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Cerebral blood flow changes during retrieval of traumatic memories before and after psychotherapy: a SPECT study

Published online by Cambridge University Press:  09 February 2007

JULIO F. P. PERES ,
ANDREW B. NEWBERG ,
JULIANE P. MERCANTE ,
MANOEL SIMÃO ,
VIVIAN E. ALBUQUERQUE ,
MARIA J. P. PERES  and
ANTONIA G. NASELLO
JULIO F. P. PERES*
Affiliation:
Neuroscience and Behavior, Institute of Psychology, Universidade de São Paulo, Brazil Instituto Nacional de Terapia Reestruturativa Vivencial Peres, São Paulo, Brazil
ANDREW B. NEWBERG
Affiliation:
Department of Nuclear Medicine, Hospital of University of Pennsylvania, PA, USA
JULIANE P. MERCANTE
Affiliation:
Institute of Psychiatry, School of Medicine, Universidade de São Paulo, Brazil
MANOEL SIMÃO
Affiliation:
Neuroscience and Behavior, Institute of Psychology, Universidade de São Paulo, Brazil Instituto Nacional de Terapia Reestruturativa Vivencial Peres, São Paulo, Brazil
VIVIAN E. ALBUQUERQUE
Affiliation:
Instituto Nacional de Terapia Reestruturativa Vivencial Peres, São Paulo, Brazil
MARIA J. P. PERES
Affiliation:
Instituto Nacional de Terapia Reestruturativa Vivencial Peres, São Paulo, Brazil
ANTONIA G. NASELLO
Affiliation:
Neuroscience and Behavior, Institute of Psychology, Universidade de São Paulo, Brazil Department of Physiological Science, Medical School, Santa Casa de Sao Paulo, Brazil
*
*Address for correspondence: Dr Julio F. P. Peres, Rua Maestro Cardim 887, São Paulo, SP 01323-001, Brazil. (Email: julioperes@yahoo.com)
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Abstract

Background

Traumatic memory is a key symptom in psychological trauma victims and may remain vivid for several years. Psychotherapy has shown that neither the psychopathological signs of trauma nor the expression of traumatic memories are static over time. However, few studies have investigated the neural substrates of psychotherapy-related symptom changes.

Method

We studied 16 subthreshold post-traumatic stress disorder (PTSD) subjects by using a script-driven symptom provocation paradigm adapted for single photon emission computed tomography (SPECT) that was read aloud during traumatic memory retrieval both before and after exposure-based and cognitive restructuring therapy. Their neural activity levels were compared with a control group comprising 11 waiting-list subthreshold PTSD patients, who were age- and profile-matched with the psychotherapy group.

Results

Significantly higher activity was observed in the parietal lobes, left hippocampus, thalamus and left prefrontal cortex during memory retrieval after psychotherapy. Positive correlations were found between activity changes in the left prefrontal cortex and left thalamus, and also between the left prefrontal cortex and left parietal lobe.

Conclusions

Neural mechanisms involved in subthreshold PTSD may share neural similarities with those underlying the fragmented and non-verbal nature of traumatic memories in full PTSD. Moreover, psychotherapy may influence the development of a narrative pattern overlaying the declarative memory neural substrates.

Type
Original Article
Information
Psychological Medicine , Volume 37 , Issue 10 , October 2007 , pp. 1481 - 1491
Copyright
Copyright © Cambridge University Press 2007

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