Longitudinal effects of cognitive behavioral therapy for depression on the neural correlates of emotion regulation
Open accessAbstract
Cognitive behavioral therapy (CBT) is effective for a substantial minority of patients suffering from major depressive disorder (MDD), but its mechanism of action at the neural level is not known. As core techniques of CBT seek to enhance emotion regulation, we scanned 31 MDD participants prior to 14 sessions of CBT using functional magnetic resonance imaging (fMRI) and a task in which participants engaged in a voluntary emotion regulation strategy while recalling negative autobiographical memories. Eighteen healthy controls were also scanned. Twenty-three MDD participants completed post-treatment fMRI scanning, and 12 healthy volunteers completed repeat scanning without intervention. Better treatment outcome was associated with longitudinal enhancement of the emotion regulation-dependent BOLD contrast within subgenual anterior cingulate, medial prefrontal cortex, and lingual gyrus. Baseline emotion regulation-dependent BOLD contrast did not predict treatment outcome or differ between MDD and control groups. CBT response may be mediated by enhanced downregulation of neural activity during emotion regulation; brain regions identified overlap with those found using a similar task in a normative sample, and include regions related to self-referential and emotion processing. Future studies should seek to determine specificity of this downregulation to CBT, and evaluate it as a treatment target in MDD.
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CBT improves capacities for cognitive regulation of emotion and is associated with decreased amygdala-associated negative emotional reactivity and enhanced activity of the emotion regulation network.
“CBT improves capacities for cognitive regulation of emotion and is associated with decreased activity in the amygdala-associated negative emotional reactivity (233) and enhanced activity of the emotion regulation network, including the subgenual ACC, medial PFC, and lingual gyrus (234).”
From A brain-centric model of suicidal behavior (2020) · cites this paper as [234]
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- Authors
- Rubin-Falcone, H., Weber, J., Kishon, R., Ochsner, K., Delaparte, L., Doré, B., Zanderigo, F., Oquendo, M. A., Mann, J. J., & Miller, J. M.
- Affiliations
- Columbia University (US)
- Stony Brook University (US)
- University of Pennsylvania (US)
- New York State Psychiatric Institute (US)
- Columbia University Irving Medical Center (US)
- Corresponding author
- Miller, Jeffrey M.
- ORCID
- Venue
- Psychiatry Research: Neuroimaging
- Publisher
- Elsevier BV
- Published
- 2018-01
- Volume
- 271
- Pages
- 82-90
- ISSN
- 0925-4927 (ISSN-L)
- PMC
- PMC5757508
- OpenAlex
- W2767702165
- Cited by
- 53
- References
- 62
- Citations by year
- 2026: 4 · 2025: 5 · 2024: 4 · 2023: 5 · 2022: 7 · 2021: 10 · 2020: 6 · 2019: 4 · 2018: 8
- FWCI
- 6.36
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Psychiatry Research Neuroimaging (publishedVersion)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- Funders
- NIMH (K08MH085061)
- Topics
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
- Life Sciences › Neuroscience › Cognitive Neuroscience › Neural and Behavioral Psychology Studies
- Health Sciences › Medicine › Pharmacology › Treatment of Major Depression
- Keywords
- cognitive behavioral therapy, major depressive disorder, emotion regulation, neural correlates, subgenual anterior cingulate cortex, medial prefrontal cortex, lingual gyrus, BOLD contrast, treatment outcome prediction, autobiographical memory, self-referential processing, emotional processing
- MeSH terms
- Adult, Brain Mapping, Depression, Emotions, Female, Gyrus Cinguli, Humans, Longitudinal Studies, Magnetic Resonance Imaging, Male, Mental Recall, Cognitive Behavioral Therapy, Treatment Outcome, Prefrontal Cortex, Young Adult, Memory, Episodic
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