Les investigations en neuroimagerie sur les effets des psychothérapies qui traitent l'état de stress post-traumatique (ESPT), dont l'EMDR (désensibilisation et retraitement par les mouvements oculaires), ont décrit des résultats cohérents avec des modifications au niveau du débit sanguin cérébral (DSC ; tomographie d'émission monophotonique [SPECT : single photon emission computed tomography]), du volume neuronal et de la densité neuronale (imagerie par résonance magnétique [IRM]) et, plus récemment, du signal électrique cérébral (électroencéphalographie [EEG]). De plus, récemment, des changements neurobiologiques en lien avec l'EMDR ont été relevés par EEG pendant la thérapie elle-même et a montré une modification de l'activation maximale depuis les régions cérébrales limbiques émotionnelles vers les régions corticales cognitives. C'était la première fois que des changements neurobiologiques se produisant au cours d'une séance de psychothérapie étaient rapportés, faisant de l'EMDR la première psychothérapie avec un effet neurobiologique prouvé. Le but de cet article est de résumer les résultats indiquant les changements fonctionnels et structurels se produisant lors du traitement de l'ESPT et présentés par divers groupes de recherche pendant la période 1999-2012. Les changements pathophysiologiques décrits sont présentés en fonction de la technique neuropsychologique et de la méthodologie employée, puis analysés de manière critique.

Given the significant growth in the migration flow of refugees who are fleeing from persecution, terrorism, and war-torn countries to Europe, there is an urgent need for effective interventions for the treatment of this highly traumatized population. EMDR Integrative Group Treatment Protocol (EMDR-IGTP) was provided to 14 child refugees (7 females) in 2016 at a Turkey orphanage near the Syrian border which was housing adult and child Syrian refugees. Treatment was provided in three groups, one each for children aged 3–7 years, pre-adolescents aged 9–12, and adolescents aged 13–18 with three sessions provided to each group. Pre-treatment assessment with multiple measures was compromised by difficulties with translator availability and refugee mobility, resulting in high attrition. When the post-treatment assessment was conducted 45 days later, many refugees had already left the orphanage. The sparse character of the data matrix produced analyzable data for 8 children (mean age 11 ± 3; 4 females) on the Children's Revised Impact of Event Scale (CRIES). Statistical analysis showed a significant decrease in CRIES scores, reflecting a decrease in severity of posttraumatic symptoms.

The exposure to a life-threatening disease such as cancer may constitute a traumatic experience that in some cases may lead to the development of posttraumatic stress disorder (PTSD). In recent years, several studies investigated this syndrome in patients with cancer, but few focused on the underlying neurobiology. The aim of this work was to review the current literature of neurobiology of PTSD in oncological diseases, focusing on a comparison with the results of neurobiological studies on PTSD in non-oncological patients and on treatments resulted effective for such disorder. Brain structures having a role in the appearance of PTSD in psycho-oncology, and in particular, in intrusive symptoms, seem to be the same involved in non-oncologic PTSD. These findings may have important implications also at clinical level, suggesting that psychotherapies found to be effective to treat PTSD in different populations may be offered also to patients with cancer-induced posttraumatic symptoms. Further studies are needed to deepen our knowledge about cancer-related PTSD neurobiology and its treatment, aiming at transferring the results into clinical practice.

La exposición a una enfermedad potencialmente mortal como el cáncer puede constituir una experiencia traumática que, en algunos casos, puede dar lugar al desarrollo de un trastorno por estrés postraumático (TEPT). En los últimos años, varios estudios han investigado este síndrome en pacientes con cáncer, pero pocos se han centrado en la neurobiología subyacente. El objetivo de este trabajo ha sido revisar la literatura actual de la neurobiología del TEPT en las enfermedades oncológicas, centrándonos en compararla con los resultados de los estudios neurobiológicos sobre el TEPT en pacientes no oncológicos y en los tratamientos que han resultado ser eficaces para dicho trastorno. Las estructuras cerebrales que desempeñan un papel en la aparición del TEPT en psico-oncología, y en particular en los síntomas intrusivos, parecen ser las mismas que están involucradas en el TEPT no oncológico. Estos hallazgos pueden tener implicaciones importantes también a nivel clínico, lo que sugiere que las psicoterapias que resulten ser eficaces para tratar el TEPT en diferentes poblaciones pueden ofrecerse también a pacientes con síntomas postraumáticos inducidos por el cáncer. Se necesitan más estudios para profundizar en nuestros conocimientos sobre la neurobiología del TEPT relacionado con el cáncer y su tratamiento, con el objetivo de transferir los resultados a la práctica clínica.

