Forum for Science, Industry and Business

Sponsored by:     3M 
Search our Site:

 

Patients recovering from depression with talk therapy show a ’distinct’ pattern of brain changes

06.01.2004


Path to recovery at the brain level appears different from drug therapy



An imaging study by neuroscientists in Canada has found that patients who recover from depression with Cognitive Behavioral Therapy (CBT) show a pattern of brain changes that is distinct from patients who recover with drug therapy.

It’s an important finding because it shows -- for the first time with definitive imaging evidence -- that the depressed brain responds ’differently’ to different treatments. It may also help doctors better understand why a particular treatment might work for one patient and not another.


The results are published in the January 2004 issue of the Archives of General Psychiatry. The study was led by The Rotman Research Institute at Baycrest Centre for Geriatric Care, in collaboration with the Centre for Addiction and Mental Health (CAMH), and University of Toronto.

"When treating clinical depression we know that one type of treatment doesn’t fit all," says principal investigator Dr. Helen Mayberg, a senior scientist at The Rotman Research Institute at Baycrest and the Sandra A. Rotman Chair in Neuropsychiatry at the University of Toronto.

"Our imaging study shows that you can correct the depression network along a variety of pathways. Anti-depressant drugs change the chemical balance in the brain through effects at very specific target sites. Cognitive behavioral therapy also changes brain activity, it’s just tapping into a different component of the same depression circuit board."

The most common treatments for clinical depression are CBT or other types of psychotherapy, drug therapy, or a combination of both. It’s not unusual for treatment to go through a trial-and-error period until one is found to provide optimal results for a patient, with the least side effects.

With CBT, patients learn to evaluate emotional provocation in their environment in a new way. They are taught cognitive strategies for reducing automatic reactivity to negative thoughts.

Using positron emission tomography (PET) -- multi-colored imaging that pinpoints where maximum changes in brain metabolism occur -- Dr. Mayberg’s team, led by CBT expert Zindel Segal, PhD, and graduate student Kimberly Goldapple, generated a detailed picture of what this self-correction looks like.

CBT has theoretically been considered a top-down approach because it focuses on the cortical (top) area of the brain -- associated with thinking functions -- to modulate abnormal mood states. It aims to modify attention and memory functions, affective bias and maladaptive information processing. In contrast, drug therapy is considered a bottom-up approach because it alters the chemistry in the brain stem and limbic (bottom) regions which drive more basic emotional and circadian behaviors resulting in eventual upstream changes in depressive thinking.

In this current study in Archives, 14 clinically-depressed adult patients underwent a full course of CBT. They each received 15 to 20 individualized outpatient sessions. None were on drug therapy. The patients’ brains were scanned prior to beginning treatment and at the end of the full course of therapy.

Investigators found that CBT targets many of the same limbic and cortical regions affected by drug therapy, but in ’different directions’. With drug therapy, metabolism (blood flow) decreases in the limbic area and increases in the cortical area. With CBT, Mayberg and colleagues identified the reverse pattern: limbic increases (in the hippocampus, dorsal mid cingulate) and cortical decreases (in the dorsolateral, ventrolateral and medial orbital frontal; inferior temporal and parietal). Furthermore, each treatment showed changes in unique brain regions supporting the top-down, bottom-up theories.

What explains this reverse pattern? As CBT patients learn to turn off the thinking paradigm that leads them to dwell on negative thoughts and attitudes, activity in certain areas in the cortical (thinking, attention) region are decreasing as well.

"The challenge continues to be how to figure out ’how to best treat’ for what the brain needs," says Dr. Mayberg. She suggests that brain scans may one day become a useful component of the treatment protocol for clinically depressed patients, helping doctors to determine in advance what treatment will be most efficacious, as well as monitor the effectiveness of a particular treatment strategy.


Dr. Mayberg’s research team included Kimberly Goldapple (The Rotman Research Institute), and Drs. Zindel Segal, Sidney Kennedy, Mark Lau and Peter Bieling, and Carol Garson of the Department of Psychiatry (CAMH).

