Abstract
BackgroundEye Movement Desensitisation and Reprocessing (EMDR) is a method in psychotherapy effective in treating symptoms of posttraumatic stress disorder. The client attends to alternating bilateral visual, auditory or sensory stimulation while confronted with emotionally disturbing material. It is thought that the bilateral stimulation as a specific element of EMDR facilitates accessing and processing of negative material while presumably creating new associative links. We hypothesized that the putatively facilitated access should be reflected in increased activation of the amygdala upon bilateral EMDR stimulation even in healthy subjects.MethodsWe investigated 22 healthy female university students (mean 23.5 years) with fMRI. Subjects were scanned while confronted with blocks of disgusting and neutral picture stimuli. One third of the blocks was presented without any additional stimulation, one third with bilateral simultaneous auditory stimulation, and one third with bilateral alternating auditory stimulation as used in EMDR.ResultsContrasting disgusting vs. neutral picture stimuli confirmed the expected robust effect of amygdala activation for all auditory stimulation conditions. The interaction analysis with the type of auditory stimulation revealed a specific increase in activation of the right amygdala for the bilateral alternating auditory stimulation. Activation of the left dorsolateral prefrontal cortex showed the opposite effect with decreased activation.ConclusionsWe demonstrate first time evidence for a putative neurobiological basis of the bilateral alternating stimulation as used in the EMDR method. The increase in limbic processing along with decreased frontal activation is in line with theoretical models of how bilateral alternating stimulation could help with therapeutic reintegration of information, and present findings may pave the way for future research on EMDR in the context of posttraumatic stress disorder.
Highlights
Eye Movement Desensitisation and Reprocessing (EMDR) is a method in psychotherapy for which meta-analyses have reliably demonstrated effectiveness in treating symptoms of posttraumatic stress disorder, PTSD [1,2]
The contribution of eye movements or other forms of bilateral stimulation is discussed controversially [5], a recent meta-analysis of 15 clinical and 11 laboratory trials on the additive effect of bilateral stimulation via eye movements came to the conclusion that processes involved in EMDR differ from other therapies based on exposure alone [6]
We set out to investigate the neurobiological correlates of bilateral stimulation as used in EMDR under laboratory conditions in a group of healthy subjects to further add to the uncovering of basic principles of action of this specific treatment intervention
Summary
Eye Movement Desensitisation and Reprocessing (EMDR) is a method in psychotherapy for which meta-analyses have reliably demonstrated effectiveness in treating symptoms of posttraumatic stress disorder, PTSD [1,2]. In line with clinical findings of decreased vividness and arousal related to trauma-associated stimuli after EMDR, neuroimaging studies reported decreased activation of limbic areas and increased activation of prefrontal brain regions related to cognitive control after completion of successful treatments [9,10]. These post-treatment studies only allowed for speculations about what happens during EMDR stimulation itself and how the effect was promoted. We hypothesized that the putatively facilitated access should be reflected in increased activation of the amygdala upon bilateral EMDR stimulation even in healthy subjects
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