The effect of eye movement desensitization on neurocognitive functioning compared to retrieval-only in PTSD patients: a randomized controlled trial

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Abstract

Background

There is robust evidence that posttraumatic stress disorder (PTSD) is associated with neurocognitive deficits, such as executive dysfunction or memory dysfunction. Eye Movement Desensitization and Reprocessing (EMDR) is an evidence-based treatment for PTSD, in which eye movements (EMs) are performed during traumatic memory retrieval. We examined whether Eye Movement Desensitization (EMD) improves neurocognitive functioning in PTSD patients, in comparison with a retrieval-only control condition without EMs.

Methods

Adult patients with PTSD ( N = 91) were randomized into EMD ( N = 47) or retrieval-only ( N = 44). Data were collected at baseline (T0), one-week post-treatment (T1), one-month follow-up (T2), and at three-month follow-up (T3). Outcome measures were the California Verbal Learning Test (CVLT), the Trail Making Test (TMT), and the Digit Span Subtest of the Wechsler Adult Intelligence Scale fourth edition (WAIS-IV). We conducted linear mixed model to analyse the main outcomes.

Results

There was a main effect of time, indicating improvements for both the EMD and retrieval-only groups in CVLT scores, TMT A, TMT B and Digit Span score of WAIS-IV (Bonferroni-adjusted p’s < 0.001) from T0 to T3. There were no effects of group ( p = .64) or group by time on CVLT total trial A (T3; p = .34), delay A (T3; p = .76), TMT A (T3; p = .61), TMT B (T3: p = .58), and Digit Span scores (T3; p = .78) of the WAIS-IV, indicating no significant differences between groups on any of the outcomes.

Conclusion

Comparing EMD and retrieval-only did not show evidence for additive effects of EMs on the treatment of PTSD in terms of improvements in neurocognitive functioning. Thus, treatments based on retrieval of traumatic memories may be used to improve neurocognitive functioning in patients with PTSD.

Clinical trial registration

The trial was registered 19/12/2017 at ClinicalTrials.gov, identifier [ISRCTN55239132].

Supplementary Information

The online version contains supplementary material available at 10.1186/s12888-024-06420-9.

Related collections

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Measurement of cognitive functions is an increasingly important goal for clinicians and researchers. Many neuropsychological test batteries are comprehensive and require specialized training to administer and interpret. The Trail Making Test is an accessible neuropsychological instrument that provides the examiner with information on a wide range of cognitive skills and can be completed in 5-10 min. Its background, psychometric properties, administration procedures and interpretive guidelines are provided in this protocol.

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A quantitative meta-analysis of neurocognitive functioning in posttraumatic stress disorder.

J Cobb Scott, Georg E Matt, Kristen M Wrocklage … (2015)

Posttraumatic stress disorder (PTSD) is associated with regional alterations in brain structure and function that are hypothesized to contribute to symptoms and cognitive deficits associated with the disorder. We present here the first systematic meta-analysis of neurocognitive outcomes associated with PTSD to examine a broad range of cognitive domains and describe the profile of cognitive deficits, as well as modifying clinical factors and study characteristics. This report is based on data from 60 studies totaling 4,108 participants, including 1,779 with PTSD, 1,446 trauma-exposed comparison participants, and 895 healthy comparison participants without trauma exposure. Effect-size estimates were calculated using a mixed-effects meta-analysis for 9 cognitive domains: attention/working memory, executive functions, verbal learning, verbal memory, visual learning, visual memory, language, speed of information processing, and visuospatial abilities. Analyses revealed significant neurocognitive effects associated with PTSD, although these ranged widely in magnitude, with the largest effect sizes in verbal learning (d = -.62), speed of information processing (d = -.59), attention/working memory (d = -.50), and verbal memory (d =-.46). Effect-size estimates were significantly larger in treatment-seeking than community samples and in studies that did not exclude participants with attention-deficit/hyperactivity disorder, and effect sizes were affected by between-group IQ discrepancies and the gender composition of the PTSD groups. Our findings indicate that consideration of neuropsychological functioning in attention, verbal memory, and speed of information processing may have important implications for the effective clinical management of persons with PTSD. Results are further discussed in the context of cognitive models of PTSD and the limitations of this literature.