This pilot study examined the efficacy of eye movement desensitization and reprocessing (EMDR) treatment compared with cognitive behavioral therapy (CBT) in treating posttraumatic stress disorder (PTSD) in oncology patients in the follow-up phase of the disease. The secondary aim of this study was to assess whether EMDR treatment has a different impact on PTSD in the active treatment or during the follow-up stages of disease. Twenty-one patients in follow-up care were randomly assigned to EMDR or CBT groups, and 10 patients in the active treatment phase were assigned to EMDR group. The Impact of Event Scale—Revised (IES-R) and Clinician-Administered PTSD Scale (CAPS) were used to assess PTSD at pretreatment and 1 month posttreatment. Anxiety, depression, and psychophysiological symptoms were also evaluated. For cancer patients in the follow-up stage, the absence of PTSD after the treatment was associated with a significantly higher likelihood of receiving EMDR rather than CBT. EMDR was significantly more effective than CBT in reducing scores on the IES-R and the CAPS intrusive symptom subscale, whereas anxiety and depression improved equally in both treatment groups. Furthermore, EMDR showed the same efficacy both in the active cancer treatment and during the follow-up of the disease.

Research in clinical psycho-oncology is becoming an area of key importance in investigating the effects of the interventions of support and/or psychotherapy with patients. This study was conducted with the aim of evaluating the effectiveness of the eye movement desensitization and reprocessing (EMDR) approach compared to a non–trauma-focused cognitive behavioral therapy (CBT) intervention. There were 11 male and 46 female participants, with mixed cancer diagnoses. Thirty-one subjects received EMDR therapy, and 26 received CBT for 12 sessions of 60 minutes each. The Symptom Checklist-90-R (SCL-90-R), COPE inventory, and Davidson Trauma Scale (DTS) were administered at three different times (T0, before intervention; T1, after the sixth session; and T2, after the 12th session); the Karnofsky Performance Status was administered at T0 only. In the EMDR group, a significant improvement was reported for the following 11 of the 17 dependent variables: COPE subscales, Avoidance Strategies and Positive Attitude; all three DTS subscales, Intrusion, Avoidance, and Hyperarousal; and 6 SCL-90-R subscales. In the CBT group, a significant improvement was reported for the following 4 of the 17 dependent variables: COPE subscales Positive Attitude and Transcendent Orientation; two DTS subscales, Intrusion, and Avoidance, with no improvement on any of the SCL-90-R subscales. This innovative study shows the value of trauma-focused treatment for patients with cancer and allows important preliminary suggestions on the usefulness of applying EMDR therapy in an oncological setting, although further research in this context is still needed.

L’exposition à une maladie mortelle comme le cancer peut constituer une expérience traumatique qui dans certains cas peut conduire au développement d’un état de stress post-traumatique (ESPT). Au cours des dernières années, plusieurs études ont investigué ce syndrome chez des patients atteints de cancer, mais peu se sont centrées sur la neurobiologie sous-jacente. Le but de ce texte est de passer en revue la littérature actuelle sur la neurobiologie de l’ESPT dans les maladies oncologiques, en se centrant sur une comparaison des résultats d’études neurobiologiques de l’ESPT chez des patients non atteints de cancer ainsi que sur les traitements ayant montré des résultats efficaces pour ce trouble. Les structures cérébrales jouant un rôle dans l’apparition de l’ESPT en psycho-oncologie, en particulier des symptômes intrusifs, semblent être les mêmes que celles impliquées dans l’ESPT non-oncologique. Ces résultats peuvent avoir des implications importantes sur un plan clinique également, en suggérant que les psychothérapies démontrées comme efficaces dans le traitement de l’ESPT dans différentes populations peuvent aussi être proposées aux patients présentant des symptômes post-traumatiques dus au cancer. D’autres études sont nécessaires pour approfondir nos connaissances sur la neurobiologie de l’ESPT lié au cancer et son traitement, afin de transposer les résultats dans la pratique clinique.

Electroencephalography (EEG), due to its peculiar time and spatial resolution, was used for the first time to fully monitor neuronal activation during the whole eye movement desensitization and reprocessing (EMDR) session, including the autobiographical script. The present case report describes the dominant cortical activations (Z-score >1.5) during the first EMDR session and in the last session after the client processed the index trauma. During the first EMDR session, prefrontal limbic cortex was essentially activated during script listening and during lateral eye movements in the desensitization phase of EMDR. In the last EMDR session, the prevalent electrical activity was recorded in temporal, parietal, and occipital cortical regions, with a clear leftward lateralization. These findings suggest a cognitive processing of the traumatic event following successful EMDR therapy and support evidence of distinct neurobiological patterns of brain activations during lateral eye movements in the desensitization phase of EMDR.

Neuroimaging investigations of the effects of psychotherapies treating posttraumatic stress disorder (PTSD), including eye movement desensitization and reprocessing (EMDR), have reported findings consistent with modifications in cerebral blood flow (CBF; single photon emission computed tomography [SPECT]), in neuronal volume and density (magnetic resonance imaging [MRI]), and more recently in brain electric signal (electroencephalography [EEG]). Additionally in the recent past, EMDR-related neurobiological changes were monitored by EEG during therapy itself and showed a shift of the maximal activation from emotional limbic to cortical cognitive brain regions. This was the first time in which neurobiological changes occurring during any psychotherapy session have been reported, making EMDR the first psychotherapy with a proven neurobiological effect. The purpose of this article was to review the results of functional and structural changes taking place at PTSD treatment and presented during the period of 1999–2012 by various research groups. The reported pathophysiological changes are presented by neuropsychological technique and implemented methodology and critically analyzed.