Francine Shapiro Library ~ EMDR Bibliography

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1. Amano, T., Selyama, A., & Toichi M. (2012, June). The activity of the brain cortex measured by NIRS during EMDR session of phantom limb pain [La actividad del cortex cerebral medida por espectroscopía casi infrarroja (NIRS) durante una sesión de EMDR en Dolor de Miembro Fantasma]. Presentation at the annual meeting of the EMDR Europe Association, Madrid, Spain.

Language: English

Format: Conference

Abstract:
We are reporting the case of a female patient with severe chronic pain, which was successfully treated applying a phantom limb pain (PLP) protocol of the Eye Movement Desensitization and Reprocessing (EMDR). The patient is a seventy-‐ year-‐old female, who suffered from paralysis in the left lower limb due to an accident during an orthopedic operation for herniated disc. After the operation, she began to experience sharp pain in the paralyzed limb, and neither nerve blocks nor trials of medicine were effective for this pain. It continued for 8 years until a PLP protocol was applied. During the sessions of the protocol, her sharp pain gradually diminished and virtually disappeared at the end of the EMDR sessions. A follow-‐up interview, held three years after the sessions, confirmed no recurrence. The study was designed to examine the changes of frontal and temporal cortices in the blood flow in brain by NIRS during sessions of EMDR. During the recall of her trauma-‐related events, her heart rate and the blood flow increased in the area of the right superior temporal sulcus. Eye movement with the recall of traumatic events leads to a generalized decrease in brain blood flow. The results suggest that a PLP protocol may be an effective option for the treatment of chronic pain. It is probably because the technique, which is effective for post-‐traumatic stress disorder, can potentially dissolve traumatic pain memory. The findings on blood flow seem to suggest that EMDR is effective in treating PTSD by normalizing excessive cerebral activation, particularly in the right hemisphere, which is related to the memory of trauma.

Presentamos el caso de una mujer con dolor crónico severo tratado con éxito mediante un protocolo de desensibilización y reprocesamiento con movimientos oculares (EMDR) para dolor de miembro fantasma (DMF). Se trata de una mujer de setenta y dos años de edad que sufría una parálisis en la extremidad inferior izquierda debido a un accidente durante una intervención quirúrgica ortopédica por una hernia discal. Tras la operación, empezó a experimentar un dolor agudo en el miembro paralizado; ni los bloqueos nerviosos regionales ni las pruebas con fármacos fueron eficaces para tratar su dolor. Así siguió durante 8 años hasta la aplicación de un protocolo para el tratamiento del DMF. Durante las sesiones en las que se seguía el protocolo, el dolor agudo que sufría disminuía progresivamente y desaparición por completo al finalizar las sesiones de EMDR. Durante una entrevista de seguimiento a los tres años se confirmó la ausencia de una recurrencia del dolor. Se diseñó el estudio para examinar los cambios del flujo sanguíneo cerebral en las cortezas frontal y temporal mediante NIRS en las sesiones de EMDR. Durante el recuerdo de los eventos relacionados con el trauma, se aumentó la frecuencia cardiaca y el flujo sanguíneo en el área del sulco temporal superior derecho. Los movimientos oculares que se producen con el recuerdo de los eventos traumáticos conlleva una disminución generalizada del flujo sanguíneo al cerebro. Los resultados sugieren que un protocolo específico para DMF puede representar una alternativa efectiva para el tratamiento del dolor crónico. Probablemente se debe a que esta técnica que es efectiva en el trastorno por estrés post-‐traumático, tiene el potencial de disolver el recuerdo del dolor traumático. Los hallazgos sobre el flujo sanguíneo parecen sugerir que EMDR es efectivo en el tratamiento del TEPT al normalizar la activación cerebral excesiva, sobre todo en el hemisferio derecho, que guarda relación con el recuerdo del trauma.

Keywords: Brain Cortex NIRS Phantom Limb Pain

Accuracy Verified: Yes

2. O’Malley, A. (2012, October). BART: A new protocol to enhance EMDR therapy. Presentation at the at the 4th Autumn EMDR Workshop Conference, Sheffield, UK .

Language: English

Format: Conference

Abstract:
Bilateral Affective Reprocessing of thoughts or BART is a dynamic new model of trauma therapy designed to complement traditional EMDR therapy. Often with early touchstone memories the client has no verbal recall. It is impossible to access negative cognitions. In BART gut feelings are activated and connected to feelings and sensations elsewhere in the body. Ultimately heartfelt sensations link to the cerebral hemispheres and eventually the prefrontal cortex. Examples will illustrate combining BART psychotherapy combined with traditional EMDR.

Keywords: BART Bilateral Affective Reprocessing of Thoughts

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. Haour, F. (2009, June). Brain source imaging of the alpha rhythm in PTSD patients using the MEG technique. In K. Zaal (Chair), Research). Symposium conducted at the annual meeting of the EMDR Europe Association, Amsterdam, the Netherlands.

Language: English

Format: Conference

Abstract:
In anxiety disorders, such as PTSD, brain imaging has demonstrated local modifications of functional activities using various techniques. In the present study the direct neuronal activities were measured in delta, theta and beta frequencies, using Magnetoencephalagraphy (MEG) which provides very fast temporal response. The technique is neither invasive nor stressful for the patients. Nineteen female volunteers with DSM-IV PTSD were included in the study. The protocol was a script-driven imagery provocation test, achieved with the patients sitting in the MEG apparatus. The scenarios, specific for ach patient, were composed of 4 active conditions: neutral image (N) traumatic memory (T), traumatic memory suppression (TS) and positive image (P) corresponding to 3 minutes where the patient had to imagine the corresponding sequence with eyes closed Measures of heat rate and subjective disturbance (SUD) were measured during the recoding. The MEG data were analysed in the source domain using a spatial filtering approach. Measurement of electrophysiological waves of various rhythms: delta: 1-4 Hetz (Hz), theta: 4.8-5.8 Hz, alpha: 8-12 Hz and beta: 12-25 Hz was obtained. Anatomical information was from MRI imaging. Signal of activation during trauma recall (T-N) were limited to the delta and theta waves and mainly found in the left hemisphere (visual, orbitofrontal and dorsolateral prefrontal and temporal gyrus (BA 8-9-10-11, 18-19, 22, 28) and in the right supra marginal gyrus (Wernicke BA 40). Signal of inhibition during trauma recall (T-N) were found mainly in the left hemisphere, in the delta, alpha and beta waves (visual, orbitofrontal, dorsolateral prefrontal and temporal gyrus (BA 8-9-10-11, 18-18, 22, 28), cingular cortex (BA 23-24, 31, 32), insula (BA 13) and Broca visual cortex (BA 18-19, 43-44). In conclusion trauma recall mainly induces a hypoactivation in the ventromedial prefrontal cortex and in the cingular cortices, structures linked to the experience and regulation of emotions.

Keywords: Alpha Rhythm Brain Imaging MEG Technique Posttraumatic Stress Disorder PTSD Research Symposium

Accuracy Verified: Yes

6. Haour, F. (2010, June). Brain source imaging using magnetoencephalography (MEG): Modifications in various rhythms during memory recall, in PTSD patients. In Research. Symposium conducted at the annual meeting of the EMDR Europe Association, Hamburg, Germany.

Language: English

Format: Conference

Keywords: Magnetoencephalography MEG Memory Recall Posttraumatic Stress Disorder PTSD Research Rhythms Symposium

Accuracy Verified: Yes

7. 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

8. Oh, D., & Choi, J. (2004). Changes in the regional cerebral perfusion after EMDR: A SPECT study of two cases. Journal of the Korean Society of Biological Psychiatry, 11(2), 173-180.

Language: Korean

Format: Journal

Abstract:
Over the last decade, EMDR(Eye Movement Desensitization and Reprocessing) has emerged as a promising new treatment for trauma and other anxiety-based disorders. However, neurobiological mechanism of EMDR has not been well understood. Authors report SPECT findings of two patients of PTSD before and after EMDR.Brain 99mTc-ECD-SPECT was performed before and after EMDR treatment. To evaluate the significance of changes in the regional cerebral perfusion, t-test was conducted on the resulting images using SPM99 . In addition, clinical scales(CAPS, CGI, STAI) were employed to asses the changes in the clinical symptoms of the patients. After EMDR treatment, each showed significant improvement in clinical symptoms. The cerebral perfusion increased in bilateral dorsolateral prefrontal cortex, and decreased in the temporal association cortex. The differences in the cerebral perfusion between patients after treatment and normal controls decreased. These changes appeared mainly in the limbic area the and the prefrontal cortex.These results suggest that EMDR may show the therapeutic effect through 1) improvement in the emotional control by increased activity in the prefrontal cortex, 2) inhibited hyperstimuli on amygdala by deactivation of the association cortex, 3) inhibition on past trauma related memory, and 4) keeping the functional balance between the limbic area and the prefrontal cortex. This case report needs further replication from studies with larger sample. [Author Abstract]

Keywords: Brain Imagining Adults Females Koreans Motor Vehicle Accidents Neurophysiology Posttraumatic Stress Disorder Psychiatric Inpatients PTSD: Rape SPECT Survivors Treatment Effectiveness

Accuracy Verified: Yes

9. 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

10. Worthington, R. (2012, April). Dealing with trauma as an intervention for aggression: A review of approaches and the value of reprocessing. Journal of Aggression, Conflict and Peace Research, 4(2), 108-118. doi:10.1108/17596591211208319.

