Universität zu Köln

Straube, Benjamin ORCID: 0000-0002-9837-0944, Lueken, Ulrike ORCID: 0000-0003-1564-4012, Jansen, Andreas ORCID: 0000-0002-3140-8207, Konrad, Carsten, Gloster, Andrew T., Gerlach, Alexander L. ORCID: 0000-0001-6794-5349, Stroehle, Andreas, Wittmann, Andre, Pfleiderer, Bettina, Gauggel, Siegfried ORCID: 0000-0002-2742-4917, Wittchen, Ulrich, Arolt, Volker and Kircher, Tilo ORCID: 0000-0002-2514-2625 (2014). Neural Correlates of Procedural Variants in Cognitive-Behavioral Therapy: A Randomized, Controlled Multicenter fMRI Study. Psychother. Psychosom., 83 (4). S. 222 - 234. BASEL: KARGER. ISSN 1423-0348

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Abstract

Background: Cognitive behavioral therapy (CBT) is an effective treatment for panic disorder with agoraphobia (PD/AG). It is unknown, how variants of CBT differentially modulate brain networks involved in PD/AG. This study was aimed to evaluate the effects of therapist-guided (T+) versus self-guided (T) exposure on the neural correlates of fear conditioning in PD/AG. Method: In a randomized, controlled multicenter clinical trial in medication-free patients with PD/AG who were treated with 12 sessions of manualized CBT, functional magnetic resonance imaging (fMRI) was used during fear conditioning before (t1) and after CBT (t2). Quality-controlled fMRI data from 42 patients and 42 healthy subjects (HS) were obtained. Patients were randomized to two variants of CBT (T+, n = 22, and T, n = 20). Results: The interaction of diagnosis (PD/AG, HS), treatment group (T+, T), time point (t1, t2) and stimulus type (conditioned stimulus: yes, no) revealed activation in the left hippocampus and the occipitotemporal cortex. The T+ group demonstrated increased activation of the hippocampus at t2 (t2 > t1), which was positively correlated with treatment outcome, and a decreased connectivity between the left inferior frontal gyrus and the left hippocampus across time (t1 > t2). Conclusion: After T+ exposure, contingency-encoding processes related to the posterior hippocampus are augmented and more de-coupled from processes of the left inferior frontal gyrus, previously shown to be dysfunctionally activated in PD/AG. Linking single procedural variants to neural substrates offers the potential to inform about the optimization of targeted psychotherapeutic interventions. (C) 2014 S. Karger AG, Basel

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Straube, Benjamin UNSPECIFIED orcid.org/0000-0002-9837-0944 UNSPECIFIED Lueken, Ulrike UNSPECIFIED orcid.org/0000-0003-1564-4012 UNSPECIFIED Jansen, Andreas UNSPECIFIED orcid.org/0000-0002-3140-8207 UNSPECIFIED Konrad, Carsten UNSPECIFIED UNSPECIFIED UNSPECIFIED Gloster, Andrew T. UNSPECIFIED UNSPECIFIED UNSPECIFIED Gerlach, Alexander L. UNSPECIFIED orcid.org/0000-0001-6794-5349 UNSPECIFIED Stroehle, Andreas UNSPECIFIED UNSPECIFIED UNSPECIFIED Wittmann, Andre UNSPECIFIED UNSPECIFIED UNSPECIFIED Pfleiderer, Bettina UNSPECIFIED UNSPECIFIED UNSPECIFIED Gauggel, Siegfried UNSPECIFIED orcid.org/0000-0002-2742-4917 UNSPECIFIED Wittchen, Ulrich UNSPECIFIED UNSPECIFIED UNSPECIFIED Arolt, Volker UNSPECIFIED UNSPECIFIED UNSPECIFIED Kircher, Tilo UNSPECIFIED orcid.org/0000-0002-2514-2625 UNSPECIFIED
URN:	urn:nbn:de:hbz:38-452676
DOI:	10.1159/000359955
Journal or Publication Title:	Psychother. Psychosom.
Volume:	83
Number:	4
Page Range:	S. 222 - 234
Date:	2014
Publisher:	KARGER
Place of Publication:	BASEL
ISSN:	1423-0348
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language SOCIAL ANXIETY DISORDER; CEREBRAL-BLOOD-FLOW; PANIC DISORDER; CONTROLLED-TRIAL; DIFFERENTIAL CONTRIBUTION; PSYCHOLOGICAL TREATMENT; MAJOR DEPRESSION; CONDITIONED FEAR; HUMAN AMYGDALA; HIPPOCAMPAL Multiple languages Psychiatry; Psychology Multiple languages
URI:	http://kups.ub.uni-koeln.de/id/eprint/45267