Francine Shapiro Library ~ EMDR Bibliography

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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. Pagani, M. (2010, June). Introduction to neuroimaging in EMDR research. Presentation at the annual meeting of the EMDR Europe Association, Hamburg, Germany.

Language: English

Format: Conference

Abstract:
In the recent years the number of neuroimaging studies evaluating neural correlates of psychotherapy has steadily increased revealing its clear neurobiological effects on brain function across a wide range of psychiatric disorders. Functional studies by single photon emission computed tomography (SPECT) and positron emission tomography (PET) detect changes in cerebral blood flow and metabolism patterns, identifying the brain areas processing the various components of emotional processing and/or affected by the disorders. investigations by magnetic resonance imaging (MRI) have also revealed psychiatry disease-related structural changes. The first part of the workshop (20 minutes) will describe the neuroimaging methodologies implemented in EMDR research and their possible clinical implementations will be discussed. In the second part (10 minutes) neuroimaging studies on the neurobiological effect of EMDR will be reviewed (1-5). The third part of the workshop (30 minutes) will deal with the last findings in EMDR research and will focus on a recent studies published by our group on the Journal of Psychiatry Research about the predictive value of MRI on the outcome of EMDR therapy (6).Moreover a collaborator of our group will describe and present the preliminary findings of an ongoing experiment aiming to identify the neurophysiological mechanisms active during EMDR therapy. The description and the discussion about the contents of the workshop will provide the audience 1 the necessary information to understand the methodological principles behind the neuroimaging techniques (PET and SPECT) and their possible applications in research and clinic; 2, the critical knowledge of the limited number of published papers in the field of EMDR-related functional and anatomical studies (1-6); 3. the basic research principles and examples to be motivated to begin, take part and/or collaborate to EMDR research in order to shed light on the neural basis of this fascinating psychotherapeutic technique. The presented material will represent the state-of-the-art of the current neuroscience EMDR-related research and of the neuroimaging methodologies available at the moment. in case more contributions will be included in this workshop the proposed presentation time schedule might change. References: Lansing et al. (2005). J Neuropsych Clin Neurosci; l7(4):526-532. Propper et al. (2007). J Nerv Met Dis; 195:785-788. Ho DH and Choi J. (2007). J EMDR Pract Res; l(l):24-30. Pagani et al. (2007). Nuc Med Comm: 28(10):757-65. Bossini et al (2007). J Neuropsych Clin Neurosci; 19(4):475-476. Nardo et al. (2010). J Psychiatry Res; D0110.1016/jjpsychires.2009.10.014

Keywords: Neuroimaging Research

Accuracy Verified: Yes

3. Tofani, L. R., & Wheeler, K. (2012). Le protocole de l'épisode traumatique récent: Evaluation et analyse des résultats de trois études de cas [The protocol for recent traumatic episode: Evaluation and analysis of the results of three case studies]. Journal of EMDR Practice and Research, 6(4), 46E-63E. doi:10.1891/1933-3196.6.4.46.

Language: French

Format: Journal

Abstract:
Cet article évalue et illustre l’application du protocole de l’épisode traumatique récent (R-TEP : recenttraumatic episode protocol) avec trois clients différents : un enfant atteint d’une maladie chronique, une femme ayant subi une perte importante et un adolescent qui s’automutilait. Le R-TEP est une adaptation du protocole EMDR pour l’intervention EMDR précoce. Les séances sont présentées de manière détaillée afin de souligner les changements qui se produisent au niveau du traitement de l’information au cours de la thérapie. Des marqueurs observés identifiés ont permis d’analyser le déroulement du traitement, incluant la distanciation vis-à-vis du trauma ; la diminution des affects négatifs ou le changement des émotions rapportées ; l’accès à des informations plus adaptatives ; des changements au niveau de l’échelle des unités subjectives de perturbation (SUDS : Subjective Units of Disturbance scale) ; l’échelle de validité de la cognition (Validity of Cognition) et l’échelle révisée d’impact de l’événement (Impact of Event Scale––Revised) indiquant des modifications de la perception du souvenir traumatique. Tous les clients ont montré des gains thérapeutiques pré/post du R-TEP, avec des changements au niveau du comportement et du fonctionnement. Les soubassements du R-TEP sont envisagés à la lumière des observations rapportées. La contribution spécifique du protocole est soulignée en considération de ses composants procéduraux et des mécanismes de changement associés plausibles.

