Using Functional Near-Infrared Spectroscopy to Elucidate Neurophysiological Mechanism of Action of Equine-Assisted Services: Proof-of-Concept Study.
Abstract: Equine-assisted services (EAS) are used for civilian and military trauma survivors to reduce depression and posttraumatic stress symptoms. While early scientific evidence supports the benefits of EAS, the neurophysiological mechanisms underlying these benefits are unknown. The specific aims of this exploratory study were to determine (1) whether functional near-infrared spectroscopy (fNIRS) neuroimaging can be used to explore neural responses of EAS veteran participants and (2) the correlation between neural responses and psychological outcomes of the participants interacting with equines. Fifteen veterans participated in a 2-day EAS program consisting of four randomized activities. An fNIRS sensor cap was used to measure the oxygenated (OHb), deoxygenated (hHb), and total hemoglobin (tHb) of the participants during each activity. The results indicated no significant differences for OHb and tHb across the visits or activities, however, a significant difference in hHb was observed. There was an increase in hHb during the activities that included an equine, which indicated a greater cognitive load and attention. Further, data from pre-/post-psychometric assessments showed a significant improvement in participants' trait anxiety, psychological flexibility, and positive and negative affect after interacting with the horse. Preliminary data revealed a potential association between the cognitive attention and psychological health of participants during an EAS session.
Publication Date: 2025-08-19 PubMed ID: 40869879PubMed Central: PMC12386777DOI: 10.3390/ijerph22081294Google 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.
- Journal Article
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.
Overview
- This study investigated whether functional near-infrared spectroscopy (fNIRS) can be used to measure brain activity during equine-assisted services (EAS) in veterans and explored how these neural responses relate to improvements in psychological outcomes such as anxiety and affect.
Introduction to Equine-Assisted Services and Research Focus
- EAS are therapeutic activities involving horses, used to help trauma survivors, including military veterans, to reduce symptoms of depression and posttraumatic stress disorder (PTSD).
- Although prior studies show EAS benefits, the brain mechanisms underlying these positive effects are not yet clearly understood.
- The study aimed to explore neurophysiological responses during EAS using functional near-infrared spectroscopy (fNIRS), a non-invasive neuroimaging technique that measures brain oxygenation changes.
- Specifically, the study investigated:
- Whether fNIRS could be effectively applied to veterans participating in EAS to capture neural activity.
- The relationship between neural activity during EAS and psychological measures such as anxiety, flexibility, and mood.
Study Design and Methods
- Participants:
- 15 veterans with trauma-related symptoms took part in the study.
- Intervention:
- A 2-day EAS program where participants completed four different randomized activities, some involving direct interaction with horses and others not.
- Data Collection:
- fNIRS sensor caps recorded hemoglobin metrics during each activity:
- Oxygenated hemoglobin (OHb)
- Deoxygenated hemoglobin (hHb)
- Total hemoglobin (tHb)
- Psychometric assessments were administered before and after the EAS sessions measuring:
- Trait anxiety
- Psychological flexibility
- Positive and negative affect (mood)
- fNIRS sensor caps recorded hemoglobin metrics during each activity:
Key Findings
- Neural Measures:
- No significant changes were found in oxygenated (OHb) and total hemoglobin (tHb) levels during the activities across visits.
- Significant increase in deoxygenated hemoglobin (hHb) was observed during activities involving interaction with the horses, suggesting higher cognitive load and mental attention during these tasks.
- Psychological Outcomes:
- Participants showed significant improvements in:
- Trait anxiety – indicating reduced general anxiety
- Psychological flexibility – suggesting better adaptive coping mechanisms
- Positive and negative affect – improved mood and emotional state
- Participants showed significant improvements in:
- Potential Correlations:
- Preliminary data indicated a possible association between increased cognitive attention (as measured by hHb changes) during EAS and enhanced psychological health.
- This suggests that neural engagement during horse interaction may relate to therapeutic benefits.
Implications and Conclusions
- This study demonstrates that fNIRS is a feasible tool to assess brain activity during EAS activities in trauma-affected veterans.
- The observed increase in deoxygenated hemoglobin during horse-related tasks points to heightened cognitive effort or attention when engaging with equines.
- Improved psychological outcomes post-EAS support the potential utility of equine-assisted therapies for mental health amelioration in trauma survivors.
- The correlation between neural markers of attention and psychological improvement provides preliminary evidence toward understanding the neurophysiological mechanism of action in EAS.
- Future larger-scale studies can build on these findings to confirm these relationships and optimize EAS protocols for maximum therapeutic effect.
Cite This Article
APA
Lanning BA, Smith CM, Ugale C, Nazarenko E, Marchand WR.