Language: English

Format: Journal

Abstract:
The purpose of this paper is to explore the impact of trauma with specific consideration to the neurological impact this has on information processing and potential links with aggression. Design/methodology/approach - This paper provides a summary of the literature in relation to theories of aggression and trauma. The paper considers how the two may interact and overlap and considers a theoretical rationale for why addressing trauma through a treatment such as Eye Movement Desensitization Reprocessing (EMDR) may assist to reduce aggression. Findings - The paper argues that the experience of trauma may contribute to inputs which may take a person closer towards engaging in aggression. This is consistent with information processing models and unified models of aggression such as the General Aggression Model. Factors that were specifically identified included physiological hyper-arousal, hostile attributions of stimulus, and neurological impairments. In addition, the paper also argued that there is evidence that as a result of trauma, a person's ability to provide cognitive accounts for the function of their behaviour may also be impaired because of the reduced interactivity between the two prefrontal hemispheres. Research limitations/implications - The paper argues that as a result, interventions designed to reduce aggression may benefit from including additional elements which directly assist clients to process emotional information and that a reprocessing treatment such as EMDR could assist to reduce levels of emotional arousal and improve treatment effectiveness. Differences in the way in which EMDR is carried out and the variances in treatment protocols used should be attended to increase the reliability of future research. Originality/value - Current modes of aggression therapy have focused on exposure based and cognitive behavioural therapy (CBT). However, there is evidence that EMDR has benefits over exposure and CBT approaches because of the way in which cognitive verbal accounts of the trauma are not required and because EMDR does not require the individual to have insight into their trauma experience and the link with aggression.

Keywords: Aggression Trauma Treatment

Accuracy Verified: Yes

11. Khalfa, S. (2012, June). Effects of EMDR on cognition, psychophysiology and cerebral mechanisms in PTSD [Efectos del EMDR en cognición, psicofisiología y mecanismos cerebrales en TEPT]. Presentation at the annual meeting of the EMDR Europe Association, Madrid, Spain.

Language: English

Format: Conference

Abstract:
Despite the emergence of many theories on biological EMDR mechanisms, research is still needed to understand the healing processes of EMDR. We conducted four experiments to explore the effects of EMDR on PTSD with 17 to 22 patients suffering from one unique trauma. The first experiment evidenced attentional bias in PTSD towards negative words that disappeared after successful EMDR Therapy. The second experiment has shown a less efficient control of emotion in PTSD as compared to healthy controls. This altered emotional suppressing measured through psychophysiological responses was restored after symptoms disappearance following EMDR. The third experiment also using psychophysiological measures confirmed the increased fear sensitization and delayed fear extinction in PTSD and again the restoration of a normal fear conditioning and extinction processes after EMDR. The last experiment explored the negative emotional cerebral mechanisms using functional magnetic resonance imagery in PTSD. Activities in prefrontal structures were modified in PTSD as compared to healthy controls. After the EMDR treatment accompanied by symptoms removal, the prefrontal responses were not different between PTSD patients and their controls. Theoretical issues of these results will be discussed in order to integrate cognitive, psychophysiological and cerebral mechanisms observations.

A pesar del emerger de muchas teorías sobre los mecanismos biológicos del EMDR, la investigación aún necesita entender el proceso de curación que se produce en EMDR. Hemos realizado 4 experimentos para explorar los efectos del EMDR en TEPT de 17 a 22 pacientes que sufrieron un único trauma. El primer experimento evidencia un sesgo atencional del TEPT ante las palabras negativas que desaparecen después de una terapia exitosa de EMDR. El Segundo experimento mostró una baja eficiencia del control de las emociones en los TEPT comparados con el control de individuos sanos. Esta alterada supresión emocional medida a través de respuestas psicofisiológicas fue restaurada después de una desaparición de los síntomas realizando EMDR. El tercer experimento también confirma mediante medidas psicofisiológicas el aumento de la sensación de miedo y un retraso en la extinción del mismo en el TEPT. De nuevo tras administrar una terapia EMDR se produjo una restauración a una condición normal de miedo y un proceso de extinción. El último experimento explica los mecanismos negativos emocionales cerebrales usando resonancia funcional magnética en TEPT. La actividad en las estructuras prefrontales fue modificada en el TEPT comparado con el control. Después del tratamiento de EMDR acompañado de una remisión de los síntomas, las respuestas prefrontales no fueron diferentes entre los pacientes con TEPT y los controles. Cuestiones teoréticas sobre estos resultados serán discutidas con el fin de integrar cognitivamente, psicofisiológicamente y observar los mecanismos cerebrales del EMDR.

Keywords: Cognition, Psychophysiology and Cerebral Mechanisms Posttraumatic Stress Disorder PTSD

Accuracy Verified: Yes

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

Language: English

Format: Journal

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

Keywords: 99mTc-HMPAO Posttraumatic Stress Disorder PTSD

Accuracy Verified: Yes

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

Language: English

Format: Conference

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

Keywords: 99mTc-HMPAO Distribution Posttraumatic Stress Disorder PTSD

Accuracy Verified: Yes

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

Language: English

Format: Conference

Keywords: 99mTc-HMPAO Distribution Posttraumatic Stress Disorder PTSD

Accuracy Verified: Yes

15. Grbesa, G., Simonovic, M., & Jankovic, D. (2010, April). Electrophysiological changes during EMDR treatment in patients with combat-related PTSD. Annals of General Psychiatry, 9(Supplement 1), S209. doi:10.1186/1744-859X-9-S1-S209.

Language: English

Format: Journal

Abstract:
1st International Congress on Neurobiology and Clinical Psychopharmacology and European Psychiatric Association Conference on Treatment Guidance
Background Efficiency of the EMDR procedure is based on a presumption of neuropsychological changes in therapeutic process.The aim of the investigation is to scann and give evidence of electroactivity changes, during the process of EMDR procedure and after finishing it. Materials and methods We have recorded a continual polygraph EEG, before, during and after EMDR therapy, in patient with combat-related PTSD. Results Before the treatment, EEG recorded basic activity of low voltage (attenuation) of 20 μV, frequency of beta range (17-26 Hz), bioccipital, with no pathologic activity. Patient had prominent vegetative symptoms (anxiety, heart rate 100/min). Background activity immediately after the treatment records the amplitude values of around 50 μV, frequency of around 11-12 Hz. After the end of the treatment background activity possesses the amplitude value of about 37 μV, holding the persistence in frequency. Conclusions If the EMDR treatment is successful, sudden increase of amplityde activity is noted imensly. This sharp border line, which signifies normal activity, appears in 2-3 seconds affter the desensitize phase. The investigation suggest that from neurophysiological point of view, cortex (in EMDR procedure), works according to the principle "all or nothing". If there is processing of traumatic memory, the activity gets completly normal. If the therapy is not successful, there are numerous artefacts, because of increased muscle activity. This kind of activity, in our investigation is marked as "Artefact therapy". The results, indicate maintaining low level of amplitude values of electrocortical activities during the treatment, as well as increase after successful treatment. The increase of amlitude is corelated to decrease of anxiety after the successful treatment. Acknowledgements The results, indicate maintaining low level of amplitude values of electrocortical activities during the treatment, as well as increase after successful treatment. The increase of amlitude is corelated to decrease of anxiety after the successful treatment. References EEG Asymmetry and its Clinical Correlates in PTSD, Steven Silverstein, Stewart Shankman Lea Williams, Patrick Hopkinson, Richard Bryant

Keywords: Combat Electrophysiological Change Posttraumatic Stress Disorder PTSD

Accuracy Verified: Yes

16. Welch, K. L. (2007, August). EMDR and neuroscience research: Some questions and implications for psychotherapy integration. EMDR Practitioner. Retrieved from http://www.emdr-practitioner.net on 12/27/2008.

Language: English

Format: Other

Abstract:
Since its introduction, Eye Movement Desensitization and Reprocessing (EMDR) (Shapiro, 1989) has received the attention of many mental health professionals. There has been much critical debate on the subject of EMDR. Most of the clinical discussion has centered on the role of EMDR in the treatment of Posttraumatic Stress Disorder (PTSD). While the EMDR procedure has been compared to Mesmerism (McNally, 1999), declared as pseudoscience (Herbert, Lilienfeld, Lohr, Montgomery, O’Donohue, Rosen, and Tolin, 2000), or regarded as a highly marketed placebo (Lilienfield, 1996), most studies support the efficacy of EMDR in treating PTSD (Ironson, Freund, Strauss, and Williams, 2002; Lee, Gavriel, Drummond, Richards, and Greenwald, 2002; Marcus, Marquis, and Sakai, 1997; Rothbaum, 1997; Van Etten and Taylor, 1998; Wilson, Becker, and Tinker, 1997). There has been some evidence for accompanying physiological changes in PTSD subjects treated with EMDR with patterns of cortex functioning, (Levin, Lazrove, and van der Kolk, 1999; Nicosia, 1994) event-related potential changes (Lamprecht, Kohnke, Sack, Matzke and Munte, 2004), as well as positive effects on the level of the stress hormone cortisol (Haber, Kellner and Yehuda, 2002).

Keywords: Neuroscience

Accuracy Verified: Yes

17. Landin-Romero, R., Novo, P., Vicens, V., McKenna, P. J., Santed, A., Pomarol-Clotet, E., Salgado-Pineda, P., Shapiro. F., & Amann, B. L. (2013, March). EMDR therapy modulates the default mode network in a subsyndromal, traumatized bipolar patient. Neuropsychobiology, 67(3), 181-184. doi:10.1159/000346654.

