FREE SHIPPING over $40
OVER 9000 FIVE-STAR REVIEWS
5% OFF ALL SUBSCRIPTIONS
100% HAPPINESS GUARANTEE
Analyze Diet
0
Home / Equine Research Bank / Hum Brain Mapp / Neural changes following equine-assisted therapy for posttra...
Human brain mapping2021; 42(6); 1930-1939; doi: 10.1002/hbm.25360

Neural changes following equine-assisted therapy for posttraumatic stress disorder: A longitudinal multimodal imaging study.

Abstract: While effective treatments for posttraumatic stress disorder (PTSD) exist, many individuals, including military personnel and veterans fail to respond to them. Equine-assisted therapy (EAT), a novel PTSD treatment, may complement existing PTSD interventions. This study employs longitudinal neuro-imaging, including structural magnetic resonance imaging (sMRI), resting state-fMRI (rs-fMRI), and diffusion tensor imaging (DTI), to determine mechanisms and predictors of EAT outcomes for PTSD. Nineteen veterans with PTSD completed eight weekly group sessions of EAT undergoing multimodal MRI assessments before and after treatment. Clinical assessments were conducted at baseline, post-treatment and at 3-month follow-up. At post-treatment patients showed a significant increase in caudate functional connectivity (FC) and reduction in the gray matter density of the thalamus and the caudate. The increase of caudate FC was positively associated with clinical improvement seen immediately at post-treatment and at 3-month follow-up. In addition, higher baseline caudate FC was associated with greater PTSD symptom reduction post-treatment. This exploratory study is the first to demonstrate that EAT can affect functional and structural changes in the brains of patients with PTSD. The findings suggest that EAT may target reward circuitry responsiveness and produce a caudate pruning effect from pre- to post-treatment.
© 2021 The Authors. Human Brain Mapping published by Wiley Periodicals LLC.
Get Full Text
Publication Date: 2021-02-05 PubMed ID: 33547694PubMed Central: PMC7978114DOI: 10.1002/hbm.25360Google Scholar: Lookup
The Equine Research Bank provides access to a large database of publicly available scientific literature. Inclusion in the Research Bank does not imply endorsement of study methods or findings by Mad Barn.
LinkedInCopy
  • Clinical Trial
  • Journal Article
  • Research Support
  • Non-U.S. Gov't

Summary

This research summary has been generated with artificial intelligence and may contain errors and omissions. Refer to the original study to confirm details provided. Submit correction.

The research article explores how equine-assisted therapy (EAT) can impact the brain structures and functions of patients with posttraumatic stress disorder (PTSD). It suggests that EAT can stimulate functional and structural changes, potentially improving patient responses to PTSD treatment.

Research Methodology

  • The researchers conducted a longitudinal neuroimaging study with 19 veterans suffering from PTSD.
  • Participants underwent eight weekly group sessions of EAT.
  • Multimodal MRI assessments were carried out before and after treatment. Further, clinical assessments were conducted at the start and end of EAT, as well as at a 3-month follow-up.

Key Findings

  • At the conclusion of the EAT treatment, patients exhibited increased functional connectivity (FC) in a part of the brain called the caudate and reduced gray matter density in the thalamus and the caudate.
  • The increase in caudate FC was positively correlated with immediate clinical improvement after treatment and at the 3-month follow-up.
  • Further, participants with higher baseline caudate FC saw a larger reduction in their PTSD symptoms post-treatment.

Conclusions and Implications

  • This study is the first to show that EAT can provoke functional and structural brain changes in patients with PTSD.
  • The observed changes suggest that EAT may influence the responsiveness of the brain’s reward circuitry and encourage a “pruning effect” on the caudate from pre- to post-treatment.
  • Results suggest that EAT could be a beneficial supplementary treatment for PTSD, particularly for individuals who have not responded well to other interventions.

