Francine Shapiro Library ~ EMDR Bibliography

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1. 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

2. Korman, S. (2007, June). Body-based interventions for self-reguation and resourcing in the treatment of complex trauma. Presentation at the annual meeting of the EMDR Europe Association, Paris, France.

Language: English

Format: Conference

Abstract:
In the clinical treatment of complex trauma, it is important to evaluate a patient’s readiness for trauma processing. This includes recognizing a clinical presentation of complex trauma and an understanding of it etiology. Additionally, it is imperative to understand the effects of trauma on the body system. Pre-mature trauma processing can serve to symptomatically worsen a pervasive pattern of systemic dysregulation. Prior to successful trauma processing, a patient must be able to maintain dual attention, regulate their affect, and tolerate the experience of affective state change. Body-based resourcing and regulatory skills can be utilized by the clinician to increase a patient’s ability to tolerate and more fully integrate pre-frontal lobe cognitive activity with the emotional and sensory experiences resultant of trauma. Strategies from many modalities, such as Dialectic Behavior Therapy, Mindfulness Practices and EMDR Resourcing can be taught to and practiced by the client in preparation for successful regulated integration of traumatic memory.

Keywords: Complex PSTD Creativity Mind/Body Resourcing Self Regulation

Accuracy Verified: Yes

3. 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

4. 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

5. Pagani, M., Hogberg, G., Salmaso, D, Tarnell, B., Nardo, D., Sundin, Ö., Jonsson, C., Soares, J., Aberg-Wistedt, A., Jacobsson, H., Larsson, S.A., Hällström, T. (2007, October). Effects of EMDR psychotherapy on 99mTc-HMPAO distribution in occupation-related post-traumatic stress disorder. Nuclear Medicine Communications, 28(10), 757-765. doi:10.1097/MNM.0b013e3282742035.

Language: English

Format: Journal

Abstract:
Background: Post-traumatic stress disorder (PTSD) is a derangement of mood control with involuntary, emotionally fraught recollections that may follow deep psychological trauma in susceptible individuals. This condition is treated with pharmacological and/or cognitive therapies as well as psychotherapy with eye movement desensitization and reprocessing (EMDR). However, only a very limited number of studies have been published dealing with work-related PTSD, and investigations on the effect of treatment on cerebral blood flow represent an even smaller number. Aim: To investigate the short-term outcome of occupation-related PTSD after EMDR therapy by 99mTc-HMPAO SPECT. Method: Fifteen patients, either train drivers suffering from PTSD after having been unintentionally responsible for a person-under-train accident or employees assaulted in the course of duty, were recruited for the study. 99mTc-HMPAO SPECT was performed on these patients both before and after EMDR therapy while they listened to a script portraying the traumatic event. Tracer distribution analysis was then carried out at volume of interest (VOI) level using a three-dimensional standardized brain atlas, and at voxel level by SPM. The CBF data of the 15 patients were compared before and after treatment as well as with those of a group of 27 controls who had been exposed to the same psychological traumas without developing PTSD. Results: At VOI analysis significant CBF distribution differences were found between controls and patients before and after treatment (P=0.023 and P=0.0039, respectively). Eleven of the 15 patients responded to treatment, i.e., following EMDR they no longer fulfilled the DSM-IV criteria for PTSD. When comparing only the eleven responders with the controls, the significant group difference found before EMDR (P=0.019) disappeared after treatment. Responders and non-responders showed after therapy significant regional differences in frontal, parieto-occipital and visual cortex and in hippocampus. SPM analysis showed significant uptake differences between patients and controls in the orbitofrontal cortex (Brodmann 11) and the temporal pole (Brodmann 38) both before and after treatment. A significant tracer distribution difference present before treatment in the uncus (Brodmann 36) disappeared after treatment, while a significant difference appeared in the lateral temporal lobe (Brodmann 21). Conclusion: Significant 99mTc-HMPAO uptake regional differences were found, mainly in the peri-limbic cortex, between PTSD patients and controls exposed to trauma but not developing PTSD. Tracer uptake differences between responders and patients not responding to EMDR were found after treatment suggesting a trend towards normalization of tracer distribution after successful therapy. These findings in occupational related PTSD are consistent with previously described effects of psychotherapy on anxiety disorders. [PubMed]

