Functional Neurocircuitry Associated With Treatment Response to CBT

Brain MRI
Brain MRI
The mechanism of treatment response by examining the relationship between baseline emotion-related neural circuitry and outcomes of the trial.

The baseline functional connectivity of the neurocircuitry underlying emotional regulation significantly predicted neural changes associated with the reduction of depression and anxiety symptoms in adults with bipolar disorder, according to a study published in Journal of Affective Disorders.

This study sought to examine how baseline functional connectivity of this neurocircuitry is associated with transdiagnostic cognitive behavioral therapy (CBT) treatment outcomes as a way of evaluating factors that affect the ability of individuals with bipolar disorder to benefit from this form of treatment.

The study findings indicate that baseline functional connectivity can predict changes in emotional regulation. Baseline levels of perceived affective control were significantly associated with the functional connectivity of the anterior insula and the salience network regions, and baseline neuroticism levels were significantly associated with the connectivity of the anterior insula and executive control. These 2 factors have a major impact on symptom improvement resulting from transdiagnostic CBT. Weaker insula-ventrolateral prefrontal cortex functional connectivity predicted greater improvements from treatment with CBT along with strong bilateral dorsal insula-bilateral amygdala functional connectivity.

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Study investigators conclude that these findings indicate a method for targeting patients who are most likely to benefit from a transdiagnostic CBT treatment approach. “Future clinical studies will allow us to more precisely measure the relationship between neural networks supporting emotion regulation in [bipolar disorder] with anxiety, and the potential for treatment related gains using transdiagnostic CBT.”


Ellard KK, Gosai AG, Bernstein EE, et al. Intrinsic functional neurocircuitry associated with treatment response to transdiagnostic CBT in bipolar disorder with anxietyJ Affect Disord. 2018; 238:383-391.