Association of Neural Reward Circuitry Function With Response to Psychotherapy in Youths With Anxiety Disorders.
Association of Neural Reward Circuitry Function With Response to Psychotherapy in Youths With Anxiety Disorders.
复制标题
DOI：
10.1176/appi.ajp.2020.20010094
复制
发表时间：
2021-04-01
期刊：
影响因子：
--
通讯作者：
Forbes EE
中科院分区：
文献类型：
--
作者：
Sequeira SL;Silk JS;Ladouceur CD;Hanson JL;Ryan ND;Morgan JK;McMakin DL;Kendall PC;Dahl RE;Forbes EE
确定对心理治疗反应的神经相关因素可以为治疗精神障碍的干预措施提供目标信息。本研究考察了在多大程度上奖赏回路的基线功能与青少年焦虑症患者对心理治疗的反应有关。认知行为疗法与比较支持疗法的随机临床试验在青少年焦虑症患者中进行。治疗前，72名患有焦虑症的青少年（9-14岁）和37名组匹配的健康对照青少年完成了货币奖励功能MRI任务。治疗反应被分类地定义为诊断评定的焦虑严重程度从治疗前到治疗后至少减少35%。在货币赢相对于输的过程中，检测了纹状体和内侧前额叶皮层（mPFC）的预处理神经激活与治疗反应的关系。应答者、无应答者和健康青年的mPFC激活在基线时对奖励和损失有显著差异。焦虑的年轻人比健康的年轻人表现出更高的mPFC活动，尽管这可能是由抑郁症状的差异驱动的。在治疗反应者（n=48）和无反应者（n=24）之间的计划比较也显示，治疗反应者在包括亚属前扣带皮层和伏隔核的一个簇中有更大的预处理神经激活。纹状体对奖赏接收的激活可能无法区分焦虑青年和健康青年。然而，更高的纹状体对奖励的反应可能会让焦虑的年轻人在治疗期间得到改善，可能是通过更多地参与治疗。奖赏回路的功能可能指导青少年焦虑症治疗的发展。NCT00774150
Identifying neural correlates of response to psychological treatment may inform targets for interventions designed to treat psychiatric disorders. This study examined the extent to which baseline functioning in reward circuitry is associated with response to psychotherapy in youth with anxiety disorders. A randomized clinical trial of cognitive behavioral therapy versus comparison supportive therapy was conducted in youth with anxiety disorders. Prior to treatment, 72 youths (9–14 years old) with anxiety disorders, and 37 group-matched healthy comparison youth, completed a monetary reward functional MRI task. Treatment response was defined categorically as at least a 35% reduction in diagnostician-rated anxiety severity from pre- to post-treatment. Pretreatment neural activation in the striatum and medial prefrontal cortex (mPFC) during monetary wins relative to losses was examined in relation to treatment response. Responders, non-responders, and healthy youth differed significantly in mPFC activation to rewards vs. losses at baseline. Youth with anxiety exhibited higher mPFC activity relative to healthy youth, though this may have been driven by differences in depressive symptoms. Planned comparisons between treatment responders (n=48) and non-responders (n=24) also revealed greater pretreatment neural activation in a cluster encompassing the subgenual anterior cingulate cortex and nucleus accumbens for responders. Striatal activation to reward receipt may not differentiate youth with anxiety from healthy youth. However, higher striatal responsivity to rewards may allow youth with anxiety to improve during treatment, potentially through more greater engagement in therapy. Function in reward circuitry may guide development of treatments for youth with anxiety. NCT00774150
登录
查看更多内容
影响因子：
15.9
作者：
Der-Avakian A;Markou A
通讯作者：
Markou A
影响因子：
3.7
作者：
Cho SS;Strafella AP
通讯作者：
Strafella AP
影响因子：
5.7
作者：
Ballard K;Knutson B
通讯作者：
Knutson B
影响因子：
5.7
作者：
Gao, Siyuan;Greene, Abigail S.;Scheinost, Dustin
通讯作者：
Scheinost, Dustin
影响因子：
7.6
作者：
Ezpeleta, L;Keeler, G;Angold, A
通讯作者：
Angold, A