Life and Health Sciences Research Institute (ICVS), University of Minho, Braga, Portugal.
ICVS/3B's, PT Government Associate Laboratory, Braga/Guimarães, Portugal.
Psychol Med. 2023 Jun;53(8):3387-3395. doi: 10.1017/S0033291721005444. Epub 2022 Jan 11.
Cognitive-behavior therapy (CBT) is a well-established first-line intervention for anxiety-related disorders, including specific phobia, social anxiety disorder, panic disorder/agoraphobia, generalized anxiety disorder, obsessive-compulsive disorder, and posttraumatic stress disorder. Several neural predictors of CBT outcome for anxiety-related disorders have been proposed, but previous results are inconsistent.
We conducted a systematic review and meta-analysis of task-based functional magnetic resonance imaging (fMRI) studies investigating whole-brain predictors of CBT outcome in anxiety-related disorders (17 studies, = 442).
Across different tasks, we observed that brain response in a network of regions involved in salience and interoception processing, encompassing fronto-insular (the right inferior frontal gyrus-anterior insular cortex) and fronto-limbic (the dorsomedial prefrontal cortex-dorsal anterior cingulate cortex) cortices was strongly associated with a positive CBT outcome.
Our results suggest that there are robust neural predictors of CBT outcome in anxiety-related disorders that may eventually lead (probably in combination with other data) to develop personalized approaches for the treatment of these mental disorders.
认知行为疗法（CBT）是一种成熟的一线干预方法，可用于治疗焦虑相关障碍，包括特定恐惧症、社交焦虑障碍、惊恐障碍/广场恐怖症、广泛性焦虑障碍、强迫症和创伤后应激障碍。已经提出了几种焦虑相关障碍 CBT 结果的神经预测因子，但先前的结果不一致。
我们对考察焦虑相关障碍 CBT 结果的全脑预测因子的基于任务的功能磁共振成像（fMRI）研究进行了系统回顾和荟萃分析（17 项研究，n=442）。
在不同的任务中，我们观察到涉及显着性和内脏感觉加工的区域网络中的大脑反应与 CBT 结果呈正相关，该网络包括额-岛（右侧额下回-前岛叶皮质）和额-边缘（背侧前额叶皮质-背侧前扣带皮质）皮质。
我们的研究结果表明，焦虑相关障碍的 CBT 结果存在强大的神经预测因子，这些预测因子可能最终导致（可能与其他数据相结合）开发针对这些精神障碍的个性化治疗方法。
