EMDR Treatment for Posttraumatic Stress Disorder, With Focus on Hippocampal Volumes: A Pilot Study

Bossini, Letizia; Tavanti, M.; Calossi, Sara; Polizzotto, Nicola Riccardo; Vatti, Giampaolo; Marino, Daniela; Castrogiovanni, Paolo

doi:10.1176/jnp.23.2.jnpe1

Cited by 11 publications

(2 citation statements)

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“…Whereas previous research indicated increased hippocampal volume following cognitive behavioral therapy (N=39) (Levy-Gigi et al, 2013) and Eye Movement and Desentization and Reprocessing (EMDR) (N=10) (Bossini et al, 2011), other studies failed to find any relationship between hippocampal volume changes and psychotherapy (Lindauer et al, 2005, (N=18); van Rooij et al, 2015, (N=47)).…”

Section: Introductionmentioning

confidence: 89%

Greater hippocampal volume is associated with PTSD treatment response

Rubin¹,

Shvil²,

Papini³

et al. 2016

Psychiatry Research: Neuroimaging

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Previous research associates smaller hippocampal volume with posttraumatic stress disorder (PTSD). It is unclear, however, whether treatment affects hippocampal volume or vice versa. Seventy-six subjects, 40 PTSD patients and 36 matched trauma-exposed healthy resilient controls, underwent clinical assessments and magnetic resonance imaging (MRI) at baseline, and 10 weeks later, during which PTSD patients completed ten weeks of Prolonged Exposure (PE) treatment. The resilient controls and treatment responders (n=23) had greater baseline hippocampal volume than treatment non-responders (n=17) (p=0.012 and p=0.050, respectively), perhaps due to more robust fear-extinction capacity in both the initial phase after exposure to trauma and during treatment.

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Section: Introductionmentioning

confidence: 89%

Greater hippocampal volume is associated with PTSD treatment response

Rubin¹,

Shvil²,

Papini³

et al. 2016

Psychiatry Research: Neuroimaging

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“…Another study did find volumetric changes in the hippocampus (manual segmentation) after multiple sessions of eye movement desensitization and reprocessing therapy. 74 Within-subject analyses demonstrated increased volume bilaterally, but the study had some methodological weaknesses including lack of a control group. Another larger and more methodologically rigorous study comparing subjects with PTSD to trauma-exposed control subjects reported that differences in hippocampal volume (automated segmentation, smaller in PTSD) were no longer present after trauma-focused CBT.…”

Section: Structural Neuroimagingmentioning

confidence: 97%

Psychotherapy for PTSD: Neuroimaging of Recovery Processes

Erickson¹,

Hurley²,

Taber³

2014

JNP

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Much of the neurobiological research on posttraumatic stress disorder (PTSD) has focused on brain structures implicated in the fear circuit. Illustrated and labeled here are the locations and general extent of the amygdala (pink), hippocampus (purple), and limbic-related cerebral cortex (yellow), which includes the cingulate and parahippocampal gyri and uncus. The general region that is considered to be ventromedial prefrontal cortex (PFC) is circled. COVER and FIGURE 2. There is considerable variability across functional imaging studies assessing neural differences associated with PTSD, in part due to small sample size. Other important aspects include whether the analysis focused only on specific regions of interest or examined the whole brain and the tasks used to evoke changes in neural activity. Summarized here are the results of two recent meta-analyses that focused primarily on studies that reported whole brain analysis, used some form of symptom provocation (e.g., trauma reminders), and compared subjects with PTSD to healthy trauma exposed individuals. 1,2 Warm colors (pink, orange) indicate areas with higher activation in subjects with PTSD, and cool colors (blue, green) indicate areas with lower activation in subjects with PTSD. Both metaanalyses found hyperactivation within multiple areas in the cingulate cortex and noted the importance of this region for salience processing. Neither meta-analysis found the response of the amygdala to differ significantly between subjects with PTSD and trauma-exposed control subjects during symptom provocation. As noted in one study, this may be due to the inherent difficulty with acquiring functional imaging of this small area or may indicate that amygdala dysfunction is not as important in PTSD as previously thought. 1 FIGURE 3. Only a handful of imaging studies have assessed treatment-related changes in brain activations induced by trauma reminders in subjects with PTSD. The results of three studies that used single photon emission computed tomography (SPECT) to compare regional cerebral blood flow (CBF) in subjects who responded to treatment compared with their own baseline or subjects who did not respond to treatment are summarized. 3-5 Warm colors (pink, orange) indicate areas with higher CBF, and cool colors (blue, greens) indicate areas with lower CBF. One study reported only general areas (e.g. Brodmann areas [BA], hippocampus) and did not specify laterality, so these are indicated by large circles in both hemispheres. 3 Smaller circles mark the locations from the two studies that reported coordinates. 4,5 The only areas reported in all three studies are in dorsolateral PFC and medial temporal lobe, but the laterality and direction of change varies. Although very preliminary, these results suggest that both normalization and compensatory changes may occur.

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