Language: English

Format: Journal

Abstract:
Background: Some functional imaging abnormalities found in bipolar disorder are state related, whereas others persist into euthymia. It is uncertain to what extent these latter changes may reflect continuing subsyndromal affective fluctuations and whether those can be modulated by therapeutic interventions. Method: We report functional magnetic resonance imaging (fMRI) findings during performance of the n-back working memory task in a bipolar patient who showed a marked improvement in subsyndromal affective symptoms after receiving eye movement desensitization and reprocessing (EMDR) therapy in the context of a clinical trial. Results: The patient's clinical improvement was accompanied by marked changes in functional imaging, as compared to 30 healthy subjects. fMRI changes were noted particularly in deactivation, with failure of deactivation in the medial frontal cortex partially normalizing after treatment. Conclusions: This case supports the potential therapeutic overall benefit of EMDR in traumatized bipolar patients and suggests a possible neurobiological mechanism of action: normalization of default mode network dysfunction. Copyright © 2013 S. Karger AG, Basel.

Keywords: Bipolar Disorder Subsyndromal Affective Symptoms

Accuracy Verified: Yes

18. Landin-Romero, R., Novo, P., Vicens, V., McKenna, P. J., Santed, A., Pomarol-Clotet, E., Salgado-Pineda, P., Shapiro. F., & Amann, B. L. (2013, March). EMDR therapy modulates the default mode network in a subsyndromal, traumatized bipolar patient. Neuropsychobiology, 67(3), 181-184. doi:10.1159/000346654.

Language: English

Format: Journal

Keywords: Bipolar Disorder Subsyndromal Affective Symptoms

Accuracy Verified: Yes

19. Landin-Romero, R., Novo, P., Vicens, V., McKenna, P. J., Santed, A., Pomarol-Clotet, E., Salgado-Pineda, P., Shapiro. F., & Amann, B. L. (2013, March). EMDR therapy modulates the default mode network in a subsyndromal, traumatized bipolar patient. Neuropsychobiology, 67(3), 181-184. doi:10.1159/000346654.

Language: English

Format: Journal

Keywords: Bipolar Disorder Subsyndromal Affective Symptoms

Accuracy Verified: Yes

20. Jacobs, S., de Jong, A., & Strack, M. (2007). EMDR und biofeedback in der therapie posttraumatischer belastungsstörungen: Evaluation eines neuropsychotherapeutischen behandlungsprogramms [EMDR and biofeedback in the therapy of posttraumatic stress disorder: Evaluation of a neuropsychotherapeutic intervention]. Verhaltenstherapie & Psychosoziale Praxis: VPP, 39(4), 855-876.

Language: German

Format: Journal

Abstract:
Eine neu entwickelte multimodale, neuropsychotherapeutic Programm für die Behandlung der Posttraumatischen Belastungsstörung (PTBS) wurde ausgewertet. Ausgehend von neueren Erkenntnissen in der Forschung neuroscienctific, so dass eine Dissoziation zwischen impliziter und expliziter Trauma-Speicher die wichtigste Grundlage der PTBS ist, verschiedene Module wurden im Rahmen der Behandlung integriert anzuzeigen. Die vereinigten Komponenten sind: spezifische Hintergrundinformationen über die Unordnung und typische PTSD-Symptome, eine pädagogische Film für Patienten, spezifische kognitive Verhaltenstherapie und Biofeedback-Techniken unterstützte Eye Movement Desensitization and Reprocessing (EMDR). Das Ziel der Biofeedback-Sitzungen während EMDR ist es, den Patienten eine direkte Rückmeldung über die implizite Prozesse während der Trauma-Exposition. Darüber hinaus Erfassung der physiologischen Daten über Biofeedback ermöglicht das Testen, ob es eine Korrelation zwischen dem Grad der subjektiven Belastung durch traumatische Erinnerungen ausgelöst (quantifiziert mit der SUD-Skala), und messbare physiologische Erregung. Elektrodermale Aktivität (EDA; Hautleitfähigkeit) wurde als eine physiologische Parameter gemessen. Die Ergebnisse einer durchgeführten Pilot-Studie (16 Patienten auf der Grundlage, mit einem wartenden Gruppe als Kontrollgruppe) zeigen verschiedene EDA-Muster während EMDR-desensitivation (fad und assoziative Wiederaufbereitung). Ein offensichtlich Reduktion der PTBS-Symptome gefunden (d = 2,27) sein, die stärker ist als in anderen Behandlungen. Die traumatischen Erinnerungen mit EMDR behandelt wurde weniger Anstrengung, die ebenfalls reflektiert in der Physiologie (verminderte autonome Erregung) und in der subjektiven Belastung fühlte sich durch die Patienten. Die Kürzungen der Erregung (d = 1,01) und subjektive Belastung (d = 2,55) zeigen, dass eine effektive Hemmung der Aktivierung der Amygdala-und damit der Angstreaktion selbst-aufgrund der Intervention geschaffen. Mit EMDR reduziert die Amygdala physiologische Erregung. Wir vermuten, dass aus diesem Grund den medialen präfrontalen Kortex und im Hippocampus kann eine kortikale Inhibition, die erfolgreich reduziert die Angst-Reaktion (Grawe, 2004) zu etablieren. Die berichteten Ergebnisse wurden durch einen dreimonatigen Follow-up-Bewertung bestätigt. Mit einer durchschnittlichen Dauer von 16 Sitzungen und einer nicht vorhandenen Drop-out-Rate (0%), die Intervention erwiesen sich ebenfalls als sehr effizient. (PsycINFO Database Record (c) 2010 APA, alle Rechte vorbehalten)

A newly developed multimodal, neuropsychotherapeutic program for the treatment of posttraumatic stress disorder (PTSD) was evaluated. Starting from recent findings in the neuroscienctific research, which indicate that a dissociation between implicit and explicit trauma-memory is the main basis of PTSD, different modules were integrated within the treatment. The combined components are: specific background information regarding the disorder and typical PTSD-symptoms, an educational movie for patients, specific cognitive behavioral intervention techniques and biofeedback-supported Eye Movement Desensitization and Reprocessing (EMDR). The aim of using biofeedback during EMDR sessions is to give patients a direct feedback about the implicit processes during trauma-exposition. In addition, recording the physiological data via biofeedback allows testing if there is a correlation between the level of subjective strain, triggered by traumatic memories (quantified with the SUD-scale), and measurable physiological arousal. Electrodermal activity (EDA; skin conductance) was measured as a physiological parameter. The results of a conducted pilot-study (based on 16 patients, with a waiting group as a control group) show different EDA-patterns during EMDR-desensitivation (bland and associative reprocessing). An evident reduction of the PTSD-symptoms could be found (d = 2.27), which is stronger than in other treatments. The traumatic memories treated with EMDR became less straining, which reflects likewise in physiology (decreased autonomous arousal) and in the subjective strain felt by the patients. The reductions of arousal (d = 1.01) and subjective strain (d = 2.55) indicate that an effective inhibition of the amygdala activation—and thereby of the anxiety reaction itself—is created due to the intervention. Using EMDR reduces the amygdala induced physiological arousal. We suppose that for this reason the medial prefrontal cortex and the hippocampus can establish a cortical inhibition, which successfully reduces the anxiety reaction (Grawe, 2004). The reported results were confirmed by a three month follow-up evaluation. With an average duration of 16 sessions and a non-existing drop-out rate (0%), the intervention also proved to be very efficient. (PsycINFO Database Record (c) 2010 APA, all rights reserved)

Keywords: Biofeedback PTSD

Accuracy Verified: Yes

21. Thompson, M. M., Pasto, L., & McCreary, D. R. (2002, July). Empirical assessment of Lanius, et al.s’ “functional MRI of EMDR in peacekeepers,’ a review of the EMDR literature and an annotated bibiliography. Defence R&D Canada – Toronto, Technical Memorandum, DRDC Toronto.

Language: English

Format: Other

Abstract:
This report reviews a research proposal, the major objective of which is to assess the relation between PTSD (Post Traumatic Stress Disorder) and limbic, paralimbic, and prefrontal brain function as assessed with functional MRI (Magnetic Resonance Imaging), and to determine whether an Eye Movement Desensitization and Reprocessing (EMDR) intervention causes those structures to return to a normal mode of functioning. The proposed study secondarily explores the effectiveness of EMDR in reducing PTSD symptomatology. While the first and second objectives of the study may have scientific merit, the mandates of other funding agencies would appear to be more appropriate for investigations of basic neuroscience processes associated with brain functioning in PTSD (e.g., NSERC or CIHR). Importantly, a critical review of the EMDR research reveals that a great deal of controversy surrounds the effectiveness of this therapy. EMDR has not been shown to be more effective than presently validated PTSD exposure-based therapies, and the eye movement component of EMDR appears to provide no therapeutic benefit. Finally, there is a lack of clarity around specific items listed in the proposed budget. Given these concerns it is not recommended that this proposal be funded at this time.

Keywords: Bibliographies Canada Desensitizing' Magnetic Resonance Imaging Eye Movements Mental DIsorders MRI Medical Research Order Disorder Transofrmations Signs and Symptoms Stress (Physiology) Traumatic Shock

Accuracy Verified: Yes

22. Ohtani, T., Matsuo, K., Kasai, K., Kato, T., & Kato, N. (2010, February). Erratum to “Hemodynamic responses of eye movement desensitization and reprocessing in posttraumatic stress disorder”. Neuroscience Research, 66(2), 232.

