TY - JOUR
T1 - Cognitive behavioral therapy effects on frontopolar cortex function during future thinking in major depressive disorder
T2 - A randomized clinical trial
AU - Katayama, Nariko
AU - Nakagawa, Atsuo
AU - Umeda, Satoshi
AU - Terasawa, Yuri
AU - Abe, Takayuki
AU - Kurata, Chika
AU - Sasaki, Yohei
AU - Mitsuda, Dai
AU - Kikuchi, Toshiaki
AU - Tabuchi, Hajime
AU - Mimura, Masaru
N1 - Funding Information:
This research was supported by Japan Agency for Medical Research and Development (AMED grant Nos. JP20dk0307084 and JP20dm0307102 ) and a Commissioned Research of National Institute of Information and Communications Technology grant. It was also supported in part by the Japan Society for the Promotion of Science (KAKENHI grant Nos. JP24120518 , JP24330210 , JP26780396 , JP17K04452 , JP17K04482, JP20H01772 and JP 21K15717 ), an MGH-SAFER grant, Inogashira Hospital Grants for Psychiatry Research, and a Keio University School of Medicine Department of Neuropsychiatry Research grant. The funder had no role in the study design, data collection, analysis and interpretation, writing of the report, or decision to submit the paper for publication.
Funding Information:
Dr. Nakagawa developed and wrote the Japanese CBT manual for depression and is involved in the Japanese National CBT Training Project funded by the Japanese Ministry of Health, Labor, and Welfare. All other authors report no financial relationships with commercial interests.
Publisher Copyright:
© 2021
PY - 2022/2/1
Y1 - 2022/2/1
N2 - Background: Despite the importance of Beck's theoretical cognitive model of psychopathology, the neural mechanisms underlying future thinking in cognitive behavioral therapy (CBT) remain elusive. Recent neuroimaging studies have shown that the function of the frontopolar cortex (Brodmann area 10 [BA10]) is associated with future thinking. We hypothesized that, compared with unstructured psychotherapy (talking control: TC), CBT may involve different neural responses in BA10 associated with future thinking. Methods: This randomized clinical trial included 38 adult patients with moderate-to-severe major depressive disorder who underwent up to 16 weeks of CBT or TC with a 6-month follow-up period. We evaluated changes in BA10 activation during distant future thinking using functional magnetic resonance imaging with a future-thinking task. We assessed frontal neurocognitive function and clinical symptoms at baseline and post-treatment. Depression severity and automatic thoughts were assessed at the 6-month follow-up. Results: We found decreased activation in the frontopolar cortex during distant future thinking after CBT (t = 3.00, df=15, p = 0.009) and no changes after TC. Further, the reduction in BA10 activity significantly correlated with changes in frontal cognitive function after the treatment (r = 0.48, p = 0.007), and in positive automatic thought after 6 months of treatments (r = 0.39; p = 0.03). Limitations: Relatively small sample size and homogenous clinical profile could limit the generalizability. Patients received pharmacotherapy including antidepressant. Conclusions: CBT appears to improve frontopolar cortex function during future thinking in a manner distinct from TC. Larger clinical trials are necessary to provide firm evidence whether BA10 activity may serve as a neuro-marker for monitoring successful depression treatment with CBT.
AB - Background: Despite the importance of Beck's theoretical cognitive model of psychopathology, the neural mechanisms underlying future thinking in cognitive behavioral therapy (CBT) remain elusive. Recent neuroimaging studies have shown that the function of the frontopolar cortex (Brodmann area 10 [BA10]) is associated with future thinking. We hypothesized that, compared with unstructured psychotherapy (talking control: TC), CBT may involve different neural responses in BA10 associated with future thinking. Methods: This randomized clinical trial included 38 adult patients with moderate-to-severe major depressive disorder who underwent up to 16 weeks of CBT or TC with a 6-month follow-up period. We evaluated changes in BA10 activation during distant future thinking using functional magnetic resonance imaging with a future-thinking task. We assessed frontal neurocognitive function and clinical symptoms at baseline and post-treatment. Depression severity and automatic thoughts were assessed at the 6-month follow-up. Results: We found decreased activation in the frontopolar cortex during distant future thinking after CBT (t = 3.00, df=15, p = 0.009) and no changes after TC. Further, the reduction in BA10 activity significantly correlated with changes in frontal cognitive function after the treatment (r = 0.48, p = 0.007), and in positive automatic thought after 6 months of treatments (r = 0.39; p = 0.03). Limitations: Relatively small sample size and homogenous clinical profile could limit the generalizability. Patients received pharmacotherapy including antidepressant. Conclusions: CBT appears to improve frontopolar cortex function during future thinking in a manner distinct from TC. Larger clinical trials are necessary to provide firm evidence whether BA10 activity may serve as a neuro-marker for monitoring successful depression treatment with CBT.
KW - Automatic thoughts
KW - Cognitive behavioral therapy
KW - Future thinking
KW - Major depressive disorder
KW - Neuroimaging
KW - Psychotherapy
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U2 - 10.1016/j.jad.2021.11.034
DO - 10.1016/j.jad.2021.11.034
M3 - Article
C2 - 34800568
AN - SCOPUS:85119922379
SN - 0165-0327
VL - 298
SP - 644
EP - 655
JO - Journal of Affective Disorders
JF - Journal of Affective Disorders
ER -