Facilitating Access to Emotions: Neural Signature of EMDR Stimulation

Abstract

BackgroundEye Movement Desensitisation and Reprocessing (EMDR) is a method in psychotherapy effective in treating symptoms of posttraumatic stress disorder. The client attends to alternating bilateral visual, auditory or sensory stimulation while confronted with emotionally disturbing material. It is thought that the bilateral stimulation as a specific element of EMDR facilitates accessing and processing of negative material while presumably creating new associative links. We hypothesized that the putatively facilitated access should be reflected in increased activation of the amygdala upon bilateral EMDR stimulation even in healthy subjects.MethodsWe investigated 22 healthy female university students (mean 23.5 years) with fMRI. Subjects were scanned while confronted with blocks of disgusting and neutral picture stimuli. One third of the blocks was presented without any additional stimulation, one third with bilateral simultaneous auditory stimulation, and one third with bilateral alternating auditory stimulation as used in EMDR.ResultsContrasting disgusting vs. neutral picture stimuli confirmed the expected robust effect of amygdala activation for all auditory stimulation conditions. The interaction analysis with the type of auditory stimulation revealed a specific increase in activation of the right amygdala for the bilateral alternating auditory stimulation. Activation of the left dorsolateral prefrontal cortex showed the opposite effect with decreased activation.ConclusionsWe demonstrate first time evidence for a putative neurobiological basis of the bilateral alternating stimulation as used in the EMDR method. The increase in limbic processing along with decreased frontal activation is in line with theoretical models of how bilateral alternating stimulation could help with therapeutic reintegration of information, and present findings may pave the way for future research on EMDR in the context of posttraumatic stress disorder.

Degrading traumatic memories with eye movements: a pilot functional MRI study in PTSD

“…Specifically, decreased amygdala activity has been found after individual trauma-focused psychotherapy (Felmingham et al, 2007; Peres et al, 2007, 2011) and decreased insula activity after individual and group trauma-focused cognitive (behavioral) treatment (Peres et al, 2007, 2011; Thomaes et al, 2012). However, our findings are at odds with the findings from a previous study in healthy controls, showing that bilateral alternating stimulation resulted in increased amygdala activity and decreased DLPFC activity (Herkt et al, 2014). The difference with our study, apart from the study population, is that Herkt et al (2014) used general disgusting visual stimuli instead of personal traumatic audio-scripts.…”

“…In a functional magnetic resonance imaging (fMRI) study in 22 healthy controls, it was found that bilateral alternating auditory stimulation while viewing disgusting pictures resulted in increased amygdala activity and decreased DLPFC activity (Herkt et al, 2014). In patients, no such experimental studies yet exist.…”

Neurobiology and Stochastic Resonance: Going Deeper

“…As attention typically amplifies neuronal responses evoked by task-relevant stimuli, while attenuating responses to irrelevant distractors (Béhuret et al, 2013), it seems likely that the bilaterality of the DAS/BLS would amplify the SR effect more than a constant, nonalternating stimulus. This is what appears to have been observed by Herkt et al (2014) when they compared three groups: bilateral alternating stimulation in the form of auditory tones, bilateral simultaneous auditory tones, and no additional stimulation. The results show that the effects for alternating BLS were greater than those for simultaneous BLS, which was in turn greater than no additional stimulation (Herkt et al, 2014).…”

“…This is what appears to have been observed by Herkt et al (2014) when they compared three groups: bilateral alternating stimulation in the form of auditory tones, bilateral simultaneous auditory tones, and no additional stimulation. The results show that the effects for alternating BLS were greater than those for simultaneous BLS, which was in turn greater than no additional stimulation (Herkt et al, 2014). This is consistent with the modeling that views increased thalamic activity as facilitating the repair and integration of somatosensory, memorial, cognitive, and synchronized hemispheric functions.…”

Effect of Ocular Movements during Eye Movement Desensitization and Reprocessing (EMDR) Therapy: A Near-Infrared Spectroscopy Study

“…To objectively explore the physiological effects of EMDR, functional imaging techniques, such as nuclear imaging [5], electroencephalography (EEG)[6], and functional Magnetic Resonance Imaging [7], have been exploited. Modifications in the patterns of cerebral activity have been evidenced, particularly in those brain regions involved in stress management: the so-called hypothalamus-pituitary-adrenal (HPA) axis (an articulated response network to a stressful condition which involves deep brain regions, such as hypothalamus and amygdala) and cortical areas, such as the prefrontal cortex (PFC) [8].…”