Keywords: 99mTc-HMPAO Posttraumatic Stress Disorder PTSD

Accuracy Verified: Yes

6. Pagani, M., Hogberg, G., Salmaso, D., Nardo, D., Jonsson, C., Danielsson, A.M., Engelin, L., Jacobsson, H., Larsson, S. A., Hallstrom, T., & Sundin, Ö. (2006, September). Effects of EMDR therapy on 99mTc-HMPAO distribution in Post-traumatic stress disorder. Presentation at the European Assocation of Nuclear Medicine Congress, Athens, Greece. European Journal of Nuclear Medical and Molecular Imaging, 33, S169.

Language: English

Format: Conference

Abstract:
Background Post-traumatic stress disorder (PTSD) is a derangement of mood control with emotional trauma recollections that may follow psychological trauma. It is treated with pharmacological and cognitive therapies as well as with eye movement desensitization and reprocessing (EMDR). However, a limited number of studies have been published dealing with job related PTSD, and an even smaller number have assessed the effects of treatment on CBF. The aim of this study was to investigate the short term outcome of occupation based PTSD after EMDR therapy by 99mTc-HMPAO SPECT. Methods Fifteen patients suffering PTSD after having experienced a person under train accident or having been assaulted at work were included into the study. 99mTc-HMPAO SPECT was performed before and after EMDR therapy while listening to a script portraying the traumatic event. Tracer distribution analysis was performed at VOI level using a 3D standardised brain atlas and at cluster of voxel level by SPM and was subjected to an analysis of treatment as well as contrasted to a group of 27 subjects exposed to the same psychological trauma and not developing PTSD. Results Eleven of 15 patients responded to treatment, i.e. they did no longer fulfil the DSM-IV criteria for PTSD after EMDR. Overall VOI analysis showed significant differences between, both before and after treatment conditions and controls (p<0.05) but no effect of period, i.e. treatment. However, when contrasting responders to controls the significant group difference present after treatment disappeared, indicating a normalization effect due to successful EMDR treatment. SPM analysis showed significant uptake differences in orbitofrontal cortex (Brodmann 11) and temporal pole (Brodmann 38) before as well as after treatment as compared to controls. A significant tracer uptake group difference present before treatment in uncus (Brodmann 36) disappeared after treatment while a significant difference appeared in lateral temporal lobe (Brodmann 21). No tracer uptake differences were found by SPM as an effect of treatment, nor between the 11 responders and controls. Conclusion Significant 99mTc-HMPAO uptake differences, mainly in peri-limbic cortex, between PTSD patients investigated before and after EMDR and subject exposed to trauma not developing PTSD were found. Differences between the tracer distribution in patients before and after therapy were not significant neither at SPM nor at VOI analyses but the latter showed at group level an effect of symptom remission on tracer distribution. The findings underscore the validity of psychotherapy in anxiety disorders and confirm the efficacy of SPECT in psychiatry. [EANM]

Keywords: 99mTc-HMPAO Distribution Posttraumatic Stress Disorder PTSD

Accuracy Verified: Yes

7. Pagani, M., Hogberg, G., Salmaso, D., Nardo, D., Jonsson, C., Danielsson, A. M., Engelin, L., Jacobsson, H., Larsson, S. A., Hallstrom, T., & Sundin, Ö. (2006, September-October). Effects of EMDR therapy on 99mTc-HMPAO distribution in Post-traumatic Stress Disorder. Presentation at the European Assocation of Nuclear Medicine Congress, Athens, Greece.

Language: English

Format: Conference

Keywords: 99mTc-HMPAO Distribution Posttraumatic Stress Disorder PTSD

Accuracy Verified: Yes

8. Bergmann, U. (2001, June). Exploring the role of the cerebellum in EMDR accelerated information processing: Recent insights and speculations. Presentation at the annual meeting of the EMDR International Association, Austin, TX.

