与仅采用回忆疗法相比，眼动脱敏疗法对创伤后应激障碍患者神经认知功能的影响：一项随机对照试验。
The effect of eye movement desensitization on neurocognitive functioning compared to retrieval-only in PTSD patients: a randomized controlled trial.
作者信息
Susanty Eka, Sijbrandij Marit, Srisayekti Wilis, Suparman Yusep, Huizink Anja C
机构信息
Faculty of Psychology, Universitas Jenderal Achmad Yani, Cimahi, Indonesia.
Department of Clinical, Neuro- and Developmental Psychology, Faculty of Behavioral and Movement Sciences, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands.
出版信息
BMC Psychiatry. 2024 Dec 27;24(1):956. doi: 10.1186/s12888-024-06420-9.
BACKGROUND
There is robust evidence that posttraumatic stress disorder (PTSD) is associated with neurocognitive deficits, such as executive dysfunction or memory dysfunction. Eye Movement Desensitization and Reprocessing (EMDR) is an evidence-based treatment for PTSD, in which eye movements (EMs) are performed during traumatic memory retrieval. We examined whether Eye Movement Desensitization (EMD) improves neurocognitive functioning in PTSD patients, in comparison with a retrieval-only control condition without EMs.
METHODS
Adult patients with PTSD (N = 91) were randomized into EMD (N = 47) or retrieval-only (N = 44). Data were collected at baseline (T0), one-week post-treatment (T1), one-month follow-up (T2), and at three-month follow-up (T3). Outcome measures were the California Verbal Learning Test (CVLT), the Trail Making Test (TMT), and the Digit Span Subtest of the Wechsler Adult Intelligence Scale fourth edition (WAIS-IV). We conducted linear mixed model to analyse the main outcomes.
RESULTS
There was a main effect of time, indicating improvements for both the EMD and retrieval-only groups in CVLT scores, TMT A, TMT B and Digit Span score of WAIS-IV (Bonferroni-adjusted p's < 0.001) from T0 to T3. There were no effects of group (p = .64) or group by time on CVLT total trial A (T3; p = .34), delay A (T3; p = .76), TMT A (T3; p = .61), TMT B (T3: p = .58), and Digit Span scores (T3; p = .78) of the WAIS-IV, indicating no significant differences between groups on any of the outcomes.
CONCLUSION
Comparing EMD and retrieval-only did not show evidence for additive effects of EMs on the treatment of PTSD in terms of improvements in neurocognitive functioning. Thus, treatments based on retrieval of traumatic memories may be used to improve neurocognitive functioning in patients with PTSD.
CLINICAL TRIAL REGISTRATION
The trial was registered 19/12/2017 at ClinicalTrials.gov, identifier [ISRCTN55239132].
背景
有充分证据表明，创伤后应激障碍（PTSD）与神经认知缺陷有关，如执行功能障碍或记忆功能障碍。眼动脱敏再处理疗法（EMDR）是一种针对PTSD的循证治疗方法，在创伤记忆提取过程中进行眼动（EMs）。我们研究了与不进行眼动的仅记忆提取对照条件相比，眼动脱敏（EMD）是否能改善PTSD患者的神经认知功能。
方法
将91名成年PTSD患者随机分为EMD组（N = 47）或仅记忆提取组（N = 44）。在基线（T0）、治疗后一周（T1）、一个月随访（T2）和三个月随访（T3）时收集数据。结局指标包括加利福尼亚言语学习测验（CVLT）、连线测验（TMT）和韦氏成人智力量表第四版（WAIS-IV）的数字广度分测验。我们进行线性混合模型分析主要结局。
结果
存在时间主效应，表明从T0到T3，EMD组和仅记忆提取组在CVLT分数、TMT A、TMT B和WAIS-IV的数字广度分数方面均有改善（Bonferroni校正p值<0.001）。在CVLT总试验A（T3；p = 0.34）、延迟A（T3；p = 0.76）、TMT A（T3；p = 0.61）、TMT B（T3：p = 0.58）和WAIS-IV的数字广度分数（T3；p = 0.78）方面，不存在组间效应（p = 0.64）或组与时间的交互效应，表明两组在任何结局上均无显著差异。
结论
比较EMD和仅记忆提取，未发现眼动在改善神经认知功能方面对PTSD治疗有附加效应的证据。因此，基于创伤记忆提取的治疗方法可用于改善PTSD患者的神经认知功能。
临床试验注册
该试验于2017年12月19日在ClinicalTrials.gov注册，标识符为[ISRCTN55239132]。
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