Purpose A growing number of research studies have impli- cated 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 hypoth- esized that the NET intervention would reduce emotional and autonomic reactivity and that this would correlate with con- nectivity changes between the cerebellum and limbic struc- tures as well as the brain stem.

Methods 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 out- come 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 stim- ulus. Pre/post comparisons were performed between the NET and control groups.

Results The results demonstrated significant changes in the NET group, as compared to the control group, in the function- al connectivity between the cerebellum (including the vermis) and the amygdala, parahippocampus, and brain stem. Likewise, participants receiving the NET intervention had sig- nificant reductions in autonomic reactivity based on heart rate response to the traumatic stimulus compared to the control group.

Conclusions This study is an initial step towards establishing a neurological signature of treatment effect for the NET inter- vention. Specifically, functional connectivity between the cer- ebellum and the amygdala and prefrontal cortex appear to be associated with a reduction in autonomic reactivity in re- sponse to distressing cancer-related memories.

Implications for cancer survivors This study contributes to the understanding of possible mechanisms by which interven- tions like NET may help reduce emotional distress in cancer patients who suffer from traumatic stress symptoms.

Keywords Neuro Emotional Technique . Emotional trauma . Distressing recollections . Cancer . fMRI . Functional connectivity . Cerebellum . Amygdala


Andrew B. Newberg [email protected]

Jefferson Integrated Magnetic Resonance Imaging Center, Department of Radiology, Thomas Jefferson University, Philadelphia, PA, USA
Division of Biostatistics, Department of Pharmacology and Experimental Therapeutics, Thomas Jefferson University, Philadelphia, PA, USA
Marcus Institute of Integrative Health, Thomas Jefferson University,925 Chestnut Street, Suite 120, Philadelphia, PA 19107, USA

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