(2025).
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, 22(8), 1294.
https://doi.org/10.3390/ijerph22081294 Publication
Researcher Affiliations
- Department of Public Health, Baylor University, Waco, TX 76655, USA.
- Department of Health, Human Performance and Recreation, Baylor University, Waco, TX 76655, USA.
- Department of Health, Human Performance and Recreation, Baylor University, Waco, TX 76655, USA.
- Whole Health Service, VA Salt Lake City Health Care System, 500 Foothill Drive, Salt Lake City, UT 84108, USA.
- Whole Health Service, VA Salt Lake City Health Care System, 500 Foothill Drive, Salt Lake City, UT 84108, USA.
- Department of Psychiatry, University of Utah, 501 Chipeta Way, Salt Lake City, UT 84108, USA.
- Department of Animal, Dairy and Veterinary Sciences, Utah State University, 0500 Old Main Hill, Logan, UT 84322, USA.
MeSH Terms
- Spectroscopy, Near-Infrared / methods
- Humans
- Male
- Animals
- Horses
- Equine-Assisted Therapy
- Female
- Adult
- Middle Aged
- Veterans / psychology
- Proof of Concept Study
- Stress Disorders, Post-Traumatic / therapy
- Hemoglobins / analysis
- Depression / therapy
Grant Funding
- 1001663 / Horses and Humans Research Foundation
Conflict of Interest Statement
The authors declare no conflicts of interest.
References
This article includes 49 references
- Goldstein RB, Smith SM, Chou SP, Saha TD, Jung J, Zhang H, Pickering RP, Ruan WJ, Huang B, Grant BF. The epidemiology of DSM-5 posttraumatic stress disorder in the United States: Results from the national epidemiologic survey on alcohol and related conditions-III. Soc. Psychiatry Psychiatr. Epidemiol. 2016;51:1137–1148.
- American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders (DSM-5). 2013.
- Kessler RC, Wang PS. The descriptive epidemiology of commonly occurring mental disorders in the United States. Ann. Rev. Public Health 2008;29:115–129.
- Lang AJ, Hamblen JL, Holtzheimer P, Kelly U, Norman SB, Riggs D, Schnurr PP, Wiechers I. A clinician’s guide to the 2023 VA/DOD clinical practice guideline for management of posttraumatic stress disorder and acute stress disorder. J. Traum. Stress 2024;37:19–34.
- Vella EJ, Milligan B, Bennett JL. Participation in outdoor recreation program predicts improved psychosocial well-being among veterans with post-traumatic stress disorder: A pilot study. Mil. Med. 2013;178:254–260.
- Sylvia L, West E, Blackburn AM, Gupta C, Bui E, Mahoney T, Duncan G, Wright EC, Lejeune S, Spencer TJ. Acceptability of an adjunct equine-assisted activities and therapies program for veterans with posttraumatic stress disorder and/or traumatic brain injury. J. Integr. Med. 2020;18:169–173.
- Steenkamp MM, Litz BT, Hoge CW, Marmar CR. Psychotherapy for military-related PTSD: A review of randomized clinical trials. JAMA 2015;314:489–500.
- Kehle-Forbes SM, Chen S, Polusny MA, Lynch KG, Koffel E, Ingram E, Foa EB, Van Horn DHA, Drapkin ML, Yusko DA. A randomized controlled trial evaluating integrated versus phased application of evidence-based psychotherapies for military veterans with comorbid PTSD and substance use disorders. Drug Alcohol Depen. 2019;205:107647.
- Wood W, Alm K, Benjamin J, Thomas L, Anderson D, Pohl L, Kane M. Optimal terminology for services in the United States that incorporate horses to benefit people: A consensus document. J. Alt. Compl. Med. 2021;27:88–95.
- 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;24:544.
- Bachi K. Application of Attachment Theory to Equine-Facilitated Psychotherapy. J. Contemp. Psychother. 2013;43:187–196.
- Meola CC. Addressing the needs of the millennial workforce through equine assisted learning. J. Manag. Dev. 2016;35:294–303.
- Rentko VT, Warner AE, Timlege E, Richman E. Equine-assisted learning—An experiential, facilitated learning model for development of professional skills and resiliency in veterinary students. J. Vet. Med. Edu. 2023;50:413–420.
- Lanning BA, Wilson AL, Krenek N, Beaujean AA. Using therapeutic riding as an intervention for combat veterans: An international classification of functioning, disability, and health (ICF) approach. Occup. Ther. Ment. Health 2017;33:259–278.
