Changes in Prefrontal Gamma-Aminobutyric Acid and Perfusion After the Computerized Relaxation Training in Women With Psychological Distress: A Preliminary Report

Eun Namgung; Jungyoon Kim; Hyeonseok Jeong; Jiyoung Ma; Gahae Hong; Ilhyang Kang; Jinsol Kim; Yoonji Joo; Rye Young Kim; In Kyoon Lyoo

doi:10.3389/fpsyg.2021.569113

Changes in Prefrontal Gamma-Aminobutyric Acid and Perfusion After the Computerized Relaxation Training in Women With Psychological Distress: A Preliminary Report

Front Psychol. 2021 Apr 13:12:569113. doi: 10.3389/fpsyg.2021.569113. eCollection 2021.

Authors

Eun Namgung¹, Jungyoon Kim^{1

2}, Hyeonseok Jeong³, Jiyoung Ma⁴, Gahae Hong¹, Ilhyang Kang¹, Jinsol Kim^{1

2}, Yoonji Joo^{1

5}, Rye Young Kim^{1

5}, In Kyoon Lyoo^{1

2

4

5}

Affiliations

¹ Ewha Brain Institute, Ewha Womans University, Seoul, South Korea.
² Department of Brain and Cognitive Sciences, Ewha Womans University, Seoul, South Korea.
³ Department of Radiology, College of Medicine, Incheon St. Mary's Hospital, The Catholic University of Korea, Seoul, South Korea.
⁴ Department of Psychiatry, University of Utah School of Medicine, Salt Lake City, UT, United States.
⁵ Graduate School of Pharmaceutical Sciences, Ewha Womans University, Seoul, South Korea.

Abstract

Computerized relaxation training has been suggested as an effective and easily accessible intervention for individuals with psychological distress. To better elucidate the neural mechanism that underpins the effects of relaxation training, we investigated whether a 10-session computerized relaxation training program changed prefrontal gamma-aminobutyric acid (GABA) levels and cerebral blood flow (CBF) in women with psychological distress. We specifically focused on women since they were reported to be more vulnerable to develop stress-related disorders than men. Nineteen women with psychological distress but without a diagnosis of psychiatric disorders received the 10-day computerized relaxation training program that consisted of 30-min cognitive-relaxation training and 10-min breathing-relaxation training per day. At baseline and post-intervention, perceived stress levels, anxiety, fatigue, and sleep quality were assessed by self-report questionnaires. Brain magnetic resonance spectroscopy and arterial spin labeling scans were also performed before and after the intervention to evaluate GABA levels and relative CBF in the prefrontal region. Levels of perceived stress (t = 4.02, P < 0.001), anxiety (z = 2.33, P = 0.02), fatigue (t = 3.35, P = 0.004), and sleep quality (t = 4.14, P < 0.001) improved following 10 sessions of computerized relaxation training, resulting in a significant relief in composite scores of stress-related symptoms (t = -5.25, P < 0.001). The prefrontal GABA levels decreased (t = 2.53, P = 0.02), while relative CBF increased (t = -3.32, P = 0.004) after the intervention. In addition, a greater increase in relative prefrontal CBF was associated with better composite scores of stress-related symptoms following the intervention (t = 2.22, P = 0.04). The current findings suggest that computerized relaxation training may improve stress-related symptoms through modulating the prefrontal GABA levels and CBF in women with psychological distress.

Keywords: cerebral blood flow; gamma-aminobutyric acid; prefrontal cortex; relaxation training; stress.