Limbic gray matter increases in response to cognitive-behavioral therapy in major depressive disorder.

IF 6.2 1区医学 Q1 PSYCHIATRY

Translational Psychiatry Pub Date : 2025-08-27 DOI:10.1038/s41398-025-03545-7

Esther Zwiky, Tiana Borgers, Melissa Klug, Philine König, Konrad Schöniger, Janine Selle, Antonia Küttner, Luisa Brunner, Elisabeth J Leehr, Udo Dannlowski, Verena Enneking, Ronny Redlich

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Abstract

Major depressive disorder (MDD) is related to volumetric decreases in (cortico-)limbic brain regions. In contrast to pharmacological and electroconvulsive therapy, little is known about the brain structural effects of psychotherapy and potential links to symptom improvements. In a naturalistic longitudinal study using structural magnetic resonance tomography, gray matter volume (GMV) and clinical measures were assessed in 30 outpatients with MDD before and after 20 cognitive-behavioral therapy (CBT) sessions. Data from 30 healthy controls was acquired. Region-of-interest analyses revealed significant GMV increases within patients for the right anterior hippocampus and the bilateral amygdala, resulting in a significant group-by-time interaction for the left amygdala (p ≤ 0.022). Simultaneously, analyses revealed volumetric decreases in the right posterior hippocampus (p = 0.016). While there were no associations with overall symptom improvement, right amygdala volume increases were slightly associated with improvements in identifying feelings (r_s = 0.321, p = 0.042). Together, findings show an impact of CBT not only on psychopathology but also on brain structure. The connection between CBT-related increased amygdala GMV and improved emotion identification emphasizes the role of improvements in emotional awareness.

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认知行为疗法对重度抑郁症患者大脑边缘灰质的影响。

重度抑郁障碍（MDD）与（皮质-）大脑边缘区域的体积减少有关。与药理学和电休克疗法相比，人们对心理疗法对大脑结构的影响以及与症状改善的潜在联系知之甚少。在一项使用结构磁共振断层扫描的自然纵向研究中，对30名MDD门诊患者在20次认知行为治疗（CBT）前后的灰质体积（GMV）和临床测量进行了评估。获得了30名健康对照者的数据。兴趣区分析显示，患者右侧前海马和双侧杏仁核的GMV显著增加，导致左侧杏仁核出现显著的组-时间交互作用（p≤0.022）。同时，分析显示右侧海马后部体积减小（p = 0.016）。虽然与整体症状改善没有关联，但右侧杏仁核体积的增加与识别感觉的改善略有相关（rs = 0.321, p = 0.042）。总之，研究结果表明CBT不仅对精神病理学有影响，而且对大脑结构也有影响。cbt相关的杏仁核GMV增加和情绪识别的改善之间的联系强调了情绪意识改善的作用。

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来源期刊

Translational Psychiatry PSYCHIATRY-

CiteScore

11.50

自引率

2.90%

发文量

484

审稿时长

23 weeks

期刊介绍： Psychiatry has suffered tremendously by the limited translational pipeline. Nobel laureate Julius Axelrod''s discovery in 1961 of monoamine reuptake by pre-synaptic neurons still forms the basis of contemporary antidepressant treatment. There is a grievous gap between the explosion of knowledge in neuroscience and conceptually novel treatments for our patients. Translational Psychiatry bridges this gap by fostering and highlighting the pathway from discovery to clinical applications, healthcare and global health. We view translation broadly as the full spectrum of work that marks the pathway from discovery to global health, inclusive. The steps of translation that are within the scope of Translational Psychiatry include (i) fundamental discovery, (ii) bench to bedside, (iii) bedside to clinical applications (clinical trials), (iv) translation to policy and health care guidelines, (v) assessment of health policy and usage, and (vi) global health. All areas of medical research, including — but not restricted to — molecular biology, genetics, pharmacology, imaging and epidemiology are welcome as they contribute to enhance the field of translational psychiatry.