Francine Shapiro Library ~ EMDR Bibliography

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1. Solvey, P., & Ferrazzano de Solvey, R. C. (2006, January 2). Algunas fobias...¿Algunos traumas? - Segunda Parte [Some phobias...some traumas - Part 2]. DePsicoterapias S.R.L. Retrieved from http://www.depsicoterapias.com/articulo.asp?IdArticulo=542/8/2009.

Language: Spanish

Format: Other

Abstract:
Este artículo postula una relación unívoca, causa efecto entre la existencia de un trauma y la aparición posterior de una fobia. Estos traumas pueden ser de distinta naturaleza, pueden ser recordados y relacionados con la fobia, recordados y no relacionados con la fobia, olvidados y cuyo recuerdo emerge con las técnicas de avanzada, y traumas perinatales, cuyo recuerdo también puede emerger durante el reprocesamiento de la fobia. Se incluye una casuística de ejemplos clínicos, complementando la parte teórica de este trabajo, que postula una función de evolución adaptativa para las fobias.

This article posits a unilinear relation cause-effect relationship between the existence of a trauma and the subsequent appearance of a phobia. These traumas can be of different nature, can be remembered and associated with the phobia, remembered and not related to the phobia, forgotten and whose memory emerges with advanced techniques, and perinatal trauma, the memory may also emerge during the reprocessing of phobia. It includes a case series of clinical examples, complementing the theoretical part of this work, we hypothesize a role of adaptive evolution for phobias.

Keywords: Phobias Trauma

Accuracy Verified: Yes

2. Solvey, P., & Ferrazzano de Solvey, R. C. (2006, January 3). Algunas fobias...¿algunos traumas? [Some phobias...some traumas?]. DePsicoterapias S.R.L. Retrieved from ://translate.google.com/translate?hl=en&sl=es&u=http://www.depsicoterapias.com/articulo.asp%3FIdArticulo%3D54&ei=jV-zS9rxA4aKlwfm1_m7BA&sa=X&oi=translate&ct=result&resnum=1&ved=0CA0Q7gEwAA&prev=/search%3Fq%3DAlgunas%2Bfobias...%25C3%2582%25C2%25BFalgunos%2Btraumas%253F%26hl%3Den%26rlz%3D1T4SNNT_enUS353US354 3/12/2006.

Language: Spanish

Format: Other

Abstract:
Este artículo postula una relación unívoca, causa efecto entre la existencia de un trauma y la aparición posterior de una fobia. Estos traumas pueden ser de distinta naturaleza, pueden ser recordados y relacionados con la fobia, recordados y no relacionados con la fobia, olvidados y cuyo recuerdo emerge con las técnicas de avanzada, y traumas perinatales, cuyo recuerdo también puede emerger durante el reprocesamiento de la fobia. Se incluye una casuística de ejemplos clínicos, complementando la parte teórica de este trabajo , que postula una función de evolución adaptativa para las fobias.

This article posits a unilinear relation cause-effect relationship between the existence of a trauma and the subsequent appearance of a phobia. These traumas can be of different nature, can be remembered and associated with the phobia, remembered and not related to the phobia, forgotten and whose memory emerges with advanced techniques, and perinatal trauma, the memory may also emerge during the reprocessing of phobia. It includes a case series of clinical examples, complementing the theoretical part of this work, we hypothesize a role of adaptive evolution for phobias.

Keywords: Phobias Trauma

Accuracy Verified: Yes

3. 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

4. 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

5. Falaschi, R., & Tizzani, E. (2001, October). Changes in electroencephalographic quantitative analysis in patients treated with EMDR. In International CIANS Conference (CIANS: Collegium Internationale Activitatis Nervosae Superioris; International Association for Integrative Nervous Functions, Neurobiology of behaviour and Psychosomatics), (p 159) Palermo.

Language: English

Format: Other

Abstract:
EMDR’s basic working theory assumes that traumatic memories remain unprocessed because the innate information processing system is stuck by the psychophysiological effects of trauma. Traumatic events are stored in their original form, and the recall of traumatic memories causes a high level of disturbance.
Left-right rhythmic stimulations of EMDR seem to remove the block in the traumatic memories processing and help memories storing mechanism function at an adaptive level. In recent years, many scientific researches have focused on the opportunity to assess the functional connection between different brain areas through quantitative analysis of EEG.
According to the aim of this presentation, our attention was drawn to the correlation between slow bands (4- 7 Hz) and the activity in the sub-cortical areas involved in working memory and, also, high frequency ranges (> 36 Hz) and cortical activities during sensorial stimuli processing. There are a few quantitative EEG studies on patients with PTSD. The EEG analysis of subject with childhood abuse histories revealed less synchronization in the two hemispheres functioning compared to normal control subjects.
EEG quantitative analysis in abused children showed a higher intra-hemispheric left coherence and a lower intra-hemispheric right coherence in comparison with normal control subjects. According to these results, the aim of this presentation is to test if there are recordable changes in the intra and inter hemispheric synchronization between brain areas where information processing occurs (limbic system, prefrontal cortical area, and posterior cortical areas) in patients with PTSD after EMDR treatment.

