Neural processing of emotions in traumatized children treated with Eye Movement Desensitization and Reprocessing therapy: a hdEEG study

Cristina Trentini,Giampaolo Nicolais,Massimo Ammaniti,Alessandra Sibilia,Anna Rita Verardo,Isabel Fernandez,Marco Pagani,Piercarlo Fania,Lucio Inguscio,Anna Maria Speranza

doi:10.3389/fpsyg.2015.01662

Abstract

Eye Movement Desensitization and Reprocessing (EMDR) therapy has been proven efficacious in restoring affective regulation in post-traumatic stress disorder (PTSD) patients. However, its effectiveness on emotion processing in children with complex trauma has yet to be explored. High density electroencephalography (hdEEG) was used to investigate the effects of EMDR on brain responses to adults’ emotions on children with histories of early maltreatment. Ten school-aged children were examined before (T0) and within one month after the conclusion of EMDR (T1). hdEEGs were recorded while children passively viewed angry, afraid, happy, and neutral faces. Clinical scales were administered at the same time. Correlation analyses were performed to detect brain regions whose activity was linked to children’s traumatic symptom-related and emotional-adaptive problem scores. In all four conditions, hdEEG showed similar significantly higher activity on the right medial prefrontal and fronto-temporal limbic regions at T0, shifting toward the left medial and superior temporal regions at T1. Moreover, significant correlations were found between clinical scales and the same regions whose activity significantly differed between pre- and post-treatment. These preliminary results demonstrate that, after EMDR, children suffering from complex trauma show increased activity in areas implicated in high-order cognitive processing when passively viewing pictures of emotional expressions. These changes are associated with the decrease of depressive and traumatic symptoms, and with the improvement of emotional-adaptive functioning over time.

Highlights

Post-traumatic stress disorder (PTSD) describes discrete conditioned behavioral and biological responses to an experience involving actual or threatened death, serious injury, or sexual violence
The striking decrease in depressive symptomatology is coherent with the description of “trauma spectrum psychiatric disorders” (Bremner, 2002), that includes mild to severe depression and anxiety disorder. These findings suggest the importance to take into account these psychopathological symptoms as a further indication of Eye Movement Desensitization and Reprocessing (EMDR) treatment in childhood trauma spectrum
Negative correlations were found between the same scores and brain activation in left medial/superior temporal areas implicated in high-order cognitive processing (Pagani et al, 2012; Olson et al, 2013), (Table 6). Such correlations confirm the role of the abovementioned clinical scales in the assessment of childhood trauma, and highlight the neurobiological correlates of EMDR therapy. This is the first study that has investigated the effects of EMDR on brain responses to adults’ emotions on children with complex trauma

Summary

Introduction

Post-traumatic stress disorder (PTSD) describes discrete conditioned behavioral and biological responses to an experience involving actual or threatened death, serious injury, or sexual violence. Other studies have demonstrated that, relative to non-maltreated comparison groups, maltreated children show a faster and more accurate response to fearful (Masten et al, 2008) and sad facial expressions (Leist and Dadds, 2009), and are more likely to perceive neutral faces as angry or sad (Leist and Dadds, 2009)

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Discussion

Conclusion