This article evaluates and illustrates the application of the protocol recent traumatic episode (R-PET: recenttraumatic episode protocol) with three different clients: a child with a chronic illness, woman who suffered a major loss and a teenager who automutilait. The R-TEP is an adaptation EMDR protocol for early EMDR intervention. The sessions are presented in detail to highlight the changes that occur in the processing of information during therapy. Observed identified markers were used to analyze the course of treatment, including distance vis-à-vis the trauma, decrease negative affect or change reported emotions; access to information more adaptive, changes at scale subjective units of disturbance (SUDS: Subjective Units of Disturbance Scale) scale validity of cognition (Validity of Cognition) and the revised scale of impact of the event (Impact of Event Scale - Revised) indicating changes in the perception of the traumatic memory. all customers have shown therapeutic gains pre / post R-TEP, with changes in behavior and functioning. The foundations of the R-TEP are considered in the light of reported sightings. The specific contribution of the protocol is emphasized in view of its procedural components and related plausible mechanisms of change.

Keywords: Evaluation of Results Mechanisms of Action Recent Trauma R-TEP

Accuracy Verified: Yes

4. Lundin, T. (2007). Nedsatt smärtkänslighet vid posttraumatiskt stressyndrom [Reduced pain sensitivity in posttraumatic stress syndrome]. Läkartidningen, 104(16), 1219.

Language: Swedish

Format: Magazine

Abstract:
Under de senaste decennierna har det blivit allt tydligare att posttraumatiskt stressyndrom (PTSD) är ett psykiskt sjukdomstillstånd med klara neurofysiologiska eller strukturella förändringar i hjärnans basala strukturer. PET- och MR-tekniker har kommit till allt större användning, såväl vid grundläggande studier av cerebrala förändringar vid PTSD som vid studiet av farmakologiska och psykologiska behandlingsinsatser, tex vid EMDR(eye movement desensitization and reprocessing)-behandling.

In recent decades there has become increasingly clear that post-traumatic stress disorder (PTSD) is a mental illness with clear neurophysiological structural changes in basal brain structures. PET and MR techniques have come to increasingly use, both at the fundamental Studies of cerebral changes in PTSD as the study of pharmacological and psychological treatment interventions, tex in EMDR (eye movement desensitization and Reprocessing) therapy.

Keywords: Letter Pain Sensitivity Posttraumatic Stress Disorder PTSD

Accuracy Verified: Yes

5. Tokunaga, H., Ikejiri, Y., Kazui, H., Masaki, Y., Hatta, N., Doronbekov, T. K., Honda, M., Oku, N., Hatazawa, J., Nishikawa, T., & Takeda, M. (2006). Neural correlates of symptom improvement in posttraumatic stress disorder: Positron emission tomography study. In N. Kato; M. Kawata, & R. K. Pitman, (Eds.), PTSD: Brain mechanisms and clinical implications (pp. 247-254). Tokyo: Springer-Verlag.

Language: English

Format: Book Section

Abstract:
We studied the neural basis of reexperiencing in patients with PTSD using positron emission tomography (PET) and investigated the change in the neural activities from before to after improvement of PTSD symptoms. As a therapy for PTSD, we used the eye movement desensitization and reprocessing (EMDR) procedure. Although the mechanism by which EMDR acts is unclear, its efficacy for PTSD is comparable to cognitive behavioral therapy. [Text pp. 247-248][Pilots]

Keywords: Adults Arousal Brain Imaging Crime Neurophysiology Japanese Survivors Posttraumatic Stress Disorder PTSD Reexperiencing

Accuracy Verified: Yes

6. Pagani, M. (2010, Novembre). Neurobiologia e nuovi concetti fisiopatologici dell’EMDR [Neurobiology and new concepts pathophysiological EMDR]. Presentazione al "Convegno La psicotraumatologia Oncologica, Roma, Italia.

Language: Italian

Format: Conference

Abstract:
La sindrome da stress post-traumatico (PTSD) causa nel cervello cambiamenti sia anatomici sia funzionali in specifiche aree cerebrali associate alla risposta emotiva al trauma ed alla relativa insorgenza dei sintomi. Studi di immagini funzionali (tomografia ad emissione di fotone singolo, SPECT, e a emissione di positroni, PET) e strutturali (risonanza magnetica, RM) hanno evidenziato significative variazioni neuropatologiche in pazienti con PTSD durante la rivisitazione del trauma. L’impiego di queste tecniche ha consentito di fare luce sui correlati neurali della psicoterapia, rivelando i suoi effetti neurobiologici sulle funzioni cerebrali. Nell’ambito dei diversi approcci psicoterapeutici, l’EMDR (Desensibilizzazione e rielaborazione attraverso i movimenti oculari) 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. Tuttavia solo un numero esiguo di studi ha indagato il substrato neurobiologico di questa psicoterapia. Verranno discussi studi che il nostro gruppo ha recentemente pubblicato su riviste internazionali e che hanno dimostrato con la SPECT come l’EMDR normalizzi il flusso ematico cerebrale nelle aree limbiche implicate nel PTSD (1) e con la RM come nei pazienti che non rispondono a terapia molte di queste aree presentino una diminuzione rilevante della densità della sostanza grigia (2). Verranno inoltre presentati i risultati preliminari del primo studio che monitora completamente con EEG una seduta EMDR e dimostra le attivazioni che i cicli di desensibilizzazione per se provocano a livello corticale e subcorticale sia durante la prima seduta che durante l’ultima quando il soggetto ha elaborato il trauma. 1. Nardo D et al. J Psychiat Res 2010; 44:477-485 2. Pagani M et al. Nucl Med Commun 2007; 28: 757-765