Keywords: EEG Posttraumatic Stress Disorder PTSD

Accuracy Verified: Yes

6. Bergmann, U. (2000, September). Further thoughts on the neurobiology of EMDR: The role of the cerebellum in accelerated information processing. Traumatology, 6(3), 175-200. doi:10.1177/153476560000600303.

Language: English

Format: Journal

Abstract:
This discussion explores, briefly, the position that the repetitive redirecting of attention in EMDR is capable of turning on the brain's REM sleep system, leading to the activation of specific areas of the the anterior cortex of the cingulate gyrus, facilitating its function as a filter, thereby facilitating the integration of traumatic memory into general semantic networks. This integration is seen to lead to the subsequent reduction in both the strength of hippocampally mediated episodic memories of the traumatic event as well as the amygdaloid mediated negative affect of PTSD. The possibility is suggested that another underlying mechanisms of EMDR stimulation is the activation of the lateral cerebellum. The contribution of the cerebellum to cognitive and language functions is explored. The activation of the dentate nuclei in the lateral neocerebellum is shown to facilitate activation of the ventrolateral and central lateral thalamic nuclei. The activation of the ventrolateral nucleus is shown to lead to the activation of the left dorsolateral prefrontal cortex; further facilitating the integration of traumatic memory into general semantic and other neocortical networks. [Author Abstract]

Keywords: Cognitive Processes Neurobiology Posttraumatic Stress Disorder PTSD Sleep Behavior Stressors Survivors

Accuracy Verified: Yes

7. Pagani, M., Nardo, D., Höberg, G., & Larson, S. (2009, November). Gray matter changes in limbic cortex in PTSD are associated with trauma load and EMDR outcome. Presentation at the 25th annual meeting of the International Society for Traumatic Stress Studies, Atlanta, GA.

Language: English

Format: Conference

Abstract:
Psychophysiological Research
There is converging evidence of gray matter (GM) structural alterations in different limbic structures in Post-Traumatic Stress Disorder (PTSD) patients. The aim of this study was to evaluate GM reduction in PTSD in relation to trauma load, and to assess the volumetric differences between responders (R) and non-responders (NR) to EMDR therapy. Magnetic Resonance Imaging scans of 21 subjects exposed to occupational trauma, who developed PTSD (S), and of 22 who did not (NS), were compared by means of an optimized Voxel-Based Morphometry (VBM) analysis as implemented in SPM. Within S, further comparisons were made between 10 R and 5 NR. A regression analysis between GM density and the Traumatic Antecedents Questionnaire (TAQ) was also performed on all 43 subjects. Results showed a highly significant GM volume reduction in S as compared to NS, bilaterally in posterior cingulate and in the left hemisphere in precuneus, lingual and parahippocampal gyri. Moreover, NR showed a highly significant GM volume reduction as compared to R in bilateral posterior cingulate, as well as insula, parahippocampal gyrus and amygdala in the right hemisphere. Regression analysis showed that GM volume reductions positively correlated with trauma load in bilateral anterior and posterior cingulate and right parahippocampal gyrus. In conclusion, GM volume reductions in posterior cingulate and parahippocampal cortex were associated with PTSD diagnosis, trauma load, and EMDR treatment outcome.

Keywords: Limbic Cortex Posttraumatic Stress Disorder PTSD Outcome Trauma Load

Accuracy Verified: Yes

8. Nardo, D., Hogberg, G., Looi, J. C., Larsson, S., Hallstrom, T., & Pagani, M. (2010, May). Gray matter density in limbic and paralimbic cortices is associated with trauma load and EMDR outcome in PTSD patients. Journal of Psychiatric Research, 44(7), 477-485. doi:10.1016/j.jpsychires.2009.10.014.

