Monti Daniel A, Tobia Anna, Stoner Marie, Wintering Nancy, Matthews Michael, He Xiao-Song, Doucet Gaelle, Chervoneva Inna, Tracy Joseph I, Newberg Andrew B
Marcus Institute of Integrative Health, Thomas Jefferson University, Philadelphia, USA.
Department of Neurology, Philadelphia, USA.
J Cancer Surviv. 2017 Aug;11(4):438-446. doi: 10.1007/s11764-017-0601-8. Epub 2017 Feb 8.
The purpose of this study was to characterize the neurophysiological and clinical effects that may result from the neuro emotional technique (NET) in patients with traumatic stress symptoms associated with a cancer-related event. We hypothesized that self-regulatory processing of traumatic memories would be observable as physiological changes in key brain areas after undergoing the NET intervention and that these changes would be associated with improvement of traumatic stress symptoms.
We enrolled 23 participants with a prior cancer diagnosis who expressed a distressing cancer-related memory that was associated with traumatic stress symptoms of at least 6 months in duration. Participants were randomized to either the NET intervention or a waitlist control condition. To evaluate the primary outcome of neurophysiological effects, all participants received functional magnetic resonance imaging (fMRI) during the auditory presentation of both a neutral stimulus and a description of the specific traumatic event. Pre/post-comparisons were performed between the traumatic and neutral condition, within and between groups. Psychological measures included the Impact of Event Scale (IES), State Trait Anxiety Index (STAI), Brief Symptom Inventory (BSI)-18, and Posttraumatic Cognitions Inventory (PTCI).
The initial fMRI scans in both groups showed significant increases in the bilateral parahippocampus and brainstem. After NET, reactivity in the parahippocampus, brainstem, anterior cingulate, and insula was significantly decreased during the traumatic stimulus. Likewise, participants receiving the NET intervention had significant reductions (p < 0.05) compared to the control group in distress as measured by the BSI-18 global severity index, anxiety as measured by the STAI, and traumatic stress as measured by the IES and PTCI.
This study is an initial step towards understanding mechanistic features of the NET intervention. Specifically, brain regions involved with traumatic memories and distress such as the brainstem, insula, anterior cingulate gyrus, and parahippocampus had significantly reduced activity after the NET intervention and were associated with clinical improvement of symptoms associated with distressing recollections.
This preliminary study suggests that the NET intervention may be effective at reducing emotional distress in patients who suffer from traumatic stress symptoms associated with a cancer-related event.
本研究旨在描述神经情感技术（NET）对患有与癌症相关事件所致创伤应激症状患者可能产生的神经生理学和临床影响。我们假设，在接受NET干预后，创伤记忆的自我调节过程可表现为关键脑区的生理变化，且这些变化将与创伤应激症状的改善相关。
我们招募了23名曾被诊断患有癌症的参与者，他们表达了一段与癌症相关的痛苦记忆，且该记忆与持续至少6个月的创伤应激症状相关。参与者被随机分为NET干预组或等待名单对照组。为评估神经生理学效应的主要结果，所有参与者在听中性刺激和特定创伤事件描述时均接受功能磁共振成像（fMRI）检查。在创伤和中性条件之间、组内和组间进行前后比较。心理测量指标包括事件影响量表（IES）、状态特质焦虑指数（STAI）、简明症状量表（BSI）-18和创伤后认知量表（PTCI）。
两组的初始fMRI扫描均显示双侧海马旁回和脑干有显著增加。NET干预后，在创伤刺激期间，海马旁回、脑干、前扣带回和脑岛的反应性显著降低。同样，与对照组相比，接受NET干预的参与者在BSI-18总体严重程度指数所测量的痛苦、STAI所测量焦虑以及IES和PTCI所测量的创伤应激方面均有显著降低（p<0.05）。
本研究是迈向理解NET干预机制特征的第一步。具体而言，参与创伤记忆和痛苦的脑区，如脑干、脑岛、前扣带回和海马旁回，在NET干预后活动显著降低，并与与痛苦回忆相关症状的临床改善相关。
这项初步研究表明，NET干预可能有效减轻患有与癌症相关事件所致创伤应激症状患者的情绪困扰。
