Laboratoire de Neurosciences Sensorielles et Cognitives, UMR 7260, Aix-Marseille Université, CNRS, Marseille, France.
Connors Center for Women's Health & Gender Biology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.
Aust N Z J Psychiatry. 2020 Aug;54(8):818-831. doi: 10.1177/0004867420913623. Epub 2020 Apr 9.
The inability to extinguish a conditioned fear is thought to be at the core of post-traumatic stress disorder. Eye movement desensitization and reprocessing therapy has been efficacious for post-traumatic stress disorder, but the brain mechanisms underlying the effect are still unknown. The core effect of eye movement desensitization and reprocessing therapy seems to rely on the simultaneous association of bilateral alternating stimulation and the recall of the traumatic memory. To shed light on how eye movement desensitization and reprocessing therapy functions, we aimed to highlight the structures activated by bilateral alternating stimulation during fear extinction and its recall.
We included 38 healthy participants in this study. Participants were examined twice in functional magnetic resonance imaging, over 2 consecutive days. On the first day, they performed two fear conditioning and extinction procedures, one with and one without the bilateral alternating stimulation during the fear extinction learning phase in a counter-balanced order across the participants. On the second day, participants completed the fear extinction recall procedure, in the same order as the previous day. Statistical significance of maps was set at < 0.05 after correction for family-wise error at the cluster level.
The analysis revealed significant activation with versus without bilateral alternating stimulation at the early extinction in the bilateral auditory areas, the right precuneus, and the left medial frontal gyrus. The same pattern was found in the early recall on the second day. The connectivity analysis found a significant increase in connectivity during bilateral alternating stimulation versus without bilateral alternating stimulation in the early extinction and recall between the two superior temporal gyri, the precuneus, the middle frontal gyrus and a set of structures involved in multisensory integration, executive control, emotional processing, salience and memory.
We show for the first time that in the eye movement desensitization and reprocessing therapy the bilateral alternating stimulation is not a simple sensory signal and can activate large emotional neural networks.
无法消除条件性恐惧被认为是创伤后应激障碍的核心。眼动脱敏再处理疗法已被证明对创伤后应激障碍有效，但该疗法的大脑机制仍不清楚。眼动脱敏再处理疗法的核心作用似乎依赖于双侧交替刺激的同时关联和创伤记忆的回忆。为了阐明眼动脱敏再处理疗法的作用机制，我们旨在强调在恐惧消退及其回忆过程中双侧交替刺激激活的结构。
我们在这项研究中纳入了 38 名健康参与者。参与者在连续两天内进行了两次功能性磁共振成像检查。在第一天，他们在两个恐惧条件反射和消退程序中进行了操作，其中一个在恐惧消退学习阶段在参与者之间以平衡的方式进行了双侧交替刺激，另一个则没有。第二天，参与者以与前一天相同的顺序完成了恐惧消退回忆程序。在对簇级的组间错误进行校正后，地图的统计显著性设置为<0.05。
分析显示，在双侧听觉区、右侧顶下小叶和左侧内侧额回中，与没有双侧交替刺激相比，在早期消退中存在显著的激活。在第二天的早期回忆中也发现了同样的模式。连接分析发现，在早期消退和回忆期间，双侧交替刺激与没有双侧交替刺激相比，双侧上颞叶之间、顶下小叶、中额回以及一组涉及多感觉整合、执行控制、情绪处理、突显和记忆的结构之间的连接性显著增加。
我们首次表明，在眼动脱敏再处理疗法中，双侧交替刺激不仅仅是一种简单的感觉信号，它可以激活大型情感神经网络。