Language: English

Format: Journal

Abstract:
There is converging evidence of gray matter (GM) structural alterations in different limbic structures in Post-Traumatic Stress Disorder (PTSD) patients. The aim of this study was to evaluate GM density in PTSD in relation to trauma load, and to assess the GM differences between responders (R) and non-responders (NR) to EMDR therapy. Magnetic Resonance Imaging (MRI) scans of 21 subjects exposed to occupational trauma, who developed PTSD (S), and of 22 who did not (NS), were compared by means of an optimized Voxel-Based Morphometry (VBM) analysis as implemented in SPM. Within S, further comparisons were made between 10 R and 5 NR. A regression analysis between GM density and the Traumatic Antecedents Questionnaire (TAQ) was also performed on all 43 subjects. Results showed a significantly lower GM density in S as compared to NS in the left posterior cingulate and the left posterior parahippocampal gyrus. Moreover, NR showed a significantly lower GM density as compared to R in bilateral posterior cingulate, as well as anterior insula, anterior parahippocampal gyrus and amygdala in the right hemisphere. Regression analysis showed that GM density negatively correlated with trauma load in bilateral posterior cingulate, left anterior insula, and right anterior parahippocampal gyrus. In conclusion, a GM lower density in limbic and paralimbic cortices were found to be associated with PTSD diagnosis, trauma load, and EMDR treatment outcome, suggesting a view of PTSD characterized by memory and dissociative disturbances.[Pubmed]

Keywords: Limbic Cortex Posterior Cingulate Posttraumatic Stress PTSD

Accuracy Verified: Yes

9. Pagani, M. (2010, June). Gray matter density is associated with EMDR outcome in PTSD patients. In Research. Symposium conducted at the annual meeting of the EMDR Europe Association, Hamburg, Germany.

Language: English

Format: Conference

Abstract:
There is converging evidence of gray matter (GM) structural alterations in different limbic structures in Post-Traumatic Stress Disorder patients. Eye Movement Desensitization Reprocessing (EMDR) is currently used to treat PTSD but its neurobiological implications are still unknown. The aim of this study was to evaluate GM density in PTSD relation to trauma load, and to assess the GM differences between responders (R) and non-responders (NR) to EMDR therapy. Structured clinical interviews for DSM-IV Axis I Disorders were carried out before and after EMDR treatment. Those who no longer fulfilled the DSM-IV criteria for PTSD were classified as R and those who still met the diagnostic criteria of PTSD after treatment were classified as NR. Two scales 0f self-related Trauma Antecedent Questionnaire (‘trauma and neglect’ TAQ-, and ‘resilience factors’ TAQ+), were administered to assess lifelong trauma load and resilience. Magnetic Resonance Imaging (MRI) scans 10 R and of 5 NR were compared before therapy by means of an optimized Voxel-Based Morphometry (VBM) analysis as implemented in SPM. For group analysis, a threshold of p<0.05 corrected for multiple comparisons at cluster level and an uncorrected threshold of p <0.001 at voxel-level were used. NR subjects showed no significant differences nor in TAQ- scores neither in TAQ+ as compared to R(t=0.140, p+0.891). The contract R>NR exhibited a significant GM lower density in NR as compared to R in three different cluster: the first bilaterally located over posterior cingulate (Brodmann Areas, Bas 23 and 31); the second centered over the left precentral (BA 4), middle and medial frontal gyri (BA 6); the third including anterior insula (BA 13), and the complex anterior parahippocampal gyrus/amygdala, over the right hemisphere. To our knowledge, this is the first study investigating GM alterations with a VBM approach in a sample of PTSD patients respond and non responding to EMDR therapy. Posterior cingulate, parahippocampal and insular lower GM concentrations have been found to relate to responsiveness to EMDR therapy suggesting a high vulnerability of these structures to the effects of stress and trauma. These regions are well known to be implicated in processes such as: integration, encoding and retrieval of autobiographical and episodic memories; emotional processing, interoceptive awareness and sefl-referential conscious experience. Thus, our study supports lower GM densities in limbic and paralimbic cortices as a potential structural basis for memory and dissociative dysfunction in PTSD. Using such methodological approach can contribute to better understand the neurostructural basis for traumatic responses and their treatment. The goals for the audience are: 1. To understand the methodological research principles; 2. To be updated on neurobiological research in EMDR; 3. to be informed on the neural basis of EMDR.

Keywords: Gray Matter Posttraumatic Stress Disorder PTSD Research Symposium

Accuracy Verified: Yes

10. Bergmann, U. (1999, November). How does EMDR work? An exploration of possible neurobiological mechanisms. Presentation at the annual meeting of the International Society for the Study of Dissociation Fall Conference, Miami, FL.