Cite This Article

APA
Zhu X, Suarez-Jimenez B, Zilcha-Mano S, Lazarov A, Arnon S, Lowell AL, Bergman M, Ryba M, Hamilton AJ, Hamilton JF, Turner JB, Markowitz JC, Fisher PW, Neria Y. (2021). Neural changes following equine-assisted therapy for posttraumatic stress disorder: A longitudinal multimodal imaging study. Hum Brain Mapp, 42(6), 1930-1939. https://doi.org/10.1002/hbm.25360

Publication

Human brain mapping
ISSN: 1097-0193
NlmUniqueID: 9419065
Country: United States
Language: English
Volume: 42
Issue: 6
Pages: 1930-1939

Researcher Affiliations

Zhu, Xi
  • Department of Psychiatry, Columbia University, New York, New York, USA.
  • New York State Psychiatric Institute, New York, New York, USA.
Suarez-Jimenez, Benjamin
  • Department of Psychiatry, Columbia University, New York, New York, USA.
  • New York State Psychiatric Institute, New York, New York, USA.
  • Neuroscience Department, University of Rochester, Rochester, New York, USA.
Zilcha-Mano, Sigal
  • Department of Psychology, University of Haifa, Haifa, Israel.
Lazarov, Amit
  • Department of Psychiatry, Columbia University, New York, New York, USA.
  • School of Psychological Sciences, Tel Aviv University, Tel Aviv, Israel.
Arnon, Shay
  • New York State Psychiatric Institute, New York, New York, USA.
Lowell, Ari L
  • Department of Psychiatry, Columbia University, New York, New York, USA.
  • New York State Psychiatric Institute, New York, New York, USA.
  • Memphis Veterans Administration Medical Center, Memphis, Tennessee, USA.
Bergman, Maja
  • New York State Psychiatric Institute, New York, New York, USA.
Ryba, Matthew
  • New York State Psychiatric Institute, New York, New York, USA.
Hamilton, Allan J
  • The University of Arizona Health Sciences, Tucson, Arizona, USA.
Hamilton, Jane F
  • Rancho Bosque Equestrian Center of Excellence, House Hamilton Business Group, PLC, Tucson, Arizona, USA.
Turner, J Blake
  • Department of Psychiatry, Columbia University, New York, New York, USA.
  • New York State Psychiatric Institute, New York, New York, USA.
Markowitz, John C
  • Department of Psychiatry, Columbia University, New York, New York, USA.
  • New York State Psychiatric Institute, New York, New York, USA.
Fisher, Prudence W
  • Department of Psychiatry, Columbia University, New York, New York, USA.
  • New York State Psychiatric Institute, New York, New York, USA.
Neria, Yuval
  • Department of Psychiatry, Columbia University, New York, New York, USA.
  • New York State Psychiatric Institute, New York, New York, USA.
  • Department of Epidemiology, Columbia University Irving Medical Center, New York, New York, USA.

MeSH Terms

  • Adult
  • Caudate Nucleus / diagnostic imaging
  • Caudate Nucleus / pathology
  • Caudate Nucleus / physiopathology
  • Connectome
  • Diffusion Tensor Imaging
  • Equine-Assisted Therapy
  • Female
  • Humans
  • Longitudinal Studies
  • Magnetic Resonance Imaging
  • Male
  • Middle Aged
  • Multimodal Imaging
  • Neuroimaging
  • Reward
  • Stress Disorders, Post-Traumatic / diagnostic imaging
  • Stress Disorders, Post-Traumatic / pathology
  • Stress Disorders, Post-Traumatic / physiopathology
  • Stress Disorders, Post-Traumatic / rehabilitation
  • Treatment Outcome

