Exploration of eye movement desensitization and reprocessing in treating posttraumatic stress-disorder in patients with acquired brain injury: a retrospective case series

Background: Posttraumatic stress disorder (PTSD) is prevalent in people with acquired brain injury (ABI). Despite the established efficacy of eye movement desensitization and reprocessing (EMDR) for PTSD in general, evaluation studies on EMDR in ABI patients with PTSD are limited.Objective: The aim of this study is to explore clinical features, treatment characteristics, feasibility and first indications of efficacy of EMDR in adult ABI patients with PTSD.Method: This retrospective consecutive case series included ABI patients, who received at least one session of EMDR for PTSD between January 2013 and September 2020. PTSD symptoms were measured using the Impact of Event Scale (IES) pre- and post-treatment. Affective distress was measured using the Subjective Units of Distress (SUD) pre- and post-treatment of the first target.Results: Sixteen ABI patients (median age 46 years, 50% males), with predominantly moderate or severe TBI (50%) or stroke (25%) were included. Treatment duration was a median of seven sessions. Post-treatment IES scores were significantly lower than pre-treatment scores (p < .001). In 81% of the cases there was an individual statistically and clinically relevant change in IES score. Mean SUD scores of the first target were significantly lower at the end of treatment compared to scores at the start of treatment (p < .001). In 88% of the patients full desensitization to a SUD of 0-1 of the first target was accomplished. Only few adjustments to the standard EMDR protocol were necessary.Conclusions: Findings suggest that EMDR is a feasible, well tolerated and potentially effective treatment for PTSD in ABI patients. For clinical practice in working with ABI patients, it is advised to consider EMDR as a treatment option.