Language: English

Format: Conference

Abstract:
Participants will: 1) gain understanding as to the formation and consolidation of emotions and memory; 2) understand the pathways of trauma in the brain and their respective psychological symptoms; 3) become more knowledgeable about accelerated information processing; and 4) gain an understanding of various possible mechanisms of EMDR treatment effects, with an emphasis on cerebellar mechanisms and their direct relation to information processing and frontal lobe activation.

Keywords: Cerebellum Neurobiology

Accuracy Verified: Yes

9. Bergmann, U. (2000, September). Exploring the role of the cerebellum in EMDR processing. Presentation at the annual meeting of the EMDR International Association, Toronto, Ontario Canada.

Language: English

Format: Conference

Abstract:
Participants will: 1) gain an understanding as to the formulation and consolidation of emotions and memory; 2) understand the pathways of trauma in the brain and their respective psychological symptoms; 3) become more knowledgeable about the neurobiological research which appears to support the hypoetheses of the accelerated information processing system; and 4) gain an understanding of various possible mechanisms of EMDR's treatment effects, with an emphasis on cerebellar mechanisms, and their direct relation to information processing and frontal lobe activation.

Keywords: Cerebellum Neurobiology

Accuracy Verified: Yes

10. Ichii, M., Amano, T., & Yoshikawa, H. (2012, June). Hemodynamic responses during EMDR treatment of traumatic memory [Respuestas hemodinámicas durante el tratamiento de memorias traumáticas con EMDR]. Presentation at the annual meeting of the EMDR Europe Association, Madrid, Spain.

Language: English

Format: Conference

Abstract:
In order to investigate brain activity during EMDR, 52-channel NIRS（near –infrared spectroscopy) and heart rate were measured in treating a traumatic memory of non-clinical twenty five year old woman. A target memory was sexually molestation by a stranger when she was ten years old, and forced to touch penis of perpetrator. And IES-R score was as low as 11. A well-experienced EMDR therapist (=M.I.) applied estandarized EMDR protocol. Negative cognition was “I am shameful person”, and positive cognition was ”I deserve to live.” The body location is both arms and hands. By thirty-seven sets of EM, 7.5 level of SUDs decreased to 0, and VOC went up from 3.5 to 7. The [oxy-Hb] change in right orbitofrontal cortex increased as the negative emotion went up, and decreased rapidly after processing. The [oxy-Hb] change in left orbitofrontal cortex decreased just after cognitive interweave of responsibility was done. The [oxy-Hb] variation in right temporal lobe increased rapidly, and the [oxy-Hb] change in left temporal lobe decreased when direction of EM was changed from horizontal to diagonal movement when negative imagery disappeared. Heart rate data show gradual decreasing tendency throughout the session. Within each set, heart rate also decreased by EM. By monitoring NIRS, various techniques or pivotal processes in EMDR may be supposed to influence brain. In order to confirm the relationship, we should collect data from more subjects.

