Psychotherapy with a demonstrable effect in the brain

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Researchers demonstrate effective effects of psychotherapy in the brain

Psychotherapy promises remarkable treatment success for patients with panic disorder. So far, however, the effects of cognitive behavioral therapy on the brain have been largely unclear. Scientists at the Clinic for Psychiatry and Psychotherapy at Philipps University in Marburg an der Lahn have now demonstrated the changes in the brains of panic patients through behavioral therapy with the help of functional magnetic resonance imaging (fMRI).

According to the research team led by Professor Dr. Tilo Kircher and Dr. Benjamin Straube from the Philipps University in Marburg on measurable changes in the frontal lobe of the brain. Accordingly, psychotherapy has been shown to have a neuronal effect. Previously hyperactive areas of the brain of panic patients are down-regulated by behavior therapy, the researchers write in the journal "Biological Psychiatry".

"Learning through conditioning is an important skill for animals and humans to acquire new behaviors", in order to ensure survival in a changing environment, the researchers explain in their current contribution. Cognitive behavioral therapy takes advantage of this in the treatment of panic disorders with agoraphobia. As part of the treatment, the patients are conditioned to the individual triggers of their panic attacks. The underlying neuronal mechanisms were previously unknown.

Brain activities regulated by psychotherapy As part of their study, the scientists analyzed the fMRI images of the brain of 42 healthy subjects and 42 panic patients. The subjects underwent twelve sessions of cognitive behavioral therapy, with fMRI tests performed at the beginning, during and after the treatment. After the completion of psychotherapy, the pictures showed a “reduced activation for the conditioned reaction in the lower left frontal turn” of the brain of the panic patients compared to the control persons, the researchers report. This region of the brain, which was hyperactive before treatment in the panic patients, had reduced its activities to a normal level during the course of the treatment. In addition, the fMRI studies also made it clear that the left inferior frontal gyrus in panic patients has increased connectivity to the brain regions of the "fear network" (amygdala, insula, anterior cingulum), the scientists write.

Cognitive behavioral therapy demonstrably has an effect The study shows the cerebral correlates (interrelationships) of cognitive and emotional processing in the brain of panic patients and demonstrates their change in the course of behavioral therapy, the experts explain. The effects of psychotherapy on fear conditioning or the corresponding changes in the brain are therefore measurable. "Further studies in this direction have promising potential for the development and optimization of targeted treatments" of panic disorders, the researchers concluded. For the roughly four percent of the population who suffer from panic disorders in Germany, however, the realization that cognitive behavioral therapies help against their panic attacks is of crucial importance. Because the sudden onset of fear, which is often accompanied by accompanying symptoms such as a rapid heartbeat, sweating or hyperventilation, often causes considerable impairments in the quality of life. In addition, as an alternative to behavioral therapy, panic patients are usually only able to use pharmacotherapy, which, however, can be associated with considerable side effects. It is all the more gratifying that psychotherapy to combat panic disorders has been shown to work. (fp)

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Image: Gerd Altmann,

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