|Title||Cognitive behavioral therapy increases amygdala connectivity with the cognitive control network in both MDD and PTSD.|
|Publication Type||Journal Article|
|Year of Publication||2017|
|Authors||Shou, H, Yang, Z, Satterthwaite, TD, Cook, PA, Bruce, SE, Shinohara, RT, Rosenberg, B, Sheline, YI|
|Keywords||Adult, Amygdala, Brain Mapping, Cognition Disorders, Cognitive Therapy, Depressive Disorder, Major, Female, Humans, Imaging, Three-Dimensional, Longitudinal Studies, Magnetic Resonance Imaging, Male, Neural Pathways, Neuropsychological Tests, Principal Component Analysis, Stress Disorders, Post-Traumatic, Treatment Outcome, Young Adult|
BACKGROUND: Both major depressive disorder (MDD) and post-traumatic stress disorder (PTSD) are characterized by alterations in intrinsic functional connectivity. Here we investigated changes in intrinsic functional connectivity across these disorders as a function of cognitive behavioral therapy (CBT), an effective treatment in both disorders.
METHODS: 53 unmedicated right-handed participants were included in a longitudinal study. Patients were diagnosed with PTSD ( = 18) and MDD ( = 17) with a structured diagnostic interview and treated with 12 sessions of manualized CBT over a 12-week period. Patients received an MRI scan (Siemens 3 T Trio) before and after treatment. Longitudinal functional principal components analysis (LFPCA) was performed on functional connectivity of the bilateral amygdala with the fronto-parietal network. A matched healthy control group ( = 18) was also scanned twice for comparison.
RESULTS: LFPCA identified four eigenimages or principal components (PCs) that contributed significantly to the longitudinal change in connectivity. The second PC differentiated CBT-treated patients from controls in having significantly increased connectivity of the amygdala with the fronto-parietal network following CBT.
LIMITATIONS: Analysis of CBT-induced amygdala connectivity changes was restricted to the a priori determined fronto-parietal network. Future studies are needed to determine the generalizability of these findings, given the small and predominantly female sample.
CONCLUSION: We found evidence for the hypothesis that CBT treatment is associated with changes in connectivity between the amygdala and the fronto-parietal network. CBT may work by strengthening connections between the amygdala and brain regions that are involved in cognitive control, potentially providing enhanced top-down control of affective processes that are dysregulated in both MDD and PTSD.
|Alternate Journal||Neuroimage Clin|
|PubMed Central ID||PMC5331144|
|Grant List||K24 MH079510 / MH / NIMH NIH HHS / United States |
R01 MH098260 / MH / NIMH NIH HHS / United States
R21 NS093349 / NS / NINDS NIH HHS / United States
RC1 MH089704 / MH / NIMH NIH HHS / United States
R01 MH064821 / MH / NIMH NIH HHS / United States
R01 NS085211 / NS / NINDS NIH HHS / United States
K23 MH090366 / MH / NIMH NIH HHS / United States
R01 MH107703 / MH / NIMH NIH HHS / United States