Para poder investigar la actividad cerebral durante EMDR, se midieron la NIRS (espectroscopia cercana al infrarrojo) de 52 canales y el ritmo cardíaco para tratar los recuerdos traumático de una mujer no clínica de veinticinco años. Un recuerdo diana fue un abuso sexual de un extraño cuando tenía 10 años y el agresor la obligó a tocarle el pene. La puntuación del IES-‐R fue de 11. Un terapeuta EMDR con experiencia (=M.I.) aplicó el protocolo estándar de EMDR. La cognición negativa fue “Soy una persona vergonzosa”, y la cognición positiva fue ”Merezco vivir.” La localización corporal fue en ambos brazos y manos. Después de 37 sets de movimientos oculares, el SUD de 7,5 bajó a 0, y el VOC subió de un 3,5 a un 7. El cambio [oxy-‐Hb] en el córtex órbitofrontal derecho aumentó a medida que aumentaba la emoción negativa, y disminuyó rápidamente después del procesamiento. El cambio [oxy-‐Hb] en el córtex órbitofrontal izquierdo disminuyó justo después de hacerse un entrelazado cognitivo de responsabilidad. La variación [oxy-‐Hb] en el lóbulo temporal derecho aumentó rápidamente, y el cambio [oxy-‐Hb] en el lóbulo temporal izquierdo disminuyó al cambiar la dirección de los movimientos oculares de horizontal a diagonal cuando desapareció la imagen negativa. Los datos del ritmo cardíaco muestran una tendencia decreciente gradual a lo largo de la sesión. En cada una de las tandas, el ritmo cardíaco también disminuyó por los movimientos oculares. A través de monitorear el NIRS, se supone que diversas técnicas o procesos centrales en EMDR influyen en el cerebro. Para poder confirmar esta relación, deberíamos recolectar datos de más sujetos.

Keywords: Hemodynamic Responses

Accuracy Verified: Yes

11. Lansing, K., Amen, D. G., Hanks, C., & Rudy, L. (2005, Fall). High-resolution brain SPECT imaging and eye movement desensitization and reprocessing in police officers with PTSD. Journal of Neuropsychiatry and Clinical Neuroscience, 17(4), 526-532. doi:10.1176/appi.neuropsych.17.4.526.

Language: English

Format: Journal

Abstract:
Eye movement desensitization and reprocessing (EMDR) has been shown to be an effective treatment for PTSD. In this study, the authors evaluated the effectiveness and physiological effects of EMDR in police officers involved with on-duty shootings and who had PTSD. 6 police officers involved with on-duty shootings and subsequent delayed-onset PTSD were evaluated with standard measures, the Posttraumatic Stress Diagnostic Scale (PDS), and high-resolution brain single photon emission computed tomography (SPECT) imaging before and after treatment. All police officers showed clinical improvement and marked reductions in the PDS score. In addition, there were decreases in the left and right occipital lobe, left parietal lobe, and right precentral frontal lobe as well as significant increased perfusion in the left inferior frontal gyrus. In our study EMDR was an effective treatment for PTSD in this police officer group, showing both clinical and brain imaging changes. [Author Abstract]

Keywords: Empirical Study Off-Duty Shootings Police Officers Posttraumatic Stress Disorder PTSD Quantitative Study SPECT

Accuracy Verified: Yes

12. Lansing, K. (2004, November). Images of healing: SPECT images of PTSD and recovery in police officers. Preconference presentation at the 20th annual meeting of the International Society of Traumatic Stress Studies, New Orleans, LA.

Language: English

Format: Conference

Abstract:
The effects of “lethal contact” (i.e., close range firefights) in both the military and law enforcement populations can render long-standing psychological impairment. In this study we evaluated the effectiveness and physiological effects of EMDR in police officers involved with on-duty shootings who had delayed PTSD. Method: Six police officers involved with on-duty shootings and subsequent delayed-onset PTSD were evaluated with standard measures, the Posttraumatic Stress Diagnostic Scale and high-resolution brain SPECT imaging, before and after treatment. Results: All police officers showed clinical improvement and marked reductions in the PDS (mean reduction from scores of 43.2 pre EMDR to 5.2 post EMDR). In addition, there were decreases in the left and right occipital lobe, left parietal lobe and right precentral frontal lobe, as well as significant increased perfusion (>0.001) in the left inferior frontal gyrus. Conclusions: In our study EMDR was an effective treatment for PTSD in this police officer group, showing both clinical and brain imaging changes. This multimedia presentation integrates selected case reviews including the dispatch recordings of the officer’s actual shooting incident/s, follow-up “check-in” messages documenting the officer’s reactions upon return to duty as well as pre- and post-treatment brain images. Brief selections of video also are used to further illustrate key principals. Clinical methodologies that were used with this group of subjects also will be discussed. Participant Alert: EMDR is a stepwise protocol designed to facilitate the reexperiencing of “trauma based” memories in order to assist the client in reformatting them into a non-disturbing / more “normalized” memory. During this protocol highly charged/upsetting images, feelings or experiences can arise for the client.

