P.1.i.021 EMDR efficacy on characteristic posttraumatic stress disorder neurobiological alterations
Post-Traumatic Stress Disorder (PTSD) is characterized by dysfunction and structural alteration of several discrete brain regions. Eye Movement Desensitization and Reprocessing (EMDR) is a psychotherapy that has been found to effectively resolve the effects of traumatic experiences and it is recognized as a first-line treatment for PTSD; moreover, in recent research, fundamental and structural neurobiological changes after successful treatment of PTSD with EMDR were proven . We proposed to evaluate the neurobiological effects of EMDR on 14 patients (age 18−65 years) with drug-na¨ıve PTSD without comorbidity, matched with 14 untreated healthy controls. Patients and control participants underwent a complete Psychiatric evaluation and were assessed with Clinical Administered PTSD Scale (CAPS) for PTSD diagnosis; psychiatric comorbidity was excluded by administration of Structured Clinical Interview for DSM-IV (SCID-I). Brain magnetic resonance imaging (MRI) measurements, with Optimized Voxel-Based Morphometry, were conducted to find out characteristic neurobiological alterations. The patients received 3 months of EMDR treatment according to the guidelines by Shapiro , and then were evaluated posttreatment with MRI and CAPS, while the healthy controls were re-evaluated with MRI at 3 months after baseline acquisition. We applied one-way Analysis of CoVariance (ANCOVA) models for cross-sectional comparisons between PTSD and control groups at baseline and repeated measure ANCOVA (RM ANCOVA) for longitudinal evaluation of brain morphology changes comparing the Time 1 and Time 2 images of patients and controls. Patients and controls did not differ for demographic data. From a clinical point of view, the diagnosis of PTSD was effectively eliminated in 11 of 14 patients, reflected in a significant improvement in CAPS scores (p<0.004). At baseline, gray matter volume (GMV) differed significantly between patients and controls: the Analyses revealed a region of significantly decreased GMV in patients’ left parahippocampal region, supplementary motor area, lingual gyrus, and both left and right superior frontal gyrus (p = 0.008). Patients with PTSD also showed a significant increase in GMV corresponding to right angular gyrus, inferior parietal lobule and left inferior temporal gyrus. Analyses of 3-month scans showed no changes for controls, while significant changes were highlighted for patients post-EMDR, with a significant increase in GMV in left parahippocampal gyrus and a significant decrease in GMV in the left thalamus region. Our results confirmed EMDR clinical efficacy on PTSD and highlighted post-EMDR changes in brain morphology. Although to date, we are still far from matching symptoms and single alterations, work with PTSD has suggested that many symptoms and/or psychopathological characterizations appear to be closely related to some specific neurobiological alterations. Future research in this direction is recommended so that we can better understand the mechanisms that underlie both etiopathogenesis and then the maintenance of the disorder. Such insights could be used to select treatments which could target specific neurobiological alterations, with the goal of achieving resolution of biological damage and, subsequently the disorder.
Original Work Citation
Caterini, C., Bossini, L., Casolaro, I., Koukouna, D., Santernecchi, E., Fernandez, I., & Fagiolini, A. (2014, October). P.1.i.021 EMDR efficacy on characteristic posttraumatic stress disorder neurobiological alterations. European Neuropsychopharmacology, 24, S309-S309
“P.1.i.021 EMDR efficacy on characteristic posttraumatic stress disorder neurobiological alterations,” Francine Shapiro Library, accessed October 22, 2020, https://emdria.omeka.net/items/show/25805.