Neurobiological features and response to eye movement desensitization and reprocessing treatment of posttraumatic stress disorder in patients with breast cancer

Figures & data

Table 1. Demographic data of participants at baseline.

	EMDR (N = 15) Mean (SD)	TAU (N = 15) Mean (SD)	p
Age (years)	55.47 (7.64)	48.40 (9.42)	.032^a
TAQ
0–6	2.14 (1.30)	1.80 (1.35)	.477^b
7–12	1.95 (1.12)	2.28 (1.04)	.505^b
13–18	2.34 (0.77)	2.46 (0.33)	1.000^b
Adult	2.59 (0.31)	2.55 (0.23)	.715^b
	n (%)	n (%)
Level of education			.535^c
Primary school	1 (6.67)	0 (0)
Low secondary school	6 (40)	3 (20)
High secondary school	6 (40)	9 (60)
University	2 (13.33)	3 (20)
Marital status			.750^c
Single	1 (6.67)	3 (20)
Married	9 (60)	9 (60)
Separated/divorced	4 (26.66)	3 (20)
Widowed	1 (6.67)	0 (0)
Employment status			.409^c
Unemployed	0 (0)	2 (13.33)
Employed	11 (73.33)	12 (80)
Pensioned	4 (26.67)	1 (6.67)
Type of cancer			.598^c
Primary	12 (80)	14 (93.33)
Relapse	3 (20)	1 (6.67)

EMDR = Eye Movement Desensitization and Reprocessing; TAU = Therapy As Usual.

^aPearson’s independent samples t-test.

^bMann–Whitney U test.

^cFisher’s exact test.

Table 2. Comparison of clinical variables for the two groups (EMDR and TAU).

	Pre-treatment (T0)			Post-treatment (T1)			Effect Time			Effect Time x Group
	EMDR (N = 14)	TAU (N = 15)	p	EMDR (N = 14)	TAU (N = 15)	p	F	p	η^2p	F	p	η^2p
IES-R	49.64 (15.46)	53.27 (13.57)	.507	16.21 (12.64)	48.60 (15.19)	< .001	42.870	< .001	.614	24.437	< .001	.475
CAPS-TOT	33.57 (9.57)	33.13 (10.63)	.908	6.43 (6.17)	27.87 (7.29)	< .001	96.387	< .001	.781	43.915	< .001	.619
CAPS-B	9.36 (3.43)	9.33 (3.60)	.986	1.93 (2.06)	7.67 (3.53)	< .001	38.808	< .001	.590	15.575	.001	.366
CAPS-C	4.43 (1.65)	3.27 (0.70)	.019	0.57 (0.76)	2.80 (1.01)	< .001	88.190	< .001	.766	54.226	< .001	.668
CAPS-D	11.00 (4.26)	12.00 (4.23)	.531	2.14 (2.03)	9.27 (2.96)	< .001	58.544	< .001	.684	16.343	< .001	.377
CAPS-E	8.93 (3.27)	8.53 (4.50)	.790	2.00 (1.66)	7.60 (2.95)	< .001	36.415	< .001	.574	21.176	< .001	.440
STAI-1	40.07 (9.47)	45.13 (10.85)	.193	44.71 (4.46)	44.73 (10.07)	.995	1.614	.215	.056	2.280	.143	.078
STAI-2	43.64 (6.56)	44.80 (6.54)	.638	45.50 (4.78)	42.33 (5.49)	.110	0.066	.800	.002	3.301	.080	.109
BDI-II	23.93 (6.89)	24.80 (9.94)	.787	10.50 (7.08)	24.93 (7.95)	< .001	25.242	< .001	.483	21.176	< .001	.440

Data are mean (SD).

TAU = Therapy As Usual.

EMDR = Eye Movement Desensitization and Reprocessing.

Table 3. Comparison between T0 and T1 of clinical variables for the two groups (EMDR and TAU).