Keywords: Police Officers SPECT

Accuracy Verified: Yes

13. 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

14. Sugawara Masakazu & Suzuki K (2004, July). Methodological and conceptual issues and tests - EMDR(Eye Movement Desensitisation and Reprocessing) and REM sleep. Poster presented at the Annual Meeting of the Australian Society for the Study of Brain Impairment (ASSBI) and the International Neuropsychological Society (INS), Brisbane, Australia.

Language: English

Format: Conference

Abstract: Desensitisation and Reprocessing) and REM sleep. [Background] Eye movement desensitization and reprocessing (EMDR) is a new innovative treatment with a high success rate for psychological disturbances rooted in traumatic memory. However, the neurophysiological mechanisms of EMDR have not yet been elucidated. Why is saccadic eye movement effective for the reprocessing of previously established conditioned reflex? [Aims] The present research analysed (i)the topographical changes of EEG (and ERP) and REM sleep after EMDR treatment, and (ii)the subjective units of emotional distress (SUDs) and VOC. [Methods] Subjects (13 males and 20 females) were assigned to three groups according to varied conditions (control, provocational, and EMDR), and engaged in sets of horizontal saccadic-eye movements lasting approximately 30 seconds per set. Topographical changes of EEG and ERP activities were recorded from 14 placements over frontal, central, parietal, temporal and occipital scalp locations in the international 10-20 system with linked mastoides (A1-A2). Electrodes were also placed on the lateral canthus and above the supercillium of the left eye in order to measure the electrooculographic and electromyographic responses. [Results and Conclusions] The statistical significance of topographical EEG differences and REM densities during the pre-0post EMDR treatment situations, were evaluated using an ANONA and Mann-Whitney U test. The neurophysiological and psychological data indicate that the density of eye movement during REM sleep increased after provocation and EMDR, and the left frontal activities might indicate a treatment efficacy. It supports the hypothesis is that REM sleep is intimately involved with the mechanisms of emotional and memory reprocessing.

Keywords: Poster REM

Accuracy Verified: Yes

15. Zarghi, A., Zali1, A., & Tehranidost, M. (2013, February). Methodological aspects of cognitive rehabilitation with eye movement desensitization and reprocessing (EMDR). Basic and Clincal Neuroscience, 4(1), 97-103.

Language: English

Format: Journal

Abstract:
A variety of nervous system components such as medulla, pons, midbrain, cerebellum, basal ganglia, parietal, frontal and occipital lobes have role in Eye Movement Desensitization and Reprocessing (EMDR) processes. The eye movement is done simultaneously for attracting client's attention to an external stimulus while concentrating on a certain internal subject. Eye movement guided by therapist is the most common attention stimulus. The role of eye movement has been documented previously in relation with cognitive processing mechanisms. A series of systemic experiments have shown that the eyes’ spontaneous movement is associated with emotional and cognitive changes and results in decreased excitement, flexibility in attention, memory processing, and enhanced semantic recalling. Eye movement also decreases the memory's image clarity and the accompanying excitement. By using EMDR, we can reach some parts of memory which were inaccessible before and also emotionally intolerable. Various researches emphasize on the effectiveness of EMDR in treating and curing phobias, pains, and dependent personality disorders. Consequently, due to the involvement of multiple neural system components, this palliative method of treatment can also help to rehabilitate the neuro-cognitive system.

Keywords: Rehabilitation

Accuracy Verified: Yes

16. Cartoni, A., Gaudin, M., Astori, M. G., Mannatrizio, A., & Brunati, E. (2012, June). Mistakes to not repeat: When the child´s body talks of the mother´s traumatic past (case) [Errores a no repetir: Cuando el cuerpo del niño habla del pasado traumático de la madre (caso)]. Presentation at the annual meeting of the EMDR Europe Association, Madrid, Spain.