Language: English

Format: Conference

Abstract: This discussion explores, briefly, the position that the repetitive redirecting of attention in EMDR is capable of turning on the brain's REM sleep system, leading to the activation of specific areas of the the anterior cortex of the cingulate gyrus, facilitating its function as a filter, thereby facilitating the integration of traumatic memory into general semantic networks. This integration is seen to lead to the subsequent reduction in both the strength of hippocampally mediated episodic memories of the traumatic event as well as the amygdaloid mediated negative affect of PTSD. The possibility is suggested that another underlying mechanisms of EMDR stimulation is the activation of the lateral cerebellum. The contribution of the cerebellum to cognitive and language functions is explored. The activation of the dentate nuclei in the lateral neocerebellum is shown to facilitate activation of the ventrolateral and central lateral thalamic nuclei. The activation of the ventrolateral nucleus is shown to lead to the activation of the left dorsolateral prefrontal cortex; further facilitating the integration of traumatic memory into general semantic and other neocortical networks

Keywords: Cognitive Processes Neurobiology Posttraumatic Stress Disorder PTSD Sleep Behavior Stressors Survivors

Accuracy Verified: Yes

11. Kaye, B. (2006). Interactive cognitive motor interweaves during EMDR. Cary, NC: Allied Psychological Services.

Language: English

Format: Other

Abstract:
A new interweave technique is described for when patients are slow to desensitize or when they are emotionally overwhelmed during EMDR treatment. The interweave is comprised of two parallel components: a finger-touching go/no-go tracking task as well as a semantic priming task. The theoretical rationale for the finger-touching task is explained relative to neuroimaging studies of the anterior cingulate cortex and other areas. The rationale for the semantic priming task is explained relative to research about dopaminergic activation projecting from the ventral tegmentum as well as novelty generated orienting responses. A two-stage model is proposed for constructing effective EMDR stimulation techniques.

Keywords: Cognitive Interweave

Accuracy Verified: Yes

12. Corrigan, F. (2002). Mindfullness, dissociation, EMDR and the anterior cingulate cortex: A hypothesis. Contemporary Hypnosis, 19(1), 8-17. doi:10.1002/ch.235.

Language: English

Format: Journal

Abstract:
Hypotheses on the neurobiology of a mindfulness-dissociation continuum are presented. Crucial to the hypotheses are the observations of a reciprocal interaction between the cognitive and affective subdivisions of the anterior cingulate cortex and the unilateral activation of right anterior cingulate in hypnotic dissociation and in post-traumatic syndromes. It is proposed that the unilateral activation can cause a loss of the reciprocal relationship between the subdivisions and that in the case of peri-traumatic dissociation the subsequent syndrome responds to eye movement desensitization and reprocessing (EMDR) through restoration of the bilateral activation and reinstatement of the reciprocal relationship between the subdivisions. Bilateral activation of the cognitive subdivisions is proposed to underlie the attentional state of concentration mindfulness in which affect is well regulated. Copyright © 2002 British Society of Experimental and Clinical Hypnosis

Keywords: Anterior Cingulate Cortex Bilateral Activation Dissociation Emotional Trauma Gyrus Cinguli Hypnosis Hypnotic Dissociation Mindfulness Posttraumatic Syndromes Reciprocal Interaction

Accuracy Verified: Yes

13. Pagani, M., Flumeri, F., Salmaso, D., Nardo, D., Sanchez-Crespo, A., Danielsson, A. M., Brolin, F., Jacobsson, H., Larsson, S. A., & Hogberg, G. (2008, October). Neurobiological changes in post traumatic stress disorder following treatment with eye movement desensitisation reprocessing. Presentation at the European Association of Nuclear Medicine Congress, Munich, Germany, European Journal of Nuclear Medical and Molecular Imaging, 35(Supp 2).

