Possible neural mechanisms of psychotherapy for trauma-related symptoms: cerebral responses to the neuropsychological treatment of post-traumatic stress disorder model individuals.

Motomi Toichi,Tamaki Amano

doi:10.1038/srep34610

Abstract

Psychotherapy is often effective for treating psychogenic disorders, but the changes that occur in the brain during such treatments remain unknown. To investigate this, we monitored cerebral activity throughout an entire session using a psychotherapeutic technique in healthy subjects. Since post-traumatic stress disorder (PTSD) is a typical psychogenic psychiatric disorder, we used PTSD-model volunteers who had experienced a moderately traumatic event. The technique used as psychotherapy was eye movement desensitisation and reprocessing (EMDR), a standard method for treating PTSD. The oxygenated haemoglobin concentration ([oxy-Hb]), a sensitive index of brain activation, measured using multi-channel near-infrared spectroscopy, revealed changes in [oxy-Hb] in the superior temporal sulcus (STS) and orbitofrontal cortex (OFC). During a vital therapeutic stage, a significant reduction in the activation by forced eye movements was observed in the right STS, and a trend toward a reduction in the left OFC. The hyperactivation of the right STS on the recall of unpleasant memories, and its normalisation by eye movements, seem to reflect an important neural mechanism of the psychotherapy. These findings suggest that psychotherapy for traumatic symptoms involves brain regions related to memory representation and emotion, and possibly those that link memory and emotion, such as the amygdala.

Highlights

Death of father male Care manager Death of mother female Office worker Death of sister female Caregiver Unfaithful partner 6 male
EMDR and cognitive behavioral therapy (CBT) are typically significantly more structured than psychodynamic therapies, and follow strict protocols. To avoid these methodological problems, we focused on eye movement desensitisation and reprocessing (EMDR)[10,11], one of the standard therapeutic methods for treating trauma-related symptoms recommended in a guideline of the American Psychological Association (APA)[12], which involves a clearly structured protocol consisting of eight phases[10,11,13]
The original EMDR protocol for a PTSD patient with clinical symptoms requires a reduction in the SUDS score to 0 and an increase in the VOC score to 7, the changes in the SUDS and VOC scores of our subjects were large enough for the therapeutic session to be regarded as successful given the low level of severity of their traumatic experiences and our use of only one brief session

Summary

Introduction

Death of father male Care manager Death of mother female Office worker Death of sister female Caregiver Unfaithful partner 6 male. Most clinical studies on therapy are often difficult to conduct under an experimental condition in which brain activities are measured. Another problem is the period needed for the psychological treatment. Several neuroimaging studies of EMDR have investigated the effects of this therapy on patients with PTSD; they found changes in the activation of the brain after (not during) treatment sessions using single-photon emission computed tomography (SPECT), magnetic resonance imaging (MRI), and positron emission tomography (PET)[15,16]. We focused on the STS, the OFC and the DLPFC

Methods

Results

Conclusion