Drs Martin & Sue Allbright

'Blending an ancient medical approach of mind and body with modern health'

C

Acupuncture Research

C

Structure

Density

Rigidity

Evidence

We would like to share with you our personal view, beliefs and approach about the research that is presented on these pages.






We both value the research of modern science and the many developments that have been discovered.

We also value the depth of wisdom and knowledge of traditional and classical five element acupuncture, which integrates the many aspects of body and mind.

We acknowledge the information gained from research, and we endevaour to use it where appropriate when meeting the needs of an individual who is suffering in health.

We hope later to share more information on the five elements of acupuncture.

01684-893393

Classical Acupuncture

This site was last updated on

18th March 2020


Copyright O 2020 Allrights reserved

c

NEUROPHYSIOLOGY


Anterior Hippocampus

Every effort has been made to ensure that the information provided in this site is accurate. It is not the intention to mislead or misinform anyone.


Acupuncture Malvern | Acupuncture Worcester | Acupuncture Worcestershire | Acupuncture West Midlands | Malvern Acupuncture | Worcester Acupuncture  Worcestershire Acupuncture | West Midlands Acupuncture

Confidentiality

© copyright Drs Martin & Sue Allbright 2009 All rights reserved

Website design by MA


Psychotherapy with Somatosensory Stimulation for Endometriosis-Associated Pain: THE ROLE OF THE ANTERIOR HIPPOCAMPUS


Abstract

Background: Endometriosis is a gynecological disorder affecting 6-10% of all women in their reproductive age. There is an emerging view in the literature that psychological trauma plays a central role in the pathogenesis of pelvic pain, one of the core symptoms of endometriosis. Here, we report central nervous mechanisms of a novel combination of psychotherapy and somatosensory stimulation that has recently shown remarkable effects in reducing pain, anxiety and depressive symptoms in these patients.


Methods: We conducted a randomized controlled trial. 67 patients with severe endometriosis associated pain (maximum pain: 7.6 ± 2.0, average pain: 4.5 ± 2.0 on a 10-point numeric rating scale) were included in the study and randomly allocated to intervention (35 pat.) or wait-list control (32 pat.). Resting-state functional magnetic resonance imaging was used to assess brain connectivity of these patients at baseline, after three months of therapy and after six months. The analysis focused on the hippocampus


Results: We identified a cortical network comprising the right anterolateral hippocampus – a region modulating the hypothalamic-pituitary-adrenal (HPA) axis – and somatosensory, viscerosensory and interoceptive brain regions. Regression analysis showed that reduction in connectivity predicted therapy-induced improvement in patients' anxiety.


Conclusions: We have identified a putative neurobiological mechanism underlying the potent combination of psychotherapy and somatic stimulation in treating symptoms of endometriosis.


 A strong emphasis is placed on the joint involvement of mind and body in the therapeutic process. To achieve this, the approach employs diagnostic concepts and stimulation methods from Traditional Chinese Medicine (TCM). All patients were treated in an outpatient setting by the same therapist (ASA), a medical specialist for psychosomatic medicine and TCM. The pre-defined minimum number of treatments in the randomized period was 4 times. However, most patients received more treatments. A typical one on-one treatment session takes 60 minutes and topics arise from the current wishes and needs of the patient. The central theme of the therapy are somatic markers, i.e feelings of pressure, tension, or pain. Thus, each therapeutic session starts by the therapist asking the patient to report present worries and accompanying bodily sensations (e.g. pain, tension, pressure etc). These somatic markers are used as a path to painful memories of adverse life experiences (e.g. death of a close relative or friend, sexual abuse, domestic violence). A list of such life experiences identified by the therapist can be found in Tables S1 and S2. Memories are then uncovered using hypnotic techniques. Once a memory surfaces, it often triggers strong emotional reactions that patients are encouraged to express. Surfacing memories are treated as if they were present experiences and the patient is encouraged to develop appropriate solutions from the present perspective. This may either resolve the problem or uncover a deeper emotional conflict, which is then treated again by the same approach. The therapist uses acupuncture and related techniques (moxibustion, cupping) in combination with psychotherapeutic techniques to resolve the current symptoms. For example, if a patient reports pain in the lower abdomen while remembering humiliation by a close relative, the patient is asked for her inner needs while visualizing this situation. At the same time acupuncture point CV3 (~1.5 cm above the symphysis)  is stimulated by moxibustion. This typically induces immediate feelings of warmth in the lower abdomen and often leads to spontaneous symptom relief. The goal of each session is to render the patient into a stable and relaxed state, free of pain and negative emotions by resolving intrusive memories of adverse life experiences.


Discussion. Our analysis aimed at elucidating underlying mechanisms and was centered around the hippocampus as a probable target for this kind of therapy. We used a novel method to identify functionally independent hippocampal subregions as well as their whole-brain connectivity, and found connectivity changes that differed between treatment and control group at the end of the randomisation phase. Three distinct hippocampal subregions showed therapy related changes, namely the left and right anterolateral and the right anteromedial regions. As hypothesized, all were located in the anterior part of the hippocampus. This was expected because of the central role that emotions and painful memories play in our therapeutic approach. In particular, patients are encouraged to express their emotional reactions triggered by memories that surface during the therapeutic sessions. The important contribution of the anterior hippocampus to the processing of emotions and affective memories is well established. Furthermore, a recent review has emphasized revisiting of autobiographical memories as one of its core functions. Finally, the anterior hippocampus plays a central role in anxiety, a personality trait with great significance for pelvic pain and chronic pain in general.


Reproduced from Florian Beissner, Christine Preibisch, Annemarie Schweizer- Arau, Roxana M. Popovici and Karin Meissner, (2017) Psychotherapy with Somatosensory Stimulation for Endometriosis-Associated Pain: The Role of the Anterior Hippocampus Psychotherapy with somatosensory stimulation, Biological

Psychiatry , http://dx.doi.org/10.1016/j.biopsych.2017.01.006

Go to top

Go to top

Go to top

Go to top