title: Successful group psychotherapy of depression in adolescents alters fronto-limbic resting-state connectivity.
abstract: Current resting state imaging findings support suggestions that the neural signature of depression and therefore also its therapy should be conceptualized as a network disorder rather than a dysfunction of specific brain regions. In this study, we compared neural connectivity of adolescent patients with depression (PAT) and matched healthy controls (HC) and analysed pre-to-post changes of seed-based network connectivities in PAT after participation in a cognitive behavioral group psychotherapy (CBT).
  
  
  
  38 adolescents (30 female; 19 patients; 13-18 years) underwent an eyes-closed resting-state scan. PAT were scanned before (pre) and after (post) five sessions of CBT. Resting-state functional connectivity was analysed in a seed-based approach for right-sided amygdala and subgenual anterior cingulate cortex (sgACC). Symptom severity was assessed using the Beck Depression Inventory Revision (BDI-II).
  
  
  
  Prior to group CBT, between groups amygdala and sgACC connectivity with regions of the default mode network was stronger in the patients group relative to controls. Within the PAT group, a similar pattern significantly decreased after successful CBT. Conversely, seed-based connectivity with affective regions and regions processing cognition and salient stimuli was stronger in HC relative to PAT before CBT. Within the PAT group, a similar pattern changed with CBT. Changes in connectivity correlated with the significant pre-to-post symptom improvement, and pre-treatment amygdala connectivity predicted treatment response in depressed adolescents.
  
  
  
  Sample size and missing long-term follow-up limit the interpretability.
  
  
  
  Successful group psychotherapy of depression in adolescents involved connectivity changes in resting state networks to that of healthy controls.
authors.affiliation: Department of Child and Adolescent Psychiatry and Psychotherapy, University Hospital Ulm, Germany.
authors.forename: J
authors.initials: J
authors.lastname: Straub
authors.affiliation: Department of Psychiatry and Psychotherapy, Otto-von-Guericke University, Magdeburg, Germany; Leibniz Institute for Neurobiology, Magdeburg, Germany; Institute of Cognitive Neurology and Dementia Research (IKND), Otto-von-Guericke University, Magdeburg, Germany; German Center for Neurodegenerative Diseases (DZNE), Magdeburg, Germany.
authors.forename: C D
authors.initials: CD
authors.lastname: Metzger
authors.affiliation: Department of Child and Adolescent Psychiatry and Psychotherapy, Central Institute of Mental Health, Mannheim, 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; Department of Child and Adolescent Psychiatry, Psychotherapy and Psychosomatics, Medical School Brandenburg, 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. Electronic address: Birgit.Abler@uni-ulm.de.
authors.forename: B
authors.initials: B
authors.lastname: Abler
mesh_terms: D000293:Adolescent; D000679:Amygdala / Q000503:physiopathology; D001931:Brain Mapping; D015928:Cognitive Behavioral Therapy / Q000379:methods*; D003863:Depression; D003866:Depressive Disorder / Q000473:pathology* / Q000628:therapy*; D005260:Female; D006179:Gyrus Cinguli / Q000503:physiopathology; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods; D011569:Psychiatric Status Rating Scales; D011615:Psychotherapy, Group / Q000379:methods*; D012146:Rest / Q000502:physiology*
keywords: Adolescents; CBT; Connectivity; Depression; Group psychotherapy; Resting state MRI