title: [Magneto-encephalographic (MEG) brain recordings during traumatic memory recall in women with post-traumatic stress disorder: A pilot study].
abstract: OBJECTIVE
  The experiment studied the effects of a short duration exposure to traumatic memories using magneto-encephalography (MEG).
  
  
  METHODS
  Nine right-handed DSM-4 PTSD patients were recruited from a unit for anxiety disorders and an organisation supporting victims of violence. In order to have a homogeneous sample, we included only women who suffered from civilian PTSD. Exclusion criteria were co-morbid major medical illness, metallic dental prostheses that would interfere in the magnetic measurement, and current drug treatment. All participants were free from neurological disease and had normal hearing. They signed a written informed consent form. An ethics committee accepted the study.
  
  
  METHODS
  A tape-recorded voice administered a script-driven imagery. The patients had to imagine, successively, a neutral image, a traumatic memory and rest, while MEG measured brain activities across delta, theta, alpha and beta bands. Each condition lasted three minutes. Heart rate (HR), anxiety and the vividness of mental images were recorded at the end of each phase. MEG power analysis was carried out with Statistical Parametric Mapping (SPM) 8. The signals were averaged for each of the three conditions of threeminutes duration. The dependent variable was a subtracted value: (trauma - rest) - (neutral - rest). The significance threshold was set at P<0.01.
  
  
  RESULTS
  Anxiety and HR significantly increased during the trauma condition and returned to the neutral level during rest. The vividness of the mental imagery remained stable across the three conditions. The left-brain demonstrated a statistically significant power decrease in the secondary visual cortex (BA 18-19) in the delta band, the insula (BA13) in the beta band, the insula (BA13), premotor cortex (BA 6), Broca area (BA 44), and BA 43, in the alpha band.
  
  
  CONCLUSIONS
  The symptom provocation protocol was successful in eliciting subjective anxiety and HR response in relation to traumatic memories. Our MEG results are in keeping with previous neuro-imagery studies showing decreased activities in the insula and Broca area during PTSD symptom provocation. However, we did not replicate the activation in the amygdala and the cingulate and prefrontal cortex found in some studies. Moreover, the within-group design, the small sample, and the inclusion of only female patients with milder dissociative symptoms limit our conclusions. The MEG protocol we used may also explain some partial discrepancies with previous MEG studies. However, our aim was to provoke a specific autobiographic recall of a traumatic event unfolding several sequential mental images along three minutes as in exposure therapy for PTSD.
  
  
  CONCLUSIONS
  Despite its limitations, this pilot study is the first to provide MEG data during trauma recall. It suggests that recalling a specific traumatic event along three minutes results in hypo-activations of the brain regions regulating language and emotions. This paves the way to recording whole sessions of specific therapies for PTSD, with MEG using the millisecond resolution. MEG might be of interest to study the suppression of traumatic memories and their activation and habituation through prolonged graduated exposure in imagination across several sessions. MEG could also be used to study the effects of medication on PTSD symptoms. A controlled replication in a larger sample including male and female patients with various traumatic experiences is needed.
authors.affiliation: Unité de traitement de l'anxiété, service de psychologie médicale, hôpital neurologique, 59, boulevard Pinel, 69677 Bron, France. Electronic address: cottraux@univ-lyon1.fr.
authors.forename: J
authors.initials: J
authors.lastname: Cottraux
authors.affiliation: Cermep, centre hospitalier du Vinatier, 95, boulevard Pinel, 69500 Lyon, France.
authors.forename: F
authors.initials: F
authors.lastname: Lecaignard
authors.affiliation: Unité de traitement de l'anxiété, service de psychologie médicale, hôpital neurologique, 59, boulevard Pinel, 69677 Bron, France.
authors.forename: S-N
authors.initials: SN
authors.lastname: Yao
authors.affiliation: Unité de traitement de l'anxiété, service de psychologie médicale, hôpital neurologique, 59, boulevard Pinel, 69677 Bron, France.
authors.forename: C
authors.initials: C
authors.lastname: De Mey-Guillard
authors.affiliation: Institut français d'EMDR, association EMDR-France, 30, place Saint-Georges, 75009 Paris, France.
authors.forename: F
authors.initials: F
authors.lastname: Haour
authors.affiliation: Cermep, centre hospitalier du Vinatier, 95, boulevard Pinel, 69500 Lyon, France; Inserm, U1028, CNRS UMR5292, centre de recherche en neurosciences, UCB Lyon 1, centre hospitalier Le-Vinatier, bâtiment 452, 95, boulevard Pinel, 69675 Bron cedex, France.
authors.forename: C
authors.initials: C
authors.lastname: Delpuech
authors.affiliation: Institut français d'EMDR, association EMDR-France, 30, place Saint-Georges, 75009 Paris, France.
authors.forename: D
authors.initials: D
authors.lastname: Servan-Schreiber
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001007:Anxiety / Q000175:diagnosis / Q000503:physiopathology / Q000523:psychology; D001143:Arousal / Q000502:physiology; D001931:Brain Mapping; D058256:Brain Waves / Q000502:physiology; D002540:Cerebral Cortex / Q000503:physiopathology; D004292:Dominance, Cerebral / Q000502:physiology; D005260:Female; D006801:Humans; D007092:Imagination / Q000502:physiology; D007223:Infant; D008016:Life Change Events; D015225:Magnetoencephalography; D011939:Mental Recall / Q000502:physiology*; D008875:Middle Aged; D010865:Pilot Projects; D013313:Stress Disorders, Post-Traumatic / Q000175:diagnosis / Q000503:physiopathology* / Q000523:psychology; D014754:Violence / Q000523:psychology
keywords: Aire visuelle secondaire; Broca area; Cortex prémoteur; Insula; Magneto-encephalography (MEG); Magnéto-encéphalographie (MEG); PTSD; Rappel de souvenirs; Région de Broca; Secondary visual area; Stress post-traumatique; Trauma recall