The effects of hypnotherapy compared to cognitive behavioral therapy in depression: a NIRS-study using an emotional gait paradigm.

Hypnotherapy (HT) is a promising approach to treating depression, but so far, no data are available on the neuronal mechanisms of functional reorganization after HT for depressed patients. Here, 75 patients with mild to moderate depression, who received either HT or Cognitive Behavioral Therapy (CBT), were measured before and after therapy using functional near-infrared spectroscopy. We investigated the patients' cerebral activation during an emotional human gait paradigm. Further, rumination was included as predictor. Our results showed a decrease of functional connectivity (FC) between two regions that are crucial to emotional processing, the Extrastriate Body Area (EBA) and the Superior Temporal Sulcus (STS). This FC decrease was traced back to an activation change throughout therapy in the right STS, not the EBA and was only found in the HT group, depending on rumination: less ruminating HT patients showed a decrease in right STS activation, while highly ruminating patients showed an increase. We carefully propose that this activation change is due to the promotion of emotional experiences during HT, while in CBT a focus lay on activating behavior and changing negative cognitions. HT seemed to have had differential effects on the patients, depending on their rumination style: The increase of right STS activation in highly ruminating patients might mirror the improvement of impaired emotional processing, whilst the decrease of activation in low ruminating patients might reflect a dismissal of an over-compensation, associated with a hyperactivity before therapy. We conclude that HT affects emotional processing and this effect is moderated by rumination.

The Positive Brain - Resting State Functional Connectivity in Highly Vital and Flourishing Individuals.

The World Health Organization has defined health as "complete physical, mental and social well-being and not merely the absence of disease or infirmity" (World Health Organization, 1948). An increasing number of studies have therefore started to investigate "the good life." However, the underlying variation in brain activity has rarely been examined. The goal of this study was to assess differences in resting state functional connectivity (RSFC) between regular healthy individuals and healthy individuals with a high occurrence of flourishing and subjective vitality. Together, flourishing, a broad measure of psycho-social functioning and subjective vitality, an organismic marker of subjective well-being comprise the phenomenological opposite of a major depressive disorder. Out of a group of 43 participants, 20 high-flourishing (highFl) and 18 high-vital (highSV) individuals underwent a 7-min resting state period, where cortical activity in posterior brain areas was assessed using functional near-infrared spectroscopy (fNIRS). Network-based statistics (NBS) of FC yielded significantly different FC patterns for the highFl and highSV individuals compared to their healthy comparison group. The networks converged at areas of the posterior default mode network and differed in hub nodes in the left middle temporal/fusiform gyrus (flourishing) and the left primary/secondary somatosensory cortex (subjective vitality). The attained networks are discussed with regard to recent neuroscientific findings for other well-being measures and potential mechanisms of action based on social information processing and body-related self-perception.

Aberrant functional connectivity in depression as an index of state and trait rumination.

Depression has been shown to be related to a variety of aberrant brain functions and structures. Particularly the investigation of alterations in functional connectivity (FC) in major depressive disorder (MDD) has been a promising endeavor, since a better understanding of pathological brain networks may foster our understanding of the disease. However, the underling mechanisms of aberrant FC in MDD are largely unclear. Using functional near-infrared spectroscopy (fNIRS) we investigated FC in the cortical parts of the default mode network (DMN) during resting-state in patients with current MDD. Additionally, we used qualitative and quantitative measures of psychological processes (e.g., state/trait rumination, mind-wandering) to investigate their contribution to differences in FC between depressed and non-depressed subjects. Our results indicate that 40% of the patients report spontaneous rumination during resting-state. Depressed subjects showed reduced FC in parts of the DMN compared to healthy controls. This finding was linked to the process of state/trait rumination. While rumination was negatively correlated with FC in the cortical parts of the DMN, mind-wandering showed positive associations.