BRIEF REPORT
Effect of Bilateral Eye Movements on Frontal
Interhemispheric Gamma EEG Coherence
Implications for EMDR Therapy
Ruth E. Propper, PhD,* Jenna Pierce, BA,* Mark W. Geisler, PhD,† Stephen D. Christman, PhD,‡
and Nathan Bellorado, BS*
Abstract: The use of bilateral eye movements (EMs) is an important
component of Eye Movement Desensitization and Reprocessing
(EMDR) therapy for posttraumatic stress disorder. The neural mech-
anisms underlying EMDR remain unclear. However, prior behav-
ioral work looking at the effects of bilateral EMs on the retrieval of
episodic memories suggests that the EMs enhance interhemispheric
interaction. The present study examined the effects of the EMs used
in EMDR on interhemispheric electroencephalogram coherence.
Relative to noneye-movement controls, engaging in bilateral EMs
led to decreased interhemispheric gamma electroencephalogram
coherence. Implications for future work on EMDR and episodic
memory are discussed.
Key Words: Interhemispheric interaction, eye movements, eye
movement desensitization therapy, posttraumatic stress disorder.
(J Nerv Ment Dis 2007;195: 785–788)
S hapiro (1995) proposed a method of treating posttraumatic
stress disorder (PTSD) symptoms (American Psychiatric
Association, 1994) called Eye Movement Desensitization and
Reprocessing (EMDR), in which the client is instructed to
think about troubling thoughts while simultaneously moving
his/her eyes back and forth following the therapist’s fingers as
they move across his/her field of vision for 20 to 30 seconds.
Eye movements (EMs) are the most commonly used external
stimulus, although therapists occasionally use bilateral audi-
tory tones, bilateral tapping, or other types of bilateral stim-
ulation. No studies have directly compared the efficacy of
these different forms of bilateral stimulation; because the
majority of articles published on EMDR involve use of
*Psychology Department, Merrimack College, North Andover, Massa-
chusetts; †Psychology Department, San Francisco State University,
San Francisco, California; and ‡Psychology Department, University
of Toledo, Toledo, Ohio.
This study was supported by the Ciejek Fellowship (R.E.P.). The first author
thanks Stephen Propper for discussion of concept and theory.
Send reprint requests to Ruth E. Propper, PhD, Psychology Department,
Merrimack College, 315 Turnpike Street, North Andover, MA 01845.
E-mail: ruth.propper@merrimack.edu.
Copyright © 2007 by Lippincott Williams & Wilkins
ISSN: 0022-3018/07/19509-0785
DOI: 10.1097/NMD.0b013e318142cf73
The Journal of Nervous and Mental Disease • Volume 195, Number 9, September 2007
bilateral EMs, they will be the focus of the current article.
Although the clinical efficacy of EMDR has been demon-
strated (e.g., Russell, 2006; Tufnell, 2005), there is little
evidence at present that it differs in efficacy from other
therapies such as cognitive behavioral therapy. However,
understanding how EMs affect the brain may help shed light
on EMDR’s underlying neural mechanisms, which remain
controversial (e.g., Perkins and Rouanzoin, 2002).
Because EMDR helps PTSD patients overcome disso-
ciative amnesia for traumatic events, EMDR’s efficacy may
be due to its action on neuroanatomical structures involved in
memory. Christman and colleagues proposed a neurobiolog-
ical framework wherein the bilateral stimulation in EMDR
enhances memory processing through increased interhemi-
spheric interaction via the corpus callosum (Christman et al.,
2003, 2004, 2006). These studies reported superior episodic
memory after EMDR-like stimulation consisting of 30 sec-
onds of bilateral saccadic EMs, relative to 30 seconds of
central fixation. Superior episodic memory took the form of
increased recall of laboratory-based and real-world memories
(Christman et al., 2003), decreased false memories (Christman
et al., 2004), and recall of earlier childhood memories
(Christman et al., 2006).
We propose that superior episodic memory after bilat-
eral EMs is a result of EM-induced increases in interhemi-
spheric communication during episodic retrieval. There is
converging evidence that episodic retrieval is associated with
increased communication between the cerebral hemispheres,
coming from imaging studies (e.g., Cabeza and Nyberg,
2000), studies of split-brain patients (e.g., Zaidel, 1995), and
visual half-field studies (Christman and Propper, 2001). How-
ever, physiological measures were not recorded in prior EM
studies from our laboratory. The purpose of the present study
is to physiologically measure interhemispheric interaction in
response to engaging in the EM procedure used in previous
studies. Specifically, in this brief report, we report results
examining frontal interhemispheric electroencephalographic
coherence (IhCo) before and after the EM procedure used in
the study by Christman et al. (2003, 2004, 2006).
