Neural connectivity during affect labeling predicts treatment response to psychological therapies for social anxiety disorder.
Neural connectivity during affect labeling predicts treatment response to psychological therapies for social anxiety disorder.
复制标题
情感标记过程中的神经连接可以预测社交焦虑症心理疗法的治疗反应。
DOI：
10.1016/j.jad.2018.08.016
复制
发表时间：
2019
影响因子：
6.6
通讯作者：
Craske,MichelleG
中科院分区：
文献类型：
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作者：
Young,KatherineS;LeBeau,RichardT;Niles,AndreaN;Hsu,KeanJ;Burklund,LisaJ;Mesri,Bita;Saxbe,Darby;Lieberman,MatthewD;Craske,MichelleG
背景虽然社交焦虑障碍（SAD）的心理治疗非常有效，但许多人对治疗没有反应。确定与改善结果相关的因素可以促进个性化治疗选择。我们调查了神经连接的模式是否预测治疗反应和是否治疗类型，认知行为疗法（CBT）或接受和承诺疗法（ACT），moderated this effectiveness.MethodsParticipants with SAD（n= 34）进行功能磁共振成像治疗前完成内隐和外显的情绪调节任务。神经连接测量是对杏仁核-前额叶皮层连接的估计。使用“临床显著变化指数”定义治疗应答者状态（Loerinc et al.，2015).结果内隐情绪调节过程中右杏仁核-右腹外侧前额叶皮层的连通性是治疗反应的显著预测因子（OR = 9.01，95%CI = 1.77，46.0，p = 0.008）。更强的反向连接与更大的治疗反应的可能性相关。有没有显着的CBT与ACT.LimitationsThe主要限制这项工作的治疗反应神经moderators是样本量小，限制了检测显着的温和的影响，结果应被解释为preliminary. ConclusionsAmygdala-VLPFC连接在影响标签预测治疗反应状态CBT或ACT后的社交焦虑障碍。这表明，支持情绪调节能力的神经回路的功能可能是从心理治疗中获益的“门户”。未来的工作应旨在复制这种效果在一个更大的样本，并考虑在此电路作为一个潜在的治疗辅助增强功能连接的方法。
BackgroundAlthough psychological treatments for social anxiety disorder (SAD) can be highly effective, many individuals do not respond to treatment. Identifying factors associated with improved outcomes can facilitate individualized treatment choices. We investigated whether patterns of neural connectivity predicted treatment responses and whether treatment type, cognitive behavioral therapy (CBT) or acceptance and commitment therapy (ACT), moderated this effect.MethodsParticipants with SAD (n= 34) underwent fMRI prior to treatment and completed implicit and explicit emotion regulation tasks. Neural connectivity measures were estimates of amygdala-prefrontal cortex connectivity. Treatment responder status was defined using the ‘clinically significant change index’ (Loerinc et al., 2015).ResultsRight amygdala-right ventrolateral prefrontal cortex connectivity during implicit emotion regulation was a significant predictor of treatment response (OR = 9.01, 95% CI = 1.77, 46.0,p= .008). Stronger inverse connectivity was associated with greater likelihood of treatment response. There were no significant neural moderators of treatment response to CBT versus ACT.LimitationsThe primary limitation of this work was the small sample size which restricted the power to detect significant moderation effects, and results should be interpreted as preliminary.ConclusionsAmygdala-vlPFC connectivity during affect labeling predicted treatment responder status following CBT or ACT for social anxiety disorder. This suggests that the functioning of neural circuitry supporting emotion regulation capacities may be a ‘gateway’ to receiving benefit from psychological treatments. Future work should aim to replicate this effect in a larger sample and consider methods for enhancing functional connectivity within this circuitry as a potential treatment adjunct.