- Shelef A, Brafman D, Rosing T, Weizman A, Stryjer R, Barak Y. Equine assisted therapy for patients with post traumatic stress disorder: A case series study. Mil. Med. 2019;184:394–399.
- Marchand W.R.. Potential mechanisms of action and outcomes of equine-assisted services for veterans with a history of trauma: A narrative review of literature.. Int. J. Environ. Res. Public Health 2023;20:6377.
- Kinney A.R., Eakman A.M., Lassell R., Wood W.. Equine-assisted interventions for veterans with service-related health conditions: A systematic mapping review.. Mil. Med. Res. 2019;6:28.
- Marchand W.R., Andersen S.J., Smith J.E., Hoopes K.H., Carlson J.K.. Equine-assisted activities and therapies for veterans with posttraumatic stress disorder: Current state, challenges and future directions.. Chronic Stress 2021;5:2470547021991556.
- García-Gómez A., Guerrero-Barona E., García-Peña I., Rodríguez-Jiménez M., Moreno-Manso J.M.. Equine-assisted therapeutic activities and their influence on the heart rate variability: A systematic review.. Compl. Ther. Clin. Pract. 2020;39:101167.
- McDuffee L.A., Montelpare W.J., LeBlanc C.. Psychophysiological effects of equine-facilitated psychotherapy on veterans with PTSD and their horse partners.. J. Mil. Veteran Fam. Health. 2024;10:135–147.
- Zhu X., Suarez-Jimenez B., Zilcha-Mano S., Lazarov A., Arnon S., Lowell A.L., Bergman M., Ryba M., Hamilton A.J., Hamilton J.F.. Neural changes following equine-assisted therapy for posttraumatic stress disorder: A longitudinal multimodal imaging study.. Hum. Brain Mapp. 2021;42:1930–1939.
- Ben-Zion Z., Korem N., Fine N.B., Katz S., Siddhanta M., Funaro M.C., Duek O., Spiller T.R., Danböck S.K., Levy I.. Structural neuroimaging of hippocampus and amygdala subregions in posttraumatic stress disorder: A scoping review.. Biol. Psychiat. Glob. Open Sci. 2024;4:120–134.
- Balters S., Li R., Espil F.M., Piccirilli A., Liu N., Gundran A., Carrion V.G., Weems C.F., Cohen J.A., Reiss A.L.. Functional near-infrared spectroscopy brain imaging predicts symptom severity in youth exposed to traumatic stress.. J. Psychiat. Res. 2021;144:494–502.
- Gramlich M.A., Neer S.M., Beidel D.C., Bohil C.J., Bowers C.A.. A functional near-infrared spectroscopy study of trauma-related auditory and olfactory cues: Posttraumatic stress disorder or combat experience?. J. Trauma Stress. 2017;30:656–665.
- Kalanadhabhatta M., Roy S., Grant T., Salekin A., Rahman T., Bergen-Cico D.. Detecting PTSD using neural and physiological signals: Recommendations from a pilot study. Proceedings of the 2023 11th International Conference on Affective Computing and Intelligent Interaction (ACII); Cambridge, MA, USA. 10–13 September 2023; pp. 1–8.
- Cazzell M., Li L., Lin Z.J., Patel S.J., Liu H.. Comparison of neural correlates of risk decision making between genders: An exploratory fNIRS study of the Balloon Analogue Risk Task (BART). Neuroimage 2012;62:1896–1911.
- Saleem S., Hussain M.M., Majeed S.M., Khan M.A.. Gender differences of heart rate variability in healthy volunteers.. J. Pak. Med. Assoc. 2012;62:422–425.
- Verkuil B., Brosschot J.F., Marques A.H., Kampschroer K., Sternberg E.M., Thayer J.F.. Gender differences in the impact of daily sadness on 24-h heart rate variability.. Psychophysiology 2015;52:1682–1688.
- Helpman L., Suarez-Jimenez B., Lazarov A., Monk C., Neria Y.. Sex differences in trauma-related psychopathology: A critical review of neuroimaging literature (2014–2017). Curr. Psychiatry Rep. 2017;19:104.
- Marchand W.R., Lackner R., Hartquist A., Finnell L., Nazarenko E.. Evaluation of a mindfulness and self-compassion-based psychotherapy incorporating horses for veterans who have experienced trauma.. Compl. Ther. Med. 2023;72:102914.
- Professional Association of Therapeutic Horsemanship International. [(accessed on 6 December 2024)]. Available online: https://www.pathintl.org/
- Holtzer R., Mahoney J.R., Izzetoglu M., Izzetoglu K., Onaral B., Verghese J.. fNIRS study of walking and walking while talking in young and old individuals.. J. Gerontol. Biol. Sci. Med. Sci. 2011;66:879–887.
