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首页> 外文期刊>Frontiers in Psychology >Metabolic and Electrophysiological Changes Associated to Clinical Improvement in Two Severely Traumatized Subjects Treated With EMDRa??A Pilot Study
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Metabolic and Electrophysiological Changes Associated to Clinical Improvement in Two Severely Traumatized Subjects Treated With EMDRa??A Pilot Study

机译：用EMDRa治疗的两个严重创伤患者的代谢和电生理变化与临床改善相关的初步研究

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Neuroimaging represents a powerful tool to investigate the neurobiological correlates of Eye Movements Desensitization and Reprocessing (EMDR). The impact of EMDR on cortical and sub-cortical brain regions has been proven by several investigations demonstrating a clear association between symptoms disappearance and changes in cortical structure and functionality. The aim of this study was to assess by electroencephalography (EEG) and for the first time by positron emission tomography (PET) the changes occurring after EMDR therapy in two cases of psychological trauma following brain concussion and comatose state due to traffic accident. A 28 and a 29 years old men underwent extensive neuropsychological examination, which investigated: (i) categorical and phonological verbal fluency; (ii) episodic verbal memory; (iii) executive functions; (iv) visuospatial abilities; (v) attention and working memory as well as clinical assessment by means of psychopathological tests (CAPS, IES, BDI, SCL90R, and DES). They were then treated by eight sessions of EMDR. During the first session EEG monitoring was continuously performed and 18F-FDG PET scans, depicting brain metabolism, were acquired at rest within a week (T0). After the last session, in which the two clients were considered to be symptoms-free, neuropsychological, clinical, and PET assessment were repeated (T1). PET data were semi-quantitatively compared to a group of 18 normal controls, as for EEG the preferential cortical activations were disclosed by thresholding the individual z-score to a p < 0.05. There was a significant improvement in clinical condition for both clients associated with a significant decrease in CAPS scores. IES and BDI were found to be pathological at T0 and improved at T1 in only one subject. Visuo-constructive abilities and abstract reasoning improved after EMDR in both subjects. As for EEG, the most striking changes occurred in fronto-temporal-parietal cortex in subject 1 while subject 2 showed only minor changes. PET showed more pronounced metabolism in orbito-frontal and prefrontal cortex at T1 as compared to T0 in both subjects. In conclusion both clients had a clear clinical improvement in PTSD symptoms associated with metabolic and electrophysiological changes in limbic and associative cortex, respectively, highlighting the value of EMDR also in such extreme pathological conditions.
机译：神经影像学是研究眼动脱敏和再加工（EMDR）的神经生物学相关性的有力工具。 EMDR对皮质和皮质下大脑区域的影响已通过多项研究证实，这些研究表明症状消失与皮质结构和功能变化之间存在明确的关联。这项研究的目的是通过脑电图（EEG）和正电子发射断层扫描（PET）首次评估在EMDR治疗后发生脑震荡和交通事故导致昏迷状态的两例心理创伤患者中发生的变化。分别对28岁和29岁的男性进行了广泛的神经心理学检查，其中包括：（i）分类和语音语言流利度; （ii）情景性口头记忆; （iii）执行职能; （iv）视觉空间能力; （v）注意和工作记忆以及通过心理病理学测试（CAPS，IES，BDI，SCL90R和DES）进行的临床评估。然后，他们接受了EMDR的八次治疗。在第一个阶段中，连续进行EEG监测，并在一周之内（T0）进行18F-FDG PET扫描，以描绘大脑新陈代谢。在上次会议之后，其中两个客户被视为无症状，重复了神经心理学，临床和PET评估（T1）。将PET数据与18个正常对照组进行半定量比较，因为对于EEG，通过将单个z评分阈值设置为p <0.05揭示了优先皮质激活。两名客户的临床状况均有显着改善，CAPS得分显着下降。发现IES和BDI在T0时是病理性的，在T1时只有一个受试者得到了改善。 EMDR后，这两个科目的视线建构能力和抽象推理均得到改善。对于脑电图，受试者1的额颞叶顶皮质发生的变化最为明显，而受试者2的变化较小。与两个受试者的T0相比，PET在T1的眶额和前额皮层中均显示出更明显的新陈代谢。总之，两位客户在与边缘和相关皮质的代谢和电生理变化分别相关的PTSD症状方面都有明显的临床改善，突出了EMDR在这种极端病理情况下的价值。

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