Language: English

Format: Conference

Abstract:
Following Siegel’s model (2005), the authors present a single case that undergone a therapeutic intervention with EMDR aimed to reprocess infantile traumatic memories reactivated in the parenting. A 4 year old child came to our Child Neuropsychiatric Unit because she presented a toe walking in absence of neurological signs. She undergone periodic physiatrist visits for one year without any symptoms regression. She was then seen from a Child Neuropsychiatrist and a Psychomotor Therapist who evaluated the importance of observations by a psychologist. Method: The psychologist observed a general anxiety state in the child characterized by perfectionism, inhibition and hypervigilance to the environment demand. The mother's life story was that of a child with an alcoholic father who she wished to save with her love and who died for cirrhosis. It was clear how the parenting experience reactivated infantile traumatic memories. It was proposed a treatment with EMDR. The child treatment was addressed to install resources and to reprocess stressing interactions with the mother. The mother treatment was aimed to reprocess infantile traumatic experience and to look at the present triggers in the interaction with the daughter who reactivated traumatic memories and cause emotion dysregulation. Results: The treatment brought to a resolution of the child symptoms and a reorganization of the interaction between the child and the mother. Conclusions: This single case report highlights the importance to understand well the psychological origin of somatic symptoms and gives an evidence of the efficacy of the treatment with EMDR following Siegel’s model.

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: Body

Accuracy Verified: Yes

17. 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

18. 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

19. 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

20. Bergmann, U., & Bromberg, P. (2003, November). The neurobiology of EMDR: Recent insights and their contribution to the treatment of dissociation. Presentation at the annual meeting of the International Society for the Study of Dissociation Fall Conference, Chicago, IL.

Language: English

Format: Conference

Abstract:
This presentation will explore the formation and consolidation of emotions and memory, various possible neural mechanisms of EMDR's treatment effects; with an emphasis on cerebellar mechanisms, and their direct relation to information processing and frontal lobe activation. Recent knowledge regarding Allan Schore's work on the orbitofrontal cortex and Steven Porges' work on the brainstem will be explored; with a major emphasis given to their implication for improved techniques to facilitate EMDR processing.

Keywords: Dissociation Neurobiology

Accuracy Verified: Yes

21. Bergmann, U. (2001, December). The neurobiology of EMDR: Recent insights and their contribution to the treatment of dissociation. Presentation at the annual meeting of the International Society for the Study of Dissociation Fall Conference, New Orleans, LA.

Language: English

Format: Conference

Keywords: Dissociation Neurobioogy

Accuracy Verified: No

22. Bergmann, U. (2003, September). The neurobiology of EMDR: Recent insights and their contribution to the treatment of complex PTSD and dissociation. Presentation at the annual meeting of the EMDR International Association, Denver, CO. ;.

Language: English

Format: Conference

Abstract:
This presentation will explore the formation and consolidation of emotions and memory, various possible neural mechanisms of EMDR's treatment effects, with an emphasis on cerebellar mechanisms, and their direct relations to information processing and frontal lobe activation. Recent knowledge regarding Allan Schore's work on the orbitofrontal cortex and Steven Porge's work on the brainstem will be explored; with a major emphasis given to their implication for improved techniques to facilitate EMDR processing.

Keywords: Alan Schore Complex Posttraumatic Stress Disorder Complex PTSD C-PTSD Neurobiology Dissociation

Accuracy Verified: Yes

23. Bergmann, U. (2002, June). The neurobiology of EMDR: Recent insights and their contribution to the treatment of complex PTSD and dissociation. Presentation at the annual meeting of the EMDR International Association, San Diego, CA.

Language: English

Format: Conference

Keywords: Allan Schore Complex Posttraumatic Stress Disorder Complex PTSD C-PTSD Dissociation Neurobiology Steven Porge

Accuracy Verified: Yes

24. Bergmann, U. (2003, May). The neurobiology of the EMDR: Recent insights and their contribution to the treatment of dissociation. Presentation at the annual meeting of the EMDR Europe Association, Rome, Italy.

