Trying to name what doesn't change: Neural nonresponse to Cognitive Therapy for depression.
Psychol Med
; 54(1): 136-147, 2024 Jan.
Article
em En
| MEDLINE
| ID: mdl-37191029
ABSTRACT
BACKGROUND:
Theoretical models of neural mechanisms underlying Cognitive Behavior Therapy (CBT) for major depressive disorder (MDD) propose that psychotherapy changes neural functioning of prefrontal cortical structures associated with cognitive-control processes (DeRubeis, Siegle, & Hollon, ); however, MDD is persistent and characterized by long-lasting vulnerabilities to recurrence after intervention, suggesting that underlying neural mechanisms of MDD remain despite treatment. It follows that identification of treatment-resistant aberrant neural processes in MDD may inform clinical and research efforts targeting sustained remission. Thus, we sought to identify brain regions showing aberrant neural functioning in MDD that either (1) fail to exhibit substantive change (nonresponse) or (2) exhibit functional changes (response) following CBT.METHODS:
To identify treatment-resistant neural processes (as well as neural processes exhibiting change after treatment), we collected functional magnetic resonance imaging (fMRI) data of MDD patients (n = 58) before and after CBT as well as never-depressed controls (n = 35) before and after a similar amount of time. We evaluated fMRI data using conjunction analyses, which utilized several contrast-based criteria to characterize brain regions showing both differences between patients and controls at baseline and nonresponse or response to CBT.RESULTS:
Findings revealed nonresponse in a cerebellar region and response in prefrontal and parietal regions.CONCLUSIONS:
Results are consistent with prior theoretical models of CBT's direct effect on cortical regulatory processes but expand on them with identification of additional regions (and associated neural systems) of response and nonresponse to CBT.Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Terapia Cognitivo-Comportamental
/
Transtorno Depressivo Maior
Tipo de estudo:
Prognostic_studies
Limite:
Humans
Idioma:
En
Revista:
Psychol Med
Ano de publicação:
2024
Tipo de documento:
Article
País de afiliação:
Estados Unidos