title: EMDR therapy modulates the default mode network in a subsyndromal, traumatized bipolar patient.
abstract: BACKGROUND
  Some functional imaging abnormalities found in bipolar disorder are state related, whereas others persist into euthymia. It is uncertain to what extent these latter changes may reflect continuing subsyndromal affective fluctuations and whether those can be modulated by therapeutic interventions.
  
  
  METHODS
  We report functional magnetic resonance imaging (fMRI) findings during performance of the n-back working memory task in a bipolar patient who showed a marked improvement in subsyndromal affective symptoms after receiving eye movement desensitization and reprocessing (EMDR) therapy in the context of a clinical trial.
  
  
  RESULTS
  The patient's clinical improvement was accompanied by marked changes in functional imaging, as compared to 30 healthy subjects. fMRI changes were noted particularly in deactivation, with failure of deactivation in the medial frontal cortex partially normalizing after treatment.
  
  
  CONCLUSIONS
  This case supports the potential therapeutic overall benefit of EMDR in traumatized bipolar patients and suggests a possible neurobiological mechanism of action: normalization of default mode network dysfunction.
authors.affiliation: FIDMAG Research Foundation Germanes Hospitalàries, Barcelona, Spain.
authors.forename: Ramon
authors.initials: R
authors.lastname: Landin-Romero
authors.forename: Patricia
authors.initials: P
authors.lastname: Novo
authors.forename: Victor
authors.initials: V
authors.lastname: Vicens
authors.forename: Peter J
authors.initials: PJ
authors.lastname: McKenna
authors.forename: Antonia
authors.initials: A
authors.lastname: Santed
authors.forename: Edith
authors.initials: E
authors.lastname: Pomarol-Clotet
authors.forename: Pilar
authors.initials: P
authors.lastname: Salgado-Pineda
authors.forename: Francine
authors.initials: F
authors.lastname: Shapiro
authors.forename: Benedikt L
authors.initials: BL
authors.lastname: Amann
mesh_terms: D000328:Adult; D001714:Bipolar Disorder / Q000503:physiopathology / Q000628:therapy*; D002986:Clinical Trials as Topic; D057169:Eye Movement Desensitization Reprocessing / Q000379:methods*; D005260:Female; D006801:Humans; D008016:Life Change Events; D008279:Magnetic Resonance Imaging; D008570:Memory, Short-Term / Q000502:physiology; D009415:Nerve Net / Q000503:physiopathology*; D009483:Neuropsychological Tests; D017397:Prefrontal Cortex / Q000503:physiopathology*; D016896:Treatment Outcome