Fear extinction learning improvement in PTSD after EMDR therapy: an fMRI study
Participants underwent a behavioural fear conditioning and extinction paradigm during functional magnetic resonance (fMRI).
Article Abstract
“Objective: Neurobiological models of Posttraumatic Stress Disorder (PTSD) implicate fear processing impairments in the maintenance of the disorder. Eye Movement Desensitization and Reprocessing (EMDR) is one of the most efficient psychotherapies to treat PTSD. We aimed at exploring the brain mechanisms of the fear circuitry involved in PTSD patients’ symptom remission after EMDR therapy.
Method: Thirty-six PTSD participants were randomly assigned to either EMDR group receiving EMDR therapy or Wait-List (WL) group receiving supportive therapy. Participants underwent a behavioural fear conditioning and extinction paradigm during functional magnetic resonance (fMRI). In the EMDR group, patients were scanned at baseline, before EMDR and one week after remission. In the WL group, patients were scanned at baseline and within the same time interval as the EMDR group.
Results: In the EMDR group after treatment, fear responses in the late extinction were significantly lower than before therapy. In parallel, significant functional activity and connectivity changes were found in the EMDR group versus the WL during the late extinction. These changes involve the fear circuit (amygdalae, left hippocampus), the right inferior frontal gyrus, the right frontal eye field and insula (pFWE < .05).
Conclusion: These functional modifications underlie a significant improvement of fear extinction learning in PTSD patients after EMDR therapy.
HIGHLIGHTS
- PTSD patients have a deficit to extinguish a conditioned fear
- This deficit is reversible after treatment
- EMDR therapy restoration of the fear conditioning ability in PTSD relies upon fear circuitry (amygdala, hippocampus) and other cortical brain structures (insula, posterior cingulate cortex, right frontal eye field, right inferior frontal gyrus and left Heschl gyrus).
—Description from publisher
Article Access
Open Access
Rousseau, P.-F., El Khoury-Malhame, M., Reynaud, E., Boukezzi, S., Cancel, A., Zendjidjian, X.,Guyon, V., Samuelian, J.-C., Guedj, E., Chaminade, T., & Khalfa, S. (2019). Fear extinction learning improvement in PTSD after EMDR therapy: an fMRI study. European Journal of Psychotraumatology, 10(1). https://doi.org/10.1080/20008198.2019.1568132
Date
January 29, 2019
Creator(s)
Pierre-François Rousseau, Myriam El Khoury-Malhame, Emmanuelle Reynaud
Contributor(s)
Sarah Boukezzi, Aïda Cancel, Xavier Zendjidjian, Valérie Guyon, Jean-Claude Samuelian, Eric Guedj, Thierry Chaminade, Stephanie Khalfa
Topics
PTSD
Practice & Methods
Mechanisms of Action, Neurobiology
Extent
11 pages
Publisher
Taylor & Francis
Rights
© 2019 The Author(s). Published by Informa UK Limited, trading as Taylor & Francis Group. This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial License (http://creativecommons.org/licenses/by-nc/4.0/), which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
APA Citation
Rousseau, P.-F., El Khoury-Malhame, M., Reynaud, E., Boukezzi, S., Cancel, A., Zendjidjian, X.,Guyon, V., Samuelian, J.-C., Guedj, E., Chaminade, T., & Khalfa, S. (2019). Fear extinction learning improvement in PTSD after EMDR therapy: an fMRI study. European Journal of Psychotraumatology, 10(1). https://doi.org/10.1080/20008198.2019.1568132
Audience
EMDR Therapists, Other Mental Health Professionals
Language
English
Content Type
Article, Peer-Reviewed
Access Type
External Resource, Open Access