Language: English

Format: Conference

Keywords: Dissociation Neurobiology

Accuracy Verified: Yes

25. 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

26. Pearson, H. J. (2009). Present and accounted for: Sensory stimulation and parietal neuroplasticity. Journal of EMDR Practice and Research, 3(1), 39-49. doi:10.1891/1933-3196.3.1.39.

Language: English

Format: Journal

Abstract:
There are commonalities between neurologic syndromes arising from lesions of the parietal cortex and psychiatric syndromes secondary to psychological trauma. Additionally some posttraumatic syndromes may reflect functional disruption of parietal areas. Directional or bilateral alternating peripheral sensory stimulation appear to assist in the amelioration of a wide range of clinical conditions, including the neglect syndrome and Posttraumatic Stress Disorder. It is posited that the stimulation may exert its effect through activation of parietal higher-order functions. The activation may result in an integration of sensory information and an updating of the current representation of person and space, which incorporates an awareness of current body reality, sense of self, and world view. It is hypothesized that the EMDR procedure is ideally constructed to facilitate parietal activation through multimodal sensory stimulation, attention and episodic memory retrieval and focus on internal and external body, space, and self. Further investigations and an integration of data between disciplines are suggested, in order to expand our range of effective treatments.

Keywords: Neglect Parietal Lobe Plasticity

Accuracy Verified: Yes

27. 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

28. Koichi, T., Matuso, K., Toshiyuki, O., Tadashi, K., Akira, I., & Nobumasa, K. [綱島浩一、松尾幸治、大溪俊幸、加藤忠史、岩波明、加藤進昌] (2003). Research on cerebral hemodynamics of frontal lobe in PTSD using NIRS. Annual Report of the Research on Nervous and Mental Disorders, 186.

Language: English

Format: Other

Abstract:
For 34 victims of Tokyo subway sarin attack, the frontal lobe function was investigated during eye movement desensitization reprocessing (EMDR). And, cerebral hemodynamics in frontal lobe was examined using near infrared spectral analysis (NIRS) for 10 healthy subjects and 2 patients with posttraumatic stress disorder (PTSD). As the result, frontal lobe functional depression of frontal lobe was indicated in PTSD patients. It was indicated that the lowering of the cathexis was concerned in frontal lobe functional depression in PTSD patients. In patients with PTSD, according to the advance of EMDRt, the activation of the frontal lobe was decreased, and it was indicated that this pattern would be similar to that of healthy subject.

Keywords: Cerebral Hemodynamics of Frontal Lobe NIRS Posttraumatic Stress Disorder PTSD

Accuracy Verified: No

29. 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

30. 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

31. Pearson, H. J. (2005, September). That was then, this is now: Sensory stimulation and parietal integrative functions. Poster presented at the annual meeting of EMDR International Association, Seattle, WA.

Language: English

Format: Conference

Keywords: Parietal Integrative Functions Poster Sensory Stimulation

Accuracy Verified: Yes

32. Kreitzberg, J. (2011). Using magneto encephalography to determine the therapeutic efficacy of EMDR in the treatment of PTSD. Symposium presented at the Annual Linfield College Science Symposium.