Language: English

Format: Journal

Abstract:
Reports an error in "Hemodynamic responses of eye movement desensitization and reprocessing in posttraumatic stress disorder" by Toshiyuki Ohta ni, Koji Matsuo, Kiyoto Kasai, Tadafumi Kato and Nobumasa Kato (Neuroscience Research, 2009[Dec], Vol 65[4], 375-383). The publisher regrets that the surname of Dr. Ohtani was incorrectly spelt in the original article. The corrected author listing is given in the erratum. (The following abstract of the original article appeared in record 2009-20201-001). Eye movement desensitization and reprocessing (EMDR) is an effective psychological intervention for posttraumatic stress disorder (PTSD). Trauma-related recall (Recall) with eye movements (EMs) is thought to reduce distress. However, the neural mechanisms underlying this process remain unknown. Thirteen patients with PTSD received EMDR treatment over the course of 2–10 weeks. We assessed the change in hemoglobin concentration in the lateral prefrontal cortex (PFC) during Recall with and without EM using multi-channel near-infrared spectroscopy (NIRS). Clinical diagnosis and improvement were evaluated using the Clinician-Administered PTSD Scale. Recall with EM was associated with a significant decrease in oxygenated hemoglobin concentration ([oxy-Hb]) in the lateral PFC as compared with Recall without EM. Longitudinally, [oxy-Hb] during Recall significantly decreased and the amount of decrease was significantly correlated with clinical improvement when the post-treatment data was compared with that of the pre-treatment. Our results suggest that performing EM during Recall reduces the over-activity of the lateral PFC, which may be part of the biological basis for the efficacy of EMDR in PTSD. NIRS may be a useful tool for objective assessment of psychological intervention in PTSD. (PsycINFO Database Record (c) 2010 APA, all rights reserved)

Keywords: Hemodynamic Responses Posttraumatic Stress Disorder PTSD

Accuracy Verified: Yes

23. Ohtani, T., & Matsuo, K. (2006). Functional abnormality of the prefrontal cortex in posttraumatic stress disorder: Psychophysiology and treatment studies assessed by near-infrared spectroscopy. In N. Kato; M. Kawata, & Pitman, R. K (Eds.), PTSD: Brain mechanisms and clinical implications (pp. 235-245). Tokyo: Springer-Verlag.

Language: English

Format: Book Section

Abstract:
A growing number of functional neuroimaging studies on PTSD have described the abnormal response of amygdala and prefrontal cortex to traumatic stimuli. Abnormal activation of some parts of the prefrontal cortex might possibly be involved in the pathophysiology of PTSD. [Adapted from Text, pp. 235-236]TOPICS TREATED: Near-infrared spectroscopy (NIRS); NIRS studies in PTSD; Neuroimaging studies of treatment in PTSD (Selective-serotonin reuptake inhibitor [SSRI] and Eye movement desensitization and reprocessing [EMDR].([Adapted from Text, pp. 235-236] [Pilots]

Keywords: Brain Imaging Neuroanatomy Posttraumatic Stress Disorder PTSD

Accuracy Verified: Yes

24. Langwig, K. E. (2008, December). A functional magnetic resonance imaging study of the effects of eye movement desensitization and reprocessing therapy on post-traumatic stress disorder car accident patients: A pilot study. Union College, Schenectady, N.Y.

Language: English

Format: Dissertation/Thesis

Abstract:
Eye movement desensitization and reprocessing (EMDR) therapy is a novel therapy that has been effective in treating post-traumatic stress disorder (PTSD). Few studies have explored the neurological underpinnings of EMDR effectiveness. Utilizing a symptom provocation study design, this study assessed non-PTSD car accident patients. These pilot participants were scanned for comparison to PTSD patients and to explore the task design effectiveness for the future study of PTSD patients. One pilot participant exhibited activation in the left precuneus, and left medial temporal gyrus, and also in the left medial frontal gyrus. In PTSD patients the medial prefrontal cortex is often hypoactive, and inversely correlated with a hyperactive amygdala. The robust activation of medial frontal gyrus in the pilot subject with a corresponding inactivation of the amygdala indicates the participant's normal processing of the car accident trauma tic memories, and that task design and study parameters are being effectively implemented.

Keywords: Automobile Accidents Car Accidents fMRI Pilot Study Posttraumatic Stress Disorder PTSD

Accuracy Verified: Yes

25. 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

26. 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

27. 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

28. Ohtani, T., Matsuoa, K., Kasai, K., Katob, T., and Katoa, N. (2005, May). Hemodynamic response to emotional memory recall with eye movement. Neuroscience Letters, 380(1-2), 75-79. doi:10.1016/j.neures.2009.08.014.

Language: English

Format: Journal

Abstract:
Previous studies on rapid eye movement sleep have demonstrated the effect of eye movement on emotional memory. However, the brain mechanism involved in the influence of the eye movement on the emotional recall remains unclear. We investigated the prefrontal response during an emotional memory recall with and without eye movement. Ten healthy volunteers were recruited. The changes in concentration of oxygenated hemoglobin ([oxy-Hb]) in the prefrontal cortex were examined using near-infrared spectroscopy (NIRS) during a task that involved emotional recall with and without eye movement. Six participants demonstrated a significant increase in [oxy-Hb] during emotional recall, and the level of increase was reduced through repeated emotional recall with eye movement. The results suggest that eye movement is associated with a reduction in the hemodynamic response to emotional memory recall

Keywords: Eye Movement Emotional Recall Near-infrared Spectroscopy Prefrontal Cortex

Accuracy Verified: Yes

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

Language: English

Format: Conference

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

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

Keywords: Hemodynamic Responses

Accuracy Verified: Yes

30. Ohtani, T., Matsuo, K., Kasai, K., Kato, T., & Kato, N. (2009, December). Hemodynamic responses of eye movement desensitization and reprocessing in posttraumatic stress disorder. Neuroscience Research, 65(4), 375-383. doi:10.1016/j.neures.2009.08.014.

Language: English

Format: Journal

Abstract:
Eye movement desensitization and reprocessing (EMDR) is an effective psychological intervention for posttraumatic stress disorder (PTSD). Trauma-related recall (Recall) with eye movements (EMs) is thought to reduce distress. However, the neural mechanisms underlying this process remain unknown. Thirteen patients with PTSD received EMDR treatment over the course of 2 to 10 weeks. We assessed the change in hemoglobin concentration in the lateral prefrontal cortex (PFC) during Recall with and without EM using multi-channel near-infrared spectroscopy (NIRS). Clinical diagnosis and improvement were evaluated using the Clinician-Administered PTSD Scale. Recall with EM was associated with a significant decrease in oxygenated hemoglobin concentration ([oxy-Hb]) in the lateral PFC as compared with Recall without EM. Longitudinally, [oxy-Hb] during Recall significantly decreased and the amount of decrease was significantly correlated with clinical improvement when the post-treatment data was compared with that of the pre-treatment. Our results suggest that performing EM during Recall reduces the over-activity of the lateral PFC, which may be part of the biological basis for the efficacy of EMDR in PTSD. NIRS may be a useful tool for objective assessment of psychological intervention in PTSD.

Keywords: Hemodynamic Responses Posttraumatic Stress Disorder PTSD

Accuracy Verified: Yes

31. 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

32. Catherall, D. R. (2003, June). How fear differs from anxiety. Traumatology, 9(2), 76-92. doi:10.1177/153476560300900202.

Language: English

Format: Journal

Abstract:
Animal models conceptualize anxiety as a response to potential danger while fear is a response to present danger. The way humans experience anxiety involves our capacity for higher thinking while the human experience of fear appears to be much the same as the animal model. This article examines these differences at both a phenomenological and neurological level and highlights implications for the treatment of conditioned fear in PTSD. The stimuli for human fear are sensory-perceptual, while the stimuli for most forms of anxiety are conceptual-linguistic. Individuals in a state of fear/terror undergo a radical shift from top-down to bottom-up processing in which access to conceptual-linguistic thought processes is severely restricted and the frontal regions of the cortex are no longer able to override impulses from brain stem and midbrain regions. Conditioned fear involves actual neurological changes in the limbic system. To overcome a traumatic memory, the individual must (1) gain some level of access to the bottom-up state in order to habituate or extinguish the conditioned fear response, and (2) also achieve access to the top-down state in order to process the fear. ]Sage Journals]

Keywords: Anxiety Fear Cognitive Neuroscience Posttraumatic Stress Disorder PTSD

Accuracy Verified: Yes

33. Brivio, R., & Bergamaschi, L. (2008, January). Human and organizational aspects affecting the wellbeing in rescue-working activity: EMDR (Eye movement desensitization and reprocessing), Mirror Neuron and Stress Inoculation: The role of training methods, practice and simulation for psychological risks prevention and management in emergency workers.. International Workshop Reinforce Rescuers' Resilience by Empowering a well-being Demension Workshop, Turin, Italy .

Language: English

Format: Conference

Abstract:
The wellbeing of rescuers: Relational, organizational and technical aspects that can affect rescuers' wellbeing during rescue activities: Stress inoculation, role playing and the role of mirror neurons in training, also through the use of video recordings. Relaxation techniques, psychological debriefing and EMDR in trainings.

