patienten mit Zahnbehandlungsphobie, (Doering, Bisping, Bohnke)] project a Magnetencephalografie (MEG) will be presented before the patients were examined before and after the EMDR intervention. It should be recognized that the expected angst associated cortical activations to go back to the EMDR treatment. As fear-inducing stimuli in the MEG images, sounds and smells will be presented, which are associated with dental treatment.
The purpose of this study is to find out whether Eye Movement Desensitization and Reprocessing (EMDR) is effective in the treatment of patients with dental phobia. This U.S. National Institues of Health Clinical trial has been completed. (U.S. National Institutes of Health ClinicalTrials.gov Identifier: NCT01207960)
Keywords: Dental Phobia
Accuracy Verified: Yes
22. Morris-Smith, J. (2012, June). Footsteps into the future: EMDR for children and families using a neurodevelopmental perspective [Pasos hacia el futuro: EMDR para niños y familias desde una perspectiva del neurodesarrollo]. Presentation at the annual meeting of the EMDR Europe Association, Madrid, Spain.
Language: English
Format: Conference
Abstract:
The
acquisition
of
clinical
skills
in
developing
successful
EMDR
therapeutic
practices
is
in
itself
a
journey
of
discovery.
Each
step
forward
brings
new
clinical
puzzles,
challenges
and
insights:
why
are
some
individuals
able
to
use
the
EMDR
therapy
more
smoothly
that
others;
what
is
the
role
of
attachment;
how
are
preverbal
memories
made
and
how
do
they
become
accessible
to
verbal
recall
with
EMDR
therapy;
what
is
the
developmental
role
of
dissociation
and
why
do
some
evolve
into
coherent,
integrated
individuals
whilst
others
develop
pathological
dissociation?
This
paper
presents
a
neurodevelopmental
approach
to
inform
our
clinical
practice
of
EMDR
therapy
with
children,
adolescents
and
adults.
Brain
development
is
affected
by
both
genetic
and
environmental
factors
and
included
in
the
latter
are:
the
family
milieu,
physical
illness,
toxins
and
developmental
opportunities.
During
development
the
brain
organizes
from
the
bottom
to
the
top
with
the
lower
parts
of
the
brain
developing
earliest.
The
majority
of
the
brain
organization
takes
place
during
the
first
4
years
of
life.
Development
of
the
brain
in
childhood
unfolds
in
a
series
of
stages
with
higher
cortical
areas
entering
final
developmental
processes
much
later
in
childhood
and
into
early
adulthood.
How
to
integrate
neurodevelopmental
aspects
with
our
EMDR
clinical
practice
to
develop
healthier
positive
future
trajectories
for
children,
adolescents
and
their
families
is
discussed.
This
paper
will
be
illustrated
by
the
use
of
video
clips
and
case
material.
La
propia
adquisición
de
las
habilidades
clínicas
para
desarrollar
prácticas
terapéuticas
de
EMDR
de
éxito
es
de
por
sí,
un
viaje
de
descubrimiento.
Cada
paso
hacia
delante
nos
plantea
nuevos
rompecabezas,
retos,
y
conocimientos
clínicos:
¿Por
qué
algunos
individuos
encuentran
menos
obstáculos
en
la
aplicación
de
terapia
con
EMDR
que
otros?;
¿Cuál
es
la
función
del
apego?;
¿Cómo
se
forman
los
recuerdos
preverbales
y
cómo
se
accede
a
ellos
mediante
el
recuerdo
verbal
con
la
terapia
con
EMDR?;
¿Qué
papel
desempeña
la
disociación
en
el
desarrollo
y
por
qué
algunas
personas
se
convierten
en
individuos
coherentes
e
integrados
mientras
que
otros
desarrollan
una
disociación
patológica?
Esta
ponencia
pretende
presentar
un
planteamiento
desde
el
neurodesarrollo
para
instruir
nuestra
práctica
clínica
de
terapia
con
EMDR
con
niños,
adolescentes
y
adultos.
El
desarrollo
cerebral
se
ve
afectado
por
factores
tanto
genéticos
como
ambientales;
entre
éstos
últimos
se
incluyen:
el
entorno
familiar,
las
enfermedades
físicas,
las
toxinas
y
las
oportunidades
de
desarrollo.
Durante
el
período
de
desarrollo,
el
cerebro
organiza
desde
abajo
hacia
arriba,
siendo
las
áreas
inferiores
del
cerebros
las
que
primero
se
desarrollan.
La
mayor
parte
del
desarrollo
cerebral
ocurre
durante
los
cuatro
primeros
años
de
vida.
El
desarrollo
del
cerebro
durante
la
infancia
sucede
en
una
serie
de
etapas,
entrando
las
áreas
corticales
superiores
en
los
últimos
procesos
de
desarrollo,
mucho
más
tarde
en
la
infancia
y
al
principio
de
la
vida
adulta.
Se
abordan
las
cuestiones
de
cómo
integrar
aspectos
de
neurodesarrollo
en
nuestro
trabajo
clínico
con
EMDR
para
poder
desarrollar
trayectorias
más
sanas
y
positivas
para
el
futuro
para
los
niños,
adolescentes
y
sus
familias.
Se
emplearán
grabaciones
en
vídeo
y
notas
clínicas
para
ilustrar
esta
ponencia.
Keywords: Children Families Neurodevelopment
Accuracy Verified: Yes
23. Pagani, M., Nardo, D., Höberg, G., & Larson, S. (2009, November). Gray matter changes in limbic cortex in PTSD are associated with trauma load and EMDR outcome. Presentation at the 25th annual meeting of the International Society for Traumatic Stress Studies, Atlanta, GA.
Language: English
Format: Conference
Abstract:
Psychophysiological Research
There is converging evidence of gray matter (GM) structural
alterations in different limbic structures in Post-Traumatic
Stress Disorder (PTSD) patients. The aim of this study was to
evaluate GM reduction in PTSD in relation to trauma load, and to
assess the volumetric differences between responders (R) and
non-responders (NR) to EMDR therapy. Magnetic Resonance
Imaging scans of 21 subjects exposed to occupational trauma,
who developed PTSD (S), and of 22 who did not (NS), were
compared by means of an optimized Voxel-Based Morphometry
(VBM) analysis as implemented in SPM. Within S, further
comparisons were made between 10 R and 5 NR. A regression
analysis between GM density and the Traumatic Antecedents Questionnaire (TAQ) was also performed on all 43 subjects.
Results showed a highly significant GM volume reduction in S
as compared to NS, bilaterally in posterior cingulate and in the
left hemisphere in precuneus, lingual and parahippocampal
gyri. Moreover, NR showed a highly significant GM volume
reduction as compared to R in bilateral posterior cingulate, as
well as insula, parahippocampal gyrus and amygdala in the
right hemisphere. Regression analysis showed that GM volume
reductions positively correlated with trauma load in bilateral
anterior and posterior cingulate and right parahippocampal
gyrus. In conclusion, GM volume reductions in posterior cingulate
and parahippocampal cortex were associated with PTSD
diagnosis, trauma load, and EMDR treatment outcome.
Keywords: Limbic Cortex Posttraumatic Stress Disorder PTSD Outcome Trauma Load
Accuracy Verified: Yes
24. O'Malley, A. (2008, June). The impact of neglect and trauma on the developing infant brain and the implications for EMDR therapy. Presentation at the annual meeting of the EMDR Europe Association, London, England .
Language: English
Format: Conference
Abstract:
This presentation starts with sensory development in pregnancy. By 22 weeks there is already a high level of
brain organisation with touch, taste, hearing and smell already well developed. Balance, vision and motor
development follow and the links to learning and states of consciousness are explained. The concept of birth as
our first traumatic experience is introduced and the implications for future EMDR therapy are discussed. Infant
brain development occurs sequentially implying vulnerabilities during the early years of life. This has a direct
relationship on attunement, which is influenced by developmental neglect and trauma. The effects of this trauma
for EMDR therapy are explored. New information about the probable mechanism of action of the bilateral
stimulation used in EMDR is presented. The mechanism of translating sensory input into new neuronal patterns is
explained. The hypothesis of a ‘window of tolerance’ in trauma is mentioned with the reasons why EMDR can help alleviate trauma by expanding the window of tolerance. The concept of a structural developmental model of
emotional awareness is explained with how this relates to trauma and a sense of self. The anatomical correlates
of emotional processing are suggested at both cortical and limbic system levels. Ways in which EMDR can be
modified in light of this knowledge are proposed. An additional model of applying EMDR is outlined. This involves
multilateral activation of sympathetic nervous systems to consciously overcome traumas. This process will be
shown to lead to brainstem stimulation activating the cranial nerves, which innervate the ocular muscles
generating rapid eye movement.