Language: English

Format: Conference

Abstract:
Background: Only few studies have reported functional or structural modifications in Post Traumatic Stress Disorder (PTSD) patients following pharmacological treatment or psychotherapy. Eye movement desensitization and reprocessing (EMDR) is a novel eclectic psychotherapy utilising, among other techniques, relaxation and safe place exercises, cognitive restructuring, future projections, and imaginal exposure of the trauma combined with sensory stimulation. The aim of the study was to analyse the differences in regional cerebral blood flow (rCBF) distribution and in brain volumetry before and after EMDR therapy. Subjects and Methods: Fifteen subjects with chronic PTSD following occupational health hazards were treated with five sessions of EMDR. They were assessed with psychometric scales and diagnostic interviews before and directly after treatment. SPECT, during administration of an individualised trauma script, was performed using 99mTc-HMPAO. After EMDR, the subjects were subdivided into responders (R, n=10) and non-responders (NS, n=5), based on the absence or presence, respectively, of full PTSD diagnosis. SPECT and volumetric data (MRI) analyses were carried out by Statistical Parametric Mapping (SPM2). SPECT and MRI data were covaried by age and by time elapsed from trauma to SPECT. SPECT data were further covaried by the amount of grey matter normalised by the total intracranial volume. Results: Immediate significant post-treatment changes towards normality in all scales measuring psychological status were found in responders. As compared to NR, R showed a significantly decreased tracer uptake in parieto-occipital (Brodmann Area, BA, 37, fusiform gyrus) and in primary visual cortex (BA17) and in the hippocampus (p<0.001). The opposite comparison highlighted an increased tracer uptake in left frontal cortex (BA 44; p<0.05). Structural grey matter modifications were found in visual, posterior cingulate and parieto-temporal cortex, paralleling the functional changes. Conclusion: The positive EMDR outcome corresponded to increased 99mTc-HMPAO uptake in the left dorsolateral frontal cortex, processing attention and self confidence and exerting an inhibitory effect on the amygdala whose firing is supposed to be responsible for PTSD. After successful treatment significant decreases were found in primary visual cortex, processing images of traumatic memories and flashbacks; in fusiform gyrus, processing the memories of faces, bodies and words and in the hippocampi, involved in episodic and autobiographical memories. Volumetric changes paralleled the ones in tracer uptake in all regions Taken as a whole these findings suggest that the positive clinical outcome following EMDR therapy causes functional and structural neurobiological changes towards normality.

Keywords: Brain Volumetry Neurobiological Changes Posttraumtic Stress Disorder PTSD rCBF Regional Cerebral Blood Flow

Accuracy Verified: Yes

14. Pagani, M., DiLorenzo, G., Verardo, A. R., Nicolais, G., Monaco, L., Lauretti, G., Russo, R., Niolu, C., Ammaniti, M. Fernandex, I., & Siracusano, A. (2012). Neurobiological correlates of EMDR monitoring - an EEG study. PLoS ONE, 7(9), 1-12. doi:10.1371/journal.pone.0045753.

Language: English

Format: Journal

Abstract:
Background: Eye Movement Desensitization and Reprocessing (EMDR) is a recognized first-line treatment for psychological trauma. However its neurobiological bases have yet to be fully disclosed. Methods: Electroencephalography (EEG) was used to fully monitor neuronal activation throughout EMDR sessions including the autobiographical script. Ten patients with major psychological trauma were investigated during their first EMDR session (T0) and during the last one performed after processing the index trauma (T1). Neuropsychological tests were administered at the same time. Comparisons were performed between EEGs of patients at T0 and T1 and between EEGs of patients and 10 controls who underwent the same EMDR procedure at T0. Connectivity analyses were carried out by lagged phase synchronization. RESULTS: During bilateral ocular stimulation (BS) of EMDR sessions EEG showed a significantly higher activity on the orbito-frontal, prefrontal and anterior cingulate cortex in patients at T0 shifting towards left temporo-occipital regions at T1. A similar trend was found for autobiographical script with a higher firing in fronto-temporal limbic regions at T0 moving to right temporo-occipital cortex at T1. The comparisons between patients and controls confirmed the maximal activation in the limbic cortex of patients occurring before trauma processing. Connectivity analysis showed decreased pair-wise interactions between prefrontal and cingulate cortex during BS in patients as compared to controls and between fusiform gyrus and visual cortex during script listening in patients at T1 as compared to T0. These changes correlated significantly with those occurring in neuropsychological tests. Conclusion: The ground-breaking methodology enabled our study to image for the first time the specific activations associated with the therapeutic actions typical of EMDR protocol. The findings suggest that traumatic events are processed at cognitive level following successful EMDR therapy, thus supporting the evidence of distinct neurobiological patterns of brain activations during BS associated with a significant relief from negative emotional experiences.

Keywords: EEG Study Neurobiological Correlates

Accuracy Verified: Yes

15. Pagani, M., Nardo, D., Flumeri, F., Salmaso, D., Looi, J., Sanchez-Crespo, A., Larsson, S.A., Sundin, Ö., Hogberg, G., & Bejerot, S. (2009, January). P03-58 Volumetric changes in PTSD and in a subgroup of PTSD patients not responding to EMDR psychotherapy. European Psychiatry, 24(Supplement 1), S1057-S1057. doi:10.1016/S0924-9338(09)71290-8.