Grant Funding

  • K01 MH122774 / NIMH NIH HHS

Conflict of Interest Statement

The authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

References

This article includes 46 references
  1. American Psychiatric Association. Diagnostic and statistical manual of mental disorders (5th ed.). 2013.
  2. Anestis MD, Anestis JC, Zawilinski LL, Hopkins TA, Lilienfeld SO. Equine-related treatments for mental disorders lack empirical support: a systematic review of empirical investigations.. J Clin Psychol 2014 Dec;70(12):1115-32.
    doi: 10.1002/jclp.22113pubmed: 24953870google scholar: lookup
  3. Arnon S, Fisher PW, Pickover A, Lowell A, Turner JB, Hilburn A, Jacob-McVey J, Malajian BE, Farber DG, Hamilton JF, Hamilton A, Markowitz JC, Neria Y. Equine-Assisted Therapy for Veterans with PTSD: Manual Development and Preliminary Findings.. Mil Med 2020 Jun 8;185(5-6):e557-e564.
    pmc: PMC7282489pubmed: 32034416doi: 10.1093/milmed/usz444google scholar: lookup
  4. Ashburner J. A fast diffeomorphic image registration algorithm.. Neuroimage 2007 Oct 15;38(1):95-113.
    pubmed: 17761438doi: 10.1016/j.neuroimage.2007.07.007google scholar: lookup
  5. Bachi K, Terkel J, Teichman M. Equine-facilitated psychotherapy for at-risk adolescents: the influence on self-image, self-control and trust.. Clin Child Psychol Psychiatry 2012 Apr;17(2):298-312.
    doi: 10.1177/1359104511404177pubmed: 21757481google scholar: lookup
  6. Beck AT, Steer RA, Ball R, Ranieri W. Comparison of Beck Depression Inventories -IA and -II in psychiatric outpatients.. J Pers Assess 1996 Dec;67(3):588-97.
    doi: 10.1207/s15327752jpa6703_13pubmed: 8991972google scholar: lookup
  7. Blevins CA, Weathers FW, Davis MT, Witte TK, Domino JL. The Posttraumatic Stress Disorder Checklist for DSM-5 (PCL-5): Development and Initial Psychometric Evaluation.. J Trauma Stress 2015 Dec;28(6):489-98.
    doi: 10.1002/jts.22059pubmed: 26606250google scholar: lookup
  8. Bovin MJ, Marx BP, Weathers FW, Gallagher MW, Rodriguez P, Schnurr PP, Keane TM. Psychometric properties of the PTSD Checklist for Diagnostic and Statistical Manual of Mental Disorders-Fifth Edition (PCL-5) in veterans.. Psychol Assess 2016 Nov;28(11):1379-1391.
    doi: 10.1037/pas0000254pubmed: 26653052google scholar: lookup
  9. Calhoun VD, Adali T, Pearlson GD, Pekar JJ. A method for making group inferences from functional MRI data using independent component analysis.. Hum Brain Mapp 2001 Nov;14(3):140-51.
    doi: 10.1002/hbm.1048pmc: PMC6871952pubmed: 11559959google scholar: lookup
  10. Cole DM, Beckmann CF, Searle GE, Plisson C, Tziortzi AC, Nichols TE, Gunn RN, Matthews PM, Rabiner EA, Beaver JD. Orbitofrontal connectivity with resting-state networks is associated with midbrain dopamine D3 receptor availability.. Cereb Cortex 2012 Dec;22(12):2784-93.
    doi: 10.1093/cercor/bhr354pubmed: 22186675google scholar: lookup
  11. Elman I, Lowen S, Frederick BB, Chi W, Becerra L, Pitman RK. Functional neuroimaging of reward circuitry responsivity to monetary gains and losses in posttraumatic stress disorder.. Biol Psychiatry 2009 Dec 15;66(12):1083-90.
    doi: 10.1016/j.biopsych.2009.06.006pubmed: 19640506google scholar: lookup
  12. Eshel N, Roiser JP. Reward and punishment processing in depression.. Biol Psychiatry 2010 Jul 15;68(2):118-24.
    doi: 10.1016/j.biopsych.2010.01.027pubmed: 20303067google scholar: lookup