Keywords: Infantile Brain Development
Accuracy Verified: Yes
25. Flumeri, F., Salmaso, D., & Pagani, M. (2008, 26-28 Settembre). Impatto dell'EMDR sulle fuzioni e sulla neurobiologia cerebrali [Impact on EMDR and neurobiological brain functions]. In T. Farma (Chair), Simposio, Il modello psicotraumatologico: Un ponte tra indicatori neurobiologici e Psicoterapia. VII Congresso SPR Italia, Modena.
Language: Italian
Format: Conference
Abstract:
Introduzione:negli ultimi anni il numero di studi condotti nell’ambito dei disturbi causati da eventi traumatici ha subito una forte accelerazione rilevando l’esistenza di alterazioni fisiologiche e morfologiche in specifiche aree cerebrali associate sia alla risposta emotiva al trauma che alla insorgenza dei sintomi della sindrome da stress post-traumatico (PTSD).
L’impiego delle tecniche di neuroimmagine ha consentito di fare luce sui correlati neurali della psicoterapia, rivelando i suoi effetti neurobiologici sulla funzione cerebrale. Nell’ambito dei diversi approcci psicoterapeutici, l’EMDR (Eye Movement Desensitization and Reprocessing therapy) è emerso come promettente risorsa per il trattamento del trauma e di altri disturbi d’ansia, sebbene ancora non sia stata completamente chiarita la sua modalità di azione sui circuiti neurali. Molte ricerche sono state effettuate per valutare l’efficacia dell’EMDR, ma solo un numero esiguo di esse ha indagato il substrato neurobiologico di questa psicoterapia.
Le metodiche di neuroimmagini utilizzate finora per studi sull’EMDR sono la Single Photon Emission Computed Tomography (SPECT) e la Magnetic Resonance Imaging (MRI). La prima raccoglie dati sull’attivita’ cellulare cerebrale mentre la seconda riporta dati anatomici strutturali.
Gli studi funzionali condotti con SPECT consentono di identificare le variazioni del metabolismo e del flusso ematico cerebrale, suggerendo un ruolo specifico per ciascuna area cerebrale coinvolta nel complesso meccanismo che sottende il processamento delle emozioni; la MRI consente invece di rilevare la presenza di variazioni morfologiche e volumetriche di specifiche strutture cerebrali. Negli ultimi anni, studi SPECT e MRI, volti ad esaminare gli effetti dell’EMDR sulla fisiopatologia cerebrale in pazienti affetti da disturbi d’ansia, hanno riscontrato sostanziali variazioni del flusso ematico ed alterazioni strutturali di alcune regioni cerebrali in seguito a terapia.
L’efficacia dell’EMDR nel trattamento del PTSD è stata confermata da uno studio SPECT su sei soggetti ( Lansing et al.) (1) che ha evidenziato dopo terapia una diminuzione del flusso ematico nel lobo occipitale bilateralmente e nel lobo parietale sinistro e un aumento di flusso nel giro frontale inferiore sinistro. Sempre utilizzando la SPECT Oh e Choi (2) hanno riportato una significativa modificazione del flusso cerebrale in seguito ad EMDR, prevalentemente riscontrabile nell’area limbica e nella corteccia prefrontale. Un recente studio con utilizzo di MRI (3) ha inoltre messo in evidenza un aumento di volume dell’ippocampo in seguito a trattamento con EMDR, aumento invece non riportato in un lavoro di Lindauer et al. su 9 soggetti con PTSD, nonostante il successo clinico della psicoterapia eclettica eseguita (4).
Obiettivi: il nostro gruppo ha studiato gli effetti a breve e lungo termine dell’EMDR (5, 6) dimostrando la sua efficacia nel trattamento di soggetti traumatizzati sul lavoro, e una stabilità del miglioramento clinico ottenuto in risposta alla terapia, ancora presente a distanza di tre anni. Nell’ambito dello stesso progetto sono state anche studiate le variazioni del flusso ematico cerebrale e della volumetria di alcune strutture cerebrali in relazione alla terapia con EMDR. Un primo studio SPECT ha analizzato la variazione della distribuzione di flusso in 11 soggetti guariti clinicamente da PTSD in seguito a EMDR messi a confronto con 5 soggetti nei quali la terapia non ha avuto effetto (7). Risultati: è stato evidenziato nei soggetti con remissione sintomatologica significative differenze di flusso in 4 aree corticali, alla disfunzione delle quali sono ascrivibili alcuni sintomi presenti in corso di PTSD. Diminuzioni di flusso post-terapia sono state registrate nell’ippocampo, nella corteccia parieto-occipitale e nella corteccia visiva primaria. L’ippocampo e’ sede della memoria a breve termine; la corteccia parieto-occipitale processa il riconoscimento di volti, dei corpi e delle parole; la corteccia visiva primaria custodisce la memoria visiva degli eventi. La mancata inibizione e/o l’iperattivita’ di queste regioni nel PTSD sono responsabili della rivisitazione patologica dell’evento traumatico e della presenza di flashback ed immagini allucinatorie. Inoltre la corteccia frontale dorsolaterale ha dimostrato un aumento di flusso nei soggetti che hanno risposto positivamente alla terapia. Questa regione chiave oltre ad essere deputata ad inibire la risposta patologica a stimoli che ricordano l’evento traumatico e’ essenziale per i processi di attenzione e di autostima, diminuiti in corso di PTSD e recuperati in seguito alla remissione della malattia. In ulteriori studi che combinano indagini funzionali e strutturali utilizzando SPECT e MRI abbiamo messo in evidenza il valore predittivo delle dimensioni dell’ippocampo riguardo all’efficacia della terapia con EMDR (Pagani et al. sottomesso).
Conclusioni: gli effetti della terapia con EMDR sono risultati, unitamente ad un consistente miglioramento della sintomatologia e ad una riduzione della iperreattività a stimoli di carattere emotivo, in una normalizzazione funzionale di alcune aree specifiche e in un aumento del volume ippocampale probabilmente ascrivibile a neo-neurogenesi. Questi risultati sono in linea con la pregressa letteratura e con le attuali conoscenze sul PTSD e suggeriscono basi neurobiologiche dell’effetto terapeutico dell’EMDR confermandone l’impatto funzionale su strutture cerebrali coinvolte in patologie ansiogene.
Bibliografia:
1. Lansing et al. (2005). J Neuropsych Clin Neurosci;17(4):526-532.
2. Ho DH and Choi J. (2007). J EMDR Pract Res;1(1):24-30.
3. Bossini et al. (2007). J Neuropsych Clin Neurosci; 19(4):475-476.
4. Lindauer et al. (2005). Psychol Med ; 35 :1-11.
5. Hogberg et al. (2007). Nord J Psych; 61(1):54-61.
6. Hogberg et al. (2008). Psych Res; doi:10.1016/j.psychres.2007.10.019.
7. Pagani et al. (2007). Nuc Med Comm; 28(10):757-65. [Pagani abstract]
Introduction In recent years the number of studies in disorders caused by traumatic events has been greatly accelerated by detecting the existence of morphological and physiological changes in specific brain areas associated with both the emotional response to trauma to the onset of symptoms Post-traumatic stress syndrome (PTSD).
The use of neuroimaging techniques has allowed to shed light on the neural correlates of psychotherapy, revealing the neurobiological effects on brain function. Under the different psychotherapeutic approaches, EMDR (eye movement desensitization and reprocessing therapy) has emerged as a promising resource for the treatment of trauma and other anxiety disorders, although still not been fully elucidated its mode of action on neural circuits. Many studies have been carried out to assess the effectiveness EMDR, but only a small number of them have investigated the neurobiological substrate of this psychotherapy.
The methods used so far for neuroimaging studies on EMDR are Single Photon Emission Computed Tomography (SPECT) and Magnetic Resonance Imaging (MRI). The first collects data on 'brain cells while the second contains structural anatomical data.
The functional studies performed with SPECT to identify changes in metabolism and cerebral blood flow, suggesting a specific role for each brain area involved in the complex mechanism underlying the processing of emotions, instead of MRI allows detection of morphological changes and volume of specific brain structures. In recent years, MRI and SPECT studies, aimed to examine the effects of EMDR on brain pathophysiology in patients with anxiety disorders, have found substantial variations in blood flow and structural alterations of some brain regions after treatment.
The effectiveness of EMDR in the treatment of PTSD was confirmed by a SPECT study in six subjects (Lansing et al.) (1) showed that after treatment reduced blood flow in the occipital lobe bilaterally and in left parietal lobe and a increase of flow in left inferior frontal gyrus. Always using SPECT Oh and Choi (2) reported a significant change of cerebral blood flow after EMDR, mainly found in limbic and prefrontal cortex. A recent study using MRI (3) has also highlighted an increase in volume of the hippocampus after treatment with EMDR, but no increase in reported work of Lindauer et al. on 9 subjects with PTSD, despite the clinical success of eclectic psychotherapy performed (4).