Focus of our intervention is the wellbeing of the rescuer. The study and research on this matter came and were carried out thanks to the activity done both during trainings and simulations of the Civil Protection than real emergencies. Our team work received contribution by some psychologists of OPP (Parma’s Psychologists’ Observatory: A.Sozzi, E.Pedrelli, F.Frati, A. Bocelli, T. Serra). Wellbeing, defined as a subjective and positive emotional state together with a global life satisfaction (Diener, 1984), is strongly at risk during rescuer’s emergency activities and can affect the rescuer both physically and psychologically. The rescuer's capabilities, that we think are technical “know how” and thorough knowledge, are essential to give the best performance according to the complexity and urgency of the intervention. These skills can really contribute to the rescuer's wellbeing, because they can improve the self-efficiency perception. To effectively manage and train rescuers, it is furthermore important to consider and acknowledge the influence of interpersonal relationships on technical performances. It is, in fact, particularly important to recognize and support the typical relationships that can be created in a team with the same task and specialization, as well as in multidisciplinary teams, or teams belonging to different Institutions but operating in the same scenario.

In recent years increasing attention has been given to training activities, even through the use of the role play for interventions in artificial emergency scenarios. To recreate scenarios of massive emergencies, different Civil Protection Associations, as well as First Aid volunteer associations and the local Institutions have been involved. In these simulations, most cases focus on improving technical performances. Lately psychologists have been asked to join the rescuers team. During these simulations, the role-play of emotional and psychological problems occurs thanks to the cooperation between emergency psychologists and the medical team. The introduction of the role and expertise of psychologists allowed to extend and strengthen the attention to cross support and care aspects for the psychological wellbeing of both victims and rescuers. The psychologist must therefore consider the “wellbeing” in all the emergency scenarios and contexts, as a sum of all the components that we talked about here and the ones we will describe during our intervention. He must first of all be aware of the complexity of each intervention in the field, and adopt a kind of approach aimed at creating and recovering wellbeing strategies, that can be used by himself as well. Strategies on how to build, recover and maintain the wellbeing identify stress as the first danger source the rescuer has to face in his training and emergency activity. When external events or stimuli are perceived as difficult to face compared with resources available at that moment, the individual gets stressed. When the person's efforts are not adaptive to the external requests and/or coherent with his performance expectations, he becomes vulnerable to emotional, behavioural, cognitive and physical reactions, which can be even very difficult to manage both in the short and/or in the medium-long term. This can happen when the sources of stress depend on the rescuer’s performance, and it can also happen in case of post traumatic stress, visible in different stages after the event. From the psychologist's specialist background and from the integration of this with the result of field experiences, the demand for a range of different tools to manage the different kinds of stress emerges, and these tools must be applicable both to the individual and to the group. This range is still improving, and the results of our observational activity from past and present experiences lead us to see the opportunity to carry on our research of tools of efficacy. During this speech we would like to underline that approaches like Stress Inoculation Training (SIT, Michenbaum, 1983) and the use of role playing allow the technical appraisal and let the rescuers improve their stress management skills, and all that can lead to a decrease in the risk of PTSD. In past simulations of emergencies, we found out that the use of videotapes for the role plays is a tool that should be taken more into account. We think it is important to evaluate its potential for the rescuers' benefit, because it seems to be not only “a record of technical performances”, but also an observation and learning tool about the rescuer's own defence and adaptive strategies. In fact, during these simulations we found out that the rescuers' psychological and emotional vulnerability emerged in several situations. The fact that even in these artificial situations there were acute stress episodes and O codes urged us to focus more on the matter of mutual influence between technical performance and internal experience of stress. We understand that such acute stress episodes may occur during real life critical events but we can see how role playing and video recordings show that such acute stress episodes affected the simulators themselves even during the simulation. The videos show that even apparently “high immunity” simulators, who are considered 'immune' thanks to their comprehensive and strong experience, experienced acute stress, perhaps because of an incorrect selfevaluation of their own stress management skills. The interest in the use of videos as a training and reprocessing tool for rescuers led some of us to specialize in role playing recording, so as to carry out a more accurate and comprehensive study on those same videos and use them as a mirror of reality and better educational tool through a vicar experience or through “seeing oneself from within the experience” and in the interpersonal dynamics that took place in the scenario. Videotapes are a very known and widely used tool in other kinds of trainings, disciplines and therapies (i.e. Family Therapy and CBT). The discovery of mirror neurons by Rizzolati, Gallese et Al., provides the evidence that when someone observes the same action performed by another person, the neurons "mirrors" the behaviour of that person, as though the observer were itself acting. Thanks to these researchers it is now proven that this can happen thanks to the motor neurons in the pre-motor cortex. Therefore, we would like to underline the role of videos as very useful and versatile training tools, since they expose a situation in an unexpected realistic manner “as if” it were true and “as if” we were really experiencing that situation, with the consequent learning movements at the emotional, cognitive and behavioural level, at the stress management level, as well as at the level of team work dynamics. Visual imagination activates the same brain regions that are active during visual perception and motor imagination activates the same brain regions activated the movement is really happening. More importantly, it was possible for us to verify that the videos recorded by other operators were not focused on showing the important psychological aspects we mentioned for the goal of the trainings, thing that happened instead with the videos recorded by psychologists. We think therefore that the use of videotapes recorded by psychologists should be given more consideration in the trainings of rescuers. During this intervention we will devote part of the time to broadcasting two short videos; the first one shows the role playing of an intervention in an emergency context, and the second one shows a part of an EMDR session (Eye Movement Desensitization Reprocessing). We think it is important to recreate and protect rescuers wellbeing in the post-role playing and post emergency stages too. For years EMDR has been proven effective in improving the individual's coping skills and in reprocessing, wherever necessary, the post traumatic aspects resulting from critical events to whom not only the victims, but also the rescuers too, are exposed during emergencies.

Keywords: Emergency Workers Mirror Neuron and Stress Inoculation Rescue-Working Activity Risk Prevention and Management

Accuracy Verified: Yes

34. 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

35. 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

36. Gómez, A. M. (2011). Mecanismos neurobiologicos del trastorno por estrés postraumático y la Terapia EMDR[Neurobiological mechanisms of PTSD and EMDR therapy]. Revista Iberoamericana de Psicotraumatología y Disociación, 1(1). Retrieved from http://revibapst.com/ARTICULO%20ALAIDE%202011.pdf on 12/9/2012.

Language: Spanish

Format: Other

Abstract:
El trastorno por estrés postraumático (TEPT) se caracteriza por temor, desesperanza u horror intensos en personas que han sido expuestas a acontecimientos traumáticos. La terapia de Desensibilización y Reprocesamiento por Movimiento Ocular (EMDR), es reconocida como un tratamiento efectivo y eficiente para tratar el TEPT. Diversos estudios han demostrado alteraciones anatómico-fisiológicas y neurobiológicas en los pacientes que presentan este trastorno, ya que intervienen estructuras como la amígdala, tálamo y diferentes áreas de la corteza prefrontal. Debido a lo anterior, se han realizado estudios sobre los mecanismos neurales y la implicación neurobiológica de la terapia EMDR en el TEPT, así como alteraciones en la función cognitiva dentro de la sintomatología clínica que se observa en los pacientes con este trastorno.

Posttraumatic stress disorder (PTSD) is characterized by fear, helplessness or horror severe in people who have been exposed to traumatic events. Eye Movement Desensitization and Reprocessing (EMDR) is recognized as an effective and efficient in treating PTSD. Several studies have shown anatomical and physiological alterations in neurobiological patients with this disorder, and involved structures like the amygdala, thalamus and different areas of the prefrontal cortex. Because of this, there have been studies on the neural mechanisms and neurobiological implications of EMDR in PTSD, as well as alterations in cognitive function within the clinical symptoms observed in patients with this disorder.

Keywords: Cognitive Function Neurobiology Posttraumatic Stress Disorder PTSD

Accuracy Verified: Yes

37. 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

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

Language: English

Format: Conference

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

Antecedente Teórico: La desensibilización y reprocesamiento por el movimiento ocular (EMDR) es una reconocida primera línea para el tratamiento del trauma psicológico. Sin embargo sus bases neurobiológicas no han sido descifradas todavía. Método: La electroencefalografía ha sido usada por primera vez para monitorizar completamente la activación neuronal durante sesiones enteras de EMDR incluyendo el guión autobiográfico. 10 Clientes con traumas psicológicos mayores fueron investigados durante la primera sesión de EMDR y durante la última después del procesamiento del trauma raíz. Las comparaciones entre los EEG de la última y primera sesión y las de EEG de los clientes en la primera sesión y 10 controles realizando el mismo procedimiento de EMDR fueron realizadas. Resultados: Durante ambos procesos, la escucha y la estimulación bilateral, el EEG mostró una actividad significativamente mayor en el córtex límbico prefontral (Brodmann Areas, BA 9-‐10) al principio comparadas con la última sesión de EMDR. La comparación opuesta muestra un cambio en la actividad fundamental entre las regiones corticales temporal, parietal y occipital (BAs 20, 21, 22, 37, 17, 18, 19) con lateralizaciones hacia la izquierda. La comparación entre los 10 clientes y los controles confirman la activación máxima de la corteza límbica en los clientes antes de procesar el trauma. Conclusiones: La metodología usada hizo posible visualizar la neuroimagen por primera vez de las activaciones cerebrales asociadas con las acciones terapéuticas que acontecen en el EMDR. Los hallazgos sugieren que el procesamiento cognitivo de los eventos traumáticos seguidos de una terapia EMDR exitosa apoyan la evidencia de un patrón neurobiológico diferenciado en las activaciones del cerebro durante la estimulación ocular bilateral asociados con una acumulación un experiencias emocionales negativas.

