Francine Shapiro Library ~ EMDR Bibliography

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Your Results - you searched for the keyword Positron Emission Tomography 15 Results

1. Huber, M., Siol, T., Herholz, K., Lenz, O., Köhle, K., & Heiss, W. D. (2001, December). Activation of thalamo-cortical systems in post-traumatic flashbacks: A positron emission tomography study. Traumatology, 7(4), 131-141. doi:10.1177/153476560100700402.

Language: English

Format: Journal

Abstract:
Trauma victims with post-traumatic stress disorder (PTSD) often experience ‘flashbacks’ that are described as being different from memories of other fearful biographic situations. We used Positron Emission Tomography and Statistical Parametric Mapping to compare in the same subject brain activation patterns during induced flashbacks with recall of fearful non-traumatic situations. During fearful recall there were significant activations of right precuneus. When traumatic memories were compared to neutral, right lingual gyrus, right thalamus / mamillary bodies, and right cerebellum were significantly activated. When brain activation during flashbacks was compared to simple fear, right mediodorsal thalamus (MD), right precuneus, and right cerebellum were significantly more active. With respect to recent experimental evidence concerning the function of thalamo-cortical systems, we hypothesize that post-traumatic flashback experiences are based on hyperactive thalamo-cortical ‘closed loop’ networks.

Keywords: Flashbacks Mediodorsal Thalamus PET Positron Emission Tomography Post-Trauamtic Stress Disorder PTSD Statistical Parameter Mapping Thalamo-Cortical Systems Trauma Victims

Accuracy Verified: Yes

2. Oh, D. H., & Park, Y. C. (2010, July). Bilateral eye movement: Changes brain default network functions in EMDR treatment. Poster presented at the 1st EMDR Asia Conference, Bali, Indonesia.

Language: English

Format: Conference

Abstract:
Introduction: The aim of this study was to clarify the effect of bilateral eye movement as one of the important therapeutic components through EEG analysis. We examined differences between pre-bilateral eye movement and post-bilateral eye movement of normal healthy volunteers in scalp recorded EEGs in two different ways. First, we used qEEG to examine differences in specific band frequencies after bilateral eye movement. Secondly, we utilized low-resolution electromagnetic tomography (LORETA) source imaging (Pascual-Marqui et al., 1994) to explore the underlying neural generators of changed EEG activity. Methods:32 college students participated in the study. EEG was recorded continuously during the experiment. All participants experienced 3 blocks: 1) pre-experiment, eye-closed EEG in resting state, 2) stimuli condition (either eye movement or fixation) and 3) post-experiment, eye-closed EEG in resting state. 32-channel, eyes-closed EEG (30 artifactfree s/subject) was analyzed (source localization using FFT approximation and LORETA). Results: We demonstrated different functional connectivity patterns of the precuneus/posterior cingulate cortex (Brodmann area 23, 31) between bilateral eye movement and eye fixation phase. Conclusion: These results provided evidence to support that the bilateral eye movements in EMDR procedure gives rise to the changes of ‘brain default network’, accompanied by the alteration of regional brain electrical activity.

Keywords: Eye Movements Poster

Accuracy Verified: Yes

3. Oh, D. H., & Choi, J. (2007). Changes in the regional cerebral perfusion after eye movement desensitization and reprocessing: A SPECT study of two cases. Journal of EMDR Practice and Research, 1(1), 24-30. doi:10.1891/1933-3196.1.1.24.

Language: English

Format: Journal

Abstract:
Eye movement desensitization and reprocessing (EMDR) has emerged as a promising new treatment for trauma and other anxiety-based disorders. However, the neurobiological mechanism of EMDR has not been well understood. This study reports changes in the resting regional cerebral blood flow after successful EMDR treatment in 2 patients with PTSD. Brain 99mTc-ECD-SPECT (Technetium 99m-ethyl cysteinate dimmer-single photon emission computerized tomography) was performed before and after EMDR, and, in addition, a pre- and posttreatment comparison was made with 10 non-PTSD participants as a control group. After EMDR, cerebral perfusion increased in bilateral dorsolateral prefrontal cortex and decreased in the temporal association cortex. The differences between participants and normal controls also decreased. Changes appeared mainly in the limbic area and the prefrontal cortex. These results are in line with current understanding of neurobiology of PTSD. EMDR treatment appears to reverse the functional imbalance between the limbic area and the prefrontal cortex. [Author Abstract]