Objectives: Our group has studied the effects of short and long term EMDR (5, 6) demonstrating its effectiveness in treating traumatized individuals at work, and stability of clinical improvement obtained in response to therapy, yet this distance three years. Within the same project were also studied changes in cerebral blood flow and volume of certain brain structures in relation to treatment with EMDR. A first SPECT study analyzed the change in flow distribution in 11 subjects clinically recovered from PTSD after EMDR compared with 5 subjects in whom treatment had no effect (7). Results: It was shown in patients with symptomatic remission, significant differences in flow in 4 cortical areas, which are attributable to dysfunction of some symptoms of PTSD being present. Flow decreases post-treatment were recorded in the hippocampus, cortex parietal-occipital and primary visual cortex. The hippocampus and 'seat of short-term memory, the parietal-occipital cortex processes the recognition of faces, bodies and words, the primary visual cortex preserves the visual memory of events. The lack of inhibition and / or 'hyperactivity' of PTSD in these regions are responsible for the pathological review of the traumatic event and the presence of flashbacks and hallucinatory images. Moreover, the dorsolateral frontal cortex showed an increase in flow in subjects who responded positively to therapy. This key region in addition to being appointed to inhibit the pathological response to stimuli that recall the traumatic event and 'essential for the processes of attention and self-esteem, decreased in the course of PTSD and recovered following the remission of the disease. In further studies that combine functional and structural investigations using SPECT and MRI have shown the predictive value of the size of the hippocampus on the effectiveness of EMDR therapy (Pagani et al. Submitted).
Conclusion: the effects of EMDR therapy were coupled with a significant improvement in symptoms and a reduction of hyperreactivity to stimuli, emotional, functional in a normalization of some specific areas and an increase in hippocampal volume probably due to neo- neurogenesis. These results are consistent with previous literature and with current knowledge about PTSD and suggest a neurobiological basis of therapeutic EMDR confirming the functional impact on brain structures involved in anxiety-disorders.
Bibliography:
1. Lansing et al. (2005). J Neuropsych Clin Neurosci, 17 (4) :526-532.
2. I DH and J. Choi (2007). J EMDR pract Res, 1 (1) :24-30.
3. Bossini et al. (2007). J Neuropsych Clin Neurosci, 19 (4) :475-476.
4. Lindauer et al. (2005). Psychol Med, 35 :1-11.
5. Högberg et al. (2007). Nord J Psych, 61 (1) :54-61.
6. Högberg et al. (2008). Psych Res, doi: 10.1016/j.psychres.2007.10.019.
7. Pagani et al. (2007). NUC Med Comm, 28 (10) :757-65. [Pagani abstract]
Keywords: Brain Functions Neurobiology
Accuracy Verified: Yes
26. Garvey, K. J. (2004). Increased interhemispheric interaction leads to decreased false memories for prose: The effects of degree of handedness and of eye movement-induced cortical activation. University of Toledo, Toledo, OH. AAT 3141037.
Language: English
Format: Dissertation/Thesis
Abstract:
Two experiments examining the effects of mixed handedness (which is associated with increased interhemispheric interaction) and horizontal saccadic eye movements (which are associated with increased bihemispheric cortical activation) on the recognition of prose are reported. In study one mixed handedness was associated with greater accuracy in both rejecting new material and recognizing old material. In study two eye movements resulted in relative improvement of episodic memory. This improvement is hypothesized to reflect increased interaction between the left and right cerebral hemispheres, which is associated with superior episodic memory. Implications for possible neuropsychological mechanisms underlying eye movement desensitization and reprocessing (EMDR), a therapeutic techniquDissertation Abstracts International: Section B: The Sciences and Engineering. 65(7-B), 2005, pp. 3738.e for PTSD, are discussed. [Author Abstract]
Keywords: Cognitive Processes Empirical Study Eye Movements False Memory Handedness Interhemispheric Interaction Neurobiology Quantitative Study Posttraumatic Stress Disorder Prose PTSD
Accuracy Verified: Yes
27. Amendolia, R. D. (1998). A narrative constructivist perspective of treatment of posttraumatic stress disorders with Ericksonian hypnosis and eye movement desensitization and reprocessing. Trauma Response, 13-14.
Language: English
Format: Magazine
Abstract:
In a trauma survivor, physiological responses are exacerbated when the affect-laden memories stored in associative networks are triggered by environmental sensory inputs or cues and activate the autonomic nervous system. Recovery from trauma involves not only amelioration of physiological and dissociative symptoms, but also the cognitive rebuilding of a viable assumptive world view which integrates the realms of vulnerability, meaning and self-esteem. This world view is contextualized in cultural idioms and values.
From an Ericksonian perspective, persons are usually attempting to problem-solve, even in a dissociative date. A symptom such as an intrusive recollection or recurrent dream of a traumatic event is therefore construed as a request for help in problem-solving. Hypnosis is a structured dissociation which facilitates cognitive flexibility; that is, the broadening of choices of the client' s belief system, rather than direct work on changing affect or behaviors. The goal of Ericksonian hypnosis is to recontextualize the traumatic memory, the affect of fear, and the physiological hyperarousal cued by the traumatic memory. This occurs within a broader context of pride, mastery and courage, and within a context inclusive of other memories and affects, which are positive for the client.
Eye Movement Desensitization and Reprocessing (EMDR), similarly has as its goal the facilitation of a transfer of traumatic data from the cortical right hemisphere to the left hemisphere. EMDR also utilizes the attainment of a state of heightened awareness, or collaborative structured dissociation, in order to facilitate the orientation of the traumatized client's conscious mind toward "revisiting" traumatic memories.
Both interventions can facilitate the self-narrative reconstruction process of trauma survivors by simultaneously modulating the person's hyperarousal while attending to the culturally significant metaphors which form the building blocks of a person' s world of meanings.
[AAETS]
Keywords: Eriksonian Hypnosis Narrative Constructionist
Accuracy Verified: Yes
28. Bossini, L., Fagiolini, A., & Castrogiovanni, P. (2007, November). Neuroanatomical changes after eye movement desensitization and reprocessing (EMDR) treatment in posttraumatic stress disorder. Journal of Neuropsychiatry and Clinical Neuroscience, 19(4), 475-476. doi:10.1176/appi.neuropsych.19.4.475.
Language: English
Format: Journal
Abstract:
Several authors have found smaller
hippocampal volumes in patients
with PTSD and some have suggested
that psychotropic drugs may
promote hippocampus neurogenesis
and reverse the decrease in hippocampus
volume.1 However, the
only study that has investigated the
effects of psychotherapy on hippocampus
volume failed to show a
volumetric increase after effective
psychotherapy. The authors evaluated the hippocampus volumetric changes after successful EMDR treatment of a 27-year-old man with a chronic PTSD related to the suicide of his mother. After 8 weeks of EMDR treatment the patient had an increase in both left and right hippocampus volumes.[Adapted from Text] [Pilots]
Keywords: Adults Brain Imaging Brain Volume Brain Size Case Report Clinical Case Study Death of Parent Death by Suicide Effectiveness Evaluation Hippocamal Volume Hippocampus Letter Males Neuroanatomy Posttraumatic Stress Disorder Psychotherapy PTSD Survivors Treatment Treatment Effectiveness Treatment Outcome/Clinical Trial
Accuracy Verified: Yes
29. Pagani, M., Flumeri, F., Salmaso, D., Nardo, D., Sanchez-Crespo, A., Danielsson, A. M., Brolin, F., Jacobsson, H., Larsson, S. A., & Hogberg, G. (2008, October). Neurobiological changes in post traumatic stress disorder following treatment with eye movement desensitisation reprocessing. Presentation at the European Association of Nuclear Medicine Congress, Munich, Germany, European Journal of Nuclear Medical and Molecular Imaging, 35(Supp 2).
Language: English
Format: Conference
Abstract:
Background: Only few studies have reported functional or structural modifications in Post Traumatic Stress Disorder (PTSD) patients following pharmacological treatment or psychotherapy. Eye movement desensitization and reprocessing (EMDR) is a novel eclectic psychotherapy utilising, among other techniques, relaxation and safe place exercises, cognitive restructuring, future projections, and imaginal exposure of the trauma combined with sensory stimulation. The aim of the study was to analyse the differences in regional cerebral blood flow (rCBF) distribution and in brain volumetry before and after EMDR therapy.
Subjects and Methods: Fifteen subjects with chronic PTSD following occupational health hazards were treated with five sessions of EMDR. They were assessed with psychometric scales and diagnostic interviews before and directly after treatment. SPECT, during administration of an individualised trauma script, was performed using 99mTc-HMPAO. After EMDR, the subjects were subdivided into responders (R, n=10) and non-responders (NS, n=5), based on the absence or presence, respectively, of full PTSD diagnosis. SPECT and volumetric data (MRI) analyses were carried out by Statistical Parametric Mapping (SPM2). SPECT and MRI data were covaried by age and by time elapsed from trauma to SPECT. SPECT data were further covaried by the amount of grey matter normalised by the total intracranial volume.
