Brain functional effects of cognitive behavioral therapy for depression: A systematic review of task-based fMRI studies.

Brain function Cognitive behavioral therapy Depression Neuroimaging Psychotherapy fMRI

Journal

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

Informations de publication

Date de publication:
17 Sep 2024
Historique:
received: 23 04 2024
revised: 26 08 2024
accepted: 14 09 2024
medline: 20 9 2024
pubmed: 20 9 2024
entrez: 19 9 2024
Statut: aheadofprint

Résumé

Depressive disorders are associated with alterations in brain function, affecting processes such as affective and reward processing and emotion regulation. However, the influence of Cognitive Behavioral Therapy (CBT) on the neuronal patterns remains inadequately understood. Therefore, this review systematically summarizes longitudinal fMRI brain activity changes in depressive patients treated with CBT and their association with symptom remission. This systematic review was conducted according to the PRISMA statement. Out of 2149 results of the literature search, N = 14 studies met the inclusion criteria (e.g., diagnosis of a current depressive disorder, assessment of longitudinal task-based fMRI, and the analysis of functional changes before and after CBT). The findings reveal (1) diminished limbic reactivity following CBT across various tasks, (2) increased striatal activity during reward processing, but decreased activity during affective processing and future thinking, and (3) alterations in cingulate and prefrontal cortex activity across tasks. Partially, these results are associated with symptom remission, especially in the subgenual anterior cingulate cortex. There are heterogenous results especially in cortical areas that might partially be due to methodological issues like differences across the studies in terms of task content, statistical evaluation, and interventions. Thus, future research should focus on the standardization of methodologies. The results indicate that CBT partially normalizes the neural patterns of depressive patients, particularly within regions involved in affective and reward processing and the development of negative cognitive biases. Overall, potential neural mechanisms underlying CBT were identified, underscoring its effectiveness on an objective neurobiological basis.

Sections du résumé

BACKGROUND BACKGROUND
Depressive disorders are associated with alterations in brain function, affecting processes such as affective and reward processing and emotion regulation. However, the influence of Cognitive Behavioral Therapy (CBT) on the neuronal patterns remains inadequately understood. Therefore, this review systematically summarizes longitudinal fMRI brain activity changes in depressive patients treated with CBT and their association with symptom remission.
METHODS METHODS
This systematic review was conducted according to the PRISMA statement. Out of 2149 results of the literature search, N = 14 studies met the inclusion criteria (e.g., diagnosis of a current depressive disorder, assessment of longitudinal task-based fMRI, and the analysis of functional changes before and after CBT).
RESULTS RESULTS
The findings reveal (1) diminished limbic reactivity following CBT across various tasks, (2) increased striatal activity during reward processing, but decreased activity during affective processing and future thinking, and (3) alterations in cingulate and prefrontal cortex activity across tasks. Partially, these results are associated with symptom remission, especially in the subgenual anterior cingulate cortex.
LIMITATIONS CONCLUSIONS
There are heterogenous results especially in cortical areas that might partially be due to methodological issues like differences across the studies in terms of task content, statistical evaluation, and interventions. Thus, future research should focus on the standardization of methodologies.
CONCLUSIONS CONCLUSIONS
The results indicate that CBT partially normalizes the neural patterns of depressive patients, particularly within regions involved in affective and reward processing and the development of negative cognitive biases. Overall, potential neural mechanisms underlying CBT were identified, underscoring its effectiveness on an objective neurobiological basis.

Identifiants

DOI: 10.1016/j.jad.2024.09.084 PMID: 39299583
pubmed: 39299583
pii: S0165-0327(24)01574-X
doi: 10.1016/j.jad.2024.09.084
pii:
doi:

Types de publication

Journal Article Review

Langues

eng

Sous-ensembles de citation

IM

Informations de copyright

Copyright © 2024. Published by Elsevier B.V.

Déclaration de conflit d'intérêts

Declaration of competing interest None.

Auteurs

Philine König (P)

Department of Psychology, University of Halle, Germany. Electronic address: philine.koenig@psych.uni-halle.de.

Esther Zwiky (E)

Department of Psychology, University of Halle, Germany.

Antonia Küttner (A)

Department of Psychology, University of Halle, Germany.

Marie Uhlig (M)

Department of Psychology, University of Halle, Germany; German Center for Mental Health, Germany; Center for Intervention and Research on adaptive and maladaptive brain Circuits (CIRC), Germany.

Ronny Redlich (R)

Department of Psychology, University of Halle, Germany; Institute of Translational Psychiatry, University of Muenster, Germany; German Center for Mental Health, Germany; Center for Intervention and Research on adaptive and maladaptive brain Circuits (CIRC), Germany.

Classifications MeSH