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A systematic review and meta-analysis of the neural correlates of psychological therapies in major depression

机译：大萧条心理疗法神经相关性的系统综述与荟萃分析

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Longitudinal neuroimaging studies in major depression have revealed cortico-limbic abnormalities which are modulated by treatment. We performed a systematic review and meta-analysis of psychotherapy treatment studies measuring neural function and metabolism using fMRI, PET, SPECT and MRS. Seventeen studies were included in the systematic review, total of 200 major depression participants (mean age 37.6 years), all medication free, and 116 healthy controls (mean age 36.4 years). Neuroimaging assessments were performed prior to initiation of treatment and following course of treatment. Treatment durations were: 16–30 weeks for CBT, 11 weeks for behavioral activation therapy, and up to 15 months for psychodynamic psychotherapy. The meta-analysis consisted of studies in which both groups had same serial scans and comparable tasks; total of 5 studies with visual presentation tasks of emotional stimuli: 55 patients (mean age: 38.7 years) and 55 healthy controls (mean age: 36.3 years). The meta-analysis revealed a significant group by time effect in left rostral anterior cingulate, in which patients showed increased activity following psychotherapy while healthy controls showed a decrease at follow up. Longitudinal treatment effects revealed reduced left precentral cortical activity in major depression. Findings could be indicative of improvements in emotion responsivity that may be achieved following psychotherapy.
机译：抑郁症的纵向神经影像学研究显示，皮质边缘异常受治疗的调节。我们对使用功能磁共振成像、PET、SPECT和MRS测量神经功能和代谢的心理治疗研究进行了系统回顾和荟萃分析。系统回顾包括17项研究，共200名抑郁症参与者（平均年龄37.6岁），所有无药物治疗，116名健康对照（平均年龄36.4岁）。在开始治疗前和治疗后进行神经影像学评估。治疗持续时间为：CBT为16-30周，行为激活疗法为11周，心理动力疗法为15个月。荟萃分析包括两组具有相同序列扫描和可比任务的研究；共有5项关于情绪刺激视觉呈现任务的研究：55名患者（平均年龄：38.7岁）和55名健康对照者（平均年龄：36.3岁）。荟萃分析显示，左嘴侧前扣带回存在显著的时间效应，患者在接受心理治疗后活动增加，而健康对照组在随访时活动减少。纵向治疗效果显示重度抑郁症患者左中央前皮质活动减少。研究结果可能表明，心理治疗后情绪反应性可能会有所改善。

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