Results: Immediate significant post-treatment changes towards normality in all scales measuring psychological status were found in responders. As compared to NR, R showed a significantly decreased tracer uptake in parieto-occipital (Brodmann Area, BA, 37, fusiform gyrus) and in primary visual cortex (BA17) and in the hippocampus (p<0.001). The opposite comparison highlighted an increased tracer uptake in left frontal cortex (BA 44; p<0.05). Structural grey matter modifications were found in visual, posterior cingulate and parieto-temporal cortex, paralleling the functional changes.
Conclusion: The positive EMDR outcome corresponded to increased 99mTc-HMPAO uptake in the left dorsolateral frontal cortex, processing attention and self confidence and exerting an inhibitory effect on the amygdala whose firing is supposed to be responsible for PTSD. After successful treatment significant decreases were found in primary visual cortex, processing images of traumatic memories and flashbacks; in fusiform gyrus, processing the memories of faces, bodies and words and in the hippocampi, involved in episodic and autobiographical memories. Volumetric changes paralleled the ones in tracer uptake in all regions Taken as a whole these findings suggest that the positive clinical outcome following EMDR therapy causes functional and structural neurobiological changes towards normality.
Keywords: Brain Volumetry Neurobiological Changes Posttraumtic Stress Disorder PTSD rCBF Regional Cerebral Blood Flow
Accuracy Verified: Yes
30. Pagani, M. et al (2012, June). Neurobiological correlates of EMDR monitoring - An EEG study [Correlatos neurobiológicos y monitorización EMDR – un estudio con EEG]. Presentation at the annual meeting of the EMDR Europe Association, Madrid, Spain.
Language: English
Format: Conference
Abstract:
Background:
Eye
Movement
Desensitization
and
Reprocessing
(EMDR)
is
a
recognized
first-‐line
treatment
for
psychological
trauma.
However
its
neurobiological
bases
have
not
been
disclosed
yet.
Methods:
Electroencephalography
was
used
for
the
first
time
to
fully
monitor
neuronal
activation
during
whole
EMDR
sessions
including
the
autobiographical
script.
Ten
clients
with
major
psychological
trauma
were
investigated
during
the
first
EMDR
session
and
during
the
last
one
performed
after
processing
the
index
trauma.
Comparisons
between
the
EEG
of
the
first
and
last
EMDR
session
and
between
the
EEG
of
the
clients
at
the
first
session
and
those
of
10
controls
undergoing
the
same
EMDR
procedure
were
performed.
Results:
During
both
script
listening
and
bilateral
stimulation
EEG
showed
significantly
higher
activity
in
the
prefrontal
limbic
cortex
(Brodmann
Areas,
BA
9-‐
10)
at
the
first
as
compared
to
the
last
EMDR
session.
The
opposite
comparison
showed
a
shift
of
the
prevalent
activity
towards
temporal,
parietal
and
occipital
cortical
regions
(BAs
20,
21,
22,
37,
17,
18,
19)
with
leftward
lateralization.
The
comparison
between
the
10
clients
and
the
10
controls
confirmed
the
maximal
activation
in
the
limbic
cortex
in
the
clients
before
processing
the
trauma.
Conclusions:
The
implemented
methodology
made
possible
to
image
for
the
first
time
the
specific
activations
associated
with
the
therapeutic
actions
contemplated
by
EMDR.
The
findings
suggested
cognitive
processing
of
traumatic
events
following
successful
EMDR
therapy
supporting
the
evidence
of
distinct
neurobiological
patterns
of
brain
activations
during
bilateral
ocular
stimulation
associated
with
a
significant
relieve
from
negative
emotional
experiences.
Antecedente
Teórico:
La
desensibilización
y
reprocesamiento
por
el
movimiento
ocular
(EMDR)
es
una
reconocida
primera
línea
para
el
tratamiento
del
trauma
psicológico.
Sin
embargo
sus
bases
neurobiológicas
no
han
sido
descifradas
todavía.
Método:
La
electroencefalografía
ha
sido
usada
por
primera
vez
para
monitorizar
completamente
la
activación
neuronal
durante
sesiones
enteras
de
EMDR
incluyendo
el
guión
autobiográfico.
10
Clientes
con
traumas
psicológicos
mayores
fueron
investigados
durante
la
primera
sesión
de
EMDR
y
durante
la
última
después
del
procesamiento
del
trauma
raíz.
Las
comparaciones
entre
los
EEG
de
la
última
y
primera
sesión
y
las
de
EEG
de
los
clientes
en
la
primera
sesión
y
10
controles
realizando
el
mismo
procedimiento
de
EMDR
fueron
realizadas.
Resultados:
Durante
ambos
procesos,
la
escucha
y
la
estimulación
bilateral,
el
EEG
mostró
una
actividad
significativamente
mayor
en
el
córtex
límbico
prefontral
(Brodmann
Areas,
BA
9-‐10)
al
principio
comparadas
con
la
última
sesión
de
EMDR.
La
comparación
opuesta
muestra
un
cambio
en
la
actividad
fundamental
entre
las
regiones
corticales
temporal,
parietal
y
occipital
(BAs
20,
21,
22,
37,
17,
18,
19)
con
lateralizaciones
hacia
la
izquierda.
La
comparación
entre
los
10
clientes
y
los
controles
confirman
la
activación
máxima
de
la
corteza
límbica
en
los
clientes
antes
de
procesar
el
trauma.
Conclusiones:
La
metodología
usada
hizo
posible
visualizar
la
neuroimagen
por
primera
vez
de
las
activaciones
cerebrales
asociadas
con
las
acciones
terapéuticas
que
acontecen
en
el
EMDR.
Los
hallazgos
sugieren
que
el
procesamiento
cognitivo
de
los
eventos
traumáticos
seguidos
de
una
terapia
EMDR
exitosa
apoyan
la
evidencia
de
un
patrón
neurobiológico
diferenciado
en
las
activaciones
del
cerebro
durante
la
estimulación
ocular
bilateral
asociados
con
una
acumulación
un
experiencias
emocionales
negativas.
Keywords: EEG Study
Accuracy Verified: Yes
31. Paulsen, S., & Lanius, U. (2011, November). Neurobiology and dissocation: Information processing and the embodied self. Presentation at the 28th annual meeting of the International Society for the Study of Trauma and Dissociation, Montreal, Quebec.
Language: English
Format: Conference
Abstract:
Neuroscience research can guide trauma treatment including EMDR, ego state, somatic, and attachment therapies (Lanius, Paulsen & Corrigan, in press). Traumatic memories tend to be encoded somatically and affectively in implicit memory. Lower brain structures, particularly basic affective circuits and the periaqueductal gray (PAG) (Panksepp, 1998), are essential to understanding of both traumatic memory and and dissociation. The polyvagal nervous system (Porges, 2001) is key to understanding the activation of different affective circuits, including the interplay between social engagement and connection, fight/flight and dissociation. A model is proposed that links alterations in consciousness to failure of integration and ultimately to structural dissociation (van der Hart et al., 2006). It is suggested that attachment trauma contributes to the failure of horizontal integration of the columnar organization of affective states, which, over time, become the foundation of discontinuous self-states: Discontinuity of self-states, amnesia barriers and dissociative state switching develop in lieu of smooth state transitions. Somatic interventions can enable sensory integration and personification (Janet, 1929), prior to trauma processing with EMDR that engages brain processing inter-hemispherically and across cortical and subcortical levels. The workshop will highlight implications of recent neurobiological findings for clinical practice.
Learning Objectives:
Articulate the role of the periaqueductal gray (PAG) in the expression and experience of emotion.
Identify two brain structures implicated in integrating affective and sensory information.
Name three branches of the polyvagal nervous systems described by Porges.
Keywords: Dissociation Embodies Self Information Processing Neurobiology
Accuracy Verified: Yes
32. Bergmann, U. (2008). The neurobiology of EMDR: Exploring the thalamus and neural integration. Journal of EMDR Practice and Research, 2(4), 300-314. doi:10.1891/1933-3196.2.4.300.
Language: English
Format: Journal
Abstract:
Recent neuroimaging studies on posttraumatic stress disorder (PTSD) have revealed a consistent decrease
in thalamic activity, relative to non-PTSD controls. Empirical studies of the past decade have
shown the thalamus to be centrally involved in the integration of perceptual, somatosensory, memorial,
and cognitive processes (thalamo-cortical-temporal binding). A theoretical model is proposed to suggest
that one underlying mechanism of EMDR stimulation (dual-attention stimulation/bilateral stimulation
[DAS/BLS] ) is thalamic activation, specifi cally of the ventrolateral and central-lateral nuclei. It is hypothesized
that this may facilitate the repair and integration of somatosensory, memorial, cognitive, frontal
lobe and synchronized hemispheric functions that are disrupted in PTSD.
Keywords: 40-Hz Gamma-Band Activity (GBA) Neural Oscillation Thalamo-Cortical-Temporal Binding Thalamus
Accuracy Verified: Yes
33. Bergmann, U. (2008, June). The neurobiology of EMDR: Recent findings and insights. Presentation at the annual meeting of the EMDR Europe Association, London, England.
