Psychotherapie im Mausmodell

Zusammenfassung

In einem Mausmodell der Angstkonditionierung und des Verlernens der Angst durch alternierende bilaterale Stimulation (ABS) wurde dem Wirkungsmechanismus der mittlerweile gut etablierten Therapieform EMDR (Eye Movement Desensitization and Reprocessing) zur Behandlung der posttraumatischen Belastungsreaktion (PTBS) nachgegangen. Hierdurch wurde nicht nur gezeigt, dass alternierende bilaterale Stimulation eine notwendige Bedingung für eine schnellere und länger anhaltende Wirksamkeit des Verlernens von Angst im Vergleich zum reinen Extinktionslernen (ohne ABS) darstellt, sondern auch, dass es sich um eine hinreichende Bedingung handelt (u. a. durch Simulation der ABS mittels optogenetischer Stimulation des Colliculus superior). Das damit vorliegende kausale Modell erscheint vor allem für die weitere Erforschung der Mechanismen von Psychotherapie im Tiermodell und für die Hypothesengenerierung bei Forschung am Menschen bedeutsam.

• Literatur

• 1 Agren T. et al. Disruption of reconsolidation erases a fear memory trace in the human amygdala.. Science 2012; 2337: 1550-1552.
• 2 Angelidis A. et al. I’m going to fail! Acute cognitive performance anxiety increases threat-interference and impairs WM performance.. PLoS ONE 2019; 14: e0210824
• 3 Arkowitz H, Lilienfeld SO. EMDR: Taking a Closer Look. Can moving your eyes back and forth help to ease anxiety? Scientific American 1.8.2012. https://www.scientificamerican.com/article/emdr-taking-a-closer-look/ abgerufen am 4.3.2019
• 4 AWMF. S3 – Leitlinie: Posttraumatische Belastungsstörung, AWMF-Registernummer 051/010 (offline, Archiv: Stand 08/2011)
• 5 Baek J. et al. Neural circuits underlying a psychotherapeutic regimen for fear disorders.. Nature 2019; 566: 339-343.
• 6 Basso MA, May PJ. Circuits for action and cognition: A view from the superior colliculus.. Annu Rev Vis Sci 2017; 3: 197-226.
• 7 Beltramo R, Scanziani M. A collicular visual cortex: Neocortical space for an ancient midbrain visual structure.. Science 2019; 363: 64-69.
• 8 Bishop SJ. Neural mechanisms underlying selective attention to threat.. Ann N Y Acad Sci 2008; 1129: 141-152.
• 9 Carroll RT. The Sceptic’s Dictionary: eye movement desensitization and reprocessing 2019 (EMDR).. http://skepdic.com/emdr.html abgerufen am 4.3.2019
• 10 Chen L, Zhang G, Hu M, Liang X. Eye movement desensitization and reprocessing versus cognitive-behavioral therapy for adult posttraumatic stress disorder: systematic review and meta-analysis.. J Nerv Ment Dis 2015; 203: 443-451.
• 11 Chen R. et al. The efficacy of eye movement desensitization and reprocessing in children and adults who have experienced complex childhood trauma.. Front Psychol 2018; 9: 534.
• 12 Evans DA. et al. A synaptic threshold mechanism for computing escape decisions.. Nature 2018; 558: 590-594.
• 13 Gaviria SL. et al. Socio-demographic patterns of posttraumatic stress disorder in Medellin, Colombia and the context of lifetime trauma exposure.. Disaster Health 2016; 3: 139-150.
• 14 Hase M, Leutner S, Tumani V, Hofmann A. Eye movement desensitization and reprocessing (EMDR). Eine ungewöhnliche Form der Psychotherapie.. Deutsches Ärzteblatt 2013; 12 (11) 512-514.
• 15 Herkt D. et al. Facilitating access to emotions: Neural signature of EMDR stimulation.. PLoS ONE 2014; 9 (08) e106350.
• 16 Herry C. et al. Switching on and off fear by distinct neuronal circuits.. Nature 2008; 454: 600-606.
• 17 Holmes A. Brains that learn not to fear.. Nature 2019; 566: 335-336.
• 18 Iacoviello BM. et al. Attention bias variability and symptoms of post-traumatic stress disorder.. J Trauma Stress 2014; 27: 232-239.
