Cognitive Behaviour Therapy for Psychosis: Insights from Neuroimaging
Journal Title: Journal of Neuroimaging in Psychiatry and Neurology - Year 2017, Vol 2, Issue 1
Abstract
Up to 40% of schizophrenia patients continue to suffer from distressing symptoms despite remaining compliant with their prescribed antipsychotic medication. Additional symptom reduction following cognitive behaviour therapy for psychosis (CBTp) has been shown, but only in about 50% of such patients. A clear understanding of the neural changes following CBTp (potential mediators of improvement in target outcomes) as well as neural predictors of CBTp-led improvement (possible moderators) may help to refine or develop it further and increase its effectiveness. We provide a review of studies published to date (9 in total) examining the neural effects and/or predictors of CBTp. The studies analysed comprised of one spectroscopic imaging study on pre- vs post-CBTp changes, five functional magnetic resonance imaging studies [two analysing prevs post-CBTp changes, two analysing pre-therapy brain properties as predictors of symptom reduction following CBTp, and one analysing pre- vs post-CBTp changes in functional connectivity as the predictors of long term (over 7 years) outcome following CBTp], and three structural magnetic resonance imaging studies [two on pre-therapy brain properties as predictors of symptom change following CBTp, and one analysing pre- vs post-CBTp changes]. The findings from pre- vs post-CBTp brain activation studies demonstrate that CBTp reduces fronto-limbic activation to social threat and normalises cortico-limbic functional connectivity, indicating improved affect regulation through top-down control after CBTp. Additionally, CBTp was found to reduce pituitary volume, potentially by lowering of symptom-related distress. The findings from studies analysing pre-therapy brain properties as predictors of symptom reduction following CBTp indicate that functional and structural properties of multiple brain areas that are implicated in a range of cognitive functions, particularly the dorsolateral (cognitive flexibility), medial (self-awareness) and inferior (verbal skills) frontal cortices, hippocampus (memory) and precuneus (self-awareness), predict symptom reduction following CBTp. These results suggest a role for cognitive enhancement in the context of CBTp.
Authors and Affiliations
Veena Kumari, Taylor Terca
Intracerebral Hemorrhage, Diffusion Restriction and Contrast Enhancement on Magnetic Resonance Imaging in Posterior Reversible Encephalopathy Syndrome Secondary to Antepartum Eclampsia: Case Report and Review of Literature
Background: The diagnosis of posterior reversible encephalopathy syndrome (PRES) is based on a characteristic radiological picture in the appropriate clinical setting. Knowledge of atypical radiological presentations o...
Automated Voxel Placement: A Linux-based Suite of Tools for Accurate and Reliable Single Voxel Coregistration
Background: Single-voxel proton magnetic resonance spectroscopy (¹H MRS) is a powerful technique for studying in vivo neurochemistry, but has an often-overlooked source of error variance: inconsistent voxel placement bet...
Tract-Specific White Matter Correlates of Age-Related Reward Devaluation Deficits in Macaque Monkeys
Aim: Cognitive aging is known to alter reward-guided behaviors that require interactions between the orbitofrontal cortex (OFC) and amygdala. In macaques, OFC, but not amygdala volumes decline with age and correlate w...
18F-AV133 Cerebral VMAT2 Binding Correlated with α-synuclein Spliced Variants in Parkinson’s Disease
The study was designed to evaluate the connections between genotyping and functional image-based phenotyping in Parkinson’s disease (PD). The associations between18F-AV133 cerebral vesicular monoamine transporter 2 (VMAT...
Brain MRI Features in Horizontal Gaze Palsy with Progressive Scoliosis
Horizontal gaze palsy with progressive scoliosis (HGPPS) is a rare disease with characteristic imaging features. We report a teenager girl with severe kyphoscoliosis and bilateral horizontal gaze palsy with normal other...