Keywords: Body

Accuracy Verified: Yes

39. 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

40. 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

41. 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

42. Pagani, M. et al (2012, June). Neurobiological correlates of EMDR monitoring - An EEG study [Correlatos neurobiológicos y monitorización EMDR – un estudio con EEG]. Presentation at the annual meeting of the EMDR Europe Association, Madrid, Spain.

Language: English

Format: Conference

Abstract:
Background: Eye Movement Desensitization and Reprocessing (EMDR) is a recognized first-‐line treatment for psychological trauma. However its neurobiological bases have not been disclosed yet. Methods: Electroencephalography was used for the first time to fully monitor neuronal activation during whole EMDR sessions including the autobiographical script. Ten clients with major psychological trauma were investigated during the first EMDR session and during the last one performed after processing the index trauma. Comparisons between the EEG of the first and last EMDR session and between the EEG of the clients at the first session and those of 10 controls undergoing the same EMDR procedure were performed. Results: During both script listening and bilateral stimulation EEG showed significantly higher activity in the prefrontal limbic cortex (Brodmann Areas, BA 9-‐ 10) at the first as compared to the last EMDR session. The opposite comparison showed a shift of the prevalent activity towards temporal, parietal and occipital cortical regions (BAs 20, 21, 22, 37, 17, 18, 19) with leftward lateralization. The comparison between the 10 clients and the 10 controls confirmed the maximal activation in the limbic cortex in the clients before processing the trauma. Conclusions: The implemented methodology made possible to image for the first time the specific activations associated with the therapeutic actions contemplated by EMDR. The findings suggested cognitive processing of traumatic events following successful EMDR therapy supporting the evidence of distinct neurobiological patterns of brain activations during bilateral ocular stimulation associated with a significant relieve from negative emotional experiences.

Antecedente Teórico: La desensibilización y reprocesamiento por el movimiento ocular (EMDR) es una reconocida primera línea para el tratamiento del trauma psicológico. Sin embargo sus bases neurobiológicas no han sido descifradas todavía. Método: La electroencefalografía ha sido usada por primera vez para monitorizar completamente la activación neuronal durante sesiones enteras de EMDR incluyendo el guión autobiográfico. 10 Clientes con traumas psicológicos mayores fueron investigados durante la primera sesión de EMDR y durante la última después del procesamiento del trauma raíz. Las comparaciones entre los EEG de la última y primera sesión y las de EEG de los clientes en la primera sesión y 10 controles realizando el mismo procedimiento de EMDR fueron realizadas. Resultados: Durante ambos procesos, la escucha y la estimulación bilateral, el EEG mostró una actividad significativamente mayor en el córtex límbico prefontral (Brodmann Areas, BA 9-‐10) al principio comparadas con la última sesión de EMDR. La comparación opuesta muestra un cambio en la actividad fundamental entre las regiones corticales temporal, parietal y occipital (BAs 20, 21, 22, 37, 17, 18, 19) con lateralizaciones hacia la izquierda. La comparación entre los 10 clientes y los controles confirman la activación máxima de la corteza límbica en los clientes antes de procesar el trauma. Conclusiones: La metodología usada hizo posible visualizar la neuroimagen por primera vez de las activaciones cerebrales asociadas con las acciones terapéuticas que acontecen en el EMDR. Los hallazgos sugieren que el procesamiento cognitivo de los eventos traumáticos seguidos de una terapia EMDR exitosa apoyan la evidencia de un patrón neurobiológico diferenciado en las activaciones del cerebro durante la estimulación ocular bilateral asociados con una acumulación un experiencias emocionales negativas.

Keywords: EEG Study

Accuracy Verified: Yes

43. Uram, S. (2008, June). The neurobiology of adult and childhod trauma made simple: What every EMDR clinician should know. Presentation at the annual mmeting of the EMDR Europe Association, London, England.

Language: English

Format: Conference

Abstract:
This workshop presents three related and integrated themes: I. - The neurobiology of trauma made simple, yet highly “usable” for clinical formulation. A. How trauma is defined by our culture and DSM-IV, versus the reality of how each human brain individually “defines” trauma. Organized and logical presentation of clinically relevant brain parts/circuits and how they process, or don’t adequately process traumatic experiences; the differing length of time the effects of trauma may manifest from these parts; the masking and masquerading of earlier traumas by the prefrontal cortex, etc. Which brain parts/circuits “trump” one another, and how this shows up in symptoms, in our personalities or in our relationships. II. - Child/Adolescent/Adult stages of human brain development made simple, but geared for clinical understanding and EMDR treatment planning. Childhood through young adulthood brain development generally mature along a sequence; Bottom to Top, and Inner to Outer .The brain areas that become more active as 31 children mature “show up” as increasing or decreasing behaviours, levels of thinking abilities, levels of emotional and mood development/stability, relational abilities, decreased dominance of certain other brain parts, etc.. Symptoms frequently reflect how each person’s level of brain maturation “filters” life experience at a given time. III. - Trauma neurobiology + different stages of brain development = potentially very different EMDR formulations, negative cognitions, etc. How the child and adult brain can identify “danger”, and therefore, “trauma” similarly, or very differently. How trauma is “understood” in the adult brain and the child brain. How and why “danger” or “traumas” are perceived, processed and present differently in children and adults

Keywords: Neurobiology

Accuracy Verified: Yes

44. Schore, A. (2000, September). The neurobiology of attachment and the origin of self: Implications for theory and clinical practice. Presentation at the annual meeting of the EMDR International Association, Toronto, Ontario Canada.

Language: English

Format: Conference

Abstract:
The participant will: 1) learn how the attachment relationship acts to regulate the child's emotional state; 2) learn how these interactions influence the experience-dependent maturation of the infant's right hemisphere; and 3) learn the structure-function relationships of a regulatory system in the orbital prefrontal areas of the cortext.

Keywords: Neurobiology

Accuracy Verified: Yes

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

Language: English

Format: Conference

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

Keywords: Dissociation Neurobiology

Accuracy Verified: Yes

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

Language: English

Format: Conference

Keywords: Dissociation Neurobioogy

Accuracy Verified: No

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

Language: English

Format: Conference

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

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

Accuracy Verified: Yes

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

Language: English

Format: Conference

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

Accuracy Verified: Yes

49. Bergmann, U. (2006, September). The neurobiology of EMDR: Thalamic, cerebellar and pontine/REM processes. Presentation at the annual meeting of the EMDR International Association, Philadelphia, PA.

Language: English

Format: Conference

Abstract:
Clinical case reports and a growing body of controlled research suggest that EMDR is equally and perhaps more efficacious when cross-compared with other methods in treating Posttraumatic Stress Disorder. However, as EMDR was originally an empirically driven method, there has persisted a need for a more defined theoretical model, further scientific validation, and a neurobiological understanding of EMDR's reported robust effects. The possibility that EMDR can effectuate change on a neurobiological level has fueled speculation as to the neural-mechanisms that might underlie EMDR's effects. Brain scans and QEEG's are beginning to shed light on the alterations of brain function that EMDR appears to yield. This presentation will synthesize the existing research with theoretical speculation correlated with Francine Shapiro's model of the Adaptive Information Processing System. Specific attention will be given to recent empirical findings involving the thalamus in information processing and memory integration. This material will be integrated with previously posited theories regarding the cerebellum's involvement in many aspects of information processing and activation processes of the left prefrontal areas and EMDR's activation of the neurophysiology of REM-sleep systems. A neurobiological definition of EMDR serve to further legitimize its usage. It can also potentially enlighten our practice by informing preparation, resourcing and target selection strategies.

Keywords: Cerebellum Neurobiology Thalamus

Accuracy Verified: Yes

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

Language: English

Format: Conference

Keywords: Dissociation Neurobiology

Accuracy Verified: Yes

51. Uram, S. (2009, August). The neurobiology of trauma made simple . Presentation at the annual meeting of the EMDR International Association, Atlanta, GA.

Language: English

Format: Conference

Abstract:
This workshop is presented in a manner that is highly “usable” for diagnostic and treatment formulation. Some of the areas that will be covered include: 1) How trauma is defined by our culture and DSM-IV, versus the reality of how each human brain individually “defines”, experiences and reflects trauma; 2) An understandable presentation of clinically relevant brain parts/circuits and how they adequately do or do not process traumatic experiences; the differing length of time the effects of trauma may manifest from these parts; the masking and masquerading of earlier traumas by the prefrontal cortex, etc., 3) How the developing brain of a human being determines how perceived trauma are integrated into the person’s personality and functioning.

Keywords: Neurobiology Trauma

Accuracy Verified: Yes

52. Koppel, H. (2005, Autumn/Winter). Opinion - Talking therapy and neuroscience - is there a convergence?. BNA British Neuroscience Association [BNA] Bulletin, a newsletter for members of the BNA, 52, 5-6.

Language: English

Format: Newsletter

Abstract:
Most of the effort that has been driving the increasing overlap between talking therapy and neuroscience has come from work that is beginning to understand the cytoarchitecture of the frontal cortex, on the one hand, and techniques like neuroimaging on the other. Non scientists seem to relate more easily to studies that involve humans engaged in some kind of cerebral activity. However, recently, therapists have begun to make what seems to be a contribution to this overlap by developing new therapeutic techniques for working with emotional or psychological issues; techniques that rely less on words, suggesting that there is a neurobiological healing process at work.

