EMDR MECHANISM OF ACTION Learning Objectives 1. Explain parts of a typical nerve cell and describe their functions. 2. Discuss common types of nerve and glia cells. 3. Describe functions of nerve and glia cells. 4. Explain electrical and chemical properties of nerve cells. 5. Describe mechanism of impulse generation and its conduction. 6. Explain nerve cell responses to injuries in the nervous system. 7. Explain differential regenerative processes between central and peripheral nervous system. 8. Discuss common neurotransmitters and their functions.

MECHANISM OF ACTION Eye Movements (EM) increase inter-hemispheric connectivity (Christman et al., 2003; Parker et al., 2008) Not supported in EEG studies (Samara et al., 2011, Propper et al., 2007) Taxing working memory reduces vividness of stored memories (Van der Hout et al., 2001; Kemps & Tiggerman 2007;Andrade et al., 2007) EM produces a reduction in the memory span Modulation of the Default Mode Network (Landin-Romero et al., 2013) While the methodology used in EMDR has been extensively validated, questions still remain regarding mechanism of action. These are some of the hypotheses that are being tested. Hereby, we published two articles and are preparing an overview on the mechanism of action of emdr. In review by Landin-Romero et al 2015 EM provokes physiological changes similar to REM-sleep (Stickgold 2002; Barrowcliff et al., 2004; Sack et al. 2008)

PICTURE TAKEN DURING MY LAST TALK ABOUT EMDR MEMORY AND SLEEP Learning Objectives 1. Explain parts of a typical nerve cell and describe their functions. 2. Discuss common types of nerve and glia cells. 3. Describe functions of nerve and glia cells. 4. Explain electrical and chemical properties of nerve cells. 5. Describe mechanism of impulse generation and its conduction. 6. Explain nerve cell responses to injuries in the nervous system. 7. Explain differential regenerative processes between central and peripheral nervous system. 8. Discuss common neurotransmitters and their functions. PICTURE TAKEN DURING MY LAST TALK ABOUT EMDR

PTSD AND SLEEP Sleep disturbances are main features of PTSD In DSM-5 nightmares are considered intrusive symptoms (cluster B) and insomnia among excitation and hyperreactivity symptoms (cluster E) Learning Objectives 1. Explain parts of a typical nerve cell and describe their functions. 2. Discuss common types of nerve and glia cells. 3. Describe functions of nerve and glia cells. 4. Explain electrical and chemical properties of nerve cells. 5. Describe mechanism of impulse generation and its conduction. 6. Explain nerve cell responses to injuries in the nervous system. 7. Explain differential regenerative processes between central and peripheral nervous system. 8. Discuss common neurotransmitters and their functions. Both impact on general health and cause also cognitive and memory deficits

SLEEP AND MEMORY Converging evidence supports the significance of sleep in learning and memory reprocessing Non-REM sleep (slow-wave-sleep, SWS) appears to have a key role in memory consolidation Learning Objectives 1. Explain parts of a typical nerve cell and describe their functions. 2. Discuss common types of nerve and glia cells. 3. Describe functions of nerve and glia cells. 4. Explain electrical and chemical properties of nerve cells. 5. Describe mechanism of impulse generation and its conduction. 6. Explain nerve cell responses to injuries in the nervous system. 7. Explain differential regenerative processes between central and peripheral nervous system. 8. Discuss common neurotransmitters and their functions. SWS also facilitates information transfer from hippocampus to neocortex and the reorganization of distant functional networks

SLEEP AND MEMORY The “dialog” between hippocampus and neo-cortex favors memory encoding During Rapid Eye Movement (REM) sleep there is a decreased activity from hippocampus to neo-cortex suggesting a more intense memory consolidation Learning Objectives 1. Explain parts of a typical nerve cell and describe their functions. 2. Discuss common types of nerve and glia cells. 3. Describe functions of nerve and glia cells. 4. Explain electrical and chemical properties of nerve cells. 5. Describe mechanism of impulse generation and its conduction. 6. Explain nerve cell responses to injuries in the nervous system. 7. Explain differential regenerative processes between central and peripheral nervous system. 8. Discuss common neurotransmitters and their functions. In this phase new associations of emotional events mediated by limbic structures take place

SLEEP AND MEMORY Learning Objectives 1. Explain parts of a typical nerve cell and describe their functions. 2. Discuss common types of nerve and glia cells. 3. Describe functions of nerve and glia cells. 4. Explain electrical and chemical properties of nerve cells. 5. Describe mechanism of impulse generation and its conduction. 6. Explain nerve cell responses to injuries in the nervous system. 7. Explain differential regenerative processes between central and peripheral nervous system. 8. Discuss common neurotransmitters and their functions.

