Department of Psychiatry, CHA Bundang Medical Center, CHA University School of Medicine, Seongnam, Republic of Korea.
Psychiatry Clin Neurosci. 2023 Jun;77(6):355-364. doi: 10.1111/pcn.13544. Epub 2023 Mar 30.
We aimed to examine the long-term benefits of mindfulness-based cognitive therapy (MBCT) on white matter plasticity in the cortical midline structures (CMS) for a period of 2 years in patients with panic disorder and the relationships between white matter changes in the CMS and severity of state and trait symptoms.
Seventy-one participants were enrolled and underwent diffusion tensor imaging at baseline and after 2 years (26 who received MBCT as an adjunct to pharmacotherapy [MBCT+PT], 20 treated with pharmacotherapy alone [PT-alone], and 25 healthy controls [HCs]). The severity of symptoms and fractional anisotropy (FA) in white matter regions underlying the CMS were assessed at baseline and 2-year follow-up.
The MBCT+PT group showed better outcomes after 2 years than the PT-alone group. The groups showed different FA changes: the MBCT+PT group showed decreased FA in the left anterior cingulate cortex (ACC); the PT-alone group showed increased FA in the bilateral dorsomedial prefrontal cortex, posterior cingulate cortex (PCC), and precuneus. Decreased white matter FA in the ACC, PCC, and precuneus was associated with improvements in the severity of state and trait symptoms in patients with panic disorder.
Alleviation of excessive white matter connectivity in the CMS after MBCT leads to improvements in clinical symptoms and trait vulnerability in patients with panic disorder. Our study provides new evidence for the long-term benefits of MBCT on white matter plasticity and its clinical applicability as a robust treatment for panic disorder.
我们旨在研究正念认知疗法（MBCT）对惊恐障碍患者皮质中线结构（CMS）内白质可塑性的长期影响，时间跨度为 2 年，并探讨 CMS 内白质变化与状态和特质症状严重程度之间的关系。
共纳入 71 名参与者，他们在基线时和 2 年后（26 名接受 MBCT 联合药物治疗[MBCT+PT]，20 名接受单独药物治疗[PT- alone]，25 名健康对照组[HCs]）接受弥散张量成像检查。在基线和 2 年随访时评估症状严重程度和 CMS 下白质区域的各向异性分数（FA）。
MBCT+PT 组在 2 年后的结果优于 PT-alone 组。两组的 FA 变化不同：MBCT+PT 组左前扣带回皮质（ACC）的 FA 降低；PT-alone 组双侧背内侧前额叶皮质、后扣带回皮质（PCC）和楔前叶的 FA 增加。ACC、PCC 和楔前叶的白质 FA 降低与惊恐障碍患者状态和特质症状严重程度的改善相关。
MBCT 后 CMS 内过度白质连接的缓解导致惊恐障碍患者临床症状和特质易感性的改善。我们的研究为 MBCT 对白质可塑性的长期影响及其作为惊恐障碍有效治疗方法的临床应用提供了新证据。