We focused on (a) frontal activity because the frontal
lobes have been specifically implicated in episodic memory
(e.g., Kavcic et al., 2003) and on (b) gamma-band and
theta-band activity because they have been associated with
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Propper et al. The Journal of Nervous and Mental Disease • Volume 195, Number 9, September 2007
episodic memory processing (e.g., Babiloni et al., 2004;
Kaiser and Lutzenberger, 2005; Klimesch et al., 1994). Be-
cause alpha has been associated with semantic memory pro-
cesses (e.g., Klimesch et al., 1994; Mima et al., 2001), we
also examined the alpha frequency to rule out a general,
nonepisodic memory-related effect of stimuli condition on
interhemispheric interaction.
METHODS
Participants
Twenty-two right-handed undergraduates participated
(M age ! 20.11, SD ! 1.49) for extra credit in a psychology
course. All read and signed an informed consent form, and
the experimental protocol received Institutional Review
Board approval from the University of Toledo Institutional
Review Board committee. A 1-second, artifact-free epoch
from at least one of the pre- or poststimuli blocks was unable
to be recovered for 4 participants; data from these individuals
were not included in analyses (total N ! 18). Ten participants
(7 females, 3 males) served in the moving stimuli (MS)
condition, and 8 (4 females, 4 males) served in the colored
stimuli condition.
Materials and Procedure
Stimuli
Stimuli and instructions were presented on a Macintosh
G3 computer with a 16-in (40.64 cm) monitor using Superlab
Pro 1.75 (Cedrus Corporation, 1997). Participants sat approx-
imately 60 cm from the monitor. Replicating (Christman et
al., 2004, 2006), the MS condition induced saccadic EMs by
having participants move their eyes to follow a black dot
(approximately 4° of visual angle in diameter) that appeared
sequentially on the left and right portions of the white screen
of the computer monitor. The dot changed positions every
500 milliseconds, resulting in 2 saccadic EMs per second, for
30 seconds. The dots were located approximately 27° of
visual angle apart. The color stimuli (CS) condition was
identical to that used in Christman et al. (2006). Participants
viewed a centrally presented dot (approximately 4° of visual
angle in diameter) that alternated between green and red
twice per second, for 30 seconds. The CS condition was a
control condition in which participants received 30 seconds
of 2 Hz periodic visual stimulation in the absence of EMs.
Because EMs result in EEG artifact at frontal sites
during the MS condition and cannot be analyzed, 4 additional
conditions were used. In the eyes-closed condition (EC),
participants closed their eyes for 30 seconds. In the eyes-open
condition (EO), participants kept their eyes open and focused
on a centrally presented static black dot (approximately 4° of
visual angle in diameter) for 30 seconds. Participants per-
formed one EC and one EO block as prestimuli baseline
conditions and, following either an MS or CS block, per-
formed one EC and one EO block as poststimuli recovery
conditions.
EEG Materials and Analysis
Biopac EL503 disposable electrodes were applied using
the International 10 –20 Electrode Placement System to Fp1
786
and Fp2, referenced to linked mastoids, and grounded to
forehead. EEG was amplified using the Biopac MP30
(Biopac Systems, Inc., Santa Barbara, CA) and digitally
recorded at 200 samples/s on a 12 in (30.5 cm) iBook
Macintosh Laptop using the AcqKnowledge 3.6.6 software.
Impedance was kept below 10 KÙ. EEG was inspected for
artifact; EEG greater than "200 !V was excluded.
The power spectrum for the first artifact-free 1-second
epoch per prestimuli and poststimuli blocks (EO pre, EC pre,
EO post, EC post) was Fast Fourier transformed using a
Hamming Window for each participant in each frequency.
This epoch definition was chosen to illustrate the immediate
impact on the EEG after the saccade that is closer in line with
the event-related brain potential literature epochs of 1 second
(Intriligator and Polich, 1995; Spencer and Polich, 1999).
Epochs occurred at least 3 seconds after the beginning or 3
seconds before the end of a block. No artifact occurred less
than 0.5 seconds before or after an epoch. EEG was band-
pass filtered such that the gamma band was 35 to 54 Hz (this
gamma band is higher than the typical beta bands that are
often measured up to 35 Hz; we chose 54 Hz as the upper
cutoff to avoid any 60 Hz notch filtering induced by AC
current that could artificially modulate gamma activity), theta
band was 4 to 8 Hz, and alpha band was 8 to 13 Hz.
