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Neurobiological links between dissociation and EMDR

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1 Neurobiological links between dissociation and EMDR
Marco Pagani Senior Researcher Institute of Cognitive Sciences and Technologies, CNR Rome, Italy Chair of the Neuroimaging Committee of the European Association of Nuclear Medicine

2 FUNCTIONAL BRAIN 2

3 TARGET REGIONS 3

4 PREFRONTAL CORTEX mPFC modulates emotional response inhibiting amygdala and estinguishing fear response

5 AMYGDALA Amygdala has a central role in formation and preservation of emotional memories Amygdala is also involved in memory modulation and consolidation

6 AMYGDALA Lacking inhibitory control from PFC hyperactive amygdala causes excessive firing of cortical and subcortical structures responsible for PTSD symptoms 6

7 HIPPOCAMPUS Hippocampus processes episodic and autobiographical memory and is essential in identifying “safe places”

8 HIPPOCAMPUS Hippocampus is extremely sensitive to stress and might decrease in volume and neuronal density following chronic cortisol secretion

9 ANTERIOR AND POSTERIOR CINGULATE CORTEX

10 ANTERIOR CINGULATE CORTEX
With amygdala and insula modulates mood and anxiety The tight connections with hippocampus contribute to memory formation Connectivity with frontal cortex is related to self-esteem and self-evaluation Anterior cingulate cohordinates hunger and sleep

11 POSTERIOR CINGULATE CORTEX
Posterior cingulate processes the “self” and conscious experiences of emotions and feelings Is relevant in enhancing attention to internal representation of memories of similar experiences With precuneus it is involved in coping with physical threats and processing stressing material

12 MAGNETIC RESONANCE Magnetic resonance exploits magnetic fields to produce anatomical images It is widespread and relatively cheap

13 STRUCTURAL MAGNETIC RESONANCE

14 FUNCTIONAL MAGNETIC RESONANCE
fMRI measures the altered levels of cerebral blood oxygenation. Regional neural activity results in increased local CBF producing an increase in oxyhemoglobin This leads to a net decrease in de-oxyhaemoglobin and the relative change in concentrations of the two results in a change in signal intensity Neuronal activity fMRI Blood oxygen level-dependent (BOLD) contrast 14

15 SPECT and PET Injected radioisotopes distribute in the brain proportionally to the function to be investigated (blood flow, metabolism or receptor density)

16 EEG 16

17 NEUROIMMAGING IN EEG 17

18 POST-TRAUMATIC STRESS DISORDER
In DSM-5 PTSD is defined by the coexistence of 4 clusters of symptoms re-experiencing (intrusive thoughts, flashbacks, nightmares) avoidance (memory impairment, feelings of detachment, efforts to avoid thoughts, places or people associated with the trauma, social withdrawal) 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. negative alterations (mood and cognition) hyperarousal (abnormal startle responses, hypervigilance, irritability, sleep disturbance, difficulty concentrating)

19 PTSD AND NEUROIMAGING The first neuroimaging studies on PTSD were performed in the USA at military hospitals including mostly Vietnam war veterans 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.

20 PTSD AND NEUROIMAGING 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.

21 STATISTICAL ANALYSES UNIVARIATE MULTIVARIATE PCA/ICA Networking
t-statistics UNIVARIATE MULTIVARIATE PCA/ICA Networking

22 CONNECTIVITY IN CIVILIAN TRAUMAS
Functional connectivity Amygdala has strong connections with anterior cingulate, insula and hippocampus

23 PTSD AND NEUROIMAGING Bremner et al. Current Psychiatry Reports 2002, 4:254–263 Gilboa et al. Biol Psych 2004; 55:263–272 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.

24 PTSD AND NEUROIMAGING All neuroimaging studies converge in identifying as implicated in PTSD: prefrontal cortex (PFC) amygdala hippocampus insula Anterior and posterior cingulate cortex 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. The impairment of PFC associated with a hyper-reactivity of the amygdala constitutes the core neural correlate of PTSD

25 NEUROIMAGING and PSYCHOTHERAPY
Neuroimaging techniques have been used in an attempt to shed light on the neurobiological correlates of various psychotherapies revealing their neurobiological effects Despite positive clinical outcomes functional and neuroanatomical studies are still poorly randomized and insufficient to draw robust conclusions 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.

26 NEUROIMAGING and PSYCHOTHERAPY
ETCR - fMRI 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. Peres et al – J Psychiatry Research 45:

27 NEUROIMAGING and PSYCHOTHERAPY
CTT-BW - fMRI 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.

28 NEUROIMAGING and PSYCHOTHERAPY
MINDFULNESS 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.

29 NEUROIMAGING and PSYCHOTHERAPY
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.

30 EMDR AND SPECT 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.

31 NEUROIMAGING and PSYCHOTHERAPY
CBT - fMRI 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. Bryant et al. 2008; Psychological Medicine 38:

32 EMDR AND MRI PTSD NS>S EMDR R>NR 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. EMDR R>NR

33 NEUROIMAGING and PSYCHOTHERAPY
Functional and anatomical studies support the evidence of neurobiological models explaining the changes which take place following PTSD-related psychotherapies These findings call for continued commitment to unravelling the pathophysiological mechanisms underlying these effective treatments of PTSD 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.

34 TIME TO METABOLIZE 5 MINUTES FOR QUESTIONS AND STRETCHING
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.

35 WHY EMDR? EMDR AND BET 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 treatment are effective but EMDR results in a faster disappearance of symptoms

36 EMDR AND EEG To explore the technical feasibility of the on-line recording of whole EMDR sessions by means of EEG and data analyses To identify the regions activated during the bilateral ocular stimulation upon traumatic memory exposure 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.

