우울증의 신경회로 모형과 인지행동치료의 치료 효과: 기능적 뇌 자기공명영상 연구를 중심으로

초록

Neuroimaging studies have suggested that dysfunction of neural circuits involved in emotion regulation, cognitive control, and reward processing were associated with the development of depression. We aimed to review functional magnetic resonance imaging (fMRI) studies on cognitive behavioral therapy (CBT) and its influence on functional changes in neural circuits in patients with depression. fMRI studies reported that CBT was associated with functional changes of neural circuits involved in emotion regulation, cognitive control, and reward processing in depression. They found that CBT was associated with normalization of hyperactivation in the amygdala (in response to negative emotional stimuli) and increased activation of the lateral prefrontal cortex, which exerts cognitive control over negative emotions in patients with depression. They also observed that CBT was related to deactivation of the anterior cingulate cortex and increased activity of the striatum in response to reward stimuli. CBT also changed functional connectivity of the amygdala, prefrontal cortex, anterior cingulate cortex, and striatum in depressive patients. Investigation of the neural effect of CBT using fMRI may provide clinically useful information and deep insights about the neurobiological mechanism of CBT in depression.

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