Coherence (IhCo) values were calculated using a point by
point squaring of a serial cross-correlation of the power
spectrum resulting in a coherence value #left (Fp1) $
right (Fp2)%/(left (Fp1) & right (Fp2)% for each power band
(gamma, alpha, and theta). EEG coherence refers to the
squared cross-correlation between EEG power from 2 scalp
locations within a frequency band and indexes the functional
covariation of activity between 2 different cortical areas
(Nunez et al., 1997). IhCo was calculated between Fp1 and
Fp2 for each epoch in each EO and EC block. IhCo change
was calculated as IhCo poststimuli $ IhCo prestimuli for EO
and EC blocks separately; positive numbers represent in-
creasing interhemispheric coherence from pre to post; nega-
tive numbers indicate decreasing interhemispheric coherence
from pre to post.
General Procedure
Before each block, instructions for each condition ap-
peared on the computer screen. The experimenter read aloud
these instructions, ensured participants’ understanding, and
covertly observed the participants’ eyes to make sure instruc-
tions were followed.
EEG was recorded continuously during the experiment.
All participants viewed 5 blocks: EO prestimuli, EC pre-
stimuli, stimuli condition (either MS or CS), EO poststimuli,
and EC poststimuli (order of EO and EC pre- and poststimuli
was counterbalanced). EO condition: participants kept eyes
focused on the black dot in the center of the computer screen;
EC condition: participants kept eyes closed, and were told
when to open them; MS condition: participants kept eyes
focused on the black dot as it flashed in different locations on
the computer screen; CS condition: participants kept eyes
focused on the color changing dot in the center of the
computer screen. Participants were not asked to think about
© 2007 Lippincott Williams & Wilkins
The Journal of Nervous and Mental Disease • Volume 195, Number 9, September 2007 Bilateral Eye Movements and EEG Coherence

this variable. An interaction between stimuli condition and

FIGURE 1. IhCo change from prestimuli to poststimuli as a
function of stimuli condition.
block was significant for the gamma frequency, F(1,16) !
6.12, p ! 0.02, such that the change in IhCo from pre- to
poststimuli in the EO condition resulted in decreased IhCo
(M ! $0.061, SD ! 0.11) after MS when compared with CS
(M ! &0.069, SD ! 0.11, d ! 1.18) (Figure 1).
To more closely examine effects of stimuli condition on
IhCo during EO in the gamma frequency, a mixed analyses of
variance was performed on IhCo for the EO blocks: 2
(between-participants stimuli condition: MS vs. CS) by 2
(within-participants block: EO pre- vs. EO poststimuli). An
interaction between stimuli condition and block, F(1,16) !
6.42, p ! 0.02 revealed lower IhCo during EO poststimuli
after MS (M ! 0.68, SD ! 0.077) when compared with CS
(M ! 0.74, SD ! 0.041; p ! 0.02, d ! 0.97). There was no
difference in IhCo during EO prestimuli before MS versus CS
(p ! 0.10), eliminating the possibility that decreased IhCo
post-MS relative to post-CS was an artifact of an initial
prestimuli difference in IhCo between stimuli conditions
(Figure 2). Identical analyses performed on theta and alpha
frequencies were not significant (Table 1 for IhCo as a
function of EO and EC blocks pre- and poststimuli condition
for each frequency).

FIGURE 2. IhCo as a function of stimuli condition during the
eyes open prestimuli and poststimuli blocks.
anything in particular but merely to “focus on the dot” or to
“keep their eyes closed.”
RESULTS
Mixed analyses of variance with stimuli condition (MS
vs. CS) and block (EO vs. EC) as between- and within-
participants (respectively) variables were performed on IhCo
change for each frequency. Order of poststimuli block (EO
block or EC block first after stimuli condition) did not interact
with stimuli condition in any band; analyses collapsed across
DISCUSSION
Contrary to our hypothesis of increased interhemi-
spheric coherence after EMs, we found decreased gamma
frequency coherence associated with engaging in 30 seconds
of bilateral EMs with eyes open. Although surprising, these
findings correspond with a recent functional magnetic reso-
nance imaging study. Umeda et al. (2005) reported decreased
functional interaction between the left and right hemispheres
in anterior prefrontal cortex during episodic retrieval. Given
that the cortical locations of Fp1 and Fp2 coincide with the
location of anterior frontal cortex in which decreased func-
tional interhemispheric interaction was reported (Umeda et
al., 2005), it seems likely that the results of the present
study are related to the findings of Umeda et al. Specifi-
cally, the EM manipulation used in the present study,
reported previously to facilitate episodic memory, resulted
in decreased interhemispheric EEG coherence in anterior
prefrontal cortex.
