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Depression-related anterior cingulate prefrontal resting state connectivity normalizes following cognitive behavioral
Spiro P Pantazatos1,2, Ashley Yttredahl1,2, Harry Rubin-Falcone2,3
1Molecular Imaging and Neuropathology, New York State Psychiatric Institute, New York, New York, USA.
Summary
Subdivisions of the subcallosal cingulate (SCC) show altered functional connectivity in major depressive disorder (MDD) patients undergoing cognitive behavioral therapy (CBT). Connectivity in the rostral anterior cingulate (rACC) and anterior SCC (aSCC) increased with symptom improvement, highlighting SCC
Area of Science:
- Neuroscience
- Psychiatry
- Radiology
Background:
- Aberrant subcallosal cingulate (SCC) activity is implicated in predicting pharmacologic treatment efficacy for major depressive disorder (MDD).
- The role of SCC subdivisions in psychotherapeutic interventions remains understudied.
- Functional differences among SCC subdivisions require further investigation.
Purpose of the Study:
- To investigate the functional connectivity (rsFC) of SCC subdivisions before and after cognitive behavioral therapy (CBT) in MDD patients.
- To explore the relationship between SCC connectivity and treatment outcomes in MDD.
- To identify potential differences in SCC subdivision involvement during psychotherapeutic interventions.
Main Methods:
- Resting-state fMRI data were acquired from unmedicated MDD patients before and after 14 CBT sessions.
- Seeds from three SCC subdivisions (rostral anterior cingulate - rACC, anterior SCC - aSCC, Brodmann's area 25 - BA25) were used for connectivity analyses.
- Analyses assessed baseline rsFC, changes in connectivity post-treatment, and prediction of symptom improvement using Beck Depression Inventory (BDI) scores.
Main Results:
- Pretreatment BDI scores negatively correlated with baseline rsFC between rACC-dorsolateral prefrontal cortex and aSCC-lateral prefrontal cortex.
- rsFC between these regions increased post-CBT, correlating with symptom improvement.
- Whole-brain analyses revealed decreased post-treatment connectivity for BA25-paracentral lobule and rACC-paracentral lobule; baseline SCC connectivity did not predict improvement.
Conclusions:
- rsFC of rACC and aSCC, but not BA25, inversely correlated with depression severity and increased after CBT.
- SCC subdivisions involved in top-down emotion regulation (rACC, aSCC) may be more relevant to cognitive interventions.
- BA25 might be more relevant for interventions targeting bottom-up processing, emphasizing the need to analyze SCC subdivisions separately.
Keywords:
Cognitive behavioral therapydepressionfunctional magnetic resonance imagingresting-state functional connectivitysubgenual cingulate cortexMore Related Videos
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