Authors: Anne Schienle Axel Schäfer Andrea Hermann Sonja Rohrmann Dieter Vaitl
Publish Date: 2007/09/27
Volume: 257, Issue: 8, Pages: 486-493
Abstract
Neurofunctional mechanisms underlying cognitive behavior therapy CBT are still not clearly understood This functional magnetic resonance imaging fMRI study focused on changes in brain activation as a result of onesession CBT in patients suffering from spider phobia Twentysix female spider phobics and 25 nonphobic subjects were presented with spider pictures generally disgustinducing generally fearinducing and affectively neutral scenes in an initial fMRI session Afterwards the patients were randomly assigned to either a therapy group TG or a waiting list group WG The scans were repeated one week after the treatment or after a oneweek waiting period Relative to the nonphobic participants the patients displayed increased activation in the amygdala and the fusiform gyrus as well as decreased activation in the medial orbitofrontal cortex OFC during the first exposure The therapy effect consisted of increased medial OFC activity in the TG relative to the WG Further therapyrelated reductions in experienced somatic anxiety symptoms were positively correlated with activation decreases in the amygdala and the insula We conclude that successful treatment of spider phobia is primarily accompanied by functional changes of the medial OFC This brain region is crucial for the selfregulation of emotions and the relearning of stimulusreinforcement associations
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