TF-CBT and EMDR are effective treatments for posttraumatic stress disorder

Trauma-focused cognitive-behavioral therapy (TF-CBT)
and eye movement desensitization and reprocessing (EMDR) are effective
treatments for posttraumatic stress disorder.

However, little is known about
their neurobiological effects. The usefulness of neurobiological measures to
predict the treatment outcome of psychotherapy also has yet to be determined.

Systematic review of randomized controlled trials (RCTs) focused on
neurobiological treatment effects of TF-CBT or EMDR and trials with
neurobiological measures as predictors of treatment response. TF-CBT was
compared with a waitlist in most trials. TF-CBT was associated with a decrease
in heart rate and blood pressure and changes in activity but not in volume of
frontal brain structures and the amygdala.

Neurobiological changes correlated
with changes in symptom severity. EMDR was only tested against other active
treatments in included trials. We did not find a difference in neurobiological
treatment effects between EMDR and other treatments.

Publications on
neurobiological predictors of treatment response showed ambiguous results.
TF-CBT was associated with a reduction of physiological reactivity.

There is
some preliminary evidence that TF-CBT influences brain regions involved in fear
conditioning, extinction learning and possibly working memory and attention
regulation; however, these effects could be nonspecific psychotherapeutic
effects.