Language: English
Format: Conference
Abstract:
Prior presentations focused on EMDR’s ability to activate REM-sleep systems and to mediate frontal lobe
activation. New research on the Thalamus and thalamo-cortical-temporal-binding and Somato-sensory
integration will be introduced. Accordingly, new speculations will be offered regarding EMDR’s ability to
reset/repair the impairment in thalamic functioning that is inherent in PTSD. This presentation will, also,
introduce more recent research, contrasting thalamic impairment in Type 1 PTSD vs. Complex PTSD. In addition,
new findings regarding the formation, content and storage of memory and its impairment, in PTSD, will be
explored vis-à-vis EMDR's ability to make repairs, in this area.
Keywords: Neurobiology
Accuracy Verified: Yes
34. Bergmann, U. (2010, September/October). The neurobiology of information processing: Recent findings and insights. Presentation at the annual meeting of EMDR International Association, Minneapolis, MN.
Language: English
Format: Conference
Abstract:
This presentation will synthesize the existing neurobiological research on information- processing. Specific attention will be given to recent empirical findings, involving the hippocampus and thalamus in perceptual, memorial, emotional, cognitive, and somatosensory integration. This data will be reviewed in reference to the organizing constructs of the Parallel Distributed Processing/Connectionism and the Thalamo-Cortical-Temporal-Binding models of information processing. Given that EMDR's application has historically been guided by information processing theory, this presentation will illustrate the neurobiological underpinnings of this foundation.
Keywords: Information Processing Neurobiology
Accuracy Verified: Yes
35. Armstrong, M., & Vaughan, K. (1996, March). An orienting response model of eye movement desensitization. Journal of Behavior Therapy and Experimental Psychiatry, 27(1), 21-32. doi:10.1016/0005-791(95)00056-9.
Language: English
Format: Journal
Abstract:
Dyck's conditioning model of EMD provides a useful description of failure of habituation in PTSD, but may not account for some common EMD phenomena. An alternative model proposes that the therapist's waving hand -- in the presence of a trauma-related cortical set -- triggers an intense orienting response (OR). Intrinsic effects of the OR facilitate continuing attention to the memory without avoidance, and provide for effective input of new trauma-related information. The person's neuronal model of the trauma alters to reflect his survival and current safety -- as true outcome of the trauma -- and associated conditioned responses extinguish. Proposals for experimental evaluation of the model are described. [Author Summary]
Keywords: Conditioned Emotional Responses PTSD Treatment Effectiveness
Accuracy Verified: Yes
36. Vaughan, K., & Armstrong, M. (1995, June). An orienting response model to EMDR. Presentation at the EMDR Network Conference, Santa Monica, CA.
Language: English
Format: Conference
Abstract:
The authors reviewed the literature of EMDR and consulted their own clinical experiences to establish the characteristic
phenomenology of EMDR. Dyck's (1993) conditioning model of eye movement desensitization provides a useful account of failure
and habituation in post-traumatic stress disorder (PTSD), but does not account for some of these common EMDR phenomena. The
authors propose an alternative model in which the therapist's waving hand-- in the presence of a trauma-related cortical set-triggers
an intense orienting response (OR). Intrinsic effects of the OR facilitate continuing attention to the memory without avoidance, and
provide for effective input of new trauma-related information. The person's neuronal model of the trauma alters to reflect their
survival and current safety -- as true outcome of the trauma - and associated conditioned responses extinguish. Some proposals for
experimental evaluation of the model are described.
Keywords: Orienting Response
Accuracy Verified: Yes
37. Pagani, M., Di Lorenzo, G., Verardo, A. R., Nicolais, G., Lauretti, G., Russo, R., Cogolo, P., Niolu, C., Ammaniti, M., Siracusano, A., & Fernandez, I. (2012, January). P-1162 Pre- intra- and post-treatment EEG imaging of EMDR - neurobiological bases of treatment efficacy. European Psychiatry, 27(Supplement 1), 1-1. doi:10.1016/S0924-9338(12)75329-4.
Language: English
Format: Journal
Abstract:
Aim: Eye Movement Desensitization and Reprocessing (EMDR) is a recognized first-line treatment for psychological trauma. However its neurobiological bases have not been disclosed yet. Methods: Electroencephalography was used for the first time to fully monitor neuronal activation during whole EMDR sessions including the autobiographical script. Nine clients with major psychological trauma were investigated during the first EMDR session and during the last one performed after processing the index trauma. Comparisons between the EEG of the first and last EMDR session and between the EEG of the clients at the first session and those of 9 controls undergoing the same EMDR procedure were performed. Results: During both script listening and bilateral stimulation EEG showed significantly higher activity in the prefrontal limbic cortex (Brodmann Areas, BA 9–10) at the first as compared to the last EMDR session. The opposite comparison showed a shift of the prevalent activity towards temporal, parietal and occipital cortical regions (BAs 20, 21, 22, 37, 17, 18, 19) with leftward lateralisation. The comparison between the 9 clients and the 9 controls confirmed the maximal activation in the limbic cortex in the clients before processing the trauma. Conclusions: The implemented methodology made possible to image for the first time the specific activations associated with the therapeutic actions contemplated by EMDR. The findings suggest cognitive processing of traumatic events following successful EMDR therapy supporting the evidence of distinct neurobiological patterns of brain activations during bilateral ocular stimulation associated with a significant relieve from negative emotional experiences.
Keywords: EEG Imaging Neurobiology
Accuracy Verified: Yes
38. Pagani, M., Nardo, D., Flumeri, F., Salmaso, D., Looi, J., Sanchez-Crespo, A., Larsson, S.A., Sundin, Ö., Hogberg, G., & Bejerot, S. (2009, January). P03-58 Volumetric changes in PTSD and in a subgroup of PTSD patients not responding to EMDR psychotherapy. European Psychiatry, 24(Supplement 1), S1057-S1057. doi:10.1016/S0924-9338(09)71290-8.
Language: English
Format: Journal
Abstract:
Background: Several studies have reported limbic structures volume decrease in Post-Traumatic Stress Disorder (PTSD). However, in PTSD the effect of therapy on brain structures has seldom been investigated. The aim of the study was to evaluate the grey matter (GM) loss in occupational related PTSD and to assess the volumetric differences between patients responding (R) and non-responding (NR) to psychotherapy.
Methods: Pre-EMDR MRI data of 21 train drives who did develop PTSD (S) and 22 who did not develop PTSD (NS) after person-under-the-train accidents were compared. Within S further comparisons were made between 10 R to Eye Movement Desensitisation Reprocessing (EMDR) therapy and 5 NR. Data were analysed by optimised voxel-based morphometry as implemented in Statistical Parametric Mapping.
Results: As compared to NS, S showed a significant GM volume reduction in precuneus, lingual gyrus, posterior cingulate and parahippocampal cortex. The R>NR comparison highlighted a significant GM reduction in NR in bilateral posterior cingulate, left middle frontal cortex and right parahippocampal, insular and temporal cortices.
Conclusions: Comparing two large groups of subjects significant GM volumetric reductions were found in PTSD in posterior limbic structures. NR showed, as compared to R, volume reduction in cortical structures including posterior cingulate and parahippocampal cortex. These latter two structures seem to be the hallmark for both PTSD diagnosis and therapy outcome prediction.
Keywords: Posttraumatic Stress Disorder PTSD
Accuracy Verified: Yes
39. Gibson, R. (2000, september). Post traumatic stress disorder and the thalamic/cortical pause. ETC: A Review of General Semantics, 57(3), 354-361.
Language: English
Format: Journal
Abstract:
Recent research supports use of "cortical/thalamic pause" treatment modality including EMDR. [Adapted from Text] [Pilots]
Keywords: Cognitive Therapy Neurophysiology Posttraumatic Stress Disorder PTSD
Accuracy Verified: Yes
40. Pagani, M. (2012, March). Pre-, intra-, and post-treatment EEG imaging of EMDR – Neurobiological bases of treatment efficacy. Poster presentation at the Scientific Programme of the 20th European Congress of Psychiatry, Prague, Czech Republic.
Language: English
Format: Conference
Abstract:
Conclusions: The implemented methodology made possible for the first time to image and represent on the cortical surface the specific brain activations associated with the therapeutic actions contemplated by EMDR protocol. These findings suggest the cognitivization of traumatic events following successful EMDR therapy with the maximal neuronal firing shifting from prefrontal-limbic to parieto-occipital associative cortex. Our results also support the evidence of distinct neurobiological patterns of brain activations during bilateral ocular stimulation.
Keywords: EEG Imaging Efficacy Neurobiology Poster
Accuracy Verified: Yes
41. Pagani, M., Di Lorenzo, G., Monaco, L., Niolu, C., Siracusano, A., Verardo, A. R., Lauretti, G., Fernandez, I., Nicolais, G., Cogolo, P., & Ammaniti, M. (2011). Pretreatment, intratreatment, and posttreatment EEG imaging of EMDR: Methodology and preliminary results from a single case. Journal of EMDR Practice and Research, 5(2), 42-56. doi:10.1891/1933-3196.5.2.42.
