Neurobiology of EMDR – Past, present and future


During the last ten years research focused on EMDR has dramatically grown. A substantial arm of the scientific knowledge of EMDR functional mechanisms is represented by neuroimaging, investigating the neurobiological correlates of the therapy. Since the very first case report and studies performed with a limited number of subjects functional neuroimaging (SPECT) has contributed to the awareness that EMDR impacts directly on the same cortical and sub-cortical brain areas involved in the pathophysiology of Post-traumatic Stress Disorder. In this respect in 2007 a relatively large study has demonstrated that cerebral blood flow in patients responding to EMDR normalized in regions hyper- and hypoactivated when symptoms were clinically evident whereas this did not occur in non-responders. These findings were confirmed by a recent functional study performed by a different technique (fMRI) in bipolar disorder patients.

On the other hand structural neuroimaging (MRI) has proven that the neuronal density before therapy might have an impact on its outcome since non-responders showed a significant atrophy in the regions target of EMDR.

However direct evidence of the impact of EMDR on brain pathophysiology was limited to studies performed pre- or post- desensitization itself and the neurobiological bases of its direct effect on the brain were still unknown. To overcome this limitation are currently in progress  studies aiming primarily at investigating the EEG on-line monitoring of the cortical activations occurring during EMDR therapy, more specifically during bilateral ocular desensitization itself. This complicated methodology involves at the same time psychotherapists, neurophysiologists, psychiatrists and EEG technicians and makes possible to image and represent on the cortical surface the specific maximal brain activations caused by the therapeutic actions contemplated by EMDR protocol. This makes EMDR the first psychotherapy ever whose neurobiological correlates and clinical effects have been investigated and depicted in real time during therapy sessions.

As for any other neuroimaging study larger cohorts of patients and control subjects are needed to confirm the pioneering achievements and identify the capability of EMDR to induce functional changes in patients suffering from different psychological traumas and/or traumas occurred at different times. This is currently in progress in central Italy and the results will be presented during this Conference.

Research efforts, including dedication and financial support, should continue addressing the fascinating attempt to completely disclose the neurobiological bases of EMDR therapy.






Marco Pagani

Original Work Citation

Pagani, M. (2014, June). Neurobiology of EMDR -- Past, present and future. Keynote presentation at the 15th EMDR Europe Association Conference, Edinburgh, Scotland



“Neurobiology of EMDR – Past, present and future,” Francine Shapiro Library, accessed October 24, 2021,

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