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Use of fMRI to Predict Recovery From Unipolar Depression With Cognitive Behavior Therapy

OBJECTIVE: In controlled treatment trials, 40%–60% of unmedicated depressed individuals respond to cognitive behavior therapy (CBT). The authors examined whether pretreatment neural reactivity to emotional stimuli accounted for this variation. METHOD: Unmedicated depressed individuals (N=14) and never depressed comparison subjects (N=21) underwent fMRI during performance of a task sensitive to sustained emotional information processing. Afterward, depressed participants completed 16 sessions of CBT. RESULTS: Participants whose sustained reactivity to emotional stimuli was low in the subgenual cingulate cortex (Brodmann’s area 25) and high in the amygdala displayed the strongest improvement with CBT. CONCLUSIONS: The presence of emotion regulation disruptions, which are targeted in CBT, may be the key to recovery with this intervention.

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				G. J. Siegle Brain Mechanisms of Borderline Personality Disorder at the Intersection of Cognition, Emotion, and the Clinic Am J Psychiatry, December 1, 2007; 164(12): 1776 - 1779. [Full Text] [PDF]

				M. L. Phillips The Emerging Role of Neuroimaging in Psychiatry: Characterizing Treatment-Relevant Endophenotypes Am J Psychiatry, May 1, 2007; 164(5): 697 - 699. [Full Text] [PDF]

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