Changes of brain activation pre- post short-term psychodynamic inpatient psychotherapy: an fMRI study of panic disorder patients

Psychiatry Res. 2010 Nov 30;184(2):96-104. doi: 10.1016/j.pscychresns.2010.06.005. Epub 2010 Oct 8.

Abstract

Cognitive-behavioural interventions have been shown to change brain functioning. We used an emotional linguistic go/nogo functional magnetic resonance imaging (fMRI) design to determine changes of brain activation patterns of panic disorder (PD) patients following short-term psychodynamic inpatient treatment. Nine PD patients underwent fMRI before and after treatment; 18 healthy controls were scanned twice at the same interval (4 weeks). In the go/nogo design, responses to panic-specific negative words were compared with linguistically matched positive and neutral words. According to hypotheses, patients rated affective words more strongly than controls and selectively recalled negative vs. positive/neutral words. Before treatment, high limbic (hippocampus and amygdala) activation was accompanied by low prefrontal activation to negative words. Inhibition-related activation patterns indicated difficulties of behavioural regulation in emotional context. At treatment termination, panic-related symptoms had improved significantly, and fronto-limbic activation patterns were normalized. Our results indicate that short-term psychodynamic treatment leads to changes in fronto-limbic circuitry not dissimilar to previous findings on cognitive-behavioural treatments.

MeSH terms

  • Brain / physiopathology*
  • Brain Mapping
  • Emotions / physiology
  • Female
  • Humans
  • Image Processing, Computer-Assisted
  • Inhibition, Psychological
  • Inpatients
  • Magnetic Resonance Imaging*
  • Male
  • Neuropsychological Tests
  • Panic Disorder / physiopathology
  • Panic Disorder / therapy*
  • Psychotherapy, Brief*
  • Treatment Outcome