Language: English

Format: Conference

Abstract:
Post-traumatic stress disorder (PTSD) is a condition that can be produced by traumatic experiences. A new study has shown that a brain scan called magneto encephalography (MEG) can identify people who have PTSD with an accuracy of 95%. Sensors measure tiny magnetic fields generated by currents flowing in and around neurons. In addition they have recently stated in the Journal of Neural Engineering that they can now watch the brain as it experiences PTSD. Imaging shows that the brain becomes hyperactive in the right temporal lobe, the location responsible for memory. Besides diagnosing PTSD, the researchers also are able to judge the severity of how much patients are suffering. Eye-movement desensitization and reprocessing (EMDR) was designed in 1987 as a treatment for PTSD. EMDR is a structured eight-phase therapy that allows for adequate reprocessing of dysfunctionally stored memory. In the processing phases the client attends to the disturbing memory in brief intervals of 15-30 seconds while also experiencing bilateral stimulation (eye movements, tones or tapping). The eight phases integrate effective elements of psychodynamic, imaginal exposure, cognitive therapy, interpersonal, experiential, physiological and somatic therapies. Now that we can locate specific biomarkers for PTSD using MEG, my hypothesis is that we will find a statistically significant difference between the control group and the group that has EMDR treatment, and that EMDR will be shown to be effective in resolving PTSD as measured by pre and post therapy MEG scans. Also using the MEG, we may be able to observe those brain actions responsible for the therapeutic efficacy of EMDR and isolate which components of EMDR trigger those brain actions. The significance of finding the answer to these questions could potentially help millions of people overcome years of suffering from psychological pain due to the after effects of severe trauma and restore them to productive lives. It could establish the status of EMDR, assisting in the decision of whether it should be listed among the evidence-based, best-practice therapy modalities and covered by insurance. Also knowing the underlying pathophysiology could contribute to the evolution, revision and refinement of diagnostic constructs for PTSD.

Keywords: Efficacy Magneto Encephalography Posttraumatic Stress Disorder PTSD Treatment

Accuracy Verified: Yes

33. Levin, P., Lazrove, S., & van der Kolk, B. (1999, January-April). What psychological testing and neuroimaging tell us about the treatment of posttraumatic stress disorder by eye movement desensitization and reprocessing. Journal of Anxiety Disorders, 13(1-2), 159-172. doi:10.1016/S0887-6185(98)00045-0.

Language: English

Format: Journal

Abstract:
To better understand the pathophysiology and treatment of Posttraumatic Stress Disorder (PTSD), standard psychological testing, Rorschach Ink Blot testing, and neuroimaging using Single Photon Emission Computed Tomography (SPECT) were administered to subjects with PTSD prior to and following three sessions of Eye Movement Desensitization and Reprocessing (EMDR). Using this within-subject design, data from one of six subjects in our series is presented as a case report. Following EMDR, the subject experienced improvement in his level of distress, which correlated with decrements in PTSD and depressive symptomatology on psychological testing. Analysis of the Rorschach data corroborated these changes. Among other findings, the Hypervigilance Index went from positive to negative, indicating that the subject was spending less time scanning the environment for threats, and available ego resources also increased, as measured by the Experience Actual variable. Upon recall of the traumatic memory during SPECT scanning, two areas of the brain were hyperactive post-EMDR treatment relative to pretreatment: the anterior cingulate gyrus and the left frontal lobe. These changes were consistent with summed data from four out of six subjects in the ongoing study. An important implication of these findings is that successful treatment of PTSD does not reduce arousal at the limbic level, but instead, enhances the ability to differentiate real from imagined threat. The psychology and neurophysiology of PTSD are discussed in greater detail. (ScienceDirect)

Keywords: Adults Americans Brain Imaging Empirical Study Posttraumatic Stress Disorder PTSD Treatment Effectiveness

Accuracy Verified: Yes

34. O'Shea, K., Goeller, J. & Goeller, G. (2010, April). A wounded mind?. Presentation at the 25th Annual Alzheimer’s Conference, Seattle, Washington.

Language: English

Format: Conference

Abstract:
This Powerpoint presentation makes use of the Powerpoint Presentation: "From Eye movement Desensitization and Reprocessing (EMDR): QEEG’s of PTSD and dementia look alike (slow wave movement in the occipital lobe)
James Kowal - 2008 EMDRIA Conference, Phoenix" to (1)"To ask the question: Is learning more important in the treatment of Alzheimer’s than we’ve thought?"; "(2)To share what I’ve learned: - about the impact of trauma (chronic illness) - about the importance of beliefs - about the role of emotion - how trauma processing might benefit those with Alzheimer’s and their caretakers"; and (3) "What works". [EMDR Editor]

Keywords: Alzheimers Caretakers Trauma

Accuracy Verified: Yes