Cognitive behavioral therapy increases amygdala connectivity with the cognitive control network in both MDD and PTSD.

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TitleCognitive behavioral therapy increases amygdala connectivity with the cognitive control network in both MDD and PTSD.
Publication TypeJournal Article
Year of Publication2017
AuthorsShou, H, Yang, Z, Satterthwaite, TD, Cook, PA, Bruce, SE, Shinohara, RT, Rosenberg, B, Sheline, YI
JournalNeuroimage Clin
Volume14
Pagination464-470
Date Published2017
ISSN2213-1582
KeywordsAdult, 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
Abstract

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.

DOI10.1016/j.nicl.2017.01.030
Alternate JournalNeuroimage Clin
PubMed ID28275546
PubMed Central IDPMC5331144
Grant ListK24 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