Because the gamma band includes the 40 Hz wave that
may indicate the active binding of information during the
consolidation of long-term memory storage (e.g., Cahn and
Polich, 2006), it is particularly notable that the changes in

TABLE 1. IhCo Mean and (SD) as a Function of Stimuli Condition and Block for Each Frequency
Stimuli Condition as a Function of Block
EO Pre EC Pre EO Post EC Post
Frequency Color Stimuli Moving Stimuli Color Stimuli Moving Stimuli Color Stimuli Moving Stimuli Color Stimuli Moving Stimuli
Alpha 0.95 (0.01) 0.94 (0.01) 0.95 (0.01) 0.95 (0.01) 0.95 (0.01) 0.94 (0.01) 0.94 (0.01) 0.95 (0.01)
Theta 0.91 (0.06) 0.90 (0.07) 0.91 (0.06) 0.93 (0.06) 0.86 (0.08) 0.89 (0.05) 0.87 (0.11) 0.93 (0.08)
Gamma 0.68 (0.10) 0.74 (0.06) 0.72 (0.06) 0.75 (0.08) 0.74* (0.04) 0.68* (0.08) 0.70 (0.09) 0.74 (0.05)
*Significance p ' 0.05.

© 2007 Lippincott Williams & Wilkins 787

Propper et al. The Journal of Nervous and Mental Disease • Volume 195, Number 9, September 2007
coherence we found are in this band. With regard to PTSD
symptoms, it may be that by changing interhemispheric
coherence in frontal areas, the EMs used in EMDR foster
consolidation of traumatic memories, thereby decreasing the
memory intrusions found in this disorder. It is not clear why
this should be the case only when the eyes are kept open after
EMs; future studies could address this issue.
It should be noted that a decrease in IhCo does not
necessarily indicate a decrease in functional interhemispheric
interaction. As noted by Uttal (2001), changes in measures of
brain activity do not always map directly onto changes in
cognitive function (e.g., increases in activation of a brain
region associated with a specific task do not necessarily
indicate that that region is primarily responsible for that task).
To illustrate, decreases in gamma-band IhCo have been
reported as subjects become better at a bimanual motor task
in which the movements of the left and right hand, and hence
right and left hemisphere processing, need to be coordinated
(Gerloff and Andres, 2002). Thus, the current results should
be interpreted as reflecting EM-induced changes in inter-
hemispheric interaction, not necessarily EM-induced de-
creases in interhemispheric interaction. For example, in-
creased IhCo implies that the 2 hemispheres are doing similar
things, whereas increased interhemispheric interaction im-
plies that the 2 hemispheres are doing coordinated but not
necessarily similar things. Future work should directly ad-
dress the question of whether decreases in IhCo are related to
increased versus decreased performance on memory tasks.
The EMs used in the current study were similar to
those used in EMDR, a treatment for PTSD (Shapiro,
1995). Controversies about the nature of EMDR therapy
stem in large part from the failure of its proponents to
suggest plausible neural mechanisms underlying its effi-
cacy (e.g., Perkins and Rouanzoin, 2002). The results of
the current experiment suggest that the EMs employed in
EMDR may induce a neurobiological change in interhemi-
spheric interaction.
Because this is the first study examining the relation-
ship between the EMDR-like EM paradigm and direct
physiological measures of interhemispheric interaction,
the time course of stimuli presentation, sampling of ep-
ochs, and recovery times were fairly arbitrary. Past re-
search has found that effects of EMs on memory occur
after 30 seconds of EMs (Christman et al., 2003, 2004), but
no work exists testing the time course of such saccadic EM
effects on physiology. That the use of the first single
second artifact-free epoch to examine IhCo resulted in
significant differences between post-MS and post-CS
blocks when the eyes were kept open suggests that the
results are robust, and may occur almost immediately after
the EMs. Future research could examine how long these
changes in interhemispheric interaction last, as well as
exploring the effects of EMs on activity in other EEG
bands. Additionally, decreased gamma only occurred when
participants kept their eyes open after EMs; the results
suggest that EMDR might be most effective when individ-
uals do not close their eyes after bilateral stimulation.
788
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