Disentangling the Neural Basis of Cognitive Behavioral Therapy in Psychiatric Disorders: A Focus on Depression

Background: Major depressive disorder (MDD) stands among the most frequent psychiatric disorders. Cognitive behavioral therapy (CBT) has been shown to be effective for treating depression, yet its neural mechanisms of action are not well elucidated. The objective of this work is to assess the availa...

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Main Authors: Moussa A. Chalah, Samar S. Ayache
Format: Article
Language:English
Published: MDPI AG 2018-08-01
Series:Brain Sciences
Subjects:
Online Access:http://www.mdpi.com/2076-3425/8/8/150
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author Moussa A. Chalah
Samar S. Ayache
author_facet Moussa A. Chalah
Samar S. Ayache
author_sort Moussa A. Chalah
collection DOAJ
description Background: Major depressive disorder (MDD) stands among the most frequent psychiatric disorders. Cognitive behavioral therapy (CBT) has been shown to be effective for treating depression, yet its neural mechanisms of action are not well elucidated. The objective of this work is to assess the available neuroimaging studies exploring CBT’s effects in adult patients with MDD. Methods: Computerized databases were consulted till April 2018 and a research was conducted according to PRISMA guidelines in order to identify original research articles published at any time in English and French languages on this topic. Results: Seventeen studies were identified. Only one study was randomized comparing CBT to pharmacological interventions, and none included an effective control. Following CBT, changes occurred in cerebral areas that are part of the fronto-limbic system, namely the cingulate cortex, prefrontal cortex and amygdala-hippocampal complex. However, the pattern of activation and connectivity in these areas varied across the studies. Conclusion: A considerable heterogeneity exists with regard to study design, adapted CBT type and intensity, and employed neuroimaging paradigms, all of which may partly explain the difference in studies’ outcomes. The lack of randomization and effective controls in most of them makes it difficult to draw formal conclusion whether the observed effects are CBT mediated or due to spontaneous recovery. Despite the observed inconsistencies and dearth of data, CBT appears to exert its anti-depressant effects mainly by modulating the function of affective and cognitive networks devoted to emotions generation and control, respectively. This concept remains to be validated in large scale randomized controlled trials.
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spelling doaj.art-a901b92c74084f3290d63c007064eee92022-12-21T18:23:48ZengMDPI AGBrain Sciences2076-34252018-08-018815010.3390/brainsci8080150brainsci8080150Disentangling the Neural Basis of Cognitive Behavioral Therapy in Psychiatric Disorders: A Focus on DepressionMoussa A. Chalah0Samar S. Ayache1EA 4391 Excitabilité Nerveuse et Thérapeutique, Université Paris-Est, 94010 Créteil, FranceEA 4391 Excitabilité Nerveuse et Thérapeutique, Université Paris-Est, 94010 Créteil, FranceBackground: Major depressive disorder (MDD) stands among the most frequent psychiatric disorders. Cognitive behavioral therapy (CBT) has been shown to be effective for treating depression, yet its neural mechanisms of action are not well elucidated. The objective of this work is to assess the available neuroimaging studies exploring CBT’s effects in adult patients with MDD. Methods: Computerized databases were consulted till April 2018 and a research was conducted according to PRISMA guidelines in order to identify original research articles published at any time in English and French languages on this topic. Results: Seventeen studies were identified. Only one study was randomized comparing CBT to pharmacological interventions, and none included an effective control. Following CBT, changes occurred in cerebral areas that are part of the fronto-limbic system, namely the cingulate cortex, prefrontal cortex and amygdala-hippocampal complex. However, the pattern of activation and connectivity in these areas varied across the studies. Conclusion: A considerable heterogeneity exists with regard to study design, adapted CBT type and intensity, and employed neuroimaging paradigms, all of which may partly explain the difference in studies’ outcomes. The lack of randomization and effective controls in most of them makes it difficult to draw formal conclusion whether the observed effects are CBT mediated or due to spontaneous recovery. Despite the observed inconsistencies and dearth of data, CBT appears to exert its anti-depressant effects mainly by modulating the function of affective and cognitive networks devoted to emotions generation and control, respectively. This concept remains to be validated in large scale randomized controlled trials.http://www.mdpi.com/2076-3425/8/8/150depressionMDDneuroimagingMRIcognitive behavioral therapyCBTcognitive therapybehavioral therapy
spellingShingle Moussa A. Chalah
Samar S. Ayache
Disentangling the Neural Basis of Cognitive Behavioral Therapy in Psychiatric Disorders: A Focus on Depression
Brain Sciences
depression
MDD
neuroimaging
MRI
cognitive behavioral therapy
CBT
cognitive therapy
behavioral therapy
title Disentangling the Neural Basis of Cognitive Behavioral Therapy in Psychiatric Disorders: A Focus on Depression
title_full Disentangling the Neural Basis of Cognitive Behavioral Therapy in Psychiatric Disorders: A Focus on Depression
title_fullStr Disentangling the Neural Basis of Cognitive Behavioral Therapy in Psychiatric Disorders: A Focus on Depression
title_full_unstemmed Disentangling the Neural Basis of Cognitive Behavioral Therapy in Psychiatric Disorders: A Focus on Depression
title_short Disentangling the Neural Basis of Cognitive Behavioral Therapy in Psychiatric Disorders: A Focus on Depression
title_sort disentangling the neural basis of cognitive behavioral therapy in psychiatric disorders a focus on depression
topic depression
MDD
neuroimaging
MRI
cognitive behavioral therapy
CBT
cognitive therapy
behavioral therapy
url http://www.mdpi.com/2076-3425/8/8/150
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