  13. Espinoza Oyarce DA, Shaw ME, Alateeq K, Cherbuin N. Volumetric brain differences in clinical depression in association with anxiety: a systematic review with meta-analysis.. J Psychiatry Neurosci 2020 Nov 1;45(6):406-429.
    doi: 10.1503/jpn.190156pmc: PMC7595741pubmed: 32726102google scholar: lookup
  14. Fani N, King TZ, Jovanovic T, Glover EM, Bradley B, Choi K, Ely T, Gutman DA, Ressler KJ. White matter integrity in highly traumatized adults with and without post-traumatic stress disorder.. Neuropsychopharmacology 2012 Nov;37(12):2740-6.
    doi: 10.1038/npp.2012.146pmc: PMC3473340pubmed: 22871912google scholar: lookup
  15. Felmingham KL, Falconer EM, Williams L, Kemp AH, Allen A, Peduto A, Bryant RA. Reduced amygdala and ventral striatal activity to happy faces in PTSD is associated with emotional numbing.. PLoS One 2014;9(9):e103653.
    doi: 10.1371/journal.pone.0103653pmc: PMC4153581pubmed: 25184336google scholar: lookup
  16. First M, Williams J, Karg R, Spitzer R. Structured clinical interview for DSM‐5 research version (SCID‐5 for DSM‐5, research version; SCID‐5‐RV). 2015.
  17. Fonzo GA, Goodkind MS, Oathes DJ, Zaiko YV, Harvey M, Peng KK, Weiss ME, Thompson AL, Zack SE, Lindley SE, Arnow BA, Jo B, Gross JJ, Rothbaum BO, Etkin A. PTSD Psychotherapy Outcome Predicted by Brain Activation During Emotional Reactivity and Regulation.. Am J Psychiatry 2017 Dec 1;174(12):1163-1174.
    doi: 10.1176/appi.ajp.2017.16091072pmc: PMC5711543pubmed: 28715908google scholar: lookup
  18. Fonzo GA, Goodkind MS, Oathes DJ, Zaiko YV, Harvey M, Peng KK, Weiss ME, Thompson AL, Zack SE, Mills-Finnerty CE, Rosenberg BM, Edelstein R, Wright RN, Kole CA, Lindley SE, Arnow BA, Jo B, Gross JJ, Rothbaum BO, Etkin A. Selective Effects of Psychotherapy on Frontopolar Cortical Function in PTSD.. Am J Psychiatry 2017 Dec 1;174(12):1175-1184.
    doi: 10.1176/appi.ajp.2017.16091073pmc: PMC5711612pubmed: 28715907google scholar: lookup
  19. HAMILTON M. A rating scale for depression.. J Neurol Neurosurg Psychiatry 1960 Feb;23(1):56-62.
    doi: 10.1136/jnnp.23.1.56pmc: PMC495331pubmed: 14399272google scholar: lookup
  20. Helpman L, Marin MF, Papini S, Zhu X, Sullivan GM, Schneier F, Neria M, Shvil E, Malaga Aragon MJ, Markowitz JC, Lindquist MA, Wager T, Milad M, Neria Y. Neural changes in extinction recall following prolonged exposure treatment for PTSD: A longitudinal fMRI study.. Neuroimage Clin 2016;12:715-723.
    doi: 10.1016/j.nicl.2016.10.007pmc: PMC5065048pubmed: 27761402google scholar: lookup
  21. Helpman L, Papini S, Chhetry BT, Shvil E, Rubin M, Sullivan GM, Markowitz JC, Mann JJ, Neria Y. PTSD REMISSION AFTER PROLONGED EXPOSURE TREATMENT IS ASSOCIATED WITH ANTERIOR CINGULATE CORTEX THINNING AND VOLUME REDUCTION.. Depress Anxiety 2016 May;33(5):384-91.
    doi: 10.1002/da.22471pmc: PMC4846556pubmed: 26864570google scholar: lookup
  22. Holder N, Holliday R, Wiblin J, LePage JP, Surís A. Predictors of dropout from a randomized clinical trial of cognitive processing therapy for female veterans with military sexual trauma-related PTSD.. Psychiatry Res 2019 Jun;276:87-93.
    doi: 10.1016/j.psychres.2019.04.022pubmed: 31030005google scholar: lookup
  23. Kang HK, Natelson BH, Mahan CM, Lee KY, Murphy FM. Post-traumatic stress disorder and chronic fatigue syndrome-like illness among Gulf War veterans: a population-based survey of 30,000 veterans.. Am J Epidemiol 2003 Jan 15;157(2):141-8.
    doi: 10.1093/aje/kwf187pubmed: 12522021google scholar: lookup
