Publications - Department of Psychiatry, University of Siena,...

Among the different therapeutic alternatives for post-traumatic stress disorder PTSD Trauma-Focused Cognitive-Behavioral Therapy TF-CBT and Eye Movement Desensitization and Reprocessing EMDR Therapy have shown promising results in helping patients cope with PTSD symptoms However given the different theoretical and methodological substrate of TF-CBT and EMDR a potentially different impact on the brain for the two interventions could be hypothesized as well as an interaction between trauma-specific PTSD symptomatology and response to a given psychotherapy In this study we monitored psychological and spontaneous functional connectivity fMRI patterns in two groups of PTSD patients who suffered by the same traumatic event i e natural disaster before and after a cycle of psychotherapy sessions based on TF-CBT and EMDR Thirty-seven 37 PTSD patients were enrolled from a larger sample of people exposed to a single acute psychological stress i e 2002 earthquake in San Giuliano di Puglia Italy Patients were randomly assigned to TF-CBT n 14 or EMDR n 17 psychotherapy Clinical assessment was performed using the Clinician-Administered PTSD Scale CAPS the Davidson Trauma Scale DTS and the Work and Social Adjustment Scale WSAS both at baseline and after treatment All patients underwent a fMRI data acquisition session before and after treatment aimed at characterizing their functional connectivity FC profile at rest as well as potential connectivity changes associated with the clinical impact of psychotherapy Both EMDR and TF-CBT induced statistically significant changes in clinical scores with no difference in the clinical impact of the two treatments Specific changes in FC correlated with the improvement at the different clinical scores and differently for EMDR and TF-CBT However a similarity in the connectivity changes associated with changes in CAPS in both groups was also observed Specifically changes at CAPS in the entire sample correlated with an i increase in connectivity between the bilateral superior medial frontal gyrus and right temporal pole and a ii decrease in connectivity between left cuneus and left temporal pole Results point to a similar beneficial psychological impact of EMDR and TF-CBT for treatment of natural-disaster PTSD patients Neuroimaging data suggest a similar neurophysiological substrate for clinical improvement following EMDR and TF-CBT involving changes affecting bilateral temporal pole connectivity

Department of Psychiatry, University of Siena, Siena, Italy

Psychological and Brain Connectivity Changes Following Trauma-Focused CBT and EMDR Treatment in Single-Episode PTSD Pati...