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 New nanomedicine slips through the cracks
24.04.2019 | University of Tokyo

nachricht Sugar entering the brain during septic shock causes memory loss
23.04.2019 | Rensselaer Polytechnic Institute

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: Energy-saving new LED phosphor

The human eye is particularly sensitive to green, but less sensitive to blue and red. Chemists led by Hubert Huppertz at the University of Innsbruck have now developed a new red phosphor whose light is well perceived by the eye. This increases the light yield of white LEDs by around one sixth, which can significantly improve the energy efficiency of lighting systems.

Light emitting diodes or LEDs are only able to produce light of a certain colour. However, white light can be created using different colour mixing processes.

Im Focus: Quantum gas turns supersolid

Researchers led by Francesca Ferlaino from the University of Innsbruck and the Austrian Academy of Sciences report in Physical Review X on the observation of supersolid behavior in dipolar quantum gases of erbium and dysprosium. In the dysprosium gas these properties are unprecedentedly long-lived. This sets the stage for future investigations into the nature of this exotic phase of matter.

Supersolidity is a paradoxical state where the matter is both crystallized and superfluid. Predicted 50 years ago, such a counter-intuitive phase, featuring...

Im Focus: Explosion on Jupiter-sized star 10 times more powerful than ever seen on our sun

A stellar flare 10 times more powerful than anything seen on our sun has burst from an ultracool star almost the same size as Jupiter

  • Coolest and smallest star to produce a superflare found
  • Star is a tenth of the radius of our Sun
  • Researchers led by University of Warwick could only see...

Im Focus: Quantum simulation more stable than expected

A localization phenomenon boosts the accuracy of solving quantum many-body problems with quantum computers which are otherwise challenging for conventional computers. This brings such digital quantum simulation within reach on quantum devices available today.

Quantum computers promise to solve certain computational problems exponentially faster than any classical machine. “A particularly promising application is the...

Im Focus: Largest, fastest array of microscopic 'traffic cops' for optical communications

The technology could revolutionize how information travels through data centers and artificial intelligence networks

Engineers at the University of California, Berkeley have built a new photonic switch that can control the direction of light passing through optical fibers...

All Focus news of the innovation-report >>>

Anzeige

Anzeige

VideoLinks
Industry & Economy
Event News

Revered mathematicians and computer scientists converge with 200 young researchers in Heidelberg!

17.04.2019 | Event News

First dust conference in the Central Asian part of the earth’s dust belt

15.04.2019 | Event News

Fraunhofer FHR at the IEEE Radar Conference 2019 in Boston, USA

09.04.2019 | Event News

 
Latest News

Proteins stand up to nerve cell regression

24.04.2019 | Life Sciences

New sensor detects rare metals used in smartphones

24.04.2019 | Life Sciences

Controlling instabilities gives closer look at chemistry from hypersonic vehicles

24.04.2019 | Life Sciences

VideoLinks
Science & Research
Overview of more VideoLinks >>>