Department of Neuropsychiatry, Graduate School of Medicine, University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-8655, Japan.
Neurosci Res. 2009 Dec;65(4):375-83. doi: 10.1016/j.neures.2009.08.014. Epub 2009 Sep 1.
Eye movement desensitization and reprocessing (EMDR) is an effective psychological intervention for posttraumatic stress disorder (PTSD). Trauma-related recall (Recall) with eye movements (EMs) is thought to reduce distress. However, the neural mechanisms underlying this process remain unknown. Thirteen patients with PTSD received EMDR treatment over the course of 2-10 weeks. We assessed the change in hemoglobin concentration in the lateral prefrontal cortex (PFC) during Recall with and without EM using multi-channel near-infrared spectroscopy (NIRS). Clinical diagnosis and improvement were evaluated using the Clinician-Administered PTSD Scale. Recall with EM was associated with a significant decrease in oxygenated hemoglobin concentration ([oxy-Hb]) in the lateral PFC as compared with Recall without EM. Longitudinally, [oxy-Hb] during Recall significantly decreased and the amount of decrease was significantly correlated with clinical improvement when the post-treatment data was compared with that of the pre-treatment. Our results suggest that performing EM during Recall reduces the over-activity of the lateral PFC, which may be part of the biological basis for the efficacy of EMDR in PTSD. NIRS may be a useful tool for objective assessment of psychological intervention in PTSD.
眼动脱敏再处理（EMDR）是一种有效的创伤后应激障碍（PTSD）心理干预方法。人们认为，与创伤相关的回忆（Recall）加上眼球运动（EMs）可以减轻痛苦。然而，这一过程的神经机制尚不清楚。13 名 PTSD 患者在 2-10 周的时间内接受了 EMDR 治疗。我们使用多通道近红外光谱（NIRS）评估了在有和没有 EM 的情况下 lateral prefrontal cortex（PFC）中血红蛋白浓度的变化。使用临床医生管理的 PTSD 量表评估临床诊断和改善情况。与没有 EM 的 Recall 相比，带有 EM 的 Recall 与 lateral PFC 中氧合血红蛋白浓度（[oxy-Hb]）的显著降低有关。纵向来看，与治疗前相比，当将治疗后的数据与治疗前的数据进行比较时，Recall 期间的[oxy-Hb]显著降低，且降低幅度与临床改善程度显著相关。我们的研究结果表明，在 Recall 期间进行 EM 可以减少 lateral PFC 的过度活跃，这可能是 EMDR 在 PTSD 中疗效的生物学基础的一部分。NIRS 可能是 PTSD 心理干预客观评估的有用工具。