MECHANISM OF ACTION Harper et al. 2009 – Traumatology 15:81-95 Learning Objectives 1. Explain parts of a typical nerve cell and describe their functions. 2. Discuss common types of nerve and glia cells. 3. Describe functions of nerve and glia cells. 4. Explain electrical and chemical properties of nerve cells. 5. Describe mechanism of impulse generation and its conduction. 6. Explain nerve cell responses to injuries in the nervous system. 7. Explain differential regenerative processes between central and peripheral nervous system. 8. Discuss common neurotransmitters and their functions. Pagani et al. 2012 – PLOS ONE Volume 7 | Issue 9 | e457535

MECHANISM OF ACTION Learning Objectives 1. Explain parts of a typical nerve cell and describe their functions. 2. Discuss common types of nerve and glia cells. 3. Describe functions of nerve and glia cells. 4. Explain electrical and chemical properties of nerve cells. 5. Describe mechanism of impulse generation and its conduction. 6. Explain nerve cell responses to injuries in the nervous system. 7. Explain differential regenerative processes between central and peripheral nervous system. 8. Discuss common neurotransmitters and their functions.

INTEGRATION OF MEMORIES (Stickgold 2002) MECHANISM OF ACTION INTEGRATION OF MEMORIES (Stickgold 2002) Fragmented episodic and traumatic memories are stored in hippocampus or amigdala without contextual integration Memory integration needs the encoding in association cortex to create an understanding in a larger context Learning Objectives 1. Explain parts of a typical nerve cell and describe their functions. 2. Discuss common types of nerve and glia cells. 3. Describe functions of nerve and glia cells. 4. Explain electrical and chemical properties of nerve cells. 5. Describe mechanism of impulse generation and its conduction. 6. Explain nerve cell responses to injuries in the nervous system. 7. Explain differential regenerative processes between central and peripheral nervous system. 8. Discuss common neurotransmitters and their functions. Hippocampal-amygdala complex memories are transferred to neocortex, replayed, consolidated into semantic associative memory networks and information integrated to create meaning and “learn from the event”

INTEGRATION OF MEMORIES (Stickgold 2002) MECHANISM OF ACTION INTEGRATION OF MEMORIES (Stickgold 2002) The transfer might occur during slow-wave-sleep (1-3 Hz) and definitive memory consolidation during REM sleep (about 4-6 Hz) The traumatic episodic memory is weakened and then removed from hippocampus. If this does not happen the lack of free space may lead to memory and cognitive deficits (3° PTSD criterium) Learning Objectives 1. Explain parts of a typical nerve cell and describe their functions. 2. Discuss common types of nerve and glia cells. 3. Describe functions of nerve and glia cells. 4. Explain electrical and chemical properties of nerve cells. 5. Describe mechanism of impulse generation and its conduction. 6. Explain nerve cell responses to injuries in the nervous system. 7. Explain differential regenerative processes between central and peripheral nervous system. 8. Discuss common neurotransmitters and their functions. Bilateral stumulation during EMDR reproduces the neurophysiological conditions favorable for episodic memory integration in associative neocortex

MECHANISM OF ACTION INTEGRATION OF MEMORIES (Stickgold 2002) EMDR REM Traumatic events are frequent in bipolar patients and can worsen the course of the disease. Whether psychotherapeutic interventions for these events have beneficial effects on mood and trauma symptoms has not been studied. Twenty DSM-IV instable bipolar I and II patients with subsyndromal mood symptoms and a history of traumatic events were randomly assigned to Eye Movement Desensitization and Reprocessing therapy (n=10) or treatment as usual (n=10). The treatment group received between 14-18 Eye Movement Desensitization and Reprocessing sessions during 12 weeks. Evaluations of affective symptoms, symptoms of trauma and trauma impact were carried out by a blind rater at baseline, 2 weeks, 5 weeks, 8 weeks, 12 weeks and at 24 weeks follow-up. Patients in the Eye Movement Desensitization and Reprocessing group showed a statistically significant improvement in affective symptoms, symptoms of trauma and trauma impact compared to the treatment as usual group after intervention. This effect was maintained at the 6 month follow-up visit. This pilot study suggests that Eye Movement Desensitization and Reprocessing therapy may be an effective and safe intervention to treat subsyndromal mood and trauma symptoms in traumatized bipolar patients. EMDR (smooth pursuit EM/Slow Wave Sleep?)

Emotional implications MECHANISM OF ACTION Semantic memory Learning Objectives 1. Explain parts of a typical nerve cell and describe their functions. 2. Discuss common types of nerve and glia cells. 3. Describe functions of nerve and glia cells. 4. Explain electrical and chemical properties of nerve cells. 5. Describe mechanism of impulse generation and its conduction. 6. Explain nerve cell responses to injuries in the nervous system. 7. Explain differential regenerative processes between central and peripheral nervous system. 8. Discuss common neurotransmitters and their functions. Episodic memory Emotional implications

PHYLOSOPHY AND (NEURO)SCIENCE A theory is clear, decisive, and positive, but it is believed by no one exept the man who created it          On the other hand experimental findings are messy and inexact but are believed by everyone except the man who did that work Learning Objectives 1. Explain parts of a typical nerve cell and describe their functions. 2. Discuss common types of nerve and glia cells. 3. Describe functions of nerve and glia cells. 4. Explain electrical and chemical properties of nerve cells. 5. Describe mechanism of impulse generation and its conduction. 6. Explain nerve cell responses to injuries in the nervous system. 7. Explain differential regenerative processes between central and peripheral nervous system. 8. Discuss common neurotransmitters and their functions. H. Shapley, 1969

GRAZIE! marco.pagani@istc.cnr.it