Language: English
Format: Journal
Abstract:
Electroencephalography (EEG), due to its peculiar time and spatial resolution, was used for the first time to fully monitor neuronal activation during the whole eye movement desensitization and reprocessing (EMDR) session, including the autobiographical script. The present case report describes the dominant cortical activations (Z-score >1.5) during the first EMDR session and in the last session after the client processed the index trauma. During the first EMDR session, prefrontal limbic cortex was essentially activated during script listening and during lateral eye movements in the desensitization phase of EMDR. In the last EMDR session, the prevalent electrical activity was recorded in temporal, parietal, and occipital cortical regions, with a clear leftward lateralization. These findings suggest a cognitive processing of the traumatic event following successful EMDR therapy and support evidence of distinct neurobiological patterns of brain activations during lateral eye movements in the desensitization phase of EMDR.
Keywords: Bilateral Ocular Stimulation Cortical Activation EEG
Accuracy Verified: Yes
42. McFarlane, A. (2010, June). PTSD as an information processing disorder. Keynote presented at the annual meeting of the EMDR Europe Association, Hamburg, Germany.
Language: English
Format: Conference
Abstract:
Posttraumatic stress disorder is a challenging condition, as people become captured by their past experiences and have difficulty engaging with the present. At the core of this condition is the role of traumatic memories, which orientate the individual's awareness and reactivity to reminders of the instigating traumatic event. The role of traumatic events has not been fully understood and grappled with in the full range of psychopathological conditions. This has important implications for the application of EMDR as a treatment for disorders above and beyond posttraumatic stress disorder.
However, the problems with information processing in PTSD go above and beyond the fear circuitry and reactivity to traumatic memories. Individuals with PTSD also have major difficulties with their self-orientation, which is reflected in deficits in default networks, the idling systems of the brain. These changes are indicative of problems in self-registration and free-floating reflection. Dissociative symptoms may relate to these abnormalities of individuals resting states as they reflect a sense of disconnection and integration of internal states into consciousness.
Secondly, posttraumatic stress disorder is associated with major problems in dealing with neutral environmental information. This is reflected in the symptoms of difficulty with concentration and emotional numbing. The underlying neurobiology of the working memory abnormalities in posttraumatic stress disorder will be highlighted. These studies show that, in PTSD, relatively simple attentional tasks recruit neural networks normally reserved for more demanding and higher order tasks. When confronted with more demanding challenges, individuals with PTSD do not have any further capacity to allocate to processing complex environments.
Individuals with PTSD also demonstrate a problem with switching their attentional focus from an idling to active state. The data suggests that they continue to use visio-spatial networks more than language-based systems for dealing with verbal tasks. This observation is in keeping with a broad body of literature, which suggests that there are problems with the processing of verbal memory tasks in PTSD. EMDR, as a treatment, may have an advantage, as it is not so dependent on verbal representations of traumatic experiences as other treatment approaches.
Finally, an important development in the field is a better understanding of the patterns of abnormal cortical arousal that accompany the peripheral arousal abnormalities in PTSD. Quantitative EEG has given insights into the instability of the cortical neural networks. Neurotherapy represents a treatment that can further assist clinicians in the management of these patients. It is important to consider the underlying psychosomatic aspects of posttraumatic stress disorder and ensure that treatment addresses these components as well the traumatic memories. Treatment should be thought of as a staged process where the processing of traumatic memories is only one component of a disorder that impacts on a range of information processing domains.
Keywords: Information Processing Keynote Posttraumatic Stress Disorder PTSD
Accuracy Verified: Yes
43. Lanius, U. F. (2005, September). PTSD, Information processing and thalamo-cortrical dialogue. Presentation at the annual meeting of the EMDR International Association, Seattle, WA.
Language: English
Format: Conference
Abstract:
The presentation integrates recent findings in neuroscience and the
neurobiology of traumatic stress and proposes a theoretical model to account
for EMDR treatment effects. It reviews relevant basic neuroscience studies
and theories with regard to learning, memory and information processing.
Participants will increase the understanding of possible underlying
neurobiological processes with regard to both PTSD and EMDR treatment
and be able to integrate Shapiro's Adaptive Information Processing Model
with current theory and research in the field of neuroscience.
Keywords: Information Processing Posttraumatic Stress Disorder PTSD Thalamo-Cortical Dialogue
Accuracy Verified: Yes
44. Pagani, M., Nardo, D., Flumeri, F., Salmaso. D., Looi, J., Sanchez-Crespo, A., Larsson, S. A., Sundin, Ö., Hogberg, G., Bejerot, S. (2009, January). PW04-01 Volumetric changes in PTSD and in a subgroup of PTSD patients not responding to EMDR psychotherapy. European Psychiatry, 24(Supplement 1), S355. doi:10.1016/S0924-9338(09)70588-7.
Language: English
Format: Journal
Abstract:
(1)Background:
Several studies have reported limbic structures volume decrease in Post-Traumatic Stress Disorder (PTSD). However, in PTSD the effect of therapy on brain structures has seldom been investigated. The aim of the study was to evaluate the grey matter (GM) loss in occupational related PTSD and to assess the volumetric differences between patients responding (R) and non-responding (NR) to psychotherapy.
(2)Methods:
Pre-EMDR MRI data of 21 train drives who did develop PTSD (S) and 22 who did not develop PTSD (NS) after person-under-the-train accidents were compared. Within S further comparisons were made between 10 R to Eye Movement Desensitisation Reprocessing (EMDR) therapy and 5 NR. Data were analysed by optimised voxel-based morphometry as implemented in Statistical Parametric Mapping.
(3)Results:
As compared to NS, S showed a significant GM volume reduction in precuneus, lingual gyrus, posterior cingulate and parahippocampal cortex. The R>NR comparison highlighted a significant GM reduction in NR in bilateral posterior cingulate, left middle frontal cortex and right parahippocampal, insular and temporal cortices.
(4)Conclusions:
Comparing two large groups of subjects significant GM volumetric reductions were found in PTSD in posterior limbic structures. NR showed, as compared to R, volume reduction in cortical structures including posterior cingulate and parahippocampal cortex. These latter two structures seem to be the hallmark for both PTSD diagnosis and therapy outcome prediction.
Keywords: Posttraumatic Stress Disorder PSTD
Accuracy Verified: Yes
45. Giovannozzi, G. (2012, June). Regulated eye contact activation and installation protocol [Regulación de la activación del contacto ocular y protocolo de instalación]. Presentation at the annual meeting of the EMDR Europe Association, Madrid, Spain.
Language: English
Format: Conference
Abstract:
Porges’
polyvagal
theory
provides
a
plausible
explanation
for
the
covariation
between
psychiatric
and
behavioral
disorders
and
the
atypical
regulation
of
the
Autonomic
Nervous
System
(ANS).
Porges
himself
associated
this
phenomenon
with
the
failed
maturation
of
the
ventrovagal
circuit,
as
well
as
with
the
child’s
failure
to
learn
the
ability
to
modulate
the
so-‐called
“vagal
break”
which
keeps
the
heart-‐rate
low
and
inhibits
the
influence
of
the
SNS,
allowing
the
modulation
of
the
facial
and
head
muscles
and,
therefore,
the
social
engagement
function,
often
impaired
in
psychiatric
pathologies.
From
a
psychotherapy
standpoint,
Porges’
finding
that
the
maturation
of
the
ventrovagal
circuit
and
of
its
associated
braking
function
occurs
ontogenetically
later
than
that
of
other
ANS
branches
(last
months
of
pregnancy
and
first
year
of
life)
and
that
a
good
relation
with
the
caregiver
is
essential
for
its
development
is
of
significant
importance.
In
this
dyad
–
with
the
cortical-‐bulbar
pathway,
sufficiently
myelinated
at
birth,
regulating
face
and
head
muscles
and
allowing
signals
exchange
with
the
caregiver
–
children
learn
to
confront
their
internal
states
and
the
environment
as
well
as
regulate
their
emotions,
regulating
an
adaptive
neuroception
with
the
consequent
possibility
of
a
good
social
involvement.
This
focus
on
the
first
year
of
life
and
the
caregiver
–
child
dyad,
in
terms
of
time
and
place
for
the
construction
of
biologically
based
behaviors
common
to
all
human
beings,
paves
the
way,
as
anticipated
by
Porges
himself,
for
new
possible
intervention
models
in
psychotherapy
directly
acting
on
the
missed
or
impaired
steps
in
this
first
phase
of
the
psycho-‐physiological
development
process,
without
disregarding
its
psychobiological
quality.
Clinical
Application
Since
I
believe
that
the
inter-‐brain
perspective
is
the
most
efficient
not
only
for
the
etiological
explanation
but
especially
for
the
restoration
of
relational
impairments
occurred
during
brain-‐brain
interactions,
I
chose
eye
contact
(EC),
because,
according
to
several
scholars,
it
is
a
privileged
communication
channel,
in
particular
between
mother
and
child.
