Cognitive Behavioral Therapy Lowers Elevated Functional Connectivity in Depressed Adolescents

Shayanti Chattopadhyay; Roger Tait; Tiago Simas; Adrienne van Nieuwenhuizen; Cindy C Hagan; Rosemary J Holt; Julia Graham; Barbara J Sahakian; Paul O Wilkinson; Ian M Goodyer; John Suckling

doi:10.1016/j.ebiom.2017.02.010

Cognitive Behavioral Therapy Lowers Elevated Functional Connectivity in Depressed Adolescents

EBioMedicine. 2017 Mar:17:216-222. doi: 10.1016/j.ebiom.2017.02.010. Epub 2017 Feb 16.

Authors

Affiliations

¹ Department of Psychiatry, University of Cambridge, Cambridge, UK. Electronic address: sc751@cam.ac.uk.
² MRC/Wellcome Trust Behavioral and Clinical Neurosciences Institute, University of Cambridge, Cambridge, UK.
³ Department of Psychiatry, University of Cambridge, Cambridge, UK.
⁴ Department of Psychiatry, University of Cambridge, Cambridge, UK; Department of Psychology, Columbia University, New York, NY, USA.
⁵ Department of Psychiatry, University of Cambridge, Cambridge, UK; Department of Psychiatry, University of Oxford, Oxford, UK.
⁶ Department of Psychiatry, University of Cambridge, Cambridge, UK; MRC/Wellcome Trust Behavioral and Clinical Neurosciences Institute, University of Cambridge, Cambridge, UK.
⁷ Department of Psychiatry, University of Cambridge, Cambridge, UK; Cambridge and Peterborough Foundation NHS Trust, Cambridge, UK.
⁸ Department of Psychiatry, University of Cambridge, Cambridge, UK; Cambridge and Peterborough Foundation NHS Trust, Cambridge, UK; MRC/Wellcome Trust Behavioral and Clinical Neurosciences Institute, University of Cambridge, Cambridge, UK.

Abstract

Imaging studies have implicated altered functional connectivity in adults with major depressive disorder (MDD). Whether similar dysfunction is present in adolescent patients is unclear. The degree of resting-state functional connectivity (rsFC) may reflect abnormalities within emotional ('hot') and cognitive control ('cold') neural systems. Here, we investigate rsFC of these systems in adolescent patients and changes following cognitive behavioral therapy (CBT). Functional Magnetic Resonance Imaging (fMRI) was acquired from adolescent patients before CBT, and 24-weeks later following completed therapy. Similar data were obtained from control participants. Cross-sectional Cohort: From 82 patients and 34 controls at baseline, rsFC of the amygdala, anterior cingulate cortex (ACC), and pre-frontal cortex (PFC) was calculated for comparison. Longitudinal Cohort: From 17 patients and 30 controls with longitudinal data, treatment effects were tested on rsFC. Patients demonstrated significantly greater rsFC to left amygdala, bilateral supragenual ACC, but not with PFC. Treatment effects were observed in right insula connected to left supragenual ACC, with baseline case-control differences reduced. rsFC changes were significantly correlated with changes in depression severity. Depressed adolescents exhibited heightened connectivity in regions of 'hot' emotional processing, known to be associated with depression, where treatment exposure exerted positive effects, without concomitant differences in areas of 'cold' cognition.

Keywords: Adolescence; Cortical thickness; Depression; Fronto-limbic; Functional connectivity; Resting-state.

Publication types

Pragmatic Clinical Trial
Randomized Controlled Trial

MeSH terms

Adolescent
Cognitive Behavioral Therapy*
Connectome*
Depressive Disorder, Major / diagnostic imaging
Depressive Disorder, Major / therapy*
Female
Humans
Magnetic Resonance Imaging
Male

Abstract

Publication types

MeSH terms

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