Language: English

Format: Journal

Abstract:
Background: Several studies have reported limbic structures volume decrease in Post-Traumatic Stress Disorder (PTSD). However, in PTSD the effect of therapy on brain structures has seldom been investigated. The aim of the study was to evaluate the grey matter (GM) loss in occupational related PTSD and to assess the volumetric differences between patients responding (R) and non-responding (NR) to psychotherapy. Methods: Pre-EMDR MRI data of 21 train drives who did develop PTSD (S) and 22 who did not develop PTSD (NS) after person-under-the-train accidents were compared. Within S further comparisons were made between 10 R to Eye Movement Desensitisation Reprocessing (EMDR) therapy and 5 NR. Data were analysed by optimised voxel-based morphometry as implemented in Statistical Parametric Mapping. Results: As compared to NS, S showed a significant GM volume reduction in precuneus, lingual gyrus, posterior cingulate and parahippocampal cortex. The R>NR comparison highlighted a significant GM reduction in NR in bilateral posterior cingulate, left middle frontal cortex and right parahippocampal, insular and temporal cortices. Conclusions: Comparing two large groups of subjects significant GM volumetric reductions were found in PTSD in posterior limbic structures. NR showed, as compared to R, volume reduction in cortical structures including posterior cingulate and parahippocampal cortex. These latter two structures seem to be the hallmark for both PTSD diagnosis and therapy outcome prediction.

Keywords: Posttraumatic Stress Disorder PTSD

Accuracy Verified: Yes

16. Park, S.-C. (2011, February). Plasma levels of neurotrophic factors predict responses to eye movement desensitization and reprocessing in complex posttraumatic stress disorder. Hanyang University, Graduate School, Seoul, Korea.

Language: English

Format: Dissertation/Thesis

Abstract:
Complex PTSD is a proposed diagnosis that describes psychological sequelae of survivors with prolonged, repeated, and interpersonal trauma, including childhood physical abuse, incest, and other forms of family violence (Herman, 1992). The diagnostic criteria for complex PTSD are composed of the functional alterations in six areas: (1) regulation of affect and impulses; (2) attention or consciousness; (3) self-perception; (4) relations with others; (5) somatization; and (6) system of meaning (Pelcovitz et al., 1997). Recently, a morphometric study showed that patients with childhood abuse-related complex PTSD had more extensive involvements of neural substrates (reduced anterior cingulate and orbitofrontal volumes) than those with classical PTSD (Thomaes et al., 2009). Changes in the neural substrates of patients with complex PTSD may reflect the relationship, established in critical developmental phases, between traumatic experiences and neurobiological factors. Eye movement desensitization and reprocessing (EMDR) is an integrative and comprehensive psychotherapy that contains various effective elements of psychodynamic, cognitive-behavioral, interpersonal, and body-centered therapies (Shapiro and Maxfield, 2002). It was originally developed to resolve symptoms of psychic trauma, and has been shown to be highly effective in reducing the symptoms of posttraumatic stress disorder (PTSD) (Bradely et al., 2005; van der Kolk et al., 2007). It has been also proposed as a rapid and effective application for treating the core symptoms of complex PTSD (Korn and Leeds, 2002; Kim and Choi, 2004; Kim, 2003). Thus, the investigation of the effects of treatment of complex PTSD by EMDR may reveal aspects of neurobehavioral plasticity dependent on neurotrophic factors.

Keywords: Complex Posttraumatic Stress Disorder Complex PTSD C-PTSD Neurotrophic Factors Plasma Levels

Accuracy Verified: Yes

17. Corrigan, F. M. (2004). Psychotherapy as assisted homeostasis: Activation of emotional processing mediated by the anterior cingulate cortex. Medical Hypotheses, 63(6), 968-973. doi:10.1016/j.mehy.2004.06.009.

Language: English

Format: Journal

Abstract:
Although psychotherapy is successful in altering emotional distress, the biological mechanism by which it achieves this has not been the subject of intensive neurobiological investigation. Mindful processing of emotion has been proposed to be a key factor in prevention of relapse in depressive illness and here that hypothesis is developed and extended to include other conditions in which emotion processing may be obstructed or dysregulated. Cognitive therapy, interpersonal psychotherapy, psycho-dynamic psychotherapy, and dialectical behaviour therapy, each in a different way and with a distinct emphasis, encourage awareness of emotions and their associated cognitions and biographies, and their varying success may depend on the degree to which they achieve activation of internal healing processes. In eye movement desensitisation and reprocessing (EMDR), the selected target is formatted for endogenous processing which is facilitated and accelerated by eye movements or alternating bilateral auditory or tactile stimulation. The ability to sustain focussed attention on the affect and its visceral, cognitive, and biographical components is postulated to activate a homeostatic process of distress resolution, seen most clearly in treatment of PTSD with EMDR, in which resolution of distress can be intense and rapid while therapist input is non-directive, although supportive, empathic, and non-judgemental. Once the therapist has helped to frame the questions, the patient's brain will find the answers needed for the resolution of the distress and all the components of the traumatic event, whether visceral, cognitive, affective, or interpersonal. The anterior cingulate cortex, especially the dorsal and rostral components, is suggested to be the key neurobiological substrate for the efficacious psychotherapeutic relief of distress, and relevant functional neuroimaging studies are summarised. One limitation of some previous imaging studies of emotion is that they have tended to use mild stimuli to discrete emotions. An alternative approach would be to image the brain during reprocessing of an unpleasant event which has profoundly affected the person so that the associated intense emotions could be clearly labelled and correlated with changes in regional brain functioning. [Author Summary]