  24. Kennis M, van Rooij SJ, Tromp do PM, Fox AS, Rademaker AR, Kahn RS, Kalin NH, Geuze E. Treatment Outcome-Related White Matter Differences in Veterans with Posttraumatic Stress Disorder.. Neuropsychopharmacology 2015 Sep;40(10):2434-42.
    pmc: PMC4538359pubmed: 25837284doi: 10.1038/npp.2015.94google scholar: lookup
  25. Laugharne J, Kullack C, Lee CW, McGuire T, Brockman S, Drummond PD, Starkstein S. Amygdala Volumetric Change Following Psychotherapy for Posttraumatic Stress Disorder.. J Neuropsychiatry Clin Neurosci 2016 Fall;28(4):312-318.
    doi: 10.1176/appi.neuropsych.16010006pubmed: 27255857google scholar: lookup
  26. Levy-Gigi E, Szabó C, Kelemen O, Kéri S. Association among clinical response, hippocampal volume, and FKBP5 gene expression in individuals with posttraumatic stress disorder receiving cognitive behavioral therapy.. Biol Psychiatry 2013 Dec 1;74(11):793-800.
    doi: 10.1016/j.biopsych.2013.05.017pubmed: 23856297google scholar: lookup
  27. Lewis C, Roberts NP, Gibson S, Bisson JI. Dropout from psychological therapies for post-traumatic stress disorder (PTSD) in adults: systematic review and meta-analysis.. Eur J Psychotraumatol 2020;11(1):1709709.
    doi: 10.1080/20008198.2019.1709709pmc: PMC7144189pubmed: 32284816google scholar: lookup
  28. Lindauer RJ, Vlieger EJ, Jalink M, Olff M, Carlier IV, Majoie CB, Den Heeten GJ, Gersons BP. Effects of psychotherapy on hippocampal volume in out-patients with post-traumatic stress disorder: a MRI investigation.. Psychol Med 2005 Oct;35(10):1421-31.
    doi: 10.1017/S0033291705005246pubmed: 16164766google scholar: lookup
  29. Matthew B, Jean‐Luc A, Romain V, Jean‐Baptiste P. Region of interest analysis using an SPM toolbox [abstract]. Presented at the 8th International Conference on Functional Mapping of the Human Brain, 16(2).
  30. Moussa MN, Steen MR, Laurienti PJ, Hayasaka S. Consistency of network modules in resting-state FMRI connectome data.. PLoS One 2012;7(8):e44428.
    doi: 10.1371/journal.pone.0044428pmc: PMC3432126pubmed: 22952978google scholar: lookup
  31. Nisar S, Bhat AA, Hashem S, Syed N, Yadav SK, Uddin S, Fakhro K, Bagga P, Thompson P, Reddy R, Frenneaux MP, Haris M. Genetic and Neuroimaging Approaches to Understanding Post-Traumatic Stress Disorder.. Int J Mol Sci 2020 Jun 24;21(12).
    doi: 10.3390/ijms21124503pmc: PMC7352752pubmed: 32599917google scholar: lookup
  32. Olson EA, Kaiser RH, Pizzagalli DA, Rauch SL, Rosso IM. Anhedonia in Trauma-Exposed Individuals: Functional Connectivity and Decision-Making Correlates.. Biol Psychiatry Cogn Neurosci Neuroimaging 2018 Nov;3(11):959-967.
    doi: 10.1016/j.bpsc.2017.10.008pmc: PMC6233731pubmed: 30409390google scholar: lookup
  33. Pizzagalli DA, Holmes AJ, Dillon DG, Goetz EL, Birk JL, Bogdan R, Dougherty DD, Iosifescu DV, Rauch SL, Fava M. Reduced caudate and nucleus accumbens response to rewards in unmedicated individuals with major depressive disorder.. Am J Psychiatry 2009 Jun;166(6):702-10.
    doi: 10.1176/appi.ajp.2008.08081201pmc: PMC2735451pubmed: 19411368google scholar: lookup
  34. Sailer U, Robinson S, Fischmeister FP, König D, Oppenauer C, Lueger-Schuster B, Moser E, Kryspin-Exner I, Bauer H. Altered reward processing in the nucleus accumbens and mesial prefrontal cortex of patients with posttraumatic stress disorder.. Neuropsychologia 2008 Sep;46(11):2836-44.
    doi: 10.1016/j.neuropsychologia.2008.05.022pubmed: 18597797google scholar: lookup
