Brain functional effects of cognitive behavioral therapy for depression: A systematic review of task-based fMRI studies.

BACKGROUND: Depressive disorders are associated with alterations in brain function, affecting processes such as affective and reward processing and emotion regulation. However, the influence of Cognitive Behavioral Therapy (CBT) on the neuronal patterns remains inadequately understood. Therefore, this review systematically summarizes longitudinal fMRI brain activity changes in depressive patients treated with CBT and their association with symptom remission. METHODS: This systematic review was conducted according to the PRISMA statement. Out of 2149 results of the literature search, N = 14 studies met the inclusion criteria (e.g., diagnosis of a current depressive disorder, assessment of longitudinal task-based fMRI, and the analysis of functional changes before and after CBT). RESULTS: The findings reveal (1) diminished limbic reactivity following CBT across various tasks, (2) increased striatal activity during reward processing, but decreased activity during affective processing and future thinking, and (3) alterations in cingulate and prefrontal cortex activity across tasks. Partially, these results are associated with symptom remission, especially in the subgenual anterior cingulate cortex. LIMITATIONS: There are heterogenous results especially in cortical areas that might partially be due to methodological issues like differences across the studies in terms of task content, statistical evaluation, and interventions. Thus, future research should focus on the standardization of methodologies. CONCLUSIONS: The results indicate that CBT partially normalizes the neural patterns of depressive patients, particularly within regions involved in affective and reward processing and the development of negative cognitive biases. Overall, potential neural mechanisms underlying CBT were identified, underscoring its effectiveness on an objective neurobiological basis.

How movies move us - movie preferences are linked to differences in neuronal emotion processing of fear and anger: an fMRI study.

Introduction: As a source of audio-visual stimulation, movies expose people to various emotions. Interestingly, several genres are characterized by negative emotional content. Albeit theoretical approaches exist, little is known about preferences for specific movie genres and the neuronal processing of negative emotions. Methods: We investigated associations between movie genre preference and limbic and reward-related brain reactivity to close this gap by employing an fMRI paradigm with negative emotional faces in 257 healthy participants. We compared the functional activity of the amygdala and the nucleus accumbens (NAcc) between individuals with a preference for a particular movie genre and those without such preference. Results and discussion: Amygdala activation was relatively higher in individuals with action movie preference (p TFCE-FWE = 0.013). Comedy genre preference was associated with increased amygdala (p TFCE-FWE = 0.038) and NAcc activity (p TFCE-FWE = 0.011). In contrast, crime/thriller preference (amygdala: p TFCE-FWE ≤ 0.010, NAcc: p TFCE-FWE = 0.036), as well as documentary preference, was linked to the decreased amygdala (p TFCE-FWE = 0.012) and NAcc activity (p TFCE-FWE = 0.015). The study revealed associations between participants' genre preferences and brain reactivity to negative affective stimuli. Interestingly, preferences for genres with similar emotion profiles (action, crime/thriller) were associated with oppositely directed neural activity. Potential links between brain reactivity and susceptibility to different movie-related gratifications are discussed.