title: Neural correlates of successful psychotherapy of depression in adolescents.
abstract: BACKGROUND
  While major effort has been put in investigating neural correlates of depression and its treatment in adults, less is known about the effects of psychotherapy in adolescents. Given the concordance of the ventral striatum, amygdala, hippocampus and the subgenual anterior cingulate cortex (sgACC) as correlates of depression and their involvement in reward processing, we used functional magnetic resonance imaging (fMRI) during performance of a monetary reward task in an intervention versus waitlist-control design to investigate the clinical and neural effects of cognitive behavioral group therapy (CBT-G).
  
  
  METHODS
  22 medication naïve adolescents with major depressive disorder were scanned before and after five sessions of CBT-G (PAT-I), or before and after five weeks of waiting (PAT-W). Changes in symptom scales were analyzed along with neural activation changes within the amygdala, hippocampus, sgACC and ventral striatum regions of interest (ROI).
  
  
  RESULTS
  Psychometric assessments and ROI activation remained unchanged in PAT-W. In PAT-I, significant reduction in clinical symptoms accompanied significant changes in brain activation within the left amygdala, left hippocampus and bilateral sgACC. In line with previous findings in adults, pre-to-post-activation changes in the bilateral sgACC correlated with pre-to-post and pre-to-follow-up symptom improvement, and individual expressions of sgACC activation before treatment were related to pre-to-follow-up therapeutic success.
  
  
  CONCLUSIONS
  Future studies should include larger sample sizes.
  
  
  CONCLUSIONS
  Successful group psychotherapy of depression in adolescents was related to signal changes in brain regions previously demonstrated to be reliably linked with successful, particularly pharmacological treatment in adults.
authors.affiliation: Department of Child and Adolescent Psychiatry and Psychotherapy, University Hospital Ulm, Germany. Electronic address: Joana.Straub@uniklinik-ulm.de.
authors.forename: J
authors.initials: J
authors.lastname: Straub
authors.affiliation: Department of Child and Adolescent Psychiatry and Psychotherapy, University Hospital Ulm, Germany.
authors.forename: P L
authors.initials: PL
authors.lastname: Plener
authors.affiliation: Department of Child and Adolescent Psychiatry and Psychotherapy, University Hospital Ulm, Germany.
authors.forename: N
authors.initials: N
authors.lastname: Sproeber
authors.affiliation: Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Philipps-University Marburg, Germany.
authors.forename: L
authors.initials: L
authors.lastname: Sprenger
authors.affiliation: Department of Child and Adolescent Psychiatry and Psychotherapy, University Hospital Ulm, Germany.
authors.forename: M G
authors.initials: MG
authors.lastname: Koelch
authors.affiliation: Department of Psychiatry and Psychotherapy III, University Hospital Ulm, Germany.
authors.forename: G
authors.initials: G
authors.lastname: Groen
authors.affiliation: Department of Psychiatry and Psychotherapy III, University Hospital Ulm, Germany.
authors.forename: B
authors.initials: B
authors.lastname: Abler
mesh_terms: D000293:Adolescent; D000679:Amygdala / Q000473:pathology*; D001921:Brain / Q000503:physiopathology; D001931:Brain Mapping; D015928:Cognitive Behavioral Therapy / Q000379:methods*; D003865:Major Depressive Disorder / Q000473:pathology* / Q000628:therapy*; D005260:Female; D006179:Gyrus Cinguli / Q000503:physiopathology; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods; D008297:Male; D016896:Treatment Outcome
keywords: Adolescents; CBT; Depression; Group psychotherapy; Reward; fMRI