Long-term results of an functional magnetic resonance imaging study: Influence of psychodynamic psychotherapy on brain activation of patients with panic disorder

Abstract

In a controlled functional magnetic resonance imaging (fMRI) study the effect of psychodynamic short-term psychotherapy on cerebral activation of panic disorder patients was determined. In a linguistic go-no go paradigm behavioral measures and cerebral activation to affective word stimuli with threatening, neutral and positive content were assessed pretreatment and post-treatment in 9 patients with panic disorder. 18 healthy controls were scanned twice at the same intervals. In an additional long-term follow-up after approximately 3 years post-treatment the effect of brain activation changes during treatment on the long-term outcome of core symptoms (panic-related cognition and fear of body sensations) were determined. In accordance with the hypotheses increased limbic (hippocampus and amygdala) activation accompanied by low prefrontal activation to negative words were found. At treatment termination, panic-related symptoms had improved significantly and fronto-limbic activation patterns were normalized. Reduction of activation of the limbic system during treatment was predictive of a favorable long-term outcome. The results indicate that short-term psychodynamic treatment leads to changes in fronto-limbic networks, similar to previous findings on cognitive-behavioural treatment.