认知行为疗法对抑郁症和焦虑症患者脑激活影响的meta分析

IF 3.3 2区 医学 Q1 PSYCHIATRY
Junjie Ren, Lijun Ma, Wanxin Wu, Juan Qiu, Zhuo Zhang, Yuxi Hong, Zushen Wang, Xinyu Hou, Jia Jin, Weixuan Hu, Yanran Wu, Xiaowei Chen, Jinyi Luo, Chuan Fan, Kai Wang, Xiaoming Li
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引用次数: 0

摘要

背景:认知行为疗法(CBT)是治疗焦虑和抑郁障碍的一种非常有效的心理疗法。尽管如此,在CBT治疗这些疾病期间,关于大脑区域激活的特异性,学术上的争论仍然存在。方法:本研究利用激活似然估计(ALE)分析,通过对脑功能区域的研究,揭示CBT对焦虑和抑郁障碍影响的神经生物学相似性和差异性。结果:meta分析共纳入22篇文章,共443例患者。我们的研究结果表明,在静息状态下,CBT治疗的抑郁症患者导致左右腹侧前扣带皮层(vACC)、左侧海马旁回(PG)、右侧回下、左侧颞下回(ITG)和右侧枕下回(IOG)的激活增加,而焦虑症患者在治疗后左右额上回(SFG)的激活增加,尾状核的激活减少。在任务状态下,焦虑症患者治疗后主要观察到右侧PG、右侧眶额叶、右侧前扣带背侧皮层(dACC)激活增加,左侧慢状核(LN)、左侧内鼻背侧皮层、右侧尾状核激活减少。对于抑郁症,在任务状态中没有出现一致的激活模式,可能是由于研究有限或在纳入的研究中任务范式的异质性。结论:CBT的疗效依赖于共同的(例如,vaccc介导的情绪调节和认知控制)和独特的神经机制(焦虑的恐惧回路调节与抑郁的记忆网络增强),为生物标志物驱动的治疗个性化提供信息。
本文章由计算机程序翻译,如有差异,请以英文原文为准。

Activation Likelihood Estimation Meta-Analysis of the Effects of Cognitive Behavioral Therapy on Brain Activation in the Treatment of Depression and Anxiety Disorders

Activation Likelihood Estimation Meta-Analysis of the Effects of Cognitive Behavioral Therapy on Brain Activation in the Treatment of Depression and Anxiety Disorders

Background: Cognitive behavioral therapy (CBT) stands as a highly efficacious psychological treatment for both anxiety and depressive disorders. Nonetheless, scholarly debates persist regarding the specificities of brain area activation during CBT treatment for these disorders.

Methodology: Utilizing activation likelihood estimation (ALE) analysis, this study aims to discern the neurobiological similarities and disparities between CBT’s effects on anxiety and depressive disorders by examining functional brain areas.

Results: A total of 22 articles, encompassing 443 patients, were included in the meta-analysis. Our results show that in the resting state, patients with depression treated with CBT resulted in increased activation of the right and left ventral anterior cingulate cortex (vACC), left parahippocampal gyrus (PG), right subgyral, left inferior temporal gyrus (ITG), and right inferior occipital gyrus (IOG), whereas patients with anxiety disorders had increased activation of the right and left superior frontal gyrus (SFG) and decreased activation of the caudate after treatment. In the task state, increased activation of the right PG, right orbital frontal lobe, and right dorsal anterior cingulate cortex (dACC) was mainly observed after treatment in patients with anxiety disorders, and the left lentiform nucleus (LN), left dorsal entorhinal cortex, and right caudate activation were decreased. For depressive disorders, no consistent activation patterns emerged in the task state, likely due to limited studies or heterogeneity in task paradigms across included studies.

Conclusion: CBT’s efficacy relies on both shared (e.g., vACC-mediated emotion regulation and cognitive control) and distinct neural mechanisms (fear-circuit modulation in anxiety vs. memory-network enhancement in depression), informing biomarker-driven treatment personalization.

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来源期刊
Depression and Anxiety
Depression and Anxiety 医学-精神病学
CiteScore
15.00
自引率
1.40%
发文量
81
审稿时长
4-8 weeks
期刊介绍: Depression and Anxiety is a scientific journal that focuses on the study of mood and anxiety disorders, as well as related phenomena in humans. The journal is dedicated to publishing high-quality research and review articles that contribute to the understanding and treatment of these conditions. The journal places a particular emphasis on articles that contribute to the clinical evaluation and care of individuals affected by mood and anxiety disorders. It prioritizes the publication of treatment-related research and review papers, as well as those that present novel findings that can directly impact clinical practice. The journal's goal is to advance the field by disseminating knowledge that can lead to better diagnosis, treatment, and management of these disorders, ultimately improving the quality of life for those who suffer from them.
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