title: Early-stage psychotherapy produces elevated frontal white matter integrity in adult major depressive disorder.
abstract: BACKGROUND
  Psychotherapy has demonstrated comparable efficacy to antidepressant medication in the treatment of major depressive disorder. Metabolic alterations in the MDD state and in response to treatment have been detected by functional imaging methods, but the underlying white matter microstructural changes remain unknown. The goal of this study is to apply diffusion tensor imaging techniques to investigate psychotherapy-specific responses in the white matter.
  
  
  METHODS
  Twenty-one of forty-five outpatients diagnosed with major depression underwent diffusion tensor imaging before and after a four-week course of guided imagery psychotherapy. We compared fractional anisotropy in depressed patients (n = 21) with healthy controls (n = 22), and before-after treatment, using whole brain voxel-wise analysis.
  
  
  RESULTS
  Post-treatment, depressed subjects showed a significant reduction in the 17-item Hamilton Depression Rating Scale. As compared to healthy controls, depressed subjects demonstrated significantly increased fractional anisotropy in the right thalamus. Psychopathological changes did not recover post-treatment, but a novel region of increased fractional anisotropy was discovered in the frontal lobe.
  
  
  CONCLUSIONS
  At an early stage of psychotherapy, higher fractional anisotropy was detected in the frontal emotional regulation-associated region. This finding reveals that psychotherapy may induce white matter changes in the frontal lobe. This remodeling of frontal connections within mood regulation networks positively contributes to the "top-down" mechanism of psychotherapy.
authors: Institute of Neuroscience, Chongqing Medical University, Chongqing, China.
authors: Tao
authors: T
authors: Wang
authors: Xiaolan
authors: X
authors: Huang
authors: Peiyu
authors: P
authors: Huang
authors: Dan
authors: D
authors: Li
authors: Fajin
authors: F
authors: Lv
authors: Yong
authors: Y
authors: Zhang
authors: Linke
authors: L
authors: Zhou
authors: Deyu
authors: D
authors: Yang
authors: Peng
authors: P
authors: Xie
mesh_terms: D000328:Adult; D016022:Case-Control Studies; D003865:Major Depressive Disorder / Q000473:pathology* / Q000628:therapy*; D056324:Diffusion Tensor Imaging; D005260:Female; D005625:Frontal Lobe / Q000473:pathology*; D006801:Humans; D008297:Male; D011613:Psychotherapy; D016896:Treatment Outcome; D055815:Young Adult
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