Art therapy and underlying fMRI brain patterns in military TBI: A case series

Abstract

TBI and PTSD are global issues and are often referred to as signature wounds of the Iraq and Afghanistan wars. Art therapy can provide unique insights into military service members' injuries and states of mind via externalisation within an art product; however, interpretation of results is complex and subjective. Advance neuroimaging tools such as resting state fMRI can be employed to demonstrate objective measures of brain structure and activity. This case series highlights two distinct patient profiles, suggesting a relationship between resting state connectivity maps and dynamic thalamic connectivity (as well as PCL-C and NSI scores and brain scars) and the corresponding visual elements of masks made during art therapy treatment. Ultimately, this study indicates a need for future research examining potential neurological changes pre-and post-art therapy treatment. ARTICLE HISTORY

Approaches to Research in Art Therapy Using Imaging Technologies

“…Most studies to date have focused on relatively healthy populations but these tools are particularly relevant in research involving the treatment of psychological trauma. It is now common knowledge that central nervous system and neurobiological mechanisms of stress response and memory recall are compromised as a result of traumatic experiences and that the creative process offers an opportunity to rework and repair fragmented memories within an attuned therapeutic relationship (Walker et al, 2016, 2018; King, 2019). It is possible to consider that learning new sensory-motor associations when experiencing the same sensory input and associating these with a different output can help overwrite traumatic memories, which can be measured and tested with this innovative technology (King, 2018).…”

“…Lastly, although not mobile, positron emission tomography and functional magnetic resonance imaging studies could examine structural as well as functional outcomes of art therapy. For example, Walker et al (2018) found correlations between visual themes of social connectedness and improved thalamic functioning in patients diagnosed with post-traumatic stress. Changes in amygdala and hippocampal volume might be other structural changes to track in combination with functional brainwave shifts seen during art making assessed through MoBI.…”

Searching for the science behind art therapy

“…In the case of the masks, Walker and her team found that service members with higher PTSD scores were more likely to depict psychological injury and trauma whereas those with lower PTSD scores were more likely to depict themes that suggested a sense of community, such as patriotic images. In collaboration with NICoE's neuroimaging department, they conducted a pilot study using fMRI to study brain activity in 10 service members with chronic mild traumatic brain injuries (7). Service members who had depicted injury and trauma in their masks had less activity in a neural network known as the task-free default mode network, which tends to be active during periods of low stimulation-hence, suggesting that their minds were less at ease when at rest.…”

The power of the art: the importance of images in art therapy literature

“…We have since seen the development of research on a wide range of approaches to art therapy which keep art making and viewing as central, such as Carr and Hancock (2017), Coles, Harrison, and Todd (2019), Huet (2017), Kalmanowitz (2016) and Walker, Stamper, Nathan, and Riedy (2018), to name but a few. In order to reflect the centrality of the art in contemporary art therapy, our editorial board recently appointed the journal's first photo editor.…”