Beutel M E
Klinik für Psychosomatische Medizin und Psychotherapie, Johannes Gutenberg-Universität Mainz, Untere Zahlbacher Strasse 8, 55131 Mainz, BRD.
Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz. 2006 Aug;49(8):749-58. doi: 10.1007/s00103-006-0005-9.
Only recently has functional neuroimaging been used increasingly in the context of psychotherapy research. Based on a literature survey, procedures, methodological underpinnings and paradigms relevant for psychotherapy research are explored regarding functional magnetic resonance imaging (fMRI) and positron emission tomography (PET). Current studies on changes of brain functions and potential mechanisms are presented based on obsessive-compulsive disorders, depression, phobia, panic and borderline personality disorders. Findings and implications are discussed regarding the use of functional neuroimaging in psychotherapy research. Systematic changes of brain activation were demonstrated following successful psychotherapy, partially resembling and partially differing from those induced by psychopharmacological treatments. Thus the traditional split between pharmacological procedures "acting on the brain" and psychological procedures making the patient "feel better" has been rendered obsolete. Procedures of functional neuroimaging have been developed to such an extent that they can be used to study issues of great relevance for psychotherapy, e. g. biological underpinnings of psychiatric disorders, plasticity of neural networks, mechanisms of change and prognostic factors of psychotherapy, etc.
直到最近，功能神经影像学才越来越多地被应用于心理治疗研究领域。基于文献调查，探讨了与心理治疗研究相关的程序、方法学基础及范式，涉及功能磁共振成像（fMRI）和正电子发射断层扫描（PET）。基于强迫症、抑郁症、恐惧症、恐慌症和边缘性人格障碍，介绍了当前关于脑功能变化及潜在机制的研究。讨论了功能神经影像学在心理治疗研究中的应用所取得的发现及意义。成功的心理治疗后显示出大脑激活的系统性变化，部分类似于且部分不同于心理药物治疗所诱发的变化。因此，传统上“作用于大脑”的药物治疗程序与使患者“感觉更好”的心理治疗程序之间的区分已过时。功能神经影像学程序已发展到可以用于研究与心理治疗高度相关的问题的程度，例如精神疾病的生物学基础、神经网络的可塑性、心理治疗的变化机制和预后因素等。