Keywords: Cognitive Processes Cognitive Therapy Neurobiology

Accuracy Verified: Yes

18. Pagani, M., Nardo, D., Flumeri, F., Salmaso. D., Looi, J., Sanchez-Crespo, A., Larsson, S. A., Sundin, Ö., Hogberg, G., Bejerot, S. (2009, January). PW04-01 Volumetric changes in PTSD and in a subgroup of PTSD patients not responding to EMDR psychotherapy. European Psychiatry, 24(Supplement 1), S355. doi:10.1016/S0924-9338(09)70588-7.

Language: English

Format: Journal

Abstract:
(1)Background: Several studies have reported limbic structures volume decrease in Post-Traumatic Stress Disorder (PTSD). However, in PTSD the effect of therapy on brain structures has seldom been investigated. The aim of the study was to evaluate the grey matter (GM) loss in occupational related PTSD and to assess the volumetric differences between patients responding (R) and non-responding (NR) to psychotherapy. (2)Methods: Pre-EMDR MRI data of 21 train drives who did develop PTSD (S) and 22 who did not develop PTSD (NS) after person-under-the-train accidents were compared. Within S further comparisons were made between 10 R to Eye Movement Desensitisation Reprocessing (EMDR) therapy and 5 NR. Data were analysed by optimised voxel-based morphometry as implemented in Statistical Parametric Mapping. (3)Results: As compared to NS, S showed a significant GM volume reduction in precuneus, lingual gyrus, posterior cingulate and parahippocampal cortex. The R>NR comparison highlighted a significant GM reduction in NR in bilateral posterior cingulate, left middle frontal cortex and right parahippocampal, insular and temporal cortices. (4)Conclusions: Comparing two large groups of subjects significant GM volumetric reductions were found in PTSD in posterior limbic structures. NR showed, as compared to R, volume reduction in cortical structures including posterior cingulate and parahippocampal cortex. These latter two structures seem to be the hallmark for both PTSD diagnosis and therapy outcome prediction.

Keywords: Posttraumatic Stress Disorder PSTD

Accuracy Verified: Yes

19. Kowal, J. (2008, September). QEEG analysis of EMDR in the treatment of childhood trauma. Presentation at the annual meeting of the EMDR International Association, Phoenix, AZ.

Language: English

Format: Conference

Abstract:
The presentation will examine the quantitative electroencephalogram (EEG) of patients with PTSD that reveals high amplitude low frequencies in the posterior region of the brain. These brain wave patterns also form abnormal amplitude asymmetries that are present prior to treatment. After EMDR treatment there is a marked improvement in the brain wave abnormalities. The presentation will explain the quantitative measurements obtained from digital analysis of quantitative EEGs and will compare the pre-treatment and post-treatment EEG analysis of PTSD patients. Analyzing the brain patterns of various psychological disorders reveals similarity in brain wave activity that interferes with memory.

Keywords: QEEG Trauma

Accuracy Verified: Yes

20. Kaye, B. (2008). Reversing reciprocal suppression in the anterior cingulated cortex: A hypothetical model to explain EMDR effectiveness. Journal of EMDR Practice and Research, 2(1), 88-99. doi:10.1891/1933-3196.1.2.88.

