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Neural predictors of cognitive-behavior therapy outcome in anxiety-related disorders: a meta-analysis of task-based fMRI studies

Published online by Cambridge University Press:  11 January 2022

Maria Picó-Pérez ,
Miquel A. Fullana Open the ORCID record for Miquel A. Fullana [Opens in a new window] ,
Anton Albajes-Eizagirre ,
Daniel Vega ,
Josep Marco-Pallarés ,
Ana Vilar ,
Jacobo Chamorro ,
Kim L. Felmingham ,
Ben J. Harrison  and
Joaquim Radua
...Show all authors
Maria Picó-Pérez
Affiliation:
Life and Health Sciences Research Institute (ICVS), University of Minho, Braga, Portugal ICVS/3B's, PT Government Associate Laboratory, Braga/Guimarães, Portugal Clinical Academic Center – Braga, Braga, Portugal
Miquel A. Fullana*
Affiliation:
Adult Psychiatry and Psychology Department, Institute of Neurosciences, Hospital Clinic, Barcelona, Spain Imaging of Mood- and Anxiety-Related Disorders (IMARD) Group, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), CIBERSAM, Barcelona, Spain
Anton Albajes-Eizagirre
Affiliation:
Imaging of Mood- and Anxiety-Related Disorders (IMARD) Group, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), CIBERSAM, Barcelona, Spain Opticks Security, Barcelona, Spain
Daniel Vega
Affiliation:
Psychiatry and Mental Health Department, Consorci Sanitari de l'Anoia & Fundació Sanitària d'Igualada, Igualada, Barcelona, Spain Unitat de Psicologia Mèdica, Departament de Psiquiatria i Medicina Legal & Institut de Neurociències, Universitat Autònoma de Barcelona, Bellaterra, Barcelona, Spain
Josep Marco-Pallarés
Affiliation:
Department of Cognition, Development and Educational Psychology, Institute of Neurosciences, University of Barcelona, Barcelona, Spain Cognition and Brain Plasticity Unit, Bellvitge Biomedical Research Institute (IDIBELL), Barcelona, Spain
Ana Vilar
Affiliation:
Institut de Neuropsiquiatria i Addiccions, Hospital de Dia Infanto Juvenil Litoral Mar, Parc de Salut Mar, Barcelona, Spain
Jacobo Chamorro
Affiliation:
Anxiety Unit, Institute of Neuropsychiatry and Addictions, Parc de Salut Mar, Barcelona, Spain
Kim L. Felmingham
Affiliation:
School of Psychological Sciences, University of Melbourne, Melbourne, Australia
Ben J. Harrison
Affiliation:
Department of Psychiatry, Melbourne Neuropsychiatry Centre, The University of Melbourne and Melbourne Health, Carlton, Victoria, Australia
Joaquim Radua
Affiliation:
Imaging of Mood- and Anxiety-Related Disorders (IMARD) Group, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), CIBERSAM, Barcelona, Spain Department of Clinical Neuroscience, Centre for Psychiatric Research and Education, Karolinska Institutet, Stockholm, Sweden Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
Carles Soriano-Mas
Affiliation:
Bellvitge Biomedical Research Institute (IDIBELL), L'Hospitalet de Llobregat, Barcelona, Spain CIBERSAM, Barcelona, Spain Department of Psychobiology and Methodology of Health Sciences, Universitat Autònoma de Barcelona, Barcelona, Spain
*
Author for correspondence: Miquel A. Fullana, E-mail: mafullana@clinic.cat
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Abstract

Background

Cognitive-behavior therapy (CBT) is a well-established first-line intervention for anxiety-related disorders, including specific phobia, social anxiety disorder, panic disorder/agoraphobia, generalized anxiety disorder, obsessive-compulsive disorder, and posttraumatic stress disorder. Several neural predictors of CBT outcome for anxiety-related disorders have been proposed, but previous results are inconsistent.

Methods

We conducted a systematic review and meta-analysis of task-based functional magnetic resonance imaging (fMRI) studies investigating whole-brain predictors of CBT outcome in anxiety-related disorders (17 studies, n = 442).

Results

Across different tasks, we observed that brain response in a network of regions involved in salience and interoception processing, encompassing fronto-insular (the right inferior frontal gyrus-anterior insular cortex) and fronto-limbic (the dorsomedial prefrontal cortex-dorsal anterior cingulate cortex) cortices was strongly associated with a positive CBT outcome.

Conclusions

Our results suggest that there are robust neural predictors of CBT outcome in anxiety-related disorders that may eventually lead (probably in combination with other data) to develop personalized approaches for the treatment of these mental disorders.

Keywords

Anxiety disorderscognitive-behavioral therapymeta-analysissalience networktask-based fMRItreatment response prediction
Type
Original Article
Information
Psychological Medicine , Volume 53 , Issue 8 , June 2023 , pp. 3387 - 3395
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Copyright
Copyright © The Author(s), 2022. Published by Cambridge University Press

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Footnotes

*

Shared first authorship

†

Shared senior authorship

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