Cognitive behavioral therapy effects on frontopolar cortex function during future thinking in major depressive disorder: A randomized clinical trial

MDPhD, Nariko Katayama; MDPhD, Atsuo Nakagawa; Umeda, Satoshi; Terasawa, Yuri; Abe, Takayuki; Kurata, Chika; Sasaki, Yohei; Mitsuda, Dai; MDPhD, Toshiaki Kikuchi; MDPhD, Hajime Tabuchi; MDPhD, Masaru Mimura

doi:10.1016/j.jad.2021.11.034

Cited by 11 publications

(12 citation statements)

References 42 publications

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“…In our samples, RTs decreased in the CBT group for both the positive and negative valence in the distant future condition. This finding is compatible with our previous study that showed that maladaptive activation in the frontopolar cortex (BA10) was associated with pessimistic future thinking during distant future thinking (11) and decreased after a course of CBT (17). Prior research has shown that depressed patients generally experience a form of thinking through abstract and overly general processing (30), that events imagined to occur in the distant future are experienced ambiguously (31), and that such patients are less likely to make concrete assessments about the future (32).…”

Section: Discussionsupporting

confidence: 93%

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The effect of cognitive behavioral therapy on future thinking in patients with major depressive disorder: A randomized controlled trial

et al. 2023

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BackgroundPessimistic thinking about the future is one of the cardinal symptoms of major depression. Few studies have assessed changes in pessimistic thinking after undergoing cognitive behavioral therapy (CBT). A randomized clinical trial (RCT) was conducted with patients diagnosed with major depressive disorder (MDD) to determine whether receiving a course of CBT affects pessimistic future thinking using a future thinking task.MethodsThirty-one patients with MDD were randomly assigned to either CBT (n = 16) or a talking control (TC) (n = 15) for a 16-week intervention. The main outcomes were the change in response time (RT) and the ratio of the responses for positive valence, measured by the future thinking task. Secondary outcomes included the GRID-Hamilton Depression Rating Scale, the Beck Depression Inventory-Second Edition (BDI-II), the Dysfunctional Attitude Scale (DAS), and the word fluency test (WFT).ResultsRegarding the main outcomes, the CBT group showed reduced RT for the positive valence (within-group Cohen’s d = 0.7, p = 0.012) and negative valence (within-group Cohen’s d = 0.6, p = 0.03) in the distant future condition. The ratio of positive valence responses in both groups for all temporal conditions except for the distant past condition increased within group (distant future: CBT: Cohen’s d = 0.5, p = 0.04; TC: Cohen’s d = 0.8, p = 0.008; near future: CBT: Cohen’s d = 1.0, p < 0.001; TC: Cohen’s d = 1.1, p = 0.001; near past: CBT: Cohen’s d = 0.8, p = 0.005; TC: Cohen’s d = 1.0, p = 0.002). As for secondary outcomes, the CBT group showed greater improvement than the TC group regarding the need for social approval as measured by the DAS (p = 0.012).ConclusionPatients with MDD who received CBT showed a reduced RT for the positive and negative valence in the distant future condition. RT in the future thinking task for depressed patients may be a potential objective measure for the CBT treatment process. Because the present RCT is positioned as a pilot RCT, a confirmatory trial with a larger number of patients is warranted to elucidate the CBT treatment process that influences future thinking.Clinical trial registrationhttps://center6.umin.ac.jp/cgi-open-bin/icdr_e/ctr_view.cgi?recptno=R000021028, identifier UMIN000018155.

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Section: Discussionsupporting

confidence: 93%

“…20150070). The neural change and functional connectivity outcomes have been reported elsewhere ( 17 ); this article focuses on the behavioral outcomes.…”

Section: Methodsmentioning

confidence: 99%

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The effect of cognitive behavioral therapy on future thinking in patients with major depressive disorder: A randomized controlled trial

et al. 2023

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“…Treatment response also influenced functional connectivity in the frontal pole, which is commonly thought to play a key role in self-reflection, long-term goals, past or future events or hypothetical scenarios (Addis et al, 2007). In treatment-resistant MDD patients, the frontal pole has been shown to be functionally hyperconnected with the DMN and disconnected with regions located in the salience networks (Fettes et al, 2018), and reduction of frontal pole neural activity has been proposed as an index of success of neuromodulation techniques (Downar and Daskalakis, 2013) and cognitive-behavioural therapy (Katayama et al, 2022). Interestingly, in treatment-resistant depressive patients, the frontal pole is functionally hyperconnected with the DMN and disconnected with regions located in the salience networks (Fettes et al, 2018).…”