Language: English

Format: Journal

Abstract:
A theoretical model is proposed to explain desensitization during Eye Movement Desensitization and Reprocessing (EMDR) as resulting from the reversal of reciprocal suppression of cognitive processing in the anterior cingulate cortex (ACC). Dual-attention and error monitoring are known to activate dorsal regions of the ACC that mediate metacognitive processing. Neuroimaging research has produced evidence that cognitive areas in the upper ACC may reciprocally suppress affective processing in the lower areas and vice versa. It is therefore proposed that the original eye-to-finger tracking task of EMDR may achieve its therapeutic effect by using error monitoring to reverse suppression of the upper ACC by the lower ACC. Contributions to EMDR effectiveness from resource installation and novelty-driven orienting reflexes may also influence ACC functioning. A distraction effect is proposed to be a negative and potentially disruptive by-product of very interactive stimulation tasks. A semantic priming procedure is suggested to limit distraction effects during more interactive forms of stimulation. [Author Abstract]

Keywords: Anterior Cingulate Cognitive Processes Neurotransmitters Reciprocal Suppression Semantic Priming

Accuracy Verified: Yes

21. Grant, M. (2000). Speculations on how EMDR might work to alleviate pain. Autism Today. Retrieved from http://www.autismtoday.com/articles/Finger-flash-therapy-catches-on.htm on 1/8/2013.

Language: English

Format: Other

Abstract:
Some of the key players of the central nervous system in pain are the thalamus, the amygdala, the anterior cingulate cortex and the frontal cortex. The Central Nervous System is also not 'hard-wired' but kept in a stable state by elaborate control mechanisms. If these control mechanisms become unstable, as a result of say prolonged stress, neurological changes can occur, producing symptoms such as those found in trauma and chronic pain.

Keywords: Chronic Pain

Accuracy Verified: Yes

22. 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

23. Robredo, J. (2011, Julio). Tratamiento con EMDR en menores victimas de abuso [EMDR treatment with children victims of abuse]. En Aplicación de EMDR en el tratamiento de distintos trastornos (Francisca García Guerrero, Coordinadora). Simposio realizado en el IX Congreso Nacional de Psicología Clínica, San Sebastián, España .

Language: Spanish

Format: Conference

Abstract:
Las estadísticas acerca del maltrato físico de los niños son alarmantes. Se estima que cientos de miles de niños han recibido abuso y maltrato a manos de sus padres o parientes. Los que sobreviven el abuso, viven marcados por el trauma emocional, que perdura mucho después de que las consecuencias físicas hayan desaparecido. A menudo el daño emocional severo a los niños maltratados no se refleja hasta la adolescencia, o aún más tarde, cuando muchos de estos niños maltratados se convierten en padres abusivos y comienzan a maltratar a sus propios hijos. El reconocer y dar tratamiento inmediato es importante para minimizar los efectos a largo plazo causados por el abuso o maltrato físico. En este sentido, en los últimos años venimos trabajando con menores que han sido víctimas de abuso, negligencia, violencia familiar o abandono. El abordaje terapéutico desde el EMDR se muestra como un paradigma muy eficaz a la hora de trabajar con niños y menores. El trabajo con la red de recuerdos y el reprocesamiento de recuerdos traumáticos ayuda a su recuperación. A través de los dibujos que los niños han ido haciendo en las sesiones se observa como el reprocesamiento en el niño es diferente al del adulto. Además la etapa del desarrollo del niño interfiere tanto en el modo de procesar información traumática como en la construcción de los recuerdos y su posterior reprocesamiento. Por lo que los protocolos de EMDR en el niño son diferentes a los del adulto para que sean igualmente eficaces. En esta comunicación se presenta el protocolo de trabajo para tratar a los menores víctimas de abuso, desarrollado desde la perspectiva de EMDR, exhibiendo cómo funciona el protocolo a través de la presentación de los datos que se han ido recogiendo durante la aplicación del programa de intervención.

The statistics on physical child abuse are alarming. It is estimated that hundreds of thousands of children are physically abused by their parents or relatives. Those who survive abuse, living marked by the emotional trauma remains long after the physical consequences are gone. Often the emotional damage severely abused children is not reflected until adolescence or even later, when many of these abused children become abusive parents and begin to abuse their own children. Early recognition and treatment is important for minimize long-term effects caused by abuse or physical abuse. In this regard, in recent years we have been working with children who have been victims of abuse, neglect, family violence or neglect. The therapeutic approach from the EMDR appears as a very effective paradigm for working with children and minors. Working with the memory network and reprocessing of traumatic memories aid their recovery. Through drawings children have been doing in the sessions were observed as the reprocessing in children is different from the adult. also stage of child development interfere much in the way of processing information traumatic as the construction of memories and subsequent reprocessing. by what EMDR protocols in children are different from the adult to be equally effective. In this paper we present the working protocol for dealing with juveniles victims of abuse, developed from the perspective of EMDR, showing how protocol through the presentation of the data have been collected during the implementation of the intervention program.

Keywords: Abuse Children Symposium

Accuracy Verified: Yes

24. 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