J Straub1, P L Plener2, N Sproeber2, L Sprenger3, M G Koelch2, G Groen4, B Abler4. 1. Department of Child and Adolescent Psychiatry and Psychotherapy, University Hospital Ulm, Germany. Electronic address: Joana.Straub@uniklinik-ulm.de. 2. Department of Child and Adolescent Psychiatry and Psychotherapy, University Hospital Ulm, Germany. 3. Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Philipps-University Marburg, Germany. 4. Department of Psychiatry and Psychotherapy III, University Hospital Ulm, Germany.
Abstract
BACKGROUND: While major effort has been put in investigating neural correlates of depression and its treatment in adults, less is known about the effects of psychotherapy in adolescents. Given the concordance of the ventral striatum, amygdala, hippocampus and the subgenual anterior cingulate cortex (sgACC) as correlates of depression and their involvement in reward processing, we used functional magnetic resonance imaging (fMRI) during performance of a monetary reward task in an intervention versus waitlist-control design to investigate the clinical and neural effects of cognitive behavioral group therapy (CBT-G). METHODS: 22 medication naïve adolescents with major depressive disorder were scanned before and after five sessions of CBT-G (PAT-I), or before and after five weeks of waiting (PAT-W). Changes in symptom scales were analyzed along with neural activation changes within the amygdala, hippocampus, sgACC and ventral striatum regions of interest (ROI). RESULTS: Psychometric assessments and ROI activation remained unchanged in PAT-W. In PAT-I, significant reduction in clinical symptoms accompanied significant changes in brain activation within the left amygdala, left hippocampus and bilateral sgACC. In line with previous findings in adults, pre-to-post-activation changes in the bilateral sgACC correlated with pre-to-post and pre-to-follow-up symptom improvement, and individual expressions of sgACC activation before treatment were related to pre-to-follow-up therapeutic success. LIMITATIONS: Future studies should include larger sample sizes. CONCLUSIONS: Successful group psychotherapy of depression in adolescents was related to signal changes in brain regions previously demonstrated to be reliably linked with successful, particularly pharmacological treatment in adults.
BACKGROUND: While major effort has been put in investigating neural correlates of depression and its treatment in adults, less is known about the effects of psychotherapy in adolescents. Given the concordance of the ventral striatum, amygdala, hippocampus and the subgenual anterior cingulate cortex (sgACC) as correlates of depression and their involvement in reward processing, we used functional magnetic resonance imaging (fMRI) during performance of a monetary reward task in an intervention versus waitlist-control design to investigate the clinical and neural effects of cognitive behavioral group therapy (CBT-G). METHODS: 22 medication naïve adolescents with major depressive disorder were scanned before and after five sessions of CBT-G (PAT-I), or before and after five weeks of waiting (PAT-W). Changes in symptom scales were analyzed along with neural activation changes within the amygdala, hippocampus, sgACC and ventral striatum regions of interest (ROI). RESULTS: Psychometric assessments and ROI activation remained unchanged in PAT-W. In PAT-I, significant reduction in clinical symptoms accompanied significant changes in brain activation within the left amygdala, left hippocampus and bilateral sgACC. In line with previous findings in adults, pre-to-post-activation changes in the bilateral sgACC correlated with pre-to-post and pre-to-follow-up symptom improvement, and individual expressions of sgACC activation before treatment were related to pre-to-follow-up therapeutic success. LIMITATIONS: Future studies should include larger sample sizes. CONCLUSIONS: Successful group psychotherapy of depression in adolescents was related to signal changes in brain regions previously demonstrated to be reliably linked with successful, particularly pharmacological treatment in adults.
Authors: Harry Rubin-Falcone; Jochen Weber; Ronit Kishon; Kevin Ochsner; Lauren Delaparte; Bruce Doré; Francesca Zanderigo; Maria A Oquendo; J John Mann; Jeffrey M Miller Journal: Psychiatry Res Neuroimaging Date: 2017-11-08 Impact factor: 2.376
Authors: Colm G Connolly; Tiffany C Ho; Eva Henje Blom; Kaja Z LeWinn; Matthew D Sacchet; Olga Tymofiyeva; Alan N Simmons; Tony T Yang Journal: J Affect Disord Date: 2016-09-23 Impact factor: 4.839
Authors: Adina S Fischer; M Catalina Camacho; Tiffany C Ho; Susan Whitfield-Gabrieli; Ian H Gotlib Journal: JAMA Psychiatry Date: 2018-05-01 Impact factor: 21.596