• 19 Khan AM. et al. Cognitive behavioral therapy versus eye movement desensitization and reprocessing in patients with post-traumatic stress disorder.. Cureus 2018; 10 (09) e3250.
• 20 Knudsen EI. Instructed learning in the auditory localization pathway of the barn owl.. Nature 2002; 417: 322-328.
• 21 Knudsen EI. Neural circuits that mediate selective attention: A comparative perspective.. TINS 2018; 41: 789-805.
• 22 Krauzlis RJ, Lovejoy LP, Zénon A. Superior colliculus and visual spatial attention.. Annu Rev Neurosci 2013; 36: 165-182.
• 23 Landin-Romero R. et al. How does eye movement desensitization and reprocessing therapy work? A systematic review on suggested mechanisms of action.. Front Psychol 2018; 9: 1395.
• 24 Mollica RF. et al. Dose-effect relationships of trauma to symptoms of depression and post-traumatic stress disorder among Cambodian survivors of mass violence.. British Journal of Psychiatry 1998; 173: 482-488.
• 25 Mollica RF. et al. The dose-effect relationships between torture and Ppychiatric symptoms in Vietnamese ex-political detainees and a comparison group.. Journal of Nervous & Mental Disease 1998; 186 (09) 543-553.
• 26 Müller JR. et al. Microstimulation of the superior colliculus focuses attention without moving the eyes.. PNAS 2005; 201: 524-529.
• 27 Naim R. et al. Threat-related attention bias variability and post traumatic stress.Am J Psychiatry. 2019. in press.
• 28 Pouille F. et al. Input normalization by global feedforward inhibition expands cortical dynamic range.. Nature Neuroscience 2009; 12: 1577-1585.
• 29 Ray S, Mounsell JHR. Do gamma oscillations play a role in cerebral cortex?. TICS 2015; 19: 78-85.
• 30 Reynolds JH, Heeger DJ. The normalization model of attention.. Neuron 2009; 61: 168-185.
• 31 Schweitzer RD. et al. Recently resettled refugee women-at-risk in Australia evidence high levels of psychiatric symptoms: individual, trauma and post-migration factors predict outcomes.. BMC Med 2018; 16: 149.
• 32 Senn V. et al. Long-range connectivity defines behavioral specificity of amygdala neurons.. Neuron 2014; 81 02: 428-37.
• 33 Servan-Schreiber D. et al. Eye Movement Desensitization and Reprocessing for Posttraumatic Stress Disorder: A Pilot Blinded, Randomized Study of Stimulation Type.. Psychother Psychosom 2006; 75: 290-297.
• 34 Spitzer M. Normierung im Gehirn.. Nervenheilkunde 2007; 26: 200-202.
• 35 Spitzer M. Gedächtnisspuren löschen?. Auf das Timing kommt es an! Nervenheilkunde 2012; 31: 944-948.
• 36 Tinghög P. et al. Prevalence of mental ill health, traumas and post-migration stress among refugees from Syria resettled in Sweden after 2011: a populationbased survey.. BMJ Open 2017; 7: e018899.
• 37 Turrigiano G. Too many cooks? Intrinsic and synaptic homeostatic mechanisms in cortical circuit refinement.. Annu Rev Neurosci; 2011: 89-103.
• 38 White BJ. et al. Superior colliculus neurons encode a visual saliency map during free viewing of natural dynamic video.. Nat Commun 2017; 8: 14263.
• 39 White BJ. et al. Superior colliculus encodes visual saliency before the primary visual cortex.. PNAS 2017; 114: 9451-9456.
• 40 Wilson G. et al. The Use of Eye-Movement Desensitization Reprocessing (EMDR) Therapy in Treating Post-traumatic Stress Disorder-A Systematic Narrative Review.. Front Psychol 2018; 9: 923.
• 41 Vokoun CR. et al. Response normalization in the superficial layers of the superior colliculus as a possible mechanism for saccadic averaging.. The Journal of Neuroscience 2014; 34: 7976-7987.
• 42 Badura-Brack AS. et al. Effect of attention training on attention bias variability and PTSD symptoms: Randomized controlled trials in Israeli and U.S. Combat Veterans.. Am J Psychiatry 2015; 172: 1233-1241.