The syndrome of post-traumatic stress disorder (PTSD) causes changes in the brain is anatomical and functional in specific brain areas associated with emotional response to trauma and the related onset of symptoms. Studies of the functional (single photon emission computed tomography, SPECT, and emission tomography, PET) and structural (magnetic resonance imaging, MRI) have shown significant neuropathological changes in patients with PTSD during revisiting the trauma. The use of these 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 (Desensitization and reprocessing through eye movements) 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 neural circuits. However, only a small number of studies have investigated the neurobiological substrate of this psychotherapy. They will discuss studies that our group has recently published in international journals and who have demonstrated with SPECT as EMDR normalize cerebral blood flow in the limbic areas implicated in PTSD (1) and with MRI as in patients who do not respond to therapy many of these areas present a significant decrease in the density of gray matter (2). We will also present the preliminary results of the first study that monitors completely with EEG and demonstrates an EMDR session activations and cycles of desensitization if they cause in the cortex and subcortical both during the first session that during the last when the subject has developed the trauma. 1. D Nardo et al. J Psychiat Res 2010; 44:477-485 2. Pagani M et al. Nucl Med Commun 2007; 28: 757-765

Keywords: Neurobiology

Accuracy Verified: Yes

7. Pagani, M., Salmaso, D., Flumeri, F., & Hogberg, G. (2008, June). The neurobiological substrates of PTSD and EMDR therapy. Presentation at the annual meeting of the EMDR Europe Association, London, England UK.

Language: English

Format: Conference

Abstract:
In the recent years, the number of studies using neuro-imaging to evaluate neural correlates of psychotherapy has steadily increased revealing its clear neurobiological effects on brain function across a wide range of psychiatric disorders. Functional studies by single photon emission computed tomography (SPECT) and positron emission tomography (PET) can now reliably detect changes in cerebral blood flow (CBF) and metabolism patterns, suggesting a specific role for each of the brain areas in various components of emotional processing. Investigations by magnetic resonance imaging (MRI) have also revealed psychiatry disease-related structural changes. Some regions have been reported to be associated with emotional response to trauma, and with symptom formation in posttraumatic stress disorder (PTSD). Several studies have provided evidence for the efficacy of Eye Movement Desensitization and Reprocessing therapy (EMDR) in the treatment of PTSD. However a very limited number of studies have investigated the neurobiological substrate of such therapy in clinical practice. SPECT and MRI studies, performed to examine the effects of EMDR on brain patho-physiology have provided some preliminary evidence that changes in brain CBF and structure patterns may follow effective treatment. In general in PTSD and in anxiety disorders functional deactivations parallel symptoms relief and decreased hyperreactivity to emotional and memory disturbances. Functional neuro-imaging is a promising tool for the investigation of the physiological impact of psychotherapy in anxiety related disorders and may thus pave the road for a better detection of its effects in psychiatric treatment. The scientific literature reporting PTSD/EMRD related neuro-imaging studies will be extensively reviewed.

Keywords: Neurobiology Posttraumatic Stress Disorder PTSD

Accuracy Verified: Yes

8. Pagani, M. (2011, June). Neuroimaging and novel neurobiological findings in EMDR research [Neuroimaging und neuartige neurobiologische erkenntnisse in der EMDR forschung]. Presentation at the annual meeting of the EMDR Europe Association, Vienna, Austria.

Language: English

Format: Conference

Abstract:
In the recent years the number of neuroimaging studies evaluating neural correlates of psychotherapy has steadily increased revealing its clear neurobiological effects on brain function across a wide range of psychiatric disorders. Functional studies by single photon emission computed tomography (SPECT) and positron emission tomography (PET) detect changes in cerebral blood flow and metabolism patterns, identifying the brain areas processing the various components of emotional processing and/or affected by the disorders. Investigations by magnetic resonance imaging (MRI) have also revealed psychiatry disease-related structural changes. The first part of the workshop (20 minutes) will describe the neuroimaging methodologies and findings in PTSD/EMDR research with and extensive review of previous literature on the neurobiological effects of EMDR. The second part of the workshop (20 minutes) will deal with the description and implementation in research and clinic of neuropsychological testing with brief comments and discussion about their use in the recent experiments performed by our group. In the third part the EEG monitoring of a complete set of EMDR therapies in 10 patients suffering of major trauma will be presented. The relative results are the first report ever on the neurobiological changes occurring before, during and after EMDR therapy sheding light on the neuronal processes underlying its clinical efficacy. Learning objectives: The description and the discussion about the contents of the workshop will provide the audience (1) the necessary information to understand the methodological principles behind the neuroimaging techniques (PET, SPECT and MRI) and their possible applications in research and clinic; (2) the critical knowledge of the limited number of published papers in the field of EMDR-related functional and anatomical studies; (3) the basic research principles and examples to be motivated to begin, take part and/or collaborate to EMDR research in order to better understand the neural basis of this fascinating psychotherapeutic technique.

