Changes in cerebellar functional connectivity and autonomic regulation in cancer patients treated with the Neuro Emotional Technique for traumatic stress symptoms
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A growing number of research studies have implicated the cerebellum in emotional processing and regulation, especially with regard to negative emotional memories. However, there currently are no studies showing functional changes in the cerebellum as a result of treatment for traumatic stress symptoms. The Neuro Emotional Technique (NET) is an intervention designed to help improve symptoms related to traumatic stress using an integrative approach that combines emotional, cognitive, and motor processing, with a particular focus on autonomic nervous system regulation. In this study, we evaluated whether the NET intervention alters functional connectivity in the brain of patients with traumatic stress symptoms associated with a cancer-related event. We hypothesized that the NET intervention would reduce emotional and autonomic reactivity and that this would correlate with connectivity changes between the cerebellum and limbic structures as well as the brain stem.
We enrolled patients with a prior cancer diagnosis who experienced distressing cancer-related memories associated with traumatic stress symptoms of at least 6 months in duration. Participants were randomized to either the NET intervention or a waitlist control. To evaluate the primary outcome of neurophysiological effects, all participants received resting-state functional blood oxygen level-dependent (BOLD) magnetic resonance imaging (rs-fMRI) before and after the NET intervention. In addition, autonomic reactivity was measured using heart rate response to the traumatic stimulus. Pre/post comparisons were performed between the NET and control groups.
The results demonstrated significant changes in the NET group, as compared to the control group, in the functional connectivity between the cerebellum (including the vermis) and the amygdala, parahippocampus, and brain stem. Likewise, participants receiving the NET intervention had significant reductions in autonomic reactivity based on heart rate response to the traumatic stimulus compared to the control group.
This study is an initial step towards establishing a neurological signature of treatment effect for the NET intervention. Specifically, functional connectivity between the cerebellum and the amygdala and prefrontal cortex appear to be associated with a reduction in autonomic reactivity in response to distressing cancer-related memories.
Implications for cancer survivors
This study contributes to the understanding of possible mechanisms by which interventions like NET may help reduce emotional distress in cancer patients who suffer from traumatic stress symptoms.
KeywordsNeuro Emotional Technique Emotional trauma Distressing recollections Cancer fMRI Functional connectivity Cerebellum Amygdala
This study was funded by the One Research Foundation.
Compliance with ethical standards
Conflict of interest
All authors declare that they have no conflict of interest.
All procedures performed in this study involving human participants were in accordance with the ethical standards of the Institutional Review Board of Thomas Jefferson University and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.
Informed consent approved by the IRB of Thomas Jefferson University was obtained from all individual participants included in the study.
- 9.Monti DA, Tobia A, Stoner M, Wintering N, Matthews M, He XS, et al. Neuro emotional technique effects on brain physiology in cancer patients with traumatic stress symptoms: preliminary findings. J Cancer Surviv. 2017; https://doi.org/10.1007/s11764-017-0601-8.
- 10.Wolpe J. The practice of behavior therapy. New York: Pergamon Press; 1973.Google Scholar
- 11.First MB, Spitzer RL, Gibbon M, Williams JBW. Structured clinical interview for DSM-IV Axis I disorders-clinical version (SCID-CV). Washington D.C.: American Psychiatric Press; 1997.Google Scholar
- 14.Schwartz MS. Biofeedback: a practitioner’s guide. 2nd ed. New York: Guilford; 1995.Google Scholar
- 15.Flor H, Miltner W, Birbaumer N. Psychophysiological recording methods. In: Turk DC, Melzack R, editors. Handbook of pain assessment. New York: Guilford; 1992. p. 169–90.Google Scholar
- 18.Spielberger CD. Manual for the state trait anxiety inventory: STAI (form Y). Palo Alto CA: Consulting Psychologists Press; 1983.Google Scholar
- 19.Derogatis LR. Brief Symptom Inventory 18: Administration Scoring and Procedure Manual. Minnesota. NCS Pearson Inc: Minneapolis; 2001.Google Scholar
- 47.Stark EA, Parsons CE, Van Hartevelt TJ, Charquero-Ballester M, McManners H, Ehlers A, et al. Post-traumatic stress influences the brain even in the absence of symptoms: a systematic, quantitative meta-analysis of neuroimaging studies. Neurosci Biobehav Rev. 2015;56:207–21.CrossRefPubMedGoogle Scholar