Several
scholars
agree
that
all
forms
of
psychopathology
share
a
failure
in
emotional
regulation,
which
can
be
mostly
traced
back
to
the
failure
in
the
child-‐
caregiver
adaptive
tuning
and
therefore
to
the
impairment
of
their
inter-‐brain
communication.
An
intervention
on
the
EC
shifts
the
therapy
focus
on
this
dysregulation
to
restore
its
functions.
The
EMDR
AIP
approach
relies
on
the
brain
adaptive
processing
ability.
EMDR
has
proved,
in
appropriate
conditions
(good
therapeutic
alliance,
client
stabilization,
compliance
with
the
EMDR
protocol),
our
brain
can
repair
traumatic
injuries,
i.e.,
reacquire
and
use
information
dysfunctionally
stored
after
a
trauma.
Successful
use
of
EMDR
on
target
not
directly
traceable
to
a
traumatic
event
(e.g.,
defenses,
chronic
pain,
etc.)
allows
for
the
possibility
to
use
this
processing
tool
in
increasingly
broad
fields
and
refines
its
resources.
Thanks
to
its
three-‐pronged
approach
to
dysfunctionally
stored
information
in
the
brain
(EMDR
works
on
the
cognitive,
emotional
and
somatic
level),
the
inter-‐brain
quality
of
its
scope
(the
therapeutic
alliance
is
part
of
the
healing
process)
and
for
its
focus
on
the
present
(EMDR
works
on
the
present,
i.e.,
on
the
current
and
active
components
of
the
pathogenetic
memory,
bypassing
all
mediations
and
interpretation),
EMDR
seemed
the
most
appropriate
therapeutic
tool
to
intervene
on
the
EC
dysregulation
found
in
several
psychiatric
pathologies.
Conclusion
An
EMDR
protocol
for
the
exploration
and
modulation
of
the
EC
is
proposed.
This
protocol
proved
particularly
useful
with
depressed
or
severely
dissociative
clients.
After
making
clients
aware
of
their
difficulty
in
maintaining
the
EC,
they
are
retrained
to
use
this
contact
first
on
objects,
then
on
animals
(excellent
mediators
of
a
primitive
form
of
social
contact)
until
they
are
able
to
achieve
eye
contact
with
the
therapist.
During
this
training,
clients
are
encouraged
to
become
aware
of
their
body
sensations,
emotions
and
beliefs,
and
the
positive
ones
are
installed
with
BLS.
Memories
of
relational
situations
where
clients
identify
an
impaired
EC
are
identified
and
these
are
targeted
with
the
standard
protocol.
The
focus
then
shifts
to
present
and
future
situations.
The
regulation
purpose
of
this
protocol
affects
the
application
mode:
interventions
must
never
be
dysregulating,
therapists
must
proceed
slowly.
Clients
must
be
rigorously
kept
within
their
window
of
tolerance,
must
be
trained
to
recognize
it
and
able
of
staying
within
its
boundaries
with
respect
to
the
microregulation
of
the
EC.
La
teoría
polivagal
de
Porges
proporciona
una
explicación
plausible
para
la
covariación
entre
los
trastornos
psiquiátricos
comportamentales
y
la
regulación
atípica
del
sistema
nervioso
autónomo
(ANS).
El
propio
Porgues
asoció
este
fenómeno
con
el
fallo
de
maduración
del
circuito
ventrovagal,
por
tanto
el
niño
falla
al
aprender
una
habilidad
también
llamada
“bloqueo
vagal”,
que
mantiene
la
tasa
cardiaca
baja
e
inhibe
la
influencia
del
SNS,
permitiendo
la
modulación
de
los
músculos
faciales
y
la
cabeza,
y
por
tanto,
la
función
optima
del
compromiso
social,
a
menudo
emparejada
con
patologías
psiquíatricas.
Partiendo
desde
un
punto
de
vista
psicoterapéutico,
Porges
encontró
que
la
maduración
del
circuito
ventrovagal
y
su
asociación
con
la
función
de
frenado
ocurre
ontogenéticamente
después
que
otras
ramas
del
sistema
nervioso
autónomo
(Los
últimos
meses
del
embarazo
y
los
primeros
años
de
vida)
y
que
una
buena
relación
con
el
cuidador
es
esencial
para
su
desarrollo
es
significativamente
importante.
En
esta
línea
–
con
vía
córtico-‐bulbar,
lo
suficientemente
mielinizada
en
el
nacimiento,
regulando
los
músculos
de
la
cara
y
la
cabeza
y
permitiendo
señales
de
intercambio
con
el
cuidador-‐
Los
niños
aprenden
a
estar
cómodos
con
sus
estados
internos
y
con
un
ambiente
que
también
regula
sus
emociones,
regular
una
neurorecepción
con
la
consecuente
posibilidad
de
una
buena
integración
social.
Centrándonos
en
el
primer
año
de
vida
del
niño
y
el
cuidador
–
La
pareja
de
niños,
en
términos
de
tiempo
y
lugar
para
la
construcción
biológica
fundamentada
y
basada
en
todos
los
seres
humanos,
allana
el
camino,
como
anticipó
Porges,
para
nuevos
modelos
de
intervención
en
psicoterapia,
actuando
directamente
con
el
paso
perdido
o
afectado
de
esta
primera
fase
del
proceso
de
desarrollo
psicofisiológico,
sin
tener
en
cuenta
su
calidad
psicobiológica.
Aplicación
Clínica.
Desde
que
creó
que
la
perspectiva
del
cerebro
interior,
continúa
siendo
la
más
eficiente
no
solo
para
desarrollar
explicaciones
etiológicas,
también
para
la
restauración
de
los
desajustes
relacionados
ocurridos
durante
las
interacciones
cerebro-‐cerebro.
Escogí
contacto
visual
(ECE),
porque,
de
acuerdo
con
numerosos
investigadores,
es
un
privilegiado
canal
de
comunicación,
particularmente
eficaz
entre
una
madre
y
su
hijo.
Numerosos
profesionales
afirman
que
todas
las
formas
de
psicopatología
comparten
una
fallo
en
la
regulación
emocional,
que
solo
puede
crear
un
error
en
el
la
comunicación
interna
del
cerebro.
Esta
intervención
en
el
EC
modifica
la
terapia
y
la
centra
en
la
desregulación
y
la
restauración
de
funciones.
El
enfoque
EMDR
SPIA
está
basado
en
la
habilidad
de
procesamiento
de
la
información
relevante,
EMDR
ha
sido
probado
en
condiciones
idóneas
(buena
alianza
terapéutica,
estabilización
de
la
queja
del
cliente
disgustado
con
el
EMDR.).
Keywords: Installation Protocol Regulated Eye Contact Activation
Accuracy Verified: Yes
46. Morton, B. E., & Paulsen, S. L. (1993). Stress disorders: Cortical plasticity, eye saccades, and multiple personalities. Paper presented at the University of Hawaii School of Medicine and Pacific Institute for Behavioral Medicine. Honolulu, HI.
Language: English
Format: Other
Abstract:
Origin and Nature of Stress Disorders:
The Defense Response occurs as part of the switch from fearful flight (Ego) to cornered, fearless fight (Id) whereby the individual attempts to obtain freedom from restraint through the violence of defensive attack. The activation of the hypothalamic-pituitary-adrenal (HPA) axis is part of this response. Stress Disorders are pathological states resulting in inappropriate, repeated activation of the Defense Response. They appear to be produced from a maladaptive cortical plasticity that occurred whenever the Defense Response failed to protect the organism from trauma.
Keywords: Cortical Plasticity Defense Response Eye Saccades HPA Hypothalamic-Pituitary-Adrenal Multiple Personalities Stress Disorders
Accuracy Verified: Yes
47. Pagani, M. (2008, Novembre). Sub-strato neurobiologico della sindrome da stress post-traumatico e relativo impatto funzionale e strutturale della terapia con EMDR [Neurobiological substrate of post-traumatic stress syndrome and impact on functional and structural therapy with EMDR]. Presentazione le Applicazioni Cliniche del EMDR Congresso Nazionale, Milano, Italia.
