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Published March 2017 | Published + Supplemental Material
Journal Article Open

Cognitive Behavioral Therapy Lowers Elevated Functional Connectivity in Depressed Adolescents

Chattopadhyay, Shayanti
Tait, Roger
Simas, Tiago
van Nieuwenhuizen, Adrienne
Hagan, Cindy C. ORCID icon
Holt, Rosemary J.
Graham, Julia
Sahakian, Barbara J.
Wilkinson, Paul O.
Goodyer, Ian M.
Suckling, John

Abstract

Imaging studies have implicated altered functional connectivity in adults with major depressive disorder (MDD). Whether similar dysfunction is present in adolescent patients is unclear. The degree of resting-state functional connectivity (rsFC) may reflect abnormalities within emotional ('hot') and cognitive control ('cold') neural systems. Here, we investigate rsFC of these systems in adolescent patients and changes following cognitive behavioral therapy (CBT). Functional Magnetic Resonance Imaging (fMRI) was acquired from adolescent patients before CBT, and 24-weeks later following completed therapy. Similar data were obtained from control participants. Cross-sectional Cohort: From 82 patients and 34 controls at baseline, rsFC of the amygdala, anterior cingulate cortex (ACC), and pre-frontal cortex (PFC) was calculated for comparison. Longitudinal Cohort: From 17 patients and 30 controls with longitudinal data, treatment effects were tested on rsFC. Patients demonstrated significantly greater rsFC to left amygdala, bilateral supragenual ACC, but not with PFC. Treatment effects were observed in right insula connected to left supragenual ACC, with baseline case-control differences reduced. rsFC changes were significantly correlated with changes in depression severity. Depressed adolescents exhibited heightened connectivity in regions of 'hot' emotional processing, known to be associated with depression, where treatment exposure exerted positive effects, without concomitant differences in areas of 'cold' cognition.

Additional Information

© 2017 The Authors. Published by Elsevier Under a Creative Commons license (Attribution 4.0 International (CC BY 4.0)). Received 13 January 2017, Revised 10 February 2017, Accepted 13 February 2017, Available online 16 February 2017. The study was funded by the UK Medical Research Council (grant: G0802226), the National Institute for Health Research (NIHR) (grant: 06-05-01), financial support from the Department of Health, and the Behavioral and Clinical Neuroscience Institute (BCNI), University of Cambridge, the latter being jointly funded by the Medical Research Council and the Wellcome Trust. Additional support was received from the Cambridge Biomedical Research Centre. SC is supported by a Cambridge CONACyT scholarship from the University of Cambridge Overseas Trust and CONACyT. Special thanks go to all participants for their contribution to this work. We also greatly appreciate the role of the Wolfson Brain Imaging Centre, Cambridgeshire and Peterborough NHS Foundation Trust, Child and Adolescent Mental Health Services, Mental Health Research Network, IMPACT research assistants, and IMPACT clinicians, without whom this study could not have taken place. Funding Sources: UK Medical Research Council (MRC) (grant: G0802226), National Institute for Health Research (grant: 06-05-01), the Department of Health, Behavioral and Clinical Neuroscience Institute (University of Cambridge), the latter being jointly funded by the MRC and the Wellcome Trust. Additional support received from the Cambridge Biomedical Research Centre. SC is supported by the University of Cambridge Overseas Trust and CONACyT: Data collection and analyses. Conflicts of Interests: SC, RT, TS, AV, CCH, and RJH report no biomedical financial interests or potential conflicts of interests. JG reports grants from MRC during the conduct of the study. BJS reports personal fees from Cambridge Cognition, Peak (Brainbow), Mundipharma, Lundbeck, Otsuka, and grants from J&J, outside the submitted work. POW reports personal fees from Lundbeck and Takeda, and grants from MRC and CLAHRC-EoE, outside the submitted work, and is an interpersonal psychotherapy supervisor and trainer. IMG reports grants from NIHR-HTA, grants from Wellcome Trust Strategic Award, outside the submitted work. JS reports grants from MRC, National Institute for Health Research, Wellcome Trust or MRC, during the conduct of the study; grants from GlaxoSmithKline plc, personal fees from GlaxoSmithKline plc, outside the submitted work. Author Contributions: SC, JS, and AV drafted the manuscript, with further edits provided by RT, TS, CCH, RJH, JG, BJS, POW, and IMG. SC conducted the literature search and designed all figures. SC, RT, and TS conducted the analyses. AV, CCH, RJH, and JG were involved in data collection. POW, IMG, and JS designed the study.

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Identifiers Funding Dates
Created:
August 22, 2023
Modified:
October 19, 2023