Changes in cerebral blood flow after cognitive behavior therapy in patients with panic disorder: a SPECT study.
OBJECTIVE
Inconsistent results continue to be reported in studies that examine the neural correlates of cognitive behavioral therapy (CBT) in patients with panic disorder. We examined the changes in regional cerebral blood flow (rCBF) associated with the alleviation of anxiety by CBT in panic patients.


METHODS
The change in rCBF and clinical symptoms before and after CBT were assessed using single photon emission computed tomography and various clinical measures were analyzed.


RESULTS
Fourteen subjects who completed CBT showed significant improvements in symptoms on clinical measures, including the Panic and Agoraphobic Scale and the Anxiety Sensitivity Index-Revised. After CBT, increased rCBF was detected in the left postcentral gyrus (BA 43), left precentral gyrus (BA 4), and left inferior frontal gyrus (BA 9 and BA 47), whereas decreased rCBF was detected in the left pons. Correlation analysis of the association between the changes in rCBF and changes in each clinical measure did not show significant results.


CONCLUSIONS
We found changes in the rCBF associated with the successful completion of CBT. The present findings may help clarify the effects of CBT on changes in brain activity in panic disorder.
Department of Psychiatry, College of Medicine, The Catholic University of Korea, Seoul, South Korea.
Ho-Jun
HJ
Seo
Metta Institute of Cognitive Behavior Therapy, Seoul, South Korea.
Young Hee
YH
Choi
Department of Radiology, Nuclear Medicine, College of Medicine, The Catholic University of Korea, Seoul, South Korea.
Yong-An
YA
Chung
Department of Psychiatry, College of Medicine, The Catholic University of Korea, Seoul, South Korea.
Wangku
W
Rho
Department of Psychiatry, College of Medicine, The Catholic University of Korea, Seoul, South Korea.
Jeong-Ho
JH
Chae
anxiety; brain activity; neural correlate; single photon emission computed tomography (SPECT)