Fast-intervening and novel therapies are continually sought out to aid with concussion recovery. One such therapy is EMDR: eye movement desensitization and reprocessing therapy which is a psychotherapy first developed by Francine Shapiro in 1987.
EMDR is traditionally used to treat post-traumatic stress disorder (PTSD) as it often includes experiencing or witnessing a traumatic or disturbing event which this type of treatment can target. Studies have shown that patients with PTSD receiving EMDR treatment showed fewer PTSD symptoms and reduced psychophysiological stress reactions. Other studies have shown that employing EMDR for recent traumatic events may be an effective tool for providing early treatment to victims of trauma and protect against more severe symptoms. Due to its protective and therapeutic effects against trauma and stressor-related disorders, some predicted that it could be beneficial for post-concussion syndrome as well.
EMDR therapy protocol relies on bilateral stimuli such as eye movement, taps, or tones to access and reprocess disturbing life experiences and the associated stored memories to integrate new and more adaptive ones. One hypothesis is that EMDR helps transfer memories and information from implicit (sensory body experiences) to explicit (more cognitive) memory systems as well as from episodic (procedural) to semantic (more factual) memories. Although the treatment often targets a critical traumatic moment that occurred, the effect usually generalizes to include all aspects of that event so it gets consolidated as a whole into a single reprocessed memory.
Symptoms of post-concussion syndrome (PCS) include headaches, memory problems, stress intolerance, personality change, and irritability. Recent studies suggested that these symptoms are not specific to brain injuries but occur for all types of trauma. Additionally, PTSD and PCS have a shared causal component in which stress plays a key role. Therefore, it was suggested that EMDR not only alleviates PTSD symptoms but can also help treat PCS and promote faster and easier recovery from concussions.
One study, in particular, compared the 3-month rate of post-concussion-like symptoms (PCLS) of patients with a high risk of PCLS arriving at an emergency room based on the treatment they received: a single 60-minute EMDR session, a 15-minute reassurance session, and a control group receiving usual care. Findings showed that the proportion of patients with PCLS after 3 months were 18%, 37%, and 65% for EMDR, reassurance, and control groups respectively. Therefore, those who received EMDR therapy were the least likely compared to the other 2 groups to develop post-concussion-like symptoms.
The mechanism by which EMDR impacts memory processing is poorly understood, but some theories suggest that the benefits occur when patients divide their attention between traumatic memory and another competing task like eye movements. Another theory suggests that EMDR enhances episodic retrieval through increased connections between the 2 hemispheres of the brain caused by eye movements.
Although more research is needed on the effects of EMDR on post-concussion recovery, there is good evidence to suggest that it can potentially be effective in mediating the effects of stress and trauma on the experienced symptoms.
Written by Lea Farah
References
Buydens, S. L., Wilensky, M., & Hensley, B. J. (2014). Effects of the EMDR protocol for recent traumatic events on acute stress disorder: A case series. Journal of EMDR Practice and Research, 8(1), 2-12. https://doi.org/10.1891/1933-3196.8.1.2
Gil-Jardiné, C., Evrard, G., Al Joboory, S., Tortes Saint Jammes, J., Masson, F., Ribéreau-Gayon, R., Galinski, M., Salmi, L., Revel, P., Régis, C. A., Valdenaire, G., & Lagarde, E. (2018). Emergency room intervention to prevent post concussion-like symptoms and post-traumatic stress disorder. A pilot randomized controlled study of a brief eye movement desensitization and reprocessing intervention versus reassurance or usual care. Journal of Psychiatric Research, 103, 229-236. https://doi.org/10.1016/j.jpsychires.2018.05.024
Sack, M., Lempa, W., & Lamprecht, F. (2007). Assessment of psychophysiological stress reactions during a traumatic reminder in patients treated with EMDR. Journal of EMDR Practice and Research, 1(1), 15-23. https://doi.org/10.1891/1933-3196.1.1.15