The Dynamic Study Of The Changes Of Brain Function Connection In Patients With Depression By CBT Treatment In The Acute And Stable Phases

Major depressivie disorder(MDD)is one of the most prevalent psychiatric disorders,and the mechanism of MDD is unkown.Cognitive behavioral therapy(CBT)is widely applied in the MDD treatment,and because of the CBT affects,the clinic symptoms and the brain network will be recovered more or less.But the previous study of CBT are less and monotonous.The study collected 31 depressed patients in Nanjing Brain hospital,and recruited 27 matched healthy controls.Both the groups are underwent the first resting-state functional magnetic resonance imaging(rs-fMRI)scanning.After that,the depression group receives weekly CBT,and they underwent the scannings in 6 week and 24 week,to explore the brain changes by short CBT(6 weeks)and long CBT(24 weeks)with functional connectivity density(FCD).The results are follows:1.lFCD results:(1)Compared the baseline depression group,after 6 weeks CBT treatment and after 24 weeks CBT treatment,the dorsalateral prefrontal cortex(dlPFC),the precuneus,the hippocampus and the putamen had the significant difference.(2)After 6 weeks CBT treatment,the 1FCD of the dlPFC,the right pallidum increasd,the right precuneus,left putamen decreased;after 24 weeks CBT treatment,the dlPFC,the putamen,the right hippocampus decreased.(3)Compared the healthy group,the baseline depression group presents the bilateral caudate,the right precuneus 1FCD increased,the bilateral dlPFC,the bilateral putamen decreased;the 6 weeks CBT treatment group shows the left dlPFC,right precuneus increased;the 24 weeks CBT treatment group shows the left precuneus increased,the left dlPFC and the bilateral putamen decreased.(4)In the baseline depression group,the 1FCD of the dlPFC,precuneus,putamen correlated with Hamilton depression scale(HAMD)indices.2.longFCD results:(1)Compared the baseline depression group,after 6 weeks CBT treatment and after 24 weeks CBT treatment,the dlPFC,the vmPFC and the precuneus has the significant difference.(2)After 6 weeks CBT treatment,the bilateral dlPFC and the left OFC longFCD increased,right precuneus decreased;after 24 weeks CBT treatment,the vmPFC increased,the right precuneus and the dlPFC decreased.(3)Compared the healthy group,the baseline depression group presents the right precuneus longFCD increased,the dlPFC decreased;the 6 weeks CBT treatment group shows the left dlPFC,the vmPFC and the left precuneus longFCD increased;the 24 weeks CBT treatment group shows the vmPFC,the right precuneus longFCD increased,the dlPFC decreased.(4)There was a positive correlation between the longFCD of the dlPFC and the HAMD scores at 6 weeks CBT.The FCD value of the precuneus at baseline depression group was positively correlated with the score of HAMD and Hamilton Anxiety Scale(HAMA).At 6 weeks of CBT treatment,it was negatively correlated with the HAMD and HAMA score.The study found that:(1)The dlPFC and the precuneus had the abnormal functional connecitivity in the depression group.(1)The 6-weeks CBT and 24-weeks CBT will bring different functional changes in the brain regions,which is reflected in the dlPFC,which is responsible for the cognitive control.(3)For some brain regions as the precuneus,CBT will repaired partly;for some brain regions as the dlPFC,CBT will play the compensatory role.