Kumari, Veena

Mason, Liam

Peters, Emmanuelle Roisin

Objective: Whilst there is now strong evidence that psychological therapies can alter theactivity of individual brain regions, their impact on the functional integration between regionshas not yet been systematically evaluated. This area is important given that braindysconnectivity has been implicated across almost all psychiatric disorders. Accordingly wesought to establish connectivity predictors and mechanisms of effective psychologicaltherapies. We further establish whether connectivity changes represent normalisation ofdisorder pathophysiology or compensatory changes.Method: We reviewed studies examining structural and functional connectivity longitudinallyas either a predictor or outcome variable of successful psychological therapies acrosspsychiatric disorders.Results: Fifteen studies met our inclusion criteria. All but three related to cognitivebehavioural therapy (CBT). Of these, five assessed resting state, nine probed affectiveprocessing and one probed cognitive processing. 12 studies reported evidence of functionalconnectivity as a significant predictor or outcome of CBT, with prefronto-limbic circuitrymost commonly implicated. Only six studies included healthy participants, limiting directinferences about normalisation as opposed to compensatory changes. Anxiety disorders wereover-represented, totalling 13 of the studies reviewed. No studies examined structuralconnectivity or utilised analyses allowing the directionality of functional connectivity to beinferred.Conclusions: Whilst the evidence base is still in its infancy for other therapy approaches,there was clearer evidence that functional connectivity both predicts and is altered by CBT.Connections from prefrontal cortex appear especially key, perhaps given their role in 3cognitive appraisal of lower-order affective, motivational and cognitive processes. A numberof recommendations are made for this rapidly developing literature

King's Research Portal

English

Functional connectivity predictors and mechanisms of cognitive behavioural therapies: a systematic review with recommendations

https://kclpure.kcl.ac.uk/portal/files/44636627/Functional_connectivity_predictors_of_CBT_systematic_review_ANZJP_Manuscript_ACCEPTED.pdf

Functional connectivity predictors and mechanisms of cognitive behavioural therapies: a systematic review with recommendations

Abstract

Similar works

Full text

Available Versions

King's Research Portal