Functional connectivity changes between frontopolar cortex and nucleus accumbens following cognitive behavioral therapy in major depression: A randomized clinical trial

Nariko Katayama, Atsuo Nakagawa, Satoshi Umeda, Yuri Terasawa, Kazushi Shinagawa, Toshiaki Kikuchi, Hajime Tabuchi, Takayuki Abe, Masaru Mimura

Research output: Contribution to journalArticlepeer-review

2 Citations (Scopus)

Abstract

Cognitive behavioral therapy (CBT) is a psychotherapy that challenges distorted cognitions; however, the neural mechanisms that underpin CBT remain unclear. Hence, we aimed to assess the treatment-related resting-state functional connectivity (rsFC) changes in the brain regions associated with future thinking and the associations between rsFC changes and clinical improvements. Thirty-eight adult patients with MDD were randomly assigned with equal likelihood to receive 16-week individual CBT or talking control with a 12-month follow-up period. We evaluated the rsFC changes in the frontal regions, nucleus accumbens, amygdala, and limbic structures key to the depression pathophysiology and future thinking with 2 × 2 mixed ANOVA interaction analysis. Pearson's correlation analysis with Bonferroni's correction was also performed to examine the associations with clinical symptoms, such as depression severity and automatic thoughts in follow-up evaluations. Treatment-specific changes include enhancement in frontopolar connectivity with the nucleus accumbens. An increased rsFC was associated with lower negative automatic thoughts postoperatively, together with lower depressive symptoms and higher positive automatic thoughts at follow-up. Conclusively, rsFC changes in the fronto-limbic neural control circuit after CBT, particularly between the frontal pole and nucleus accumbens, may be clinically meaningful functional changes related to the depression recovery process.

Original languageEnglish
Article number111643
JournalPsychiatry Research - Neuroimaging
Volume332
DOIs
Publication statusPublished - 2023 Jul

Keywords

  • Cognitive behavioral therapy
  • Frontal pole
  • Functional magnetic resonance imaging
  • Major depressive disorder
  • Mood disorder
  • Neuroimaging
  • Psychotherapy

ASJC Scopus subject areas

  • Neuroscience (miscellaneous)
  • Radiology Nuclear Medicine and imaging
  • Psychiatry and Mental health

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