Meta Analysis Of Brain Functional Neuroimaging Based On Effective Psychotherapy

BackgroundThe effectiveness of psychotherapy has been widely demonstrated in many studies.In the last few years,neuroimaging approaches to psychotherapy research have provided considerable evidence of changes in brain networks accompanying treatment.However,results of those studies are lack of consistency.Several reviews of neuroimaging studies on psychotherapy of depression and anxiety have noted that treatment results in changes in brain areas,but which still can not provide a solid evidence.ObjectiveTo utilize the Evidence-based medicine and the method of systematic analysis,the quantitative analysis of literature about brain functional imaging based on effective psychotherapy can provide clinical evidence and guidance for psychotherapy.MethodsAccording to the requisition of systematic evaluation,we formulate detailed standardization of the inclusion and exclusion criteria(including types of literature,the type of research subjects,interventions and outcomes of events),database and search strategy,data extraction and quality evaluation of literature.Subsequently,meta-analyses were conducted with the Activation Likelihood Estimation(ALE)technique,which evaluates the overlap between foci of activation across studies.Results29 literatures were selected for Meta-analysis based on our including and excludingstandards.The score of Newcastle-Ottawa Scale(NOS)for the inclusion of literatures was from 7 to 9,it's suggested that the inclusion of literatures has a good quality.In meta-analysis for resting state studies,from 45 foci of decreased activation,85 subjects in6 separate experiments(Anxiety 2,Depression 3,Obsessive compulsive 1)and 36 foci of increased activation,108 subjects in 7 separate experiments(Anxiety 2,Depression 3,Obsessive compulsive 1)after psychotherapy,three clusters of decreased activation were found,one in the right middle frontal gyrus(BA 11),one in the right medial frontal gyrus(BA 10),and one in the left middle frontal gyrus(BA 10).No significant clusters of increased activation were found in the meta-analysis.In meta-analysis for tasking state studies,22 studies reported negative emotional stimulate in task state neuroimaging.From85 foci of decreased activation,298 subjects and 17 separate experiments(Anxiety 8,Depression 6,Post traumatic stress 3)after psychotherapy,3 significant clusters were found that survived the cluster level inference threshold.Cluster 1 was found in left superior temporal gyrus(BA 39),cluster 2 was found in left parahippocampal / amygdala /hippocampus(BA 28),and cluster 3 was found in right caudate.From 83 foci of increased activation,210 subjects and 12 separate experiments(Anxiety 6,Depression 2,Obsessive compulsive 1,Post traumatic stress 3)after psychotherapy,3 significant clusters were found that survived the cluster level inference threshold.Cluster 1 was found in right superior frontal gyrus(BA 10),cluster 2 was found in left cingulate gyrus(BA 32),and cluster 3 was found in right middle occipital gyrus(BA 19).ConclusionOur study found that patients with depression and anxiety symptoms were treated with effective psychotherapy,whose activation cluster changed in the prefrontal cortex and limbic system cortex.Especially,the effective psychotherapy is closely associated with the activation changed in ventromedial prefrontal cortex(VMPFC)and amygdale.It is speculated that the effective psychological treatment may inhibit the posterior vmPFC activation degree to achieve negative emotional control and reduce of negative emotionalarousal.In addition,it may through the activation of the anterior vmPFC to wake up the positive emotion processing system and improve the brain reaction types when subjected to negative emotional stimuli.Although there are some limitations in this study,it is still to provide an important basis for the elucidation of the mechanism of psychotherapy.