Keywords: Adults Brain Imaging Females Koreans Motor Traffic Accidents Neuroimaging Neurophysiology Posttraumatic Stress Disorder Psychiatric Inpatients PTSD Rape RCBF Regional Cerebral Blood Flow Single Photon Emission Computerized Tomography Survivors Treatment Effectiveness

Accuracy Verified: Yes

4. Pagani, M., Högberg, G., Fernandez, I., & Siracusano, A. (2013). Correlates of EMDR therapy in functional and structural neuroimaging: A critical summary of recent findings. Journal of EMDR Practice and Research, 7(1), 29-38. doi:10.1891/1933-3196.7.1.29.

Language: English

Format: Journal

Abstract:
Neuroimaging investigations of the effects of psychotherapies treating posttraumatic stress disorder (PTSD), including eye movement desensitization and reprocessing (EMDR), have reported findings consistent with modifications in cerebral blood flow (CBF; single photon emission computed tomography [SPECT]), in neuronal volume and density (magnetic resonance imaging [MRI]), and more recently in brain electric signal (electroencephalography [EEG]). Additionally in the recent past, EMDR- related neurobiological changes were monitored by EEG during therapy itself and showed a shift of the maximal activation from emotional limbic to cortical cognitive brain regions. This was the first time in which neurobiological changes occurring during any psychotherapy session have been reported, making EMDR the first psychotherapy with a proven neurobiological effect. The purpose of this article was to review the results of functional and structural changes taking place at PTSD treatment and presented during the period of 1999–2012 by various research groups. The reported pathophysiological changes are presented by neuropsychological technique and implemented methodology and critically analyzed.

Keywords: EEG Limbic System MRI Neurobiology SPECT

Accuracy Verified: Yes

5. Pagani, M. (2013, June). Functional and structural neuroimaging and EEG monitoring related to EMDR and CBT treatments for PTSD. Presentation at the 13th annual conference for the European Society for Traumatic Stress Studies (ESTSS), Bologna, Italy.

Language: English

Format: Conference

Abstract:
In the recent past several neuroimaging studies aimed at evaluating the neural correlates of PTSD-related psychotherapies revealing their neurobiological effects on brain function. Functional studies by single photon emission computed tomography (SPECT) and electroencephalography (EEG) detected changes in cerebral blood flow and neuronal activation patterns, identifying the brain areas implicated in the various components of emotional processing and/or affected by the disorder. Investigations by magnetic resonance imaging (MRI) have also revealed PTSD-related structural changes. The first part of the workshop will review the neuroimaging methodologies and findings in PTSD treatment-related research with an extensive review of previous literature on the neurobiological effects of the various psychotherapies. The second part will deal with the description and implementation in research and clinic of neuropsychological testing with brief comments and discussion about their use in recent studies published by our group. In the third part the EEG monitoring of a complete set of Eye Movement Desensitization and Reprocessing therapies in 30 patients suffering of major trauma as compared to 20 healthy controls will be presented. These findings will also be compared to the neurobiological effects of trauma-focussed Cognitive Behavioural Therapy in a second group of psychologically traumatized clients. The results are the first report ever on the neurobiological changes occurring before, during and after PTSD-related psychotherapies shedding light on the neuronal processes underlying their clinical efficacy. 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 neuroimaging techniques (SPECT, EEG and MRI) and their possible applications in research and clinic; (2) the up-dated critical knowledge of the published papers in the field of PTSD-related psychotherapies functional and anatomical studies; (3) the basic research principles and examples to be motivated to start, take part and/or collaborate to functional studies in order to better understand the neural basis of psychotherapeutic techniques. The presented material will represent the state-of-the-art of the current neuroscience PTSD-related research and of the neuroimaging methodologies available at the moment.

Keywords: CBT Cognitive Behavior Therapy EEG Monitoring Neuroimaging Posttraumatic Stress Disorder PTSD

Accuracy Verified: Yes

6. 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

7. 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

8. 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

9. 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

10. 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

11. 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

12. 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

13. 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

14. 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

15. 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