Functional neuroimaging of psychotherapeutic processes in anxiety and depression

Abstract

Present findings encourage the search for predictors providing clinically meaningful information for single patients. However, independent validation as a crucial prerequisite for clinical use is still needed. Identifying nonresponders a priori creates the need for alternative treatment options that can be developed based on an improved understanding of those neural mechanisms underlying effective interventions.

Meta-analyses of the neural mechanisms and predictors of response to psychotherapy in depression and anxiety

“…In line with the dual-process model, we hypothesised that psychological therapy would be associated with increased prefrontal activity and reduced limbic activity post- compared to pre-therapy. We hypothesised that increased baseline ACC activation would be predictive of greater symptomatic improvement in accordance with results from a meta-analysis primarily of pharmacological treatment prognostic neural biomarkers ( Fu et al, 2013 ) and a recent review of neuroimaging predictors of response in anxiety and depression ( Lueken and Hahn, 2016 ).…”

“…Psychological interventions are first-line treatments for depression and anxiety disorders ( Baldwin et al, 2014 ; Cleare et al, 2015 ; NICE, 2009 ) but are ineffective for as many as 50% of patients ( Cuijpers et al, 2014 ; Loerinc et al, 2015 ). Research investigating the neural correlates of therapy aims to provide a greater understanding about the formation, recovery and maintenance of symptoms, in addition to aiding the development of improved treatments and personalised medicine according to likely response ( Lueken and Hahn, 2016 ), which could improve outcomes for recipients of psychological interventions. Recent reviews have highlighted the promise of functional neuroimaging studies in this field for both depression and anxiety disorders ( Fu et al, 2013 ; Hamilton et al, 2012 ; Ma, 2015 ; Wise et al, 2014 ).…”

N-Palmitoylethanolamide Exerts Antidepressant-Like Effects in Rats: Involvement of PPARα Pathway in the Hippocampus

“…Depression is characterized by a significant and persistent negative mood and is associated with clinical symptoms such as decreased physical activity, sluggish thoughts, feelings of helplessness, and cognitive dysfunction. Most patients have a tendency to relapse and may even have suicidal attempts or behaviors, placing a substantial mental and economic burden on their families and society (Lueken and Hahn, 2016).…”

“…Currently, drug therapy is the main treatment of moderate or severe depressive episodes, but these treatments still have many disadvantages, such as the delayed onset of action and numerous side effects of antidepressants. Therefore, researchers in the medical community have focused on identifying additional drug targets and developing safer and more effective antidepressants (Lueken and Hahn, 2016), and some endogenous substances may have certain therapeutic advantages. The central endocannabinoid system (ECS) is a neuroactive lipid signaling system in the brain that plays important roles in neuroprotection and reward system activation, among others, by controlling neurotransmitter release (Boorman et al, 2016;Morena et al, 2016).…”

Predicting cognitive behavioral therapy response in social anxiety disorder with anterior cingulate cortex and amygdala during emotion regulation

“…However, results have been inconsistent, which may relate to methodological differences across studies. That is, the direction of neuromarker effects (enhanced vs. reduced activation) is sensitive to the neurocognitive probe of interest (e.g., type of task), location within a region (e.g., dorsal versus rostral ACC) (Lueken and Hahn, 2016), and criteria used to define ‘significance’ of brain activity as noted above.…”