Section: Discussionmentioning

confidence: 99%

Hippocampal and parahippocampal volume and function predict antidepressant response in patients with major depression: A multimodal neuroimaging study

Paolini,

Harrington,

Colombo

et al. 2023

J Psychopharmacol

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Background: For many patients with major depressive disorder (MDD) adequate treatment remains elusive. Neuroimaging techniques received attention for their potential use in guiding and predicting response, but were rarely investigated in real-world psychiatric settings. Aims: To identify structural and functional Magnetic Resonance Imaging (MRI) biomarkers associated with antidepressant response in a real-world clinical sample. Methods: We studied 100 MDD inpatients admitted to our psychiatric ward, treated with various antidepressants upon clinical need. Hamilton Depression Rating Scale percentage decrease from admission to discharge was used as a measure of response. All patients underwent 3.0 T MRI scanning. Grey matter (GM) volumes were investigated both in a voxel-based morphometry (VBM), and in a regions of interest (ROI) analysis. In a subsample of patients, functional resting-state connectivity patterns were also explored. Results: In the VBM analysis, worse response was associated to lower GM volumes in two clusters, encompassing the left hippocampus and parahippocampal gyrus, and the right superior and middle temporal gyrus. Investigating ROIs, lower bilateral hippocampi and amygdalae volumes predicted worse treatment outcomes. Functional connectivity in the right temporal and parahippocampal gyrus was also associated to response. Conclusion: Our results expand existing literature on the relationship between the structure and function of several brain regions and treatment response in MDD. While we are still far from routine use of MRI biomarkers in clinical practice, we confirm a possible role of these techniques in guiding treatment choices and predicting their efficacy.

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“…Beck’s cognitive therapy is a present-centered, problem-oriented, proactive, and guiding treatment method, 8 that aims to correct patients’ irrational cognitive processes and concepts and change their negative emotions and behaviors. This cognitive model proposes that distorted or dysfunctional thoughts are a common phenomenon in various psychological disorders.…”

Section: Introductionmentioning

confidence: 99%

A Retrospective Case–Control Study Evaluating Effects of Beck’s Cognitive Therapy on Anxiety in Patients after Breast Reconstruction

Li,

Wang,

Wang

et al. 2024

ALPHA PSYCHIATRY

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Objective: To explore the effects of Beck’s cognitive therapy on the anxiety of patients after breast reconstruction. Methods: This study retrospectively analyzed clinical data of 150 patients with breast cancer undergoing breast reconstruction from June 2020 to June 2021 in our hospital, excluded 5 patients who did not meet the inclusion criteria, divided the remaining cases into an experimental group (EG, n = 70, perioperative routine management + Beck’s cognitive therapy intervention) and a reference group (RG, n = 75, perioperative routine management) in accordance with different perioperative intervention programs, and compared the emotions of anxiety and depression, sense of social disability, and prognosis quality in both groups. Results: At 2 months after surgery (T2) and 3 months after surgery (T3), EG had overtly lower Hamilton Anxiety Scale (HAMA) and Beck Depression Inventory (BDI) scores than RG ( P < .05), with no difference in HAMA and BDI scores at 3 days before surgery (T0) and 1 month after surgery (T1) ( P > .05). At the T0 stage, both groups were diagnosed as having a social disability, with no overt difference ( P > .05). At T1 stage, The Social Disability Screening Schedule (SDSS) scores in both groups increased remarkably and fell back at the T2 and T3 stages. At T1-T2 stages, SDSS scores of EG were significantly different from those of RG ( P < .05), with no significant difference at T3 stage ( P > .05). The excellent rate of prognosis in EG was 78.57% (55/70), higher than 77.33% (58/75) in RG, with no statistical difference in both groups ( P < .05). Conclusion: The implementation of Beck’s cognitive therapy in patients with breast reconstruction effectively improves adverse emotions in patients, which is of great significance for promoting postoperative rehabilitation and is an effective intervention program in the perioperative period.

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Cognitive behavioral therapy effects on frontopolar cortex function during future thinking in major depressive disorder: A randomized clinical trial

Cited by 11 publications

References 42 publications

The effect of cognitive behavioral therapy on future thinking in patients with major depressive disorder: A randomized controlled trial

The effect of cognitive behavioral therapy on future thinking in patients with major depressive disorder: A randomized controlled trial

Hippocampal and parahippocampal volume and function predict antidepressant response in patients with major depression: A multimodal neuroimaging study

A Retrospective Case–Control Study Evaluating Effects of Beck’s Cognitive Therapy on Anxiety in Patients after Breast Reconstruction

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