Neuropsychological Research on EMDR
Eye movement desensitisation and reprocessing (EMDR) is a standardised protocol of emotional, physical, and cognitive assessment associations of distress to painful memories. One of the main components of EMDR is bilateral stimulation, which involves either somaesthetic, visual, or auditory stimulithat alternate between the left and right sides of the body. The important therapeutic results of EMDR areachieved by associating the traumatic memory of the clientand the presentation of bilateral stimulation. This association can lead to a rapid reduction of emotional responses generated by the painful memory. Online EMDR clinic will present some information on the topic.
More and more advanced neuroimaging studies have been conducted over the past yearsin order to discover the neurobiological mechanisms of EMDR therapy. These studies seem to be appropriate for answering persistent questions regarding the way EMDR works, while also addressing some limitations of early research. The following paragraphs provide relevant details regarding a few of the aforementioned studies, along with the hope that more conclusive research will be conducted in the future. The research is conducive to EMDR therapy delivered online.
Emotion and memory processing structures have been investigated through a set of brain imaging studies with the purpose of learning more about the brain correlates of EMDR therapy. Nardo et al. carried out a magnetic resonance imaging [MRI] study in 22 healthy controls compared with 21 participants with a PTSD diagnostic. They found that, in comparison with participants who were responsive to EMDR, those who were unresponsive had a decreased level of gray matter density in several paralytic and limbic regions. Reduced gray matter density in the insular, parahippocampal, and posteriorcortices was associated with PTSD diagnosis, poor therapy outcome, and trauma load, suggesting that lower neuronal integrity in the aforementioned regions may determine the lack of response to EMDR therapy. Bossini et al. used high-resolution MRI scansto study structural modifications in 10individualswith PTSD and manually delineatedhippocampi. After concluding that the participantsshowed great bilateralhippocampal increases in volume and stopped meeting PTSD criteria after eight weeks of EMDR treatment, the authors speculated on the prospect of volumetric effects generated by psychotherapy. However, this speculation should not be accepted without objection, as these structural modificationscould have been determined by increased water/electrolyte content or neurogenesis.
The first functional imaging study was conducted by Levin and cols. and it examined modifications in metabolism with single-proton emission computer tomography [SPECT], as well as a symptom provocation paradigmin oneindividual with PTSDbefore and after 3EMDR sessions. The outcome showed increased activity in the left frontal lobe and the anterior cingulate gyrus post-EMDR treatment. The authors suggested that the activation of these regionshelps individuals make the distinction between painful memories which are not connected with current experiences and real threats. Lansing et al. also studied brain activation with SPECT during the recollection of a traumatic memory in six traumatized police officers before and after EMDR therapy. After the removal of PTSD symptoms, they discoveredgreat metabolic reductions in left parietal, posterior frontal andoccipitallobes, as well asmetabolic increases in the left inferior frontal gyrus. These results suggest that successful EMDR therapy may determine an increase in prefrontal control over hyperactive limbic subsystems. At the same time, they provide preliminary evidencein favor of neural integration models. A further SPECT study conducted by Pagani et al. in15 participants and 22 controls who displayed no symptoms despite having experienced the same trauma confirmed these results. A subgroup of individuals who were responsive to the EMDR treatment showed a great metabolic normalization in the hippocampus and in posterior cortical regions after therapy, as well as ablood perfusion increase in the lateral prefrontal cortex. Oh et al. have conducted another SPECT EMDR study in 2participantswith psychological traffic trauma and 10 healthy controls. They discovered decreased metabolism in the temporal association cortex and increased metabolism in bilateral dorsolateral prefrontal cortex post-EMDR therapy.
However, SPECT isn’t the only neuroimaging technique which has been used for the examination of EMDR-related brain functional changes. Ohtani et al. carried out the first near-infrared spectroscopy (NIRS) study with the purpose of monitoring brain hemodynamic modifications related to EMDR treatment during memory recollection. In this study, recall with eye movements was associated with majorblood flow decreasesin the lateral prefrontal cortex, as opposed to recall without eye movements. Furthermore, the concentration of oxygenated hemoglobin was associated with post-treatment clinical improvement. The authors speculated that the efficacy of EMDR may be related to the reduction of lateral prefrontal cortex due to activation during trauma-related recollection. In another fMRI study, Landin-Romero et al. studiedbrain activity modifications after successful EMDR therapy in a traumatized and subsyndromal bipolar individuals. The findings showed that, compared with 30 healthy controls, post-treatment symptom recovery was followed by a functional normalization of brain activity. This normalization was marked in the default mode network, which is generally accepted as dysfunctional in numerous severe mental disorders such as PTSD. The authors suggested that large scale network modulation, particularly in the default mode network, could be a prospective neurobiological correlate of EMDR therapy.
The studies discussed in this article were conducted in order to discover the underlying mechanisms of EMDR. While this form of psychotherapy has led to impressive results in a lot of cases, particularly in terms of treating PTSD, specialists are still unaware of how it works – EMDR has many components, so there could be countless possible explanations. Because of this, some researchers believe that its effects can only be captured by using an integrative model. Several proposals have already been made: in 2016, an integrative model involving EMDR theories, functional brain imaging of individuals with PTSD, and neurophysiological findings on eye movements was developed by Olivier Coubard. A few other integrative models were proposed much earlier on, in 2008.
While it is true that progress is being made, the neural mechanisms of EMDR therapy will not be fully understood anytime soon. In order to get there, well-designed studies need to be conducted in the meantime, and they should involve multidimensional neurobiological indexes which are reliable. Online EMDR clinic was happy to present a summary of these findings.