The effect of psychotherapy on the brain
Frontal lobe of the brain as a central network structure for cognitive behavioral therapy
In Germany, approximately one third of people ill at least once in life to a subject in need of mental illness. Psychotherapy is in addition to the pharmacotherapy an effective and widely used method for treating these diseases. Panic disorder occurs in approximately 3-5% and is characterized by sudden onset of panic, palpitations, sweating, and the thought of having to die or to faint.
An innovative study on the influence of psychotherapy on brain processes in patients with panic disorder was led by Professor Dr. med. Tilo Kircher and dr. Benjamin Straube supervised and evaluated in the Department of Psychiatry and Psychotherapy of the Philipps-University Marburg. It was published under the title: "Effect of cognitive-behavioral therapy on neural correlates of fear conditioning in panic disorder" at the 1. January 2013 in the journal "Biological Psychiatry". It is the world's largest study of the effect of psychotherapy on the brain as measured by functional magnetic resonance imaging (fMRI). The work funded by the BMBF is part of a large, nationwide investigation. Until now, it was unclear how psychotherapy affects the brain of patients with panic disorder.
The results of this study demonstrate the special role of the left inferior frontal cortex in fear conditioning in patients with panic disorder. Patients show hyperactivation of this region before therapy compared to healthy subjects, who reduce to normal levels after participating in cognitive-behavioral therapy (KVT) (Kircher et al., 2013). Furthermore, it has been shown that in patients the left inferior frontal gyrus has an increased linkage (connectivity) to regions of fear processing (eg, amygdala, anterior cingulate cortex, insula), indicating an increased correlation between "cognitive" and "emotional" processes Patients with panic disorder compared to healthy points.
Kircher's study is the first to demonstrate the effects of cognitive-behavioral therapy on neural correlates of fear conditioning. Thus, cognitive behavioral therapy does not appear to act primarily on emotional processes, but rather on cognitive processes associated with the left inferior frontal gyrus. A "mental" method, namely psychotherapy, plastically changes the "material" brain.
This finding should help to further optimize therapy procedures in order to treat patients with panic disorder and their consequences (eg, agoraphobia) even more efficiently. For example, further analyzes should shed light on whether genetic predispositions of patients influence the neural processes described and the success of the therapy (see Reif et al., In press). By contrast, other evaluation strategies tend to focus on differences in neural processing between patients that predict better or worse effects of cognitive-behavioral therapy prior to therapy.
Further information:
Kircher T, Arolt V, Jansen A, Pyka M, Reinhardt I, Kellermann T, Konrad C, Lueken U, Gloster AT, Gerlach AL, Ströhle A, Wittmann A, Pfleiderer B, Wittchen HU, Straube B. Effect of cognitive-behavioral therapy on neural correlates of fear conditioning in panic disorder. Biol Psychiatry. 2013 Jan 1; 73 (1): 93 101.
http://www.biologicalpsychiatryjournal.com/article/S0006-3223(12)00670-1/fulltext
Source: Marburg [Philipps University]
