SfN: CBT May Improve PTSD, Depression Through Common Biological Mechanism

The dimensional brain-behavioral associations could potentially serve as an imaging marker to index inter-individual differences in treatment responses.

Researchers found that cognitive behavioral therapy (CBT), an effective treatment for both depression and post-traumatic stress disorder (PTSD), may work by normalizing cognitive control and emotional regulation dysfunctions in both disorders. The associations observed between the brain and symptoms suggest that CBT helps normalize functional deficits in the dorsolateral prefrontal cortext (DLPFC). These findings were presented at the 2016 Society for Neuroscience Annual Meeting, November 12-16, 2016 in San Diego, California.

Yvette I. Sheline, MD, from the University of Pennsylvania in Philadelphia, and colleagues scanned patients with Siemens 3T Trio at baseline and after 12 weeks of CBT to probe emotional and cognitive control networks. They also assessed amygdala functional connectivity (n = 17 with depression, n = 21 with PTSD) and task activation (n = 15 with depression, n = 16 with PTSD) at baseline and post-treatment. Patients were also assessed with the Montgtomery-Asberg Depression Score (MADRS), the Mood and Anxiety Symptom Questionnaire (MASQ), and the Post-traumatic Diagnostic Scale (PDS).

The researchers found that across patients, task-based activations of the left DLPFC, bilateral inferior frontal gyrus (IFG), bilateral dorsal anterior cingulated cortex (ACC), left posterior insula, and left dorso-medial striatum were normalized after treatment. Dimensional brain-symptom associations also showed that left DLPFC baseline activation was significantly correlated with a treatment-related decrease in the MADRS (r = -0.39, P = .03, n = 31). Resting-state results also showed that amygdala functional connectivity with bilateral dorsal ACC and left anterior insula increased with treatment to levels comparable with healthy controls.

“The dimensional brain-behavioral associations observed could potentially serve as an imaging marker to index inter-individual differences in treatment responses and provide empirical evidence to support dimensional approaches to understanding psychopathology,” the authors concluded.

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Sheline YI, Yang Z, Oathes D, et al. Cognitive behavior therapy (CBT) changes resting-state and task brain activity across MDD and PTSD. Presented at: 2016 Society for Neuroscience Annual Meeting. November 12-16, 2016; San Diego, California. Abstract 820.07 / WW4.