Psychotherapy and inhibitory control: Insights from fMRI research

Despite the widespread clinical use of psychotherapy, the neural mechanisms linking treatment to changes in inhibitory control networks supporting self-regulation remain unclear. This study addresses this gap by meta-analyzing neuroimaging research on how psychotherapy affects brain regions involved in inhibitory control.

We conducted a systematic literature review, selecting functional magnetic resonance imaging (fMRI) studies that examined inhibitory control tasks before and after psychotherapeutic interventions. Fifteen studies met the inclusion criteria and were analyzed using the activation likelihood estimation (ALE) algorithm.

Results revealed three significant clusters of activations, namely: the superior and medial frontal gyrus (including pre-supplementary motor area), anterior cingulate cortex (ACC), and subcortical regions, such as the thalamus and globus pallidus. These areas are commonly reported as key nodes of the inhibitory control brain network.

Overall, our main result indicates that psychotherapy might modulate key brain region activations involved in inhibitory control, particularly the prefrontal cortex-anterior cingulate network. This suggests that psychotherapy enhances cognitive and emotional regulation through strengthening inhibitory mechanisms. Moreover, the observed neural changes appear to parallel those induced by pharmacologic interventions, pointing to potential convergent therapeutic targets despite differing mechanisms of action.