37 CLIENTS PRE-EMDR vs non-symptomatic CONTROLS DURING BILATERAL OCULAR STIMULATION
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.

38 CLIENTS PRE-EMDR vs CLIENTS POST-EMDR NEUROPSYCHOLOGICAL DATA
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.

39 CLIENTS PRE-EMDR vs CLIENTS POST-EMDR DURING BILATERAL OCULAR STIMULATION
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.

40 EMDR AND EEG 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.

41 EMDR AND EEG We monitored by EEG EMDR psychotherapy sessions in two groups of clients In the symptomatic phase trauma exposure caused prevalent prefrontal activation After symptoms disappearance the activation shifted to cognitive associative areas In chronically exposed clients the neurobiological response was similar to that in healthy controls 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. The social context impacts on the neurobiological response to trauma exposure

42 MEMORY MECHANISMS 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.

43 NEUROIMAGING AND DISSOCIATION
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. Prefrontal and limbic structures underlie dissociative responses in PTSD. Differences observed clinically, psychophysiologically, and neurobiologically between patients with dissociative versus non-dissociative responses may suggest different neuronal mechanisms underlying these two distinct reactions.

44 NEUROIMAGING AND DISSOCIATION
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. Conscious fear Unconscious fear Dissociation is a regulatory strategy invoked to cope with extreme arousal in PTSD, but this strategy appears to function only during conscious processing of threat

45 NEUROIMAGING AND DISSOCIATION
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. Dissociation correlated positively with activity in the left medial prefrontal and right superior temporal cortices, and negatively with the left superior temporal cortex

46 NEUROIMAGING AND DISSOCIATION
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.

47 Dissociative subjects show significant dissociative response including depersonalization and derealization

48 PTSD AND DISSOCIATION Dissociative symptoms often occur together with Post-Traumatic Stress Disorder (PTSD) The role that dissociation plays in the genesis of PTSD and its current taxonomy as an anxiety disorder separate from dissociative disorders has been put into question Neuroimaging studies have shown a rather heterogeneous pattern of results, by which dissociation might be associated with functional alterations in various areas

49 PTSD AND DISSOCIATION Some works have suggested that PTSD subjects can be divided into two subtypes: subjects who relive their traumatic experiences in form of intensely upsetting recollections and flashbacks, accompanied by an increase in heart rate (hyperarousal subtype, characterized by so-called ‘primary dissociation’) subjects who show dissociative responses and report experiences such as depersonalization, derealization or ‘zooming out’ phenomena, and do not show any increase in heart rate (dissociative subtype, characterized by so-called ‘secondary dissociation’) 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.

50 PTSD AND DISSOCIATION AIMS The aims of this study were:
to investigate brain structural alteration associated with the presence of dissociative traits along a continuum in a group of traumatized subjects with or without PTSD to explore the neural correlates associated with different psychological dimensions of dissociation 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.

51 PTSD AND DISSOCIATION METHODS
Thirty-two subjects either developing (N=15) or non-developing (N=17) PTSD underwent MRI and Gray matter volume (GMV) was analyzed Trait Dissociative Experience Scale (DES), subscales for pathological (DES-T) and non-pathological (DES-A) dissociation, and other clinical measures were assessed PTSD and non-PTSD subjects were compared to evaluate brain alterations related to PTSD pathology Correlation analyses between dissociation measures and GMV were performed on the whole sample (N=32), irrespective of PTSD diagnosis, to identify alterations related to trait dissociation 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.

52 PTSD AND DISSOCIATION RESULTS
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. Regions in which grey matter volume correlated inversely with PTSD symptoms (in red) and positively (in blue) with overall trait dissociation score

53 PTSD AND DISSOCIATION RESULTS
Such increase was mainly due to non-PTSD subjects (green diamonds) in which GMV was strongly positively correlated to trait Dissociation scores 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.

54 PTSD AND DISSOCIATION RESULTS
Correlations between GMV and trait, pathological and non-pathological dissociation 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.

55 PTSD AND DISSOCIATION CONCLUSIONS
Our results indicate that PTSD and trait dissociation are associated with opposite patterns of GMV alterations in medial and lateral prefrontal cortex, where PTSD is associated with a volumetric decrease, while trait dissociation with a volumetric increase. The peculiar increase in GMV in lateral PFC in non pathological dissociation might be associated with an enhanced working memory capacities and unconscious suppression of unwanted memories 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.

56 PTSD AND DISSOCIATION CONCLUSIONS
Our results are consistent with previous findings and might underlie the different patterns of emotional modulation (under- vs. overmodulation) and cognitive style (i.e., self-related processing, episodic/autobiographical memory, attention, and working memory) observed in PTSD and dissociation. We have also shown that in sub-clinically dissociated subjects, the tendency to experience pathological dissociative phenomena (i.e., pathological dissociation) and absorption or imaginative involvement (i.e., non-pathological dissociation) widely share the same neural substrates supporting a view of dissociation along a continuum. 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.

57 INTEGRATION OF MEMORIES (Stickgold 2002)
MECHANISM OF ACTION INTEGRATION OF MEMORIES (Stickgold 2002) We are not claiming that we have solid evidence for all of the links and interpretations in the train of logic presented here Our goal is to demonstrate that there is a reasonable explanation of our findings which is consonant with modern neurobiology and cognitive neuroscience 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. Stickgold, Journal of Clinical Psychology 2002; 58: 61-75

58 THANKS marco.pagani@istc.cnr.it
58


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