The study was funded by the Sandra A. Rotman Chair in Neuropsychiatry (Rotman Research Institute, University of Toronto), the Canadian Institutes of Health Research, and a University of Toronto Institute of Medical Science Open Fellowship Award.

Dr. Mayberg is now Professor of Psychiatry and Neurology at Emory University School of Medicine in Atlanta, and remains an associate scientist with The Rotman Research Institute at Baycrest.

Kelly Connelly | EurekAlert!
Further information:
http://www.baycrest.org/

More articles from Health and Medicine:

nachricht Cystic fibrosis alters the structure of mucus in airways
28.06.2017 | University of Iowa Health Care

nachricht Mice provide insight into genetics of autism spectrum disorders
28.06.2017 | University of California - Davis

All articles from Health and Medicine >>>

The most recent press releases about innovation >>>

Die letzten 5 Focus-News des innovations-reports im Überblick:

Im Focus: Can we see monkeys from space? Emerging technologies to map biodiversity

An international team of scientists has proposed a new multi-disciplinary approach in which an array of new technologies will allow us to map biodiversity and the risks that wildlife is facing at the scale of whole landscapes. The findings are published in Nature Ecology and Evolution. This international research is led by the Kunming Institute of Zoology from China, University of East Anglia, University of Leicester and the Leibniz Institute for Zoo and Wildlife Research.

Using a combination of satellite and ground data, the team proposes that it is now possible to map biodiversity with an accuracy that has not been previously...

Im Focus: Climate satellite: Tracking methane with robust laser technology

Heatwaves in the Arctic, longer periods of vegetation in Europe, severe floods in West Africa – starting in 2021, scientists want to explore the emissions of the greenhouse gas methane with the German-French satellite MERLIN. This is made possible by a new robust laser system of the Fraunhofer Institute for Laser Technology ILT in Aachen, which achieves unprecedented measurement accuracy.

Methane is primarily the result of the decomposition of organic matter. The gas has a 25 times greater warming potential than carbon dioxide, but is not as...

Im Focus: How protons move through a fuel cell

Hydrogen is regarded as the energy source of the future: It is produced with solar power and can be used to generate heat and electricity in fuel cells. Empa researchers have now succeeded in decoding the movement of hydrogen ions in crystals – a key step towards more efficient energy conversion in the hydrogen industry of tomorrow.

As charge carriers, electrons and ions play the leading role in electrochemical energy storage devices and converters such as batteries and fuel cells. Proton...

Im Focus: A unique data centre for cosmological simulations

Scientists from the Excellence Cluster Universe at the Ludwig-Maximilians-Universität Munich have establised "Cosmowebportal", a unique data centre for cosmological simulations located at the Leibniz Supercomputing Centre (LRZ) of the Bavarian Academy of Sciences. The complete results of a series of large hydrodynamical cosmological simulations are available, with data volumes typically exceeding several hundred terabytes. Scientists worldwide can interactively explore these complex simulations via a web interface and directly access the results.

With current telescopes, scientists can observe our Universe’s galaxies and galaxy clusters and their distribution along an invisible cosmic web. From the...

Im Focus: Scientists develop molecular thermometer for contactless measurement using infrared light

Temperature measurements possible even on the smallest scale / Molecular ruby for use in material sciences, biology, and medicine

Chemists at Johannes Gutenberg University Mainz (JGU) in cooperation with researchers of the German Federal Institute for Materials Research and Testing (BAM)...

All Focus news of the innovation-report >>>

Anzeige

Anzeige

Event News

Plants are networkers

19.06.2017 | Event News

Digital Survival Training for Executives

13.06.2017 | Event News

Global Learning Council Summit 2017

13.06.2017 | Event News

 
Latest News

Supersensitive through quantum entanglement

28.06.2017 | Physics and Astronomy

X-ray photoelectron spectroscopy under real ambient pressure conditions

28.06.2017 | Physics and Astronomy

Mice provide insight into genetics of autism spectrum disorders

28.06.2017 | Health and Medicine

VideoLinks
B2B-VideoLinks
More VideoLinks >>>