Language: Italian
Format: Conference
Abstract:
Recenti studi hanno dimostrato come la sindrome da stress post-traumatico (PTSD) possa causare nel cervello cambiamenti sia strutturali che funzionali. Studi di imaging funzionale tramite tomografia ad emissione di fotone singolo (SPECT) e ad emissione di positrone (PET) hanno evidenziato significative variazioni del flusso cerebrale in pazienti con PTSD durante la rivisitazione del trauma. A questo proposito sono stati riportati aumenti e diminuzioni di flusso nell’ippocampo, nell’amigdala, nella corteccia prefrontale mediale, nel cingolo anteriore e posteriore e nella corteccia temporale. Il modello prevalente collega i sintomi del PTSD ad una mancata inibizione dell’ amigdala, iperattivata dalla sensazione di incombente minaccia, da parte della corteccia prefrontale. E’ stato anche proposto che i cambiamenti strutturali dell’ippocampo e del cingolo anteriore rivelati dalla risonanza magnetica strutturale (RM) siano causati dalla risposta neuronale allo stress. L’obiettivo delle nostre ricerche e’ stato quello di analizzare la risposta funzionale e le variazioni strutturali in due gruppi di soggetti esposti a trauma occupazionale che hanno sviluppato (S=sintomatici, n=20) o no (NS=non sintomatici, n=27) il PTSD. Una parte dei S (n=16) è stata trattata con EMDR. La diagnosi di PTSD prima e dopo la terapia è stata basata sia sui criteri del DSM-IV sia su vari test neuropsicologici mirati. La SPECT (n=47) e la RM (n=33) sono state eseguite da 3 mesi a sei anni dal trauma e la prima è stata ripetuta dopo EMDR. I sintomi sono stati provocati da uno script individualizzato che ha riportato alla memoria il trauma e durante il quale è stato iniettato il tracciante di flusso cerebrale.
Le analisi eseguite hanno mostrato differenze significative tra S e NS nella risposta del flusso cerebrale allo script. Nei 33 soggetti in cui sono state eseguite sia la SPECT che la RM sono state trovate differenze significative sia funzionali che strutturali nella corteccia temporo-parietale sinistra e nell’ippocampo, regioni nelle quali gli score dei test neuropsicologici correlano significativamente con il flusso cerebrale. Nei soggetti con remissione sintomatologica dopo EMDR (R; n=11) sono state trovate rispetto ai soggetti che non hanno risposto alla terapia (NR; n=5) significative differenze di flusso in 4 aree corticali che processano funzioni deteriorate in corso di PTSD. Diminuzioni di flusso dopo la terapia sono state registrate nei R rispetto ai NR nell’ippocampo, nel giro fusiforme (corteccia parieto-occipitale) e nella corteccia visiva primaria. L’ippocampo è sede della memoria episodica ed autobiografica; il giro fusiforme processa il riconoscimento di volti, dei corpi e delle parole; la corteccia visiva primaria custodisce la memoria visiva degli eventi. La mancata inibizione e/o l’iperattività di queste regioni nel PTSD sono responsabili della rivisitazione patologica figurata e somatica dell’evento traumatico e della presenza di flashback ed immagini allucinatorie. Viceversa la corteccia frontale dorsolaterale ha mostrato un aumento di flusso nei R. Questa regione oltre ad essere deputata ad inibire nel sistema limbico la risposta patologica a stimoli che ricordano l’evento traumatico è essenziale per i processi di attenzione e del “senso di sé”, diminuiti in corso di PTSD e recuperati in seguito alla remissione della malattia. In questi soggetti la RM ha inoltre messo in evidenza il valore predittivo delle dimensioni dell’ippocampo rispetto all’efficacia della terapia con EMDR.
I nostri risultati confermano il coinvolgimento della corteccia temporo-parieto-occipitale nel PTSD e sottolineano il valore delle neuroimmagini sia nello svelare gli effetti neurobiologici dell’EMDR che determinare il valore delle indagini strutturali nel predirne l’efficacia.
Recent studies have shown that the post-traumatic stress syndrome (PTSD) may result in both structural and functional brain changes. Imaging studies using functional Single photon emission tomography (SPECT) and positron emission tomography (PET) shown significant changes in cerebral blood flow in patients with PTSD during revisiting the trauma. In this regard have been reported increases and decreases in flow hippocampus, amygdala, medial prefrontal cortex, the anterior cingulate and posterior and temporal cortex. The dominant model linking the symptoms of PTSD to a no inhibition of 'amygdala hyperactivity disorder by the sense of impending threat by the prefrontal cortex. E 'was also proposed that the structural changes of the hippocampus and
anterior cingulate revealed by structural magnetic resonance imaging (MRI) are caused by the response neuronal stress. The aim of our research and 'was to analyze the response
functional and structural variations in two groups of subjects exposed to occupational trauma that have developed (S = symptomatic, n = 20) or not (NS = non-symptomatic, n = 27) PTSD. Part of S (n = 16) was treated with EMDR. The diagnosis of PTSD before and after the therapy was based on both DSM-IV has on several neuropsychological tests targeting. SPECT (n = 47) and MRI (n = 33) are were performed from 3 months to six years from the trauma and the first was repeated after EMDR. Symptoms were caused by a script individual who reported to the memory of the trauma and during which were injected with a tracer of cerebral blood flow. The analysis performed showed significant differences between S and NS in the response of flow brain to the script. In the 33 subjects in which they were performed both SPECT and MRI were found significant differences in both functional and structural temporo-parietal cortex left hippocampus, regions in which the scores of neuropsychological tests correlate significantly with the flow in the brain. In subjects with symptomatic remission after EMDR (R; n = 11) were found compared with subjects who did not respond to therapy (NR, n = 5) significant differences in flow in 4 cortical areas that process functions deteriorated in the course of PTSD. Decreases in flow after treatment were recorded in R than NR hippocampus, within fusiform (parieto-occipital cortex) and in the primary visual cortex. The hippocampus is the seat of episodic memory and autobiographical, and the processes around the fusiform recognition of faces, bodies and words, the primary visual cortex preserves the memory visual events. The non-inhibition and / or 'hyperactivity of these regions in PTSD are
responsible for pathological figured revisiting the traumatic event and physical and presence of flashbacks and hallucinatory images. Contrast, the dorsolateral frontal cortex has showed an increase of flow in R. This region in addition to being deputies to inhibit the system limbic response to pathological stimuli that recall the traumatic event is essential for processes of attention and the "sense of self, decreased in the course of PTSD and recovered following remission. In these subjects, MRI has also highlighted the predictive value the size of the hippocampus compared the efficacy of EMDR therapy. Our results confirm the involvement of the temporo-parietal-occipital cortex in PTSD and emphasize the value of neuroimaging in revealing both the neurobiological effects of EMDR that determine the value of the structural surveys in predicting effectiveness.
Keywords: Neurobiology Posttraumatic Stress Disorder PTSD
Accuracy Verified: Yes
48. Pagani, M., Lorenzo, Gd., Verardo, A., Nicolais, G., Monaco, L., Niolu, C., Fernandez, I., & Siracusano, A. (2012, March-April). Substrato neurobiologico della terapia con EMDR [Neurobiological correlates of EMDR therapy]. Rivista di Psichiatria, 47(Supplement 1), 16S-18S. doi:10.1708/1071.11734.
Language: Italian
Format: Journal
Abstract:
I EEG in un gruppo di dieci soggetti con grave trauma psicologico trattati con EMDR e in dieci controlli sono stati registrati sia durante l'ascolto del racconto autobiografico del trauma indice (script) e nel corso di una intera sessione EMDR. Gli EEG sono stati eseguiti nuovamente durante l'ultima sessione di EMDR quando i pazienti erano liberi da sintomi. Durante l'ascolto uno script di attivazione prevalente delle regioni limbiche corrispondenti alla corteccia prefrontale e orbitofrontale è stato registrato, essere spiegato come l'eccitazione emotiva durante trauma rivivere nella fase sintomatica. La diminuzione significativa di tali attivazioni durante la fase tardiva asintomatica rappresenta il correlato neurobiologico del recupero. Inoltre, l'evidenza di una significativa attivazione corticale nelle aree temporo-parieto-occipitale, durante l'ultima sessione, suggerisce uno switch del segnale elettrico dominante verso aree corticali con funzione prevalente cognitiva.
The EEGs in a group of ten subjects with major psychological trauma treated with EMDR and in ten controls have been registered both during the listening of the autobiographical narrative of the index trauma (script) and during a whole EMDR session. The EEGs have been performed again during the last EMDR session when patients were free of symptoms. During script listening a prevalent activation of the limbic regions corresponding to prefrontal and orbitofrontal cortex has been registered, being explained as the emotional arousal during trauma reliving at the symptomatic phase. The significant decrease of such activations during the late asymptomatic phase represents the neurobiological correlate of recovery. Moreover, the evidence of significant cortical activation in the parietal-temporo-occipital areas, during the last session, suggests a switch of the dominant electrical signal towards cortical areas with a prevalent cognitive function.
Keywords: Neurobiology
Accuracy Verified: Yes
49. Pagani, M., Nardo, D., Flumeri, F., Salmaso, D., Looi, J., Sanchez-Crespo, A., Larsson, S. A., Sundin, Ö., & Hogberg, G. (2009, January). Volumetric changes in PTSD and in a subgroup of PTSD patients not responding to EMDR psychotherapy. Poster presented at the 17th European Congress of Psychiatry, Lisbon Portugal.
Language: English
Format: Conference
Keywords: Poster Posttraumatic Stress Disorder PTSD
Accuracy Verified: Yes


