在患有创伤后应激障碍的患者中,心理治疗对负面情绪处理期间大脑激活的影响:系统性审查和元分析
Inga Aarts1,2,3, A L Thorsen4,5, C Vriend6,7,8
1Sinai Centrum, Arkin, Amstelveen, The Netherlands. inga.aarts@sinaicentrum.nl.
Brain imaging and behavior
|December 4, 2023
概括
在患有创伤后应激障碍 (PTSD) 的患者中,心理治疗可能会降低与情绪处理和记忆相关的区域的大脑活动. 这一元分析提供了关于PTSD治疗后神经生物学变化的见解.
科学领域:
- 神经科学是一个神经科学.
- 精神病学是一个精神病学.
- 医疗成像医学成像
背景情况:
- 创伤后应激障碍 (PTSD) 与情绪失调,记忆力缺陷和认知控制受损有关.
- 心理治疗是PTSD的主要治疗方法,但大约50%的患者没有充分的反应.
- 了解治疗反应的神经生物学基础对于改善治疗结果至关重要.
研究的目的:
- 在PTSD患者接受心理治疗后,在情绪处理过程中对大脑激活变化的首次元分析.
- 整合现有神经成像研究的发现,以确定神经变化的一致模式.
- 探索潜在的神经生物学机制,这些机制是心理治疗在PTSD中的有效性基础.
主要方法:
- 使用基于种子的d映射进行神经成像研究的系统元分析.
- 包括12项涉及191名PTSD患者的研究,从3700篇选文章中进行了选择.
- 治疗干预和神经成像方法的质量评估;对全样本和全脑子集进行的分析.
主要成果:
- 在心理治疗后,在包括左桃体,海马体,中间叶,下额头回环,腹侧前额叶皮质,前带皮质和岛屿在内的区域观察到大脑活化显著下降.
- 在报告全脑分析的研究中,左桃体和左腹侧前额皮层的活性减少是一致的.
- 结果表明,在PTSD心理治疗后的情绪处理过程中,恐惧和认知控制网络中的激活减少的暂时支持,尽管结果无法在多次比较中得到纠正.
结论:
- 对PTSD的心理治疗可能会导致关键情绪处理和认知控制电路中的大脑活动正常化.
- 这些发现突出了与PTSD治疗相关的潜在神经生物学目标和机制.
- 未来的研究应该专注于更大的样本大小,可控设计,并调查治疗异质性,以提高理解.
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