Cognitive Behavioral Therapy Effects on Lateral Prefrontal Cortex Connectivity in High Ruminators
Poster No:
427
Submission Type:
Abstract Submission
Authors:
Chanyu WANG1, Qinyuan Chen1, Guorong Wu2, Paula Horczak1, Jonathan Remue1, Chris Baeken1
Institutions:
1Ghent University, Ghent, Belgium, 2Southwest University, Chongqing, China
First Author:
Co-Author(s):
Introduction:
Repetitive negative thinking (RNT), such as rumination or worry, is regarded as a transdiagnostic process underlying mood and anxiety disorders [1]. Individuals with RNT have increased risk for developing mood and anxiety disorders [2]. Cognitive behavioural therapy (CBT) has proven to be effective in reducing RNT among patients with major depressive disorder (MDD) and generalized anxiety disorder (GAD) [3]. Despite the widespread use of CBT to target RNT, its potential impact on underlying brain mechanisms remains insufficiently understood. This study investigates the effects of group CBT on functional connectivity (FC) changes based on the frontoparietal network in such individuals.
Methods:
The study included 50 healthy controls (HC) and 75 patients with high RNT. All participants completed questionnaires and underwent fMRI scans at baseline. Patients were randomly assigned to either the CBT group (CBTG; N = 43), which received eight CBT sessions, or the waiting list control group (WLCG; N = 32), which received treatment as usual over the same period. After the intervention, patients completed follow-up questionnaires and a second fMRI scan. The analysis compared seed-based FC in the frontoparietal network including left Lateral Prefrontal Cortex (LPFC, -43, 33, 28), right LPFC (41, 38, 30), left Posterior Parietal Cortex (PPC, -46, -58, 49), and right PCC (52, -52, 45) between HC and patients. The FC-previously identified at baseline between HC and patients-were also extracted and examined within the CBTG and WLCG before and after therapy. A linear mixed model (LMM) was conducted to examine the effects of group (CBTG and WLCG), timepoint (pre- and post-intervention), and their interaction on FC between the right LPFC and the precuneus, as well as between the left LPFC and the precuneus. The LMM included a random intercept for participants to account for repeated measures. Finally, the FC changes (post-pre) was correlated with questionnaire changes. This study is part of a registered clinical trial (NCT01983033).
Results:
A two-sample t-test revealed that patients compared with HC showed significantly higher FC between the left LPFC and the precuneus (MNI coordinates: x = -10, y = -58, z = 16, voxel-level p < 0.001, cluster-level p < 0.05, FDR-corrected, Figure 1B & C), and the significantly higher FC between the right LPFC and precuneus (MNI coordinates: x = -4, y = -62, z = 18, Figure 1E & F). The LMM did not reveal significant main effects of group (χ2(1) = 0.030, p = 0.862), timepoint (χ2(1) = 0.086, p = 0.769), or their interaction (χ2(1) = 2.640, p = 0.104) on the FC between the right LPFC and the precuneus or between the left LPFC and the precuneus for the CBTG and WLCG groups across pre- and post-intervention. However post hoc contrasts within the LMM revealed a significant decrease in FC between the right LPFC and the precuneus from pre- to post-intervention in CBTG (β ̂ = 0.101, SE = 0.037, t (51) = 2.737, p = 0.0085; d = 0.719, 95% CI [0.188,1.249]; Figure 2E). At the post-intervention timepoint, the CBTG also exhibited significantly lower FC between the right LPFC and the precuneus compared to WLCG (β ̂ = 0.095, SE = 0.042, t (100) = 2.301, p = 0.024; d = 0.686, 95% CI [0.087,1.285]; Figure 2E). Furthermore, the reduction in FC was significantly associated with improved quality-of-life scores in the CBTG (r = -0.41, p = 0.036; Figure 2F).
Conclusions:
This study showed that group CBT affects LPFC-based FC, highlighting its ability to alter brain activity and enhance well-being. These findings support the therapeutic benefits of CBT and its impact on brain function.
Disorders of the Nervous System:
Psychiatric (eg. Depression, Anxiety, Schizophrenia) 1
Modeling and Analysis Methods:
Connectivity (eg. functional, effective, structural)
Novel Imaging Acquisition Methods:
BOLD fMRI 2
Keywords:
Affective Disorders
Anxiety
DISORDERS
Emotions
FUNCTIONAL MRI
MRI
Psychiatric
Psychiatric Disorders
Other - Depression; Repetitive Negative Thinking
1|2Indicates the priority used for review
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2. McEvoy, P. M., Salmon, K., Hyett, M. P., Jose, P. E., Gutenbrunner, C., Bryson, K., & Dewhirst, M. (2019). Repetitive Negative Thinking as a Transdiagnostic Predictor of Depression and Anxiety Symptoms in Adolescents. Assessment, 26(2), 324–335. https://doi.org/10.1177/1073191117693923
3. Rogiers, R., Baeken, C., Watkins, E. R., van den Abbeele, D., Remue, J., de Raedt, R., & Lemmens, G. M. D. (2022). A Psychoeducational CBT-based Group Intervention ("Drop It") for Repetitive Negative Thinking: Theoretical Concepts and Treatment Processes. International journal of group psychotherapy, 72(3), 257–292. https://doi.org/10.1080/00207284.2022.2066535