Keywords: Neurobiology Neuroimaging

Accuracy Verified: Yes

9. Tarquinio. C., Brennstuhl, M. J., Reichenbach, S., Rydberg, J. A., & Tarquinio, P. (2012, July-September). Prise en charge précoce de victimes de viols et présentation d’un protocole d’urgence de thérapie EMDR [Early treatment of rape victims: Presentation of an emergency EMDR protocol]. Sexologies: Revue européenne de sexologie et de santé sexuelle & European Journal of Sexology and Sexual Health, 21(3), 147-156 doi:10.1016/j.sexol.2011.11.013.

Language: French

Format: Journal

Abstract:
L’objectif de cette contribution sera de tester l’efficacité d’une nouvelle forme de prise en charge précoce des conséquences de viol. Issue d’une intégration de plusieurs protocoles EMDR d’urgence comme le R-TEP (Recent Traumatic Episode Protocol) de Shapiro (2009), et Modifed Abridged EMDR Protocol de Kutz, Risnik et Dekel (2008), et inspiré par la pratique du débriefing psychologique nous avons pris en charge sur la base d’une seule séance 17 femmes victimes de viols et prises en charge dans les 24 à 78h après leur agression. Suivies après 4 semaines, puis après 6 mois, nous avons mesuré les effets de ce suivi psychologique sur la symptomatologie post-traumatique, la détresse psychologique, ainsi que sur certains indicateurs de la sexualité de ces femmes victimes, en référence à leur sexualité antérieure. Les résultats obtenus montrent qu’en une séance on assiste à une réduction intéressante des différentes mesures qui se révèle stable 4 semaines et 6 mois après la prise en charge, de la même manière que la sexualité semble réinvesti par les victimes. Si ce type d’intervention d’urgence ne se substitue en rien à une psychothérapie plus approfondie, sa contribution et sa pertinence dans le cadre d’une prise en charge immédiate ouvre des perspectives intéressantes pour la prise en charge des victimes d’agressions sexuelles.

The aim of this contribution is to test the effectiveness of a new form of early management of the consequences of rape. After an integration of several protocols EMDR emergency such as R-PET (Recent Traumatic Episode Protocol) Shapiro (2009), and modifed Abridged EMDR Protocol of Kutz, Risnik and Dekel (2008), and inspired by the practice of psychological debriefing we supported on the basis of a single session 17 women victims of rape and supported in the 24 to 78 hours after the assault. Followed after 4 weeks, then after six months, we measured the effects of psychological symptoms on post-traumatic psychological distress, as well as some indicators of sexuality of these women who, in reference to their sexuality earlier. The results show that a session there is an interesting reduction of the various measures that proves stable 4 weeks and 6 months after treatment, the same way that sexuality seems reinvested by the victims. If this type of emergency is not a substitute for psychotherapy in no further, its contribution and its relevance in the context of an immediate management opens interesting perspectives for the treatment of victims of sexual assault.

Keywords: Emergency Protocol Rape

Accuracy Verified: Yes

10. Kirk, R. (2004, May 1). Residential school trauma: As time runs out for the Aboriginal Healing Fund, new treatments show promising results. The need for healing is still huge, but will the resources be available to ease the suffering and resultant social costs?. Regina, SK Canada: Briarpatch.

Language: English

Format: Newspaper

Abstract:
I conducted my doctoral dissertation on my use of EMDR with 56 individuals, finding it working more quickly and effectively than other interventions. The EMDR process asks the individual not only to focus on the trauma, but also on their bodily reactions and the beliefs that they hold about what happened. People do not necessarily report to the therapist an in-detail recounting of the historic event, but often gain new insights about themselves and their situations that had not occurred to them in any previous self-reflection. Positive-emission topography (PET) scans on the brains of people recalling their traumas and those undergoing EMDR show different parts of the brain lighting up, and post-treatment, the areas of the brain that are activated are more balanced in both hemispheres than before.

Keywords: General Overview Regina, SK Canada

Accuracy Verified: Yes

11. 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