	EMDR (N = 14)				TAU (N = 15)
	T0	T1	Mean difference (95% CI)	p	T0	T1	Mean difference (95% CI)	p
IES-R	49.64 (15.46)	16.21 (12.64)	−33.429 (−42.014; −24.843)	< .001	53.27 (13.57)	48.60 (15.19)	−4.667 (−12.961; 3.628)	.258
CAPS-TOT	33.57 (9.57)	6.43 (6.17)	−27.143 (−32.014; −22.271)	< .001	33.13 (10.63)	27.87 (7.29)	−5.267 (−9.973; −.560)	.030
CAPS-B	9.36 (3.43)	1.93 (2.06)	−7.429 (−9.583; −5.274)	< .001	9.33 (3.60)	7.67 (3.53)	−1.667 (−3.748; .415)	.112
CAPS-C	4.43 (1.65)	0.57 (0.76)	−3.857 (−4.537; −3.178)	< .001	3.27 (0.70)	2.80 (1.01)	−.467 (−1.123; .190)	.156
CAPS-D	11.00 (4.26)	2.14 (2.03)	−8.857 (−11.093; −6.622)	< .001	12.00 (4.23)	9.27 (2.96)	−2.733 (−4.893; −.574)	.015
CAPS-E	8.93 (3.27)	2.00 (1.66)	−6.929 (−8.851; −5.006)	< .001	8.53 (4.50)	7.60 (2.95)	−.933 (−2.791; .924)	.312
STAI-1	40.07 (9.47)	44.71 (4.46)	4.643 (−.286; 9.571)	.064	45.13 (10.85)	44.73 (10.07)	−.400 (−5.161; 4.361)	.864
STAI-2	43.64 (6.56)	45.50 (4.78)	1.857 (−1.655; 5.369)	.288	44.80 (6.54)	42.33 (5.49)	−2.467 (−5.860; .926)	.147
BDI-II	23.93 (6.89)	10.50 (7.08)	−13.429 (−17.334; −9.524)	< .001	24.80 (9.94)	24.93 (7.95)	.133 (−3.639; 3.906)	.943

Data are mean (SD).

TAU = Therapy As Usual.

EMDR = Eye Movement Desensitization and Reprocessing.

Table 4. Multivariable linear regression models for each clinical score at T1. β values regard the effect of receiving EMDR (vs. TAU).

	Model 1*			Model 2^§
Outcome (T1)	β treatment (SE)	p	Adj R^2	β treatment (SE)	p	Adj R^2
IES-R	−30.99 (4.91)	< .001	0.63	−35.65 (5.56)	< .001	0.64
CAPS-TOT	−21.59 (2.21)	< .001	0.78	−19.86 (2.54)	< .001	0.79
CAPS-B	−5.74 (1.03)	< .001	0.52	−5.49 (1.22)	< .001	0.50
CAPS-C	−2.54 (0.35)	< .001	0.65	−2.57 (0.37)	< .001	0.64
CAPS-D	−6.90 (0.91)	< .001	0.70	−5.91 (0.97)	< .001	0.75
CAPS-E	−5.72 (0.80)	< .001	0.66	−5.57 (0.95)	< .001	0.64
STAI-1	2.06 (2.61)	.437	0.23	1.40 (3.07)	.653	0.19
STAI-2	3.55 (1.78)	.057	0.19	3.48 (2.03)	.099	0.21
BDI-II	−13.96 (2.25)	< .001	0.66	−13.09 (2.71)	< .001	0.64

*adjusted by clinical score at T0.

^§adjusted by clinical score at T0, age and CAPS-C.

SE = Standard Error.

Figure 1. T0 vs. T1 power spectral density analysis (PSD).

(Middle) Topographic representation of the permutation t-test for delta plus theta bands (T0 vs. T1). (Left) PSD of channel P3 for the TAU and EMDR groups for T0 (blue line) and T1 (red line). (Right) PSD of channel P08 for the TAU and EMDR groups for T0 (blue line) and T1 (red line). For both left and right panel solid horizontal black line (area highlighted in grey) indicate significant difference between T0 and T1 (p < .05).

Figure 2. T0 vs. T1 EMDR PSD difference localization analysis.

Position of the equivalent current dipole (ECD) superimposed on the MNI brain template and Brodmann areas template (within MRICron software – www.mricro.com) are shown. Axial, coronal, and sagittal views are shown for the Angular Gyrus (left panel) and Fusiform Gyrus (right panel) PSD difference between T0 vs. T1 EMDR group. Talairach (x, y, z) coordinates as well as MNI coordinates and Broadman areas (BAs) are also shown.

Figure 3. Correlation analysis.

(Upper row – left) Pearson correlation analysis between Δ(PSD_delta) channel P3 and Δ(IES TOT), Δ(CAPS TOT) and Δ(BDI). (Upper row – right) correlation analysis between Δ(PSD_theta) same channel and Δ(IES TOT). (Lower row – left) Pearson correlation analysis between Δ(PSD_delta) channel PO8 and Δ(IES TOT), Δ(CAPS TOT) and Δ(BDI). (Lower row – right) correlation analysis between Δ(PSD_theta) same channel and Δ(IES TOT). Correlation R value and p value were reported on the top right corner of each panel.