Cognitive behavioral therapy may have a rehabilitative, not normalizing, effect on functional connectivity in adolescent depression.


Journal

Journal of affective disorders
ISSN: 1573-2517
Titre abrégé: J Affect Disord
Pays: Netherlands
ID NLM: 7906073

Informations de publication

Date de publication:
01 05 2020
Historique:
received: 23 08 2019
revised: 05 12 2019
accepted: 20 01 2020
pubmed: 12 3 2020
medline: 16 2 2021
entrez: 12 3 2020
Statut: ppublish

Résumé

Whether the differences in brain structure and function, characteristic of adult major depressive disorder (MDD 128 adolescent MDD patients and 40 adolescent controls were enrolled in the study. We investigated pre-treatment differences in cortical thickness, white matter volume, and resting-state functional connectivity. We also investigated the longitudinal effects of CBT on resting-state functional connectivity, and the relationship between pre-treatment functional disruption and CBT-related changes to resting-state functional connectivity was assessed by the correlation of pre-treatment cross-sectional effects and longitudinal CBT-related effects across multiple brain regions. Patients had greater cortical thickness and white matter volume within fronto-limbic regions of the brain. Patients had greater pre-treatment resting-state functional connectivity within the default-mode, fronto-limbic, central-executive, and salience networks. CBT increased resting-state functional connectivity of the subgenual anterior cingulate and amygdala seeds with predominantly frontal regions. Regions showing the greatest pre-treatment functional disruption showed the weakest CBT-related changes. For ethical reasons, there was no placebo group. Adolescent MDD is associated with structural and functional differences also seen in adult patients. CBT-related changes in resting-state functional connectivity do not appear to show a normalizing effect, but instead indicate rehabilitative effects on resting-state functional connectivity.

Sections du résumé

BACKGROUND
Whether the differences in brain structure and function, characteristic of adult major depressive disorder (MDD
METHODS
128 adolescent MDD patients and 40 adolescent controls were enrolled in the study. We investigated pre-treatment differences in cortical thickness, white matter volume, and resting-state functional connectivity. We also investigated the longitudinal effects of CBT on resting-state functional connectivity, and the relationship between pre-treatment functional disruption and CBT-related changes to resting-state functional connectivity was assessed by the correlation of pre-treatment cross-sectional effects and longitudinal CBT-related effects across multiple brain regions.
RESULTS
Patients had greater cortical thickness and white matter volume within fronto-limbic regions of the brain. Patients had greater pre-treatment resting-state functional connectivity within the default-mode, fronto-limbic, central-executive, and salience networks. CBT increased resting-state functional connectivity of the subgenual anterior cingulate and amygdala seeds with predominantly frontal regions. Regions showing the greatest pre-treatment functional disruption showed the weakest CBT-related changes.
LIMITATIONS
For ethical reasons, there was no placebo group.
CONCLUSIONS
Adolescent MDD is associated with structural and functional differences also seen in adult patients. CBT-related changes in resting-state functional connectivity do not appear to show a normalizing effect, but instead indicate rehabilitative effects on resting-state functional connectivity.

Identifiants

pubmed: 32157998
pii: S0165-0327(19)32251-7
doi: 10.1016/j.jad.2020.01.103
pii:
doi:

Types de publication

Journal Article Research Support, Non-U.S. Gov't

Langues

eng

Sous-ensembles de citation

IM

Pagination

1-11

Subventions

Organisme : Medical Research Council
ID : G0802226
Pays : United Kingdom
Organisme : Department of Health
ID : 06-05-01
Pays : United Kingdom
Organisme : Wellcome Trust
ID : 095844/Z/11/Z
Pays : United Kingdom

Informations de copyright

Copyright © 2020. Published by Elsevier B.V.

Déclaration de conflit d'intérêts

Declaration of Competing Interest Luca Villa, Professor Suckling, Dr. Wilkinson, Dr. Tait, and Professor Reynolds have no conflicts of interest to disclose. Professor Ian Goodyer has received consulting fees from Lundbeck Pharmaceuticals and is supported by a strategic award from the Wellcome Trust (095844/Z/11/Z). Dr. Raphael Kelvin has received consulting fees from Lundbeck Pharmaceuticals.

Auteurs

L M Villa (LM)

Department of Psychiatry, University of Cambridge, Herchel Smith Building, Robinson Way, Cambridge CB2 0SZ, United Kingdom. Electronic address: lmv31@cam.ac.uk.

I M Goodyer (IM)

Department of Psychiatry, University of Cambridge, Herchel Smith Building, Robinson Way, Cambridge CB2 0SZ, United Kingdom.

R Tait (R)

Faculty of Computing, Engineering and the Built Environment, Birmingham City University, United Kingdom.

R Kelvin (R)

Department of Psychiatry, University of Cambridge, Herchel Smith Building, Robinson Way, Cambridge CB2 0SZ, United Kingdom; The Royal College of Psychiatrists, United Kingdom; The Association for Child and Adolescent Mental Health, United Kingdom.

S Reynolds (S)

School of Psychology and Clinical Language Sciences, University of Reading, United Kingdom; Charlie Waller Institute, University of Reading, United Kingdom.

P O Wilkinson (PO)

Department of Psychiatry, University of Cambridge, Herchel Smith Building, Robinson Way, Cambridge CB2 0SZ, United Kingdom; Cambridge and Peterborough NHS Foundation Trust, United Kingdom.

J Suckling (J)

Department of Psychiatry, University of Cambridge, Herchel Smith Building, Robinson Way, Cambridge CB2 0SZ, United Kingdom; Behavioural and Clinical Neuroscience Institute, University of Cambridge, United Kingdom; NIHR Cambridge Biomedical Research Centre, United Kingdom; Cambridge and Peterborough NHS Foundation Trust, United Kingdom.

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