Cognitive behaviour therapy affects brain activity differently from antidepressants
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《英国医生杂志》
London
Cognitive behaviour therapy triggers a different pattern of changes in brain activity than that triggered by the antidepressant paroxetine, according to a small pilot study that provides the first scan based evidence that the treatments work in different ways.
The researchers scanned 17 previously untreated patients with unipolar depression before and after a 15-20 session course of outpatient cognitive behaviour therapy. The group's mean score on the 17 item Hamilton depression rating scale, which rates items on a scale from 0 (absent) to 4 (very severe), was 20±3 before treatment. The score improved to 6.7±4 in the 14 patients who completed cognitive behavioural therapy. Positron emission tomography was used to examine changes in the brain. The tomography showed significant metabolic changes in the patterns of brain activity in the patients who underwent cognitive behaviour therapy, with increased activity in the hippocampus and dorsal cingulate regions and decreases in cortical activity ( Archives of General Psychiatry 2003;61: 34-41).
The results were compared after the study with an independent group of 13 men with depression (mean Hamilton depression rating scale score 22.4±3.6) who were scanned before and after six weeks of treatment with the antidepressant paroxetine. Scans showed changes in brain activity in similar regions as those triggered in patients who underwent cognitive behaviour therapy but in the opposite direction, with increases in activity in the prefrontal cortex and decreases in the hippocampal and dorsal cingulate regions, which are located in the medial part of the temporal lobe.
The limbic system of the brain
Credit: JOHN BAVOSI/SPL
The Canadian researchers said that—like other treatments for depression—cognitive behaviour therapy seems to help by modulating the function of specific sites in the limbic and cortical regions of the brain. However, they proposed that the difference in the direction of the changes in brain activity may reflect specific effects relating to the type of treatment.
One of the researchers, Helen Mayberg, professor of psychiatry at the University of Toronto, said: "Our imaging results suggest that you can correct the depression network along a variety of pathways. Antidepressant drugs change the chemical balance in the brain through effects at very specific target sites. Cognitive behaviour therapy also changes brain activity: it's just tapping into a different component of the same depression circuit board."(Sue Mayor)
Cognitive behaviour therapy triggers a different pattern of changes in brain activity than that triggered by the antidepressant paroxetine, according to a small pilot study that provides the first scan based evidence that the treatments work in different ways.
The researchers scanned 17 previously untreated patients with unipolar depression before and after a 15-20 session course of outpatient cognitive behaviour therapy. The group's mean score on the 17 item Hamilton depression rating scale, which rates items on a scale from 0 (absent) to 4 (very severe), was 20±3 before treatment. The score improved to 6.7±4 in the 14 patients who completed cognitive behavioural therapy. Positron emission tomography was used to examine changes in the brain. The tomography showed significant metabolic changes in the patterns of brain activity in the patients who underwent cognitive behaviour therapy, with increased activity in the hippocampus and dorsal cingulate regions and decreases in cortical activity ( Archives of General Psychiatry 2003;61: 34-41).
The results were compared after the study with an independent group of 13 men with depression (mean Hamilton depression rating scale score 22.4±3.6) who were scanned before and after six weeks of treatment with the antidepressant paroxetine. Scans showed changes in brain activity in similar regions as those triggered in patients who underwent cognitive behaviour therapy but in the opposite direction, with increases in activity in the prefrontal cortex and decreases in the hippocampal and dorsal cingulate regions, which are located in the medial part of the temporal lobe.
The limbic system of the brain
Credit: JOHN BAVOSI/SPL
The Canadian researchers said that—like other treatments for depression—cognitive behaviour therapy seems to help by modulating the function of specific sites in the limbic and cortical regions of the brain. However, they proposed that the difference in the direction of the changes in brain activity may reflect specific effects relating to the type of treatment.
One of the researchers, Helen Mayberg, professor of psychiatry at the University of Toronto, said: "Our imaging results suggest that you can correct the depression network along a variety of pathways. Antidepressant drugs change the chemical balance in the brain through effects at very specific target sites. Cognitive behaviour therapy also changes brain activity: it's just tapping into a different component of the same depression circuit board."(Sue Mayor)