Keywords: Neurobiology

Accuracy Verified: Yes

53. Pagani, M., Di Lorenzo, G., Verardo, A. R., Nicolais, G., Lauretti, G., Russo, R., Cogolo, P., Niolu, C., Ammaniti, M., Siracusano, A., & Fernandez, I. (2012, January). P-1162 Pre- intra- and post-treatment EEG imaging of EMDR - neurobiological bases of treatment efficacy. European Psychiatry, 27(Supplement 1), 1-1. doi:10.1016/S0924-9338(12)75329-4.

Language: English

Format: Journal

Abstract:
Aim: Eye Movement Desensitization and Reprocessing (EMDR) is a recognized first-line treatment for psychological trauma. However its neurobiological bases have not been disclosed yet. Methods: Electroencephalography was used for the first time to fully monitor neuronal activation during whole EMDR sessions including the autobiographical script. Nine clients with major psychological trauma were investigated during the first EMDR session and during the last one performed after processing the index trauma. Comparisons between the EEG of the first and last EMDR session and between the EEG of the clients at the first session and those of 9 controls undergoing the same EMDR procedure were performed. Results: During both script listening and bilateral stimulation EEG showed significantly higher activity in the prefrontal limbic cortex (Brodmann Areas, BA 9–10) at the first as compared to the last EMDR session. The opposite comparison showed a shift of the prevalent activity towards temporal, parietal and occipital cortical regions (BAs 20, 21, 22, 37, 17, 18, 19) with leftward lateralisation. The comparison between the 9 clients and the 9 controls confirmed the maximal activation in the limbic cortex in the clients before processing the trauma. Conclusions: The implemented methodology made possible to image for the first time the specific activations associated with the therapeutic actions contemplated by EMDR. The findings suggest cognitive processing of traumatic events following successful EMDR therapy supporting the evidence of distinct neurobiological patterns of brain activations during bilateral ocular stimulation associated with a significant relieve from negative emotional experiences.

Keywords: EEG Imaging Neurobiology

Accuracy Verified: Yes

54. 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

55. Pagani, M. (2012, March). Pre-, intra-, and post-treatment EEG imaging of EMDR – Neurobiological bases of treatment efficacy. Poster presentation at the Scientific Programme of the 20th European Congress of Psychiatry, Prague, Czech Republic.

Language: English

Format: Conference

Abstract:
Conclusions: The implemented methodology made possible for the first time to image and represent on the cortical surface the specific brain activations associated with the therapeutic actions contemplated by EMDR protocol. These findings suggest the cognitivization of traumatic events following successful EMDR therapy with the maximal neuronal firing shifting from prefrontal-limbic to parieto-occipital associative cortex. Our results also support the evidence of distinct neurobiological patterns of brain activations during bilateral ocular stimulation.

Keywords: EEG Imaging Efficacy Neurobiology Poster

Accuracy Verified: Yes

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

Language: English

Format: Journal

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

Keywords: Neglect Parietal Lobe Plasticity

Accuracy Verified: Yes

57. Pagani, M., Di Lorenzo, G., Monaco, L., Niolu, C., Siracusano, A., Verardo, A. R., Lauretti, G., Fernandez, I., Nicolais, G., Cogolo, P., & Ammaniti, M. (2011). Pretreatment, intratreatment, and posttreatment EEG imaging of EMDR: Methodology and preliminary results from a single case. Journal of EMDR Practice and Research, 5(2), 42-56. doi:10.1891/1933-3196.5.2.42.

Language: English

Format: Journal

Abstract:
Electroencephalography (EEG), due to its peculiar time and spatial resolution, was used for the first time to fully monitor neuronal activation during the whole eye movement desensitization and reprocessing (EMDR) session, including the autobiographical script. The present case report describes the dominant cortical activations (Z-score >1.5) during the first EMDR session and in the last session after the client processed the index trauma. During the first EMDR session, prefrontal limbic cortex was essentially activated during script listening and during lateral eye movements in the desensitization phase of EMDR. In the last EMDR session, the prevalent electrical activity was recorded in temporal, parietal, and occipital cortical regions, with a clear leftward lateralization. These findings suggest a cognitive processing of the traumatic event following successful EMDR therapy and support evidence of distinct neurobiological patterns of brain activations during lateral eye movements in the desensitization phase of EMDR.

Keywords: Bilateral Ocular Stimulation Cortical Activation EEG

Accuracy Verified: Yes

58. van der Kolk, B. A., Burbridge, J. A., & Suzuki, J. (1997, June). The psychobiology of traumatic memory: Clinical implications of neuro imaging studies. Annals of the New York Academy of Sciences, 821, 99-113. doi:10.1111/j.1749-6632.1997.tb48272.x .

Language: English

Format: Journal

Abstract:
Whereas most patients with PTSD construct a narrative of their trauma over time, it is a characteristic of PTSD that sensory elements of the trauma itself continue to intrude as flashbacks and nightmares, altered states of consciousness in which the trauma is relived, unintegrated with an overall sense of self. Because traumatic memories are so fragmented, it seems reasonable to postulate that extreme emotional arousal leads to failure of the central nervous system (CNS) to synthesize the sensations related to the trauma into an integrated whole. Earlier models for a biological substrate of these phenomena have become rapidly outdated with the availability of new information derived from neuroimaging studies of patients with PTSD. The emerging body of knowledge from these studies has stimulated a gradual shift in emphasis away from the neurochemicals involved in the organisms' response to overwhelming threat to a focus on the neuronal filters concerned in the interpretation of sensory information: the interactions between the various parts of the CNS that process and interpret the meaning of incoming information, such as the amygdala, hippocampus, corpus callosum, anterior cingulte, and prefrontal cortex. [Text, p. 99]
Review Article: 58 references. This volume of the Annals was published as "Psychobiology of posttraumatic stress disorder," edited by Rachel Yehuda and Alexander C. McFarlane (New York: New York Academy of Sciences, 1997; ISBN 1-57331-078-6). These papers are the result of a conference entitled "Psychobiology of Posttraumatic Stress Disorder" sponsored by the New York Academy of Sciences, New York, 1996 September 7-10.

Keywords: Brain Imaging Dissociative Amnesia Etiology Literature Review Neuroanatomy Neuroendocrinology Psychobiology PTSD Stressors Survivors Treatment Effectiveness

Accuracy Verified: Yes

59. Corrigan, F. M. (2004). Psychotherapy as assisted homeostasis: Activation of emotional processing mediated by the anterior cingulate cortex. Medical Hypotheses, 63(6), 968-973.

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

60. 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

61. Cole, J., & Webb, J. (2004, September). The reenactment protocol: Using the drive to reenact therapeutically. Presentation at the annual meeting of the EMDR International Association, Montreal, Quebec Canada.

Language: English

Format: Conference

Abstract:
While it has been observed for a long time that victims of trauma tend to reenact the trauma, this process has been seen as problematic and avoided. This therapeutic process uses that energy and drive in a respectful and safe way to allow the client to recreate the traumatic incident and experience a strong internal locus of control while carrying through with a new outcome. While evidence seems to indicate that much chronic pain is really memories of pain in the motor cortex, this process works to reconnect or reprogram these memories with a more powerful and less painful memory.

Keywords: Reenactment Protocol

Accuracy Verified: Yes

62. Hassard, A. (1996, October). Reverse learning and the physiological basis of eye movement desensitization. Medical Hypotheses, 47(4), 277-282.

Language: English

Format: Journal

Abstract:
Eye movement desensitization is a new and effective procedure for PTSD that requires explanation. Reverse learning is a model developed in artificial neural networks as a theoretical explanation of rapid-eye-movement sleep. It demonstrates that an overloaded node within a network can be consolidated with a series of non-specific activations. Rapid-eye-movement sleep is suspected to have a memory consolidation function. Ponto-geniculo-occipital spikes, which occur in rapid-eye-movement sleep, are a candidate for such activations in the real brain. In cats, the phasic functions of rapid-eye-movement sleep are driven by ponto-geniculo-occipital spikes, which are non-specific, at highest amplitude in the visual system but present in other parts of the cortex. Such spikes can be evoked by sensory events such as eye movements. There is evidence of similar events in the human brain. Induced eye movements could generate ponto-geniculo-occipital equivalent spikes and eye movement desensitization/reprocessing could be explained as a focused and artificial exploitation of the rapid-eye-movement sleep mechanism. This theory of eye movement desensitization/reprocessing enables some explanation of current results and may be relevant to other problems, such as stereotyped behaviour. [Author Abstract]

Keywords: Neurophysiology Posttraumatic Stress Disorder PTSD Review Sleep Behavior

Accuracy Verified: Yes

63. 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

64. Bates, B. (2003, August). Sensory-based PTSD therapy may prove more calming than words. Clinical Psychiatry News, 31(8), 53.

Language: English

Format: Newspaper

Abstract:
Vancouver, BC — Terror registers most sharply in the subcortical brain, not the prefrontal cortex, explaining why talk-based therapies for posttraumatic stress disorder often have limited success, Dr. Bessel van der Kolk said at a meeting on Posttraumatic Stress Disorder sponsored by Vancouver General Hospital. [Elsevier]

Keywords: Posttraumatic Stress Disorder PTSD

Accuracy Verified: Yes

65. Richardson, P., Williams, S. R., Hepenstall, S., Gregory, L., McKie, S., & Corrigan, F. (2009). A single-case fMRI study: EMDR treatment of a patient with posttraumatic stress disorder. Journal of EMDR Practice and Research, 3(1), 10-23. doi:10.1891/1933-3196.3.1.10.