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The nature and significance of memory disturbance in posttraumatic stress disorder.

Chris Brewin (2011)

Disturbances in aspects of memory described in current learning and cognitive theories are much more strongly associated with the presence of psychiatric disorder than with mere exposure to traumatic events. In posttraumatic stress disorder (PTSD), there are numerous associated changes that involve memory capacity, the content of memories for trauma, and a variety of memory processes. Whereas some changes appear to reflect the effects of the disorder, other evidence supports a predictive or causal role for memory disturbance. The following aspects of memory are likely to play a causal role in the development or maintenance of PTSD: verbal memory deficits, negative conceptual knowledge concerning the self, overgeneral memory, avoidance or suppression of memories, and negative interpretation of memory symptoms. Other aspects of memory likely to play a causal role that are in addition specific to PTSD are the integration of the trauma with identity, impairment in retrieval of voluntary trauma memories, and increased incidence of sensation-based memories or flashbacks. © 2011 by Annual Reviews. All rights reserved

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Author and article information

Contributors

Eka Susanty:

ORCID: http://orcid.org/0000-0002-8725-143X

e.s.susanty@vu.nl

Journal

Journal ID (nlm-ta): BMC Psychiatry

Journal ID (iso-abbrev): BMC Psychiatry

Title: BMC Psychiatry

Publisher: BioMed Central (London )

ISSN (Electronic): 1471-244X

Publication date (Electronic): 27 December 2024

Publication date PMC-release: 27 December 2024

Publication date Collection: 2024

Volume: 24

Electronic Location Identifier: 956

Affiliations

[1 ]Faculty of Psychology, Universitas Jenderal Achmad Yani, ( https://ror.org/02k1der83) Cimahi, Indonesia

[2 ]Department of Clinical, Neuro- and Developmental Psychology, Faculty of Behavioral and Movement Sciences, Vrije Universiteit Amsterdam, ( https://ror.org/008xxew50) Amsterdam, the Netherlands

[3 ]Department of General and Experimental Psychology, Faculty of Psychology, Universitas Padjadjaran, ( https://ror.org/00xqf8t64) Bandung, Indonesia

[4 ]Department of Statistics, Faculty of Mathematic and Natural Sciences, Universitas Padjadjaran, ( https://ror.org/00xqf8t64) Bandung, Indonesia

[5 ]Department of Clinical, Neuro- and Developmental Psychology, Faculty of Behavioral and Movement Science, Vrije Universiteit Amsterdam, ( https://ror.org/008xxew50) Van der Boechorststraat 7, Amsterdam, 1081 BT The Netherlands

Author information

Eka Susanty http://orcid.org/0000-0002-8725-143X

Marit Sijbrandij http://orcid.org/0000-0001-5430-9810

Wilis Srisayekti http://orcid.org/0000-0002-5146-1216

Anja C. Huizink http://orcid.org/0000-0003-2015-4819

Article

Publisher ID: 6420

DOI: 10.1186/s12888-024-06420-9

PMC ID: 11673372

PubMed ID: 39731040

SO-VID: 71e6081c-9290-453b-9ac2-d4cb681f11e0

License:

Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/.

History

Date received : 16 January 2024

Date accepted : 18 December 2024

Funding

Funded by: FundRef http://dx.doi.org/10.13039/501100014538, Lembaga Pengelola Dana Pendidikan;

Award ID: S2747/LPDP.3/2016

Custom metadata

ScienceOpen disciplines: Clinical Psychology & Psychiatry

Keywords: posttraumatic stress disorder,eye movement desensitization,neurocognitive functioning,learning memory,attention,working memory,executive function,information processing speed

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