Use of FMRI to predict recovery from unipolar depression with cognitive behavior therapy

Am J Psychiatry. 2006 Apr;163(4):735-8. doi: 10.1176/appi.ajp.163.4.735.

Abstract

Objective: In controlled treatment trials, 40%-60% of unmedicated depressed individuals respond to cognitive behavior therapy (CBT). The authors examined whether pretreatment neural reactivity to emotional stimuli accounted for this variation.

Method: Unmedicated depressed individuals (N=14) and never depressed comparison subjects (N=21) underwent fMRI during performance of a task sensitive to sustained emotional information processing. Afterward, depressed participants completed 16 sessions of CBT.

Results: Participants whose sustained reactivity to emotional stimuli was low in the subgenual cingulate cortex (Brodmann's area 25) and high in the amygdala displayed the strongest improvement with CBT.

Conclusions: The presence of emotion regulation disruptions, which are targeted in CBT, may be the key to recovery with this intervention.

Publication types

  • Comparative Study
  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, Non-P.H.S.

MeSH terms

  • Adult
  • Amygdala / physiology
  • Amygdala / physiopathology
  • Brain Mapping
  • Cognitive Behavioral Therapy / methods*
  • Depressive Disorder / diagnosis
  • Depressive Disorder / physiopathology*
  • Depressive Disorder / therapy*
  • Emotions / physiology
  • Female
  • Gyrus Cinguli / physiology
  • Gyrus Cinguli / physiopathology
  • Humans
  • Magnetic Resonance Imaging / methods
  • Magnetic Resonance Imaging / statistics & numerical data*
  • Male
  • Middle Aged
  • Oxygen / blood
  • Prognosis
  • Psychiatric Status Rating Scales
  • Psychomotor Performance / physiology
  • Severity of Illness Index
  • Treatment Outcome
  • Verbal Behavior / physiology

Substances

  • Oxygen