Language: English

Format: Journal

Abstract:
This study assessed the effects of a session of eye movement desensitization and reprocessing (EMDR) with auditory alternating bilateral stimulation (ABS) using functional magnetic resonance imaging (fMRI) of brain activations. A case study was conducted with a female participant who was suffering from posttraumatic stress disorder following a severe assault. The fMRI scan began with safe-place imagery, for purposes of comparison, and then attention to the trauma memory without ABS. After this, ABS was provided as she began using EMDR procedures to process the traumatic memory. At postsession, the traumatic memory showed robust and significant changes on self-report measures. The initiation of the EMDR protocol with provision of ABS was associated with a marked change in brain activation within the prefrontal cortex demonstrating a ventromedial shift. The authors argue that the structure of the EMDR protocol encourages such a ventromedial activation, which is then intensified by ABS to overcome the block to information processing that has been preventing natural healing from occurring spontaneously.

Keywords: fMRI Functional Magnetic Resonance Imaging Posttraumatic Stress Disorder PTSD Single Case

Accuracy Verified: Yes

66. 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

67. 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

68. Pagani, M., Lorenzo, Gd., Verardo, A., Nicolais, G., Monaco, L., Niolu, C., Fernandez, I., & Siracusano, A. (2012, March-April). Substrato neurobiologico della terapia con EMDR [Neurobiological correlates of EMDR therapy]. Rivista di Psichiatria,47(2 Supp 1):16S-18S. doi: 10.1708/1071.11734.

Language: Italian

Format: Journal

Abstract:
I EEG in un gruppo di dieci soggetti con grave trauma psicologico trattati con EMDR e in dieci controlli sono stati registrati sia durante l'ascolto del racconto autobiografico del trauma indice (script) e nel corso di una intera sessione EMDR. Gli EEG sono stati eseguiti nuovamente durante l'ultima sessione di EMDR quando i pazienti erano liberi da sintomi. Durante l'ascolto uno script di attivazione prevalente delle regioni limbiche corrispondenti alla corteccia prefrontale e orbitofrontale è stato registrato, essere spiegato come l'eccitazione emotiva durante trauma rivivere nella fase sintomatica. La diminuzione significativa di tali attivazioni durante la fase tardiva asintomatica rappresenta il correlato neurobiologico del recupero. Inoltre, l'evidenza di una significativa attivazione corticale nelle aree temporo-parieto-occipitale, durante l'ultima sessione, suggerisce uno switch del segnale elettrico dominante verso aree corticali con funzione prevalente cognitiva.

The EEGs in a group of ten subjects with major psychological trauma treated with EMDR and in ten controls have been registered both during the listening of the autobiographical narrative of the index trauma (script) and during a whole EMDR session. The EEGs have been performed again during the last EMDR session when patients were free of symptoms. During script listening a prevalent activation of the limbic regions corresponding to prefrontal and orbitofrontal cortex has been registered, being explained as the emotional arousal during trauma reliving at the symptomatic phase. The significant decrease of such activations during the late asymptomatic phase represents the neurobiological correlate of recovery. Moreover, the evidence of significant cortical activation in the parietal-temporo-occipital areas, during the last session, suggests a switch of the dominant electrical signal towards cortical areas with a prevalent cognitive function.

Keywords: Neurobiology

Accuracy Verified: Yes

69. Unfried, N. (2003). Trauma und entwicklung: Physiologische und biologische veränderungen nach frühen kindlichen traumata und deren behandlungsmöglichkeit [Trauma and development: Physiologic and biologic variations after early infant traumatisations and attendance of them]. Zeitschrift für Psychotraumatologie und Psychologische Medizin (ZPPM), 1(3), 59-71.

Language: German

Format: Journal

Abstract:
Behandlung psychotraumatischer belastungsstörungen mit EMDR
Die Entwicklung des Kindes ist heutzutage als Prozess zu verstehen. Ein Kind ist dementsprechend zu jedem Zeitpunkt seiner Entwicklung "reif", einschließlich seines intrauterinen Lebens, d.h. es verfügt über die für die jeweilige Zeit notwenige Ausstattung. Von Beginn an erfolgt dieses mehr oder weniger störanfällige Geschehen mit anderen im aktiven intra- und interagierenden informativen, energetischen und stofflichen Austausch. An diesem Entwicklungsprozess nimmt der gesamte Körper, jede Zelle, einschließlich des Gehirns als Organ der sensomotorischen und psychophysischen Verarbeitung teil. Die Stressreaktion und Stress auf bewältigbarem Niveau hilft dem Kind kritische Phasen zu überstehen (Hüther, 1999). Jedoch führt nicht bewältigbarer Stress zu tiefgreifenden Veränderungen funktionell bis strukturell, wenn der Organismus keine neue Lösungsmöglichkeit findet. Mehrere Autoren belegen, dass traumatische Erlebnisse Veränderungen im limbischen System und Cortex zeigen können (Hüther, 1999; van den Kolk, 1998; Roth, 1998). Bei unkontrolliertem Stress (frühzeitig) kommt es zur Daueraktivierung der Amygdala und über die Amygdala zur Aktivierung mehrerer Systeme, unter anderem auch der Hypothalamus-Hypophysen-Nebennieren- Achse mit einem Ausschütten von Stresshormonen. Diese Daueraktivierung löst körperlich die Notfallreaktion im Sinne einer Schockreaktion aus, gleichzeitig führt sie zur Störung der Einspeicherung von Informationen in den Hippocampus. Die imaginativ-methodische Herangehensweise scheint für frühtraumatisierte Kinder und Jugendliche eine Möglichkeit zu sein, die dissoziierten Anteile der traumatischen Szene abzurufen und somit einen Weg zur Integration zu finden. Die therapeutische Beziehung ermöglicht das Wiedererleben der Schmerzen, der Angst, aber auch die Beendigung der traumatischen Situation. Es konnte gezeigt werden, wie die triggerabhängigen Projektionen bei den Kindern endeten und Veränderungen der Persönlichkeitsentwicklung nachweisbar waren. Der Erfahrungsbericht stellt ein vorläufiges Ergebnis dar.

Psychosocial treatment of traumatic stress disorders with EMDR
Children’s development is now understood as a process. Balance and imbalance are said to alternate with one another, and impaired functioning is to be seen as an inducement for further development. Even the early organism has the opportunity of finding a new level of organisation. Right from the beginning, this process, which is susceptible to disruption to a greater or lesser extent, takes place with others in an intra- and interactive exchange of energy and material. This developmental process involves the entire body, every cell, including the brain as the organ of sensomotoric and psychophysical processing. The stress reaction and stress at a manageable level help the child to survive critical periods (Hüther, 1999). However, stress that is not manageable leads to far-reaching changes, in both functional and structural terms, unless the organism finds new solutions. There are sensitive stages during prenatal development that give the brain a high degree of adaptability; however, they also make the embryo, foetus and young infant receptive for disruptive or even hostile influences can lead to changes in the limbic system and the cortex (Hüther 1999; van den Kolk 1998; Roth, 1998). In the event of (early) uncontrolled stress, the amygdala becomes permanently activated, and via the amygdala, several systems are also activated, including the hypothalamic-pituitary-adrenal axis, by the secretion of stress hormones. This permanent activation triggers a physical emergency reaction in the sense of a shock reaction and at the same time leads to a disruption of the storage of information in the hippocampus. The imaginative approach to be a way for children and adolescents with early traumas to recall the dissociated parts of the traumatic scene and hence to find a way of integrating them. The therapeutic relationship allows the pain and fear to be reenacted, but also enables the traumatic situation to be brought to a close. It was able to be shown how the trigger-dependent projections stopped in the children, and changes in personality development were able to be observed. The report presents preliminary results.

Keywords: Attachment Chidlren Biologic Variations Psysiologic Variations Trauma

Accuracy Verified: Yes

70. Ponzano, R. A., & Gozzano, E. (2008, June). Use and consumption of the traumatic experience as a defence from pain: EMDR and defence mechanisms. Poster session presented at the annual meeting of the EMDR Europe Association, London, England.

Language: English

Format: Conference

Abstract:
Objective: to illustrate the EMDR usefulness within the psycho-dynamical therapy. Foreword: a type of pain exists that’s nameless and inenarrable. During our psycho-dynamical practice as EMDR specialists, we met various defensive modalities adopted by patients presenting diverse pathologies to elude grief associated to that type of pain left segregated within the emotional portion of the brain. In particular, we take into account patients keen to coactively repeat the traumatic experience either directly in-person or through using others. The presumption is that the traumatic experience, when too early, too invasive or reiterated, may render it impossible to be expressed verbally (by use of the cortex), leading to express it either through the body or through reiterated use of the traumatic experience itself (coactions to repeat). This last point, within our clinical experience, seems being linked to ambivalent feelings vs. the very resolution of the experience itself (healing). Patients living this type of situation may namely be entangled by two conflicting wishes to either wish a real improvement of their condition or to seek maintaining that pathology in the fear of loosing the sense of security inspired them by the type of fake identity they built around the trauma. Benefits: using the technique of bilateral sensorial stimuli strives breaking off that defensive mood that feeds pathological coactions to reiterate the experience as the means to tolerate the grief. Namely its purpose is to penetrate through those defensive modalities and to successfully aid patients to abandon them thanks to a low structured context adequately freed by internal or external conditioning (ambivalence, judgement, rationalization, etc.).

Keywords: Defense Mechanisms Pain

Accuracy Verified: Yes