  35. Sanjuan PM, Thoma R, Claus ED, Mays N, Caprihan A. Reduced white matter integrity in the cingulum and anterior corona radiata in posttraumatic stress disorder in male combat veterans: a diffusion tensor imaging study.. Psychiatry Res 2013 Dec 30;214(3):260-8.
    doi: 10.1016/j.pscychresns.2013.09.002pmc: PMC3988979pubmed: 24074963google scholar: lookup
  36. Schmidt A, Denier N, Magon S, Radue EW, Huber CG, Riecher-Rossler A, Wiesbeck GA, Lang UE, Borgwardt S, Walter M. Increased functional connectivity in the resting-state basal ganglia network after acute heroin substitution.. Transl Psychiatry 2015 Mar 24;5(3):e533.
    doi: 10.1038/tp.2015.28pmc: PMC4354356pubmed: 25803496google scholar: lookup
  37. Selby A, Smith-Osborne A. A systematic review of effectiveness of complementary and adjunct therapies and interventions involving equines.. Health Psychol 2013 Apr;32(4):418-32.
    doi: 10.1037/a0029188pubmed: 22888815google scholar: lookup
  38. Sesack SR, Grace AA. Cortico-Basal Ganglia reward network: microcircuitry.. Neuropsychopharmacology 2010 Jan;35(1):27-47.
    doi: 10.1038/npp.2009.93pmc: PMC2879005pubmed: 19675534google scholar: lookup
  39. Siehl S, King JA, Burgess N, Flor H, Nees F. Structural white matter changes in adults and children with posttraumatic stress disorder: A systematic review and meta-analysis.. Neuroimage Clin 2018;19:581-598.
    doi: 10.1016/j.nicl.2018.05.013pmc: PMC6029559pubmed: 29984166google scholar: lookup
  40. Suarez-Jimenez B, Zhu X, Lazarov A, Mann JJ, Schneier F, Gerber A, Barber JP, Chambless DL, Neria Y, Milrod B, Markowitz JC. Anterior hippocampal volume predicts affect-focused psychotherapy outcome.. Psychol Med 2020 Feb;50(3):396-402.
    doi: 10.1017/S0033291719000187pmc: PMC6698431pubmed: 30773148google scholar: lookup
  41. Sullivan GM, Neria Y. Pharmacotherapy in post-traumatic stress disorder: evidence from randomized controlled trials.. Curr Opin Investig Drugs 2009 Jan;10(1):35-45.
    pmc: PMC3630071pubmed: 19127485
  42. van Rooij SJ, Kennis M, Sjouwerman R, van den Heuvel MP, Kahn RS, Geuze E. Smaller hippocampal volume as a vulnerability factor for the persistence of post-traumatic stress disorder.. Psychol Med 2015 Oct;45(13):2737-46.
    doi: 10.1017/S0033291715000707pubmed: 25936409google scholar: lookup
  43. Volkow ND, Baler RD, Goldstein RZ. Addiction: pulling at the neural threads of social behaviors.. Neuron 2011 Feb 24;69(4):599-602.
    doi: 10.1016/j.neuron.2011.01.027pmc: PMC3188411pubmed: 21338873google scholar: lookup
  44. Yang C, Wu S, Bai Y, Hou C, Gao H. [Voxel based morphometric study of brain structure in patients with posttraumatic stress disorder].. Sheng Wu Yi Xue Gong Cheng Xue Za Zhi 2009 Feb;26(1):30-3.
    pubmed: 19334548
  45. Zhang L, Li W, Shu N, Zheng H, Zhang Z, Zhang Y, He Z, Hou C, Li Z, Liu J, Wang L, Duan L, Jiang T, Li L. Increased white matter integrity of posterior cingulate gyrus in the evolution of post-traumatic stress disorder.. Acta Neuropsychiatr 2012 Feb;24(1):34-42.
    doi: 10.1111/j.1601-5215.2011.00580.xpubmed: 25288457google scholar: lookup
  46. Zhu X, Suarez-Jimenez B, Lazarov A, Helpman L, Papini S, Lowell A, Durosky A, Lindquist MA, Markowitz JC, Schneier F, Wager TD, Neria Y. Exposure-based therapy changes amygdala and hippocampus resting-state functional connectivity in patients with posttraumatic stress disorder.. Depress Anxiety 2018 Oct;35(10):974-984.
    doi: 10.1002/da.22816pmc: PMC6168398pubmed: 30260530google scholar: lookup