- Suzuki M., Miyai I., Ono T., Kubota K.. Activities in the frontal cortex and gait performance are modulated by preparation. An fNIRS study.. Neuroimage 2008;39:600–607.
- Yanagisawa H., Dan I., Tsuzuki D., Kato M., Okamoto M., Kyutoku Y., Soya H.. Acute moderate exercise elicits increased dorsolateral prefrontal activation and improves cognitive performance with Stroop test.. Neuroimage 2010;50:1702–1710.
- Bond F.W., Hayes S.C., Baer R.A., Carpenter K.M., Guenole N., Orcutt H.K., Waltz T., Zettle R.D.. Preliminary psychometric properties of the Acceptance and Action Questionnaire-II: A revised measure of psychological inflexibility and experiential avoidance.. Behav. Therapy 2011;42:676–688.
- Marteau T.M., Bekker H.. The development of a six-item short-form of the State Scale of the Spielberger State-Trait Anxiety Inventory (STAI). Br. J. Clin. Psychol. 1992;31:301–306.
- Watson D., Clark L.A., Tellegen A.. Development and validation of brief measures of Positive and Negative Affect: The PANAS Scales.. J. Pers. Soc. Psychol. 1988;54:1063–1070.
- Yoo J.H., Oh Y., Jang B., Song J., Kim J., Kim S., Lee J., Shin H.Y., Kwon J.Y., Kim Y.H.. The effects of equine-assisted activities and therapy on resting-state brain function in attention-deficit/hyperactivity disorder: A pilot study.. Clin. Psychopharmacol. Neurosci. 2016;14:357–364.
- Carius D., Herold F., Clauss M., Kaminski E., Wagemann F., Sterl C., Ragert P.. Increased cortical activity in novices compared to experts during table tennis: A whole-brain fNIRS study using threshold-free cluster enhancement analysis.. Brain Topogr. 2023;36:500–516.
- Tempest G.D., Reiss A.L.. The utility of functional near-infrared spectroscopy for measuring cortical activity during cycling exercise.. Med. Sci. Sports Exerc. 2019;51:979–987.
- Jones J.L.. Horse Brain, Human Brain: The Neuroscience of Horsemanship.. Trafalgar Square Books; North Pomfret, VT, USA: 2020.
- Miller E.K., Cohen J.D.. An integrative theory of prefrontal cortex function.. Annu. Rev. Neurosci. 2001;24:167–202.
- Gunaydin L.A., Kreitzer A.C.. Cortico–basal ganglia circuit function in psychiatric disease.. Ann. Rev. Physiol. 2016;78:327–350.
- Marchand W.R., Joubert K., Smith J., Nazarenko E., Klinger W., Sheppard S., Hoopes K.H.. A pilot observational study of implementing an equine-a ssisted services program within a VA medical center residential substance use disorder treatment program.. Mil. Med. 2023;188:e2175–e2180.
- Monroe M., Whitworth J.D., Wharton T., Turner J.. Effects of an equine-assisted therapy program for military veterans with self-reported PTSD.. Soc. Anim. 2019;29:577–590.
- Romaniuk M., Evans J., Kidd C.. Evaluation of an equine-assisted therapy program for veterans who identify as 'wounded, injured or ill' and their partners.. PLoS ONE 2018;13:e0203943.
- Gehrke E.K., Noquez A.E., Ranke P.L., Myers M.P.. Measuring the psychophysiological changes in combat veterans participating in an equine therapy program.. J. Mil. Veteran Fam. Health. 2018;4:60–69.
- Gehrke E.K., Tontz P., Bhawal R., Schiltz P., Mendez S., Myers M.P.. A mixed-method analysis of an equine complementary therapy program to heal combat veterans.. J. Compl. Alter. Healthc. 2018;8:555739.
- Fisher P.W., Lazarov A., Lowell A., Arnon S., Turner B., Bergman M., Ryba M., Such S., Marohasy C., Zhu X.. Equine-assisted therapy for posttraumatic stress disorder among military veterans: An open trial.. J. Clin. Psychiatry. 2021;82:36449.
Citations
This article has been cited 0 times.Use Nutrition Calculator
Check if your horse's diet meets their nutrition requirements with our easy-to-use tool Check your horse's diet with our easy-to-use tool
Talk to a Nutritionist
Discuss your horse's feeding plan with our experts over a free phone consultation Discuss your horse's diet over a phone consultation
Submit Diet Evaluation
Get a customized feeding plan for your horse formulated by our equine nutritionists Get a custom feeding plan formulated by our nutritionists