Treatment effect of cognitive behavioral psychotherapy in panic disorder - fmri study

IntroductionThe aim of our study was the correlation of regional brain activity with intensity of psychopathology and the correlation of treatment effect of CBT in patients suffering from panic disorder.MethodFive patients suffering from panic disorder and five healthy controls were studied in fMRI during the exposition of threat-related words compared with neutral words and emotional faces compared with fixation points. Inpatients were treated with CBT (Cognitive Behavioral Therapy) and existing pharmacotherapy for 6 weeks. Patients were studied in fMRI scanner before and after the treatment. Psychopathology was assessed using Beck Anxiety Inventory (BAI) and Beck Depression Inventory (BDI), The Clinical Global Impression rating scales (CGI), Panic Disorder Severity Scale (PDSS), Dissociative Experiences Scale (DES). Data were analyzed using software for functional magnetic analysis (AFNI) and compared with psychopathology rating scales.ResultsHyperactivity of cerebellum in patient treated with CBT compared with healthy controls was observed after activation by anxiety words and faces. The scores of psychopathology rating scales decreased in patient treated with CBT and correlates with decrease of hyperactivity in cerebellum.ConclusionChanges of brain activity in fMRI after the CBT treatment were observed in patient suffering from panic disorder. Threat-related words and emotional faces showed cerebellum hyperactivity in patients compared with healthy controls. Decrease of cerebellum hyperactivity was observed after treatment with CBT, compared with healthy controls. Predictor of therapeutic response in fMRI was not find. Cerebellum play an important role in panic disorder.Supported with project IGA NS 10301-3/2009</jats:sec

Comparison of the effect of pharmacotherapy and the combination of psychotherapy and pharmacotherapy in the treatment of depressive disorder

IntroductionSome studies showed auxilary effect of psychotherapy in patients suffering from depression treated by psychopharmacology. The aim of our study was to verify the treatment effect of training psychotherapy under the conditions of The Department of Psychiatry in Olomouc.MethodTotal amount of 40 patients, who were hospitalized at The Psychiatric Department during the time period of years 2003–2004 with the diagnosis of Major Depressive Disorder-mild, moderate and severe form was included. 20 patients received psychiatric medication only (without any systematic psychotherapeutic support) and 20 remaining patients of the open psychotherapeutic department received combination of psychotherapy and pharmacotherapy. Psychopharmacological treatment was comparable in both samples as far as quality and quantity is concerned. We used at the psychotherapeutic department group training therapy and individual psychotherapy. Before the treatment was used HAMD and CGI- Seriousness of the disorder, before the end of the hospitalization and the therapy, we used HAMD and CGI/ Global Improvement.ResultsEvaluation of the obtained data showed decrease on the HAMD scale (0,5 points) for the patients treated with the combination of psychotherapy and pharmacotherapy in the comparison with the group treated only with pharmacotherapy. This finding was even more obvious on the CGI scale, where the difference of the improvement reached up to 0,3 points again for the combined treatment, but were not significant.ConclusionIn the treatment of the acute phase of Major depressive disorder, we did not prove a positive effect of the training psychotherapy.</jats:sec

Functional MRI Study of Gender Effects in Brain Activations During Verbal Working Memory Task

Neuroimaging methods have been used to study differences of brain function between males and females. Differences in working memory have been also investigated, but results of such studies are mixed with respect to behavioral data, reaction times and activated brain areas. We tried to analyze functional MRI data acquired during the working memory task and search for differences of brain activation between genders. 20 healthy right-handed volunteers (10 males and 10 females) participated in the study. All of them were university students or fresh graduates. Subjects underwent block designed verbal working memory task (Item Recognition Task) inside the MRI scanner. Standard single-subject pre-processing and group fMRI analyses were performed using the FEAT software from FSL library. In the behavioral data, there was no statistically significant difference in the number of correct responses during the task. The task activated similar bilateral regions of frontal, parietal, temporal and occipital lobes, basal ganglia, the brainstem and in the cerebellum, which corresponds to the previous verbal working memory neuroimaging research. In direct comparison, there was no statistically significant difference in brain activation between small samples of male and female young healthy volunteers.</jats:p