Citations

This article has been cited 13 times.
  1. Marchand WR. Potential Mechanisms of Action and Outcomes of Equine-Assisted Services for Veterans with a History of Trauma: A Narrative Review of the Literature. Int J Environ Res Public Health 2023 Jul 16;20(14).
    doi: 10.3390/ijerph20146377pubmed: 37510609google scholar: lookup
  2. Mo X, He M, Zhou L, Liu Y, Zhu H, Huang X, Zeng G, Zhang J, Li L. Mapping structural covariance networks in children and adolescents with post-traumatic stress disorder after earthquake. Front Psychiatry 2022;13:923572.
    doi: 10.3389/fpsyt.2022.923572pubmed: 36186852google scholar: lookup
  3. Berardi A, Di Napoli G, Ernesto M, Fabbrini G, Conte A, Ferrazzano G, Viselli F, Galeoto G. The Effectiveness of Equine Therapy Intervention on Activities of Daily Living, Quality of Life, Mood, Balance and Gait in Individuals with Parkinson's Disease. Healthcare (Basel) 2022 Mar 17;10(3).
    doi: 10.3390/healthcare10030561pubmed: 35327039google scholar: lookup
  4. Kolla NJ, Smaragdi A, Gainham G, Karas KH, Hawco C, Haas J, Skilling TA, Walsh M, Augimeri L. Psychosocial Intervention for Youth With High Externalizing Behaviors and Aggression Is Associated With Improvement in Impulsivity and Brain Gray Matter Volume Changes. Front Psychiatry 2021;12:788240.
    doi: 10.3389/fpsyt.2021.788240pubmed: 35087430google scholar: lookup
  5. Tumlin K, Liu S, Park JH. Framing Future of Work Considerations through Climate and Built Environment Assessment of Volunteer Work Practices in the United States Equine Assisted Services. Int J Environ Res Public Health 2021 Oct 2;18(19).
    doi: 10.3390/ijerph181910385pubmed: 34639685google scholar: lookup
  6. Held A, Hubbard K, Nazarenko E, Marchand W. A Pilot Observational Study in Ohio, USA of the Healing of Our Veterans Equine Services Intensive Intervention for Veterans with Trauma Histories. Healthcare (Basel) 2025 Nov 28;13(23).
    doi: 10.3390/healthcare13233111pubmed: 41373328google scholar: lookup
  7. Kowalski H, Van Buiten H, Hopkins P, Baldwin C, Nazarenko E, Marchand WR. A Multi-Site Observational Evaluation of the Equine Assisted Growth and Learning Association Model of Equine-Assisted Psychotherapy for Veteran Trauma Survivors. Int J Environ Res Public Health 2025 Oct 13;22(10).
    doi: 10.3390/ijerph22101557pubmed: 41154961google scholar: lookup
  8. Lanning BA, Smith CM, Ugale C, Nazarenko E, Marchand WR. Using Functional Near-Infrared Spectroscopy to Elucidate Neurophysiological Mechanism of Action of Equine-Assisted Services: Proof-of-Concept Study. Int J Environ Res Public Health 2025 Aug 19;22(8).
    doi: 10.3390/ijerph22081294pubmed: 40869879google scholar: lookup
  9. Kapteijn C, Reinders N, Hueting M, Van Huffelen RA, Vermetten E, Rodenburg B, Endenburg N. Are Equine Assisted Interactions (EAI) a Dark Horse Bet? A Systematic Review on Measuring the Psychological and Physiological Effects of EAI on PTSD, Anxiety and/or Mood Disorders. Psychiatry Clin Psychopharmacol 2025 Aug 11;35(Suppl 1):S90-S112.
    doi: 10.5152/pcp.2025.24958pubmed: 40865011google scholar: lookup
  10. Zhang H, Hu Y, Yu Y, Zhou Z, Sun Y, Qi C, Yang L, Xie H, Zhang J, Zhu H. The value of multimodal neuroimaging in the diagnosis and treatment of post-traumatic stress disorder: a narrative review. Transl Psychiatry 2025 Jun 20;15(1):208.
    doi: 10.1038/s41398-025-03416-1pubmed: 40541953google scholar: lookup
  11. Provan M, Ahmed Z, Stevens AR, Sardeli AV. Are equine-assisted services beneficial for military veterans with post-traumatic stress disorder? A systematic review and meta-analysis. BMC Psychiatry 2024 Aug 1;24(1):544.
    doi: 10.1186/s12888-024-05984-wpubmed: 39085783google scholar: lookup
  12. Rankins EM, Quinn A, McKeever KH, Malinowski K. Ground-based adaptive horsemanship lessons for veterans with post-traumatic stress disorder: a randomized controlled pilot study. Front Psychiatry 2024;15:1390212.
    doi: 10.3389/fpsyt.2024.1390212pubmed: 38863605google scholar: lookup
  13. Burback L, Brémault-Phillips S, Nijdam MJ, McFarlane A, Vermetten E. Treatment of Posttraumatic Stress Disorder: A State-of-the-art Review. Curr Neuropharmacol 2024;22(4):557-635.
    doi: 10.2174/1570159X21666230428091433pubmed: 37132142google scholar: lookup
Subscribe to our newsletter